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'Back Jack' Eases Pain
BACKGROUND: Almost everyone will experience low back pain at some point in their lives, and a common cause is spinal stenosis. Stenosis occurs when the space around the spinal cord narrows, putting pressure on nerve roots. Lumbar spinal stenosis -- stenosis of the lower back -- is often a normal part of aging since soft tissues and bones harden as we age.
According to the American Academy of Orthopaedic Surgeons, 95 percent of people experience degeneration of the spine by age 50, and stenosis most often occurs in people over 60 years old.
Symptoms of spinal stenosis include back pain, burning pain in the buttocks or legs (sciatica), numbness or tingling in the buttocks or legs, and weakness in the legs. Another symptom is "foot drop," or the sensation of the foot slapping on the ground while walking.
TREATMENT: If treatment with physical therapy and anti-inflammatory medication fails, patients with poor quality of life because of stenosis may be candidates for surgery. For stenosis, surgeons often perform a laminectomy -- or spinal decompression -- which involves removing the bone, bone spurs and ligaments that are pressing on painful nerves. In patients with arthritis that would cause the spine to collapse after decompression surgery, spinal fusion is performed as well. In spinal fusion, surgeons fuse together two or more vertebrae using a graft from another area of the body. Rods and screws may also be put in place to fuse the bone together.
Tradition spinal fusion can leave a patient in pain afterwards due to the placement of screws and rods. Some surgeons are combining minimally invasive decompression surgery with placement of a new plate instead of screws and rods. The plate works like a car jack. "Basically, a car jack imparts lift, and what we do in this procedure is we mechanically impart lift between two vertebral segments," Hyun Bae, M.D., orthopedic spine surgeon at St. John's Health Center in Santa Monica, Calif., told Ivanhoe.
Dr. Bae says patients can walk the day after the surgery and resume most of their normal activities after about three weeks. After the initial healing time, patients are put into physical therapy for two to four weeks and can then get back to all normal activities.