Below, we’ll discuss the most prevalent causes, typical symptoms, and available treatments for spondylolisthesis to help guide your recovery journey. For symptoms lasting longer than a few weeks or that become severe, contact your spine specialist for an evaluation. 

Spondylolisthesis at a Glance:

• Causes: Age-related degeneration, stress fracture, spinal defects, genetic factors
• Symptoms: Lower back pain, stiffness, sciatica, tight hamstrings
• Treatments: Physical therapy, medications, surgery (for severe cases)

Spondylolysis vs. Spondylolisthesis: What’s the Difference?

Spondylolysis is a stress fracture that runs through the pars interarticularis, a small segment of bone that connects two vertebrae. Spondylolisthesis is the downward slippage of a vertebra due to instability; spondylolysis is a possible cause of spondylolisthesis. 

When the pars interarticularis is fractured, patients may experience back pain that worsens with physical activity. However, not all spondylolysis patients have symptoms. 

Approximately one out of 20 people has spondylolysis, making it a relatively common condition. Additionally, spondylolysis can lead to spondylolisthesis. This is because the pars interarticularis fracture can diminish the stability of the spine and potentially lead to slippage. 

What is Spondylosis? 

Spondylosis refers to spinal degeneration, usually related to aging. Over time, it can lead to degenerative spondylolisthesis. Spondylosis is very common among older adults, with prevalence rates upwards of 95% by age 65.  

Is Spondylolisthesis The Same As a Slipped Disc?

No, spondylolisthesis isn’t the same as a slipped disc. Spondylolisthesis involves a vertebra that slips out of position, while a slipped disc is an injured spinal disc.  While the common medical term “a slipped disc” may seem to indicate the slippage involved in spondylolisthesis, it’s an entirely different condition. 

Spondylolisthesis affects the spinal bones, which are known as vertebrae. A slipped disc is an injury involving an intervertebral disc, which is a cushion of shock-absorbing tissue. There’s an intervertebral disc located in between each of the vertebrae in the spine. 

Types of Spondylolisthesis

Degenerative spondylolisthesis is the most common type, followed by isthmic spondylolisthesis. Other possible types include congenital, traumatic, and pathological. 

• Degenerative spondylolisthesis: The most common cause of spondylolisthesis is degenerative changes in the vertebral joints and cartilage due to aging.
• Isthmic spondylolisthesis results from a defect in the pars interarticularis, potentially from:
  • A stress fracture (spondylolysis), commonly from overuse in teen athletes
  • Genetic factors, including naturally thinner pars interarticularis, and spinal anatomy
• Congenital spondylolisthesis (also known as dysplastic spondylolisthesis) is caused by a birth defect in the facet of the vertebra. The defect, which is present at birth, can cause the vertebra to slip out of position. This is referred to as dysplastic spondylolisthesis.
• Traumatic spondylolisthesis may be caused by: 
• Spinal trauma: Spondylolisthesis can also result from sudden trauma, such as a sports injury or car accident. This is known as traumatic spondylolisthesis and can occur in people of all ages. 
• Sports injury: In athletes who repetitively strain and overstretch the spine, spondylolisthesis is a relatively common injury. This is especially true in younger athletes, given that their spines haven’t fully developed.  
• Pathological spondylolisthesis results from underlying conditions that compromise bone strength, like osteoporosis or a tumor. 

Understanding Grades of Spondylolisthesis: The Meyerding Classification System

The Meyerding classification system defines five grades of spondylolisthesis, and it’s used to evaluate the condition’s severity based on a lateral spine X-ray image. It may be used to help clearly diagnose spondylolisthesis and help patients better understand the extent of the vertebral slippage. 

To use this system, the medical professional draws a line through the posterior (back) wall of the superior and inferior vertebral bodies. They then calculate a percentage of the distance between the two lines to measure the movement of the vertebral body above. 

The five grades of spondylolisthesis, according to the Meyerding system, are:

• Grade 1 spondylolisthesis is a 0 to 25% slippage. 
• Grade 2 spondylolisthesis is a 26 to 50% slippage.
• Grade 3 spondylolisthesis is a 51 to 75% slippage. 
• Grade 4 spondylolisthesis is a 76 to 100% slippage. 
• Grade 5 spondylolisthesis, or spondyloptosis, is an over 100% slippage.  

What Does Spondylolisthesis Feel Like?

Spondylolisthesis generally feels like persistent lower back pain and stiffness, potentially with nerve-related symptoms like sciatica, tingling, and numbness. 

• Lower back pain: The most frequent symptom of lumbar spondylolisthesis is lower back pain. The pain typically worsens after exercise and abates when you sit or bend forward.
• Reduced mobility: Decreased range of motion and tightness of the hamstring muscles are common spondylolisthesis symptoms.
• Sciatica: Lumbar spondylolisthesis can cause sciatica, the term for compression of the sciatic nerve, which extends from the lower lumbar vertebrae into the buttocks and down the backs of the legs. Sciatica symptoms include:
  • Burning, shooting, or electric shock-like pain down one or both legs
  • Tingling, numbness, or pins and needles sensation
  • Muscle weakness
• Muscle tightness, especially in the hamstring muscles

While not exactly a symptom of spondylolisthesis, spinal stenosis, an abnormal narrowing of the spinal canal, can be caused by degenerative spondylolisthesis. 

Who’s at Risk for Spondylolisthesis?

Risk factors for spondylolisthesis include being over age 50, female, overweight, participating in high-impact activities, pre-existing medical conditions, and a family history of the condition. 

Age: Over 50

Adults over age 50 are more vulnerable to degenerative spondylolisthesis due to age-related spinal changes and cumulative wear and tear. Age-related spinal changes that can contribute to spondylolisthesis include:

• Drier, weaker spinal discs
• Weakened spinal ligaments
• Arthritic facet joints (spondylosis)

Female Gender

Women are significantly more likely to develop degenerative spondylolisthesis: it affects an estimated 8.4% in women and 2.7% in men, according to StatPearls. This is likely due to a combination of factors, including:

• Menopause-related hormonal shifts (reduced estrogen)
• Anatomical differences
• Increased ligament laxity 

Family History and Pre-Existing Conditions

A family history of spondylolisthesis, particularly from genetic spinal abnormalities like thinner pars interarticularis, increases your risk of developing the condition. Certain pre-existing conditions can also increase your risk, including spondylolysis, spondylosis, and osteoporosis. 

Obesity

Increased body weight from obesity increases the mechanical load on the lumbar spine, which can exacerbate spinal wear and tear. This leaves the spine more vulnerable to degenerative conditions, including spondylolisthesis. 

In a large-scale epidemiological study using the Medicare Claims 5% Limited Data Set, obese individuals had approximately 1.84 to 3.75 times the prevalence of most degenerative spinal conditions compared to non-obese individuals. 

Sports and Physical Activities

Spondylolisthesis in athletes may occur, particularly in sports that involve a high degree of impact, deep spinal bends, twists, and extensions, and intense axial loading (heavy overhead lifting). Another prominent risk factor is in young athletes, who are more prone to spondylolysis (spinal stress fracture), which can destabilize the spine and lead to spondylolisthesis. Spondylolysis rates in teen athletes as high as 30% have been reported, according to the Journal of Sports Medicine. 

Physical activities that may increase your risk of developing spondylolisthesis include:

• Contact sports
• Weightlifting and powerlifting
• Figure skating
• Dancing
• Tennis
• Baseball 
• Diving
• Rowing

Warning Signs: When to See a Spine Specialist

It’s time to see a spine specialist for spondylolisthesis if you experience:

• Pain that lasts longer than two weeks or consistently worsens
• Sciatica
• Difficulty walking

Though rare, lumbar spondylolisthesis can cause cauda equina syndrome, a medical emergency involving compression of the cauda equina, a sack of nerve roots at the base of the spine. If you experience any of these warning signs of cauda equina syndrome, go to the ER immediately for emergency medical care:

• Saddle anesthesia (numbness or tingling in the inner thighs, groin, or buttocks)
• Severe, sudden, or rapidly progressing numbness or weakness in the legs
• Changes in bowel or bladder function
• Sudden sexual dysfunction

How is Spondylolisthesis Diagnosed?

A physician specializing in spinal disorders can diagnose spondylolisthesis using radiographs and X-ray imaging, as well as a comprehensive physical exam. You’ll likely stand sideways as the X-rays are taken so your physician can see the vertebra’s slippage clearly (this is called a standing lateral X-ray). 

After your physician has examined the imaging test results, the severity of your spondylolisthesis case will be graded. The grading scale is based on the degree of slippage from the vertebra’s normal position, using the Meyerding classification system (as discussed above).

Upon making a diagnosis, a physician can recommend appropriate treatments for spondylolisthesis.

What Makes Spondylolisthesis Worse?

Several factors can worsen spondylolisthesis, including:

• High-intensity physical activities
• Heavy lifting
• Poor posture
• Being involved in an auto accident

If you’ve been diagnosed with spondylolisthesis, your physician likely recommended lifestyle adjustments to help you avoid the factors listed above. 

Spondylolisthesis Exercises To Avoid

Any exercises that involve heavy lifting and excessive twisting or bending should be avoided with spondylolisthesis. If you enjoy a specific sport, you should talk to your physician about whether it’s safe to participate in that sport while you’re struggling with spondylolisthesis symptoms.  

Sports that tend to exacerbate spondylolisthesis symptoms include:

• Weightlifting and powerlifting
• Running
• Football
• Soccer
• Diving
• Competitive swimming
• Gymnastics
• Certain types of dance, including ballet

Non-Surgical Spondylolisthesis Treatments

Non-surgical treatments for spondylolisthesis include physical therapy, exercises for relieving pressure on the affected spinal nerves, medication, and epidural steroid injections. In many patients, these treatments are sufficient to alleviate the symptoms of spondylolisthesis.

What Does Physical Therapy For Spondylolisthesis Involve?

Physical therapists can help patients manage spondylolisthesis in several ways.

For one, your PT can offer valuable insights and education about how your lifestyle is affecting your symptoms. From your exercise regimen to your footwear to your posture, your physical therapist can identify areas for improvement. In making the recommended adjustments, you can likely reduce the pressure on your spine, leading to an improvement in spondylolisthesis symptoms. 

Additionally, your PT can implement various non-invasive methods of pain management. Targeted heat and cold therapy can help alleviate inflammation and pain. Electrical stimulation is another popular method among physical therapists to gently reduce the transmission of pain signals to the brain. 

Physical therapists can also recommend stretching and strengthening exercises for spondylolisthesis. By stretching to reduce muscle tension, you can gain greater back flexibility. By strengthening various muscle groups, you can gain greater stability in the lumbar spine, hips, and pelvis. 

Does Chiropractic Care Help With Spondylolisthesis?

Many spondylolisthesis patients find that chiropractic care is a helpful tool for alleviating their symptoms; it’s particularly popular among those looking to treat spondylolisthesis naturally. Chiropractors specialize in spinal manipulation to treat issues involving the musculoskeletal system.

Key goals of chiropractic care for spondylolisthesis include improving spinal mechanics, restoring spinal function, and improving posture. In achieving these goals, your chiropractor may alleviate compression on the spinal nerves, which often leads to reduced symptoms. 

One of the main benefits of chiropractic care for spondylolisthesis is that it’s non-invasive. Chiropractors focus on methods including manual and instrument-assisted manipulation to adjust the spine, making it a safe back pain treatment option. 

Which Medications Are Used To Treat Spondylolisthesis?

Physicians often recommend over-the-counter medications to help spondylolisthesis patients manage pain and inflammation. In more advanced cases that don’t improve with over-the-counter options, physicians may instead suggest prescription medications. 

There are a few different types of drugs that may help with spondylolisthesis. The main types include:

• Analgesics

In simpler terms, analgesics are painkillers. These over-the-counter medications’ primary function is to relieve pain. The most common analgesic is acetaminophen, or Tylenol. 

• NSAIDs (non-steroidal anti-inflammatory drugs)

NSAIDs alleviate inflammation along with pain. There are numerous over-the-counter NSAIDs, such as aspirin, Aleve, and Advil (ibuprofen), as well as prescription NSAIDs. 

• Neuropathic agents

This type of prescription medication can be helpful for patients suffering from spondylolisthesis nerve pain. Neuropathic agents target nerve pain directly and can help with spondylolisthesis symptoms, including tingling, numbness, and weakness.

Gabapentin and pregabalin (Lyrica) are two of the most commonly prescribed neuropathic agents for spondylolisthesis. 

• Muscle relaxants

Some spondylolisthesis patients experience chronic back pain caused by muscle spasms in the back. In these cases, physicians may prescribe a muscle relaxant to stop the spasms. Soma, Flexeril, Baclofen, Tizanidine, and Robaxin are among the most widely prescribed muscle relaxants. 

To learn more about conservative strategies for spondylolisthesis symptom management, check out our blog article: Spondylolisthesis Self-Care: Effective Pain Management Techniques for Daily Relief

Epidural Steroid Injections

Epidural steroid injections involve injecting steroid medication into the epidural space (the area surrounding the spinal cord). The treatment goal is to reduce inflammation around the spinal nerves to alleviate pain. However, pain relief from steroid injections is typically temporary, and it’s not recommended to receive them more than three times annually, as doing so may lead to complications like weakened muscles and reduced bone density. 

Success Rate of Epidural Steroid Injections for Spondylolisthesis

A study in the Journal of Back and Musculoskeletal Rehabilitation reported epidural steroid injection success rates of 66.1% for degenerative spondylolisthesis and 46.9% for isthmic spondylolisthesis. However, a study in the Journal of Bone and Joint Surgery found that epidural steroid injections may help relieve pain from degenerative spondylolisthesis for up to four months, but had little effect on the eventual need for surgery. 

Spondylolisthesis Surgery: Approaches and Fusion Alternatives

For patients with moderate to severe spondylolisthesis who don’t respond to conservative therapies, physicians may recommend spinal decompression surgery. The idea of undergoing surgery can be daunting, but note that most patients’ symptoms improve with non-surgical treatment.

If you and your physician determine that spondylolisthesis surgery is the right treatment route, you’ll likely discuss the spinal decompression procedure. 

What is Spinal Decompression?

Spinal decompression involves removing portions of the vertebrae that impinge on the spinal cord and nerve roots. There are several different approaches to spinal decompression, including laminectomy, foraminotomy, discectomy, and corpectomy. For spondylolisthesis, surgeons often opt for a laminectomy. 

Laminectomy involves removing some or all of the lamina. This is the small section of bone that covers the back of the spinal canal. By removing it, your surgeon can create more space for the spinal nerves and alleviate nerve impingement. 

Spinal decompression can have a dramatic effect, relieving pain and other spondylolisthesis symptoms. However, removing portions of the lamina reduces the stability of the spinal column. So, after decompression surgery, spinal stability remains a key concern for spondylolisthesis patients.

This is why surgeons traditionally perform spinal fusion after spinal decompression. 

What is Spinal Fusion?

Spinal fusion involves placing bone graft material in between the affected vertebrae. Then, screws and rods are implanted to secure the graft in place and provide additional stability.

In the period following spinal fusion surgery, the bone graft material will spur the permanent joining of the affected vertebrae. This prevents all movement between the fused vertebrae, which can prevent instability in spondylolisthesis patients. 

Unfortunately, in stabilizing the vertebrae, spinal fusion eliminates the natural independent motion that gives the spine flexibility. This diminishes patients’ ability to carry out certain movements, namely those that require the bending or twisting of the spine. Fusion has also been shown to promote the deterioration of adjacent vertebrae.

The TOPS System For Spondylolisthesis

For those looking for motion-preserving fusion alternatives for spondylolisthesis, there’s the TOPS System. It’s a dynamic non-fusion that replaces the tissues removed during spinal decompression and establishes a controlled range of spinal motion. TOPS is FDA approved to treat degenerative spondylolisthesis (up to grade I) at one level from L3 to L5 with moderate to severe lumbar spinal stenosis, and it’s earned a superior-to-fusion claim from the FDA. 

Regain your mobility with Premia Spine! Contact us now

In a seven-year study for patients with degenerative spondylolisthesis and lumbar spinal stenosis, the TOPS System maintained clinical improvement and stability. Additionally, in a five-year study of the TOPS System for 10 patients with degenerative spondylolisthesis and lumbar spinal stenosis, the clinical outcome scores “improved significantly across all scoring systems”. In this study, there were no failures at five years and no patients required revision surgery.   

TOPS Testimonials

Patient and surgeon testimonials are highly encouraging for the TOPS System as a spondylolisthesis treatment. Many patients note that they’re able to return to their favorite activities after the TOPS procedure, as it preserves spinal mobility. 

We encourage anyone with persistent back problems to consult a physician who specializes in spinal disorders and learn about the latest available treatment options.

FAQs: Spondylolisthesis

What’s the difference between spondylolysis and spondylolisthesis?

Spondylolysis is a fracture in the pars interarticularis; spondylolisthesis involves the slip of the vertebra that can result from spondylolysis.  

What should I not do with spondylolisthesis?

Heavy lifting, high-impact activities, excessive spinal twisting or bending 

How long to rest with spondylolisthesis?

Avoid staying in bed longer than one to two days; take a break from intense exercise, but engage in light, low-impact movement (like walking) 

Can spondylolisthesis get worse over time?

Yes, spondylolisthesis can get worse over time if it’s left untreated. 

Can spondylolisthesis be cured without surgery?

While the slip itself can’t be “cured” without surgery, spondylolisthesis is often successfully treated without surgery, especially if it’s addressed promptly. 

The post What is Spondylolisthesis? Causes, Symptoms, and Treatments appeared first on Premia Spine.

Back pain can occur anywhere on the back, from the neck (cervical area) to the middle of your back (thoracic area) to the lower back (lumbar area) with the lower back often being the most common location of severe and lifestyle-limiting pain, since the lower back bears most of your weight. That weight can compress the cartilage cushion between your vertebrae. And, over time, you might experience a degeneration of that cushioning cartilage, causing your discs to compress or slide out of place.

Walking, bending, lifting, twisting, even sitting and standing can then become excruciating. Back pain flares up and then goes away on its own after a few days for some people. But for others, sharp pains and limited motion becomes a bigger, more longer-lasting problem requiring medical care.

Here are some of the more severe back pain conditions:

• Disc degeneration: Discs in the spine can deteriorate with age, and the deterioration of discs can lead to inflammation and irritation in the spine, which can cause great pain.
• Sciatica: While many people associate the term ‘sciatica’ with pain in the buttocks area, sciatica can be a painful condition in the back. Sciatica is caused when the sciatic nerve (a bundle of lumbar nerves) becomes irritated by a herniated disc. This condition is known as spinal stenosis. The sciatic nerve can also be irritated by an abnormality in a vertebra that puts pressure on it. Sciatic pain may be felt in the lower back or buttocks, and may also be felt in the calf and the foot. Sciatica pain can be mild with tingling, or it can become severe, growing worse at night. You might experience worse sciatica pain when you have long stretches of standing or sitting.
• Lumbar spinal stenosis: When spinal degeneration occurs, the canal through which spinal nerves travel can narrow. As part of the aging process, discs can dry out and shrink. When these two conditions occur, you might experience painful pressure on a spinal nerve. This can happen with a minor injury, as a symptom of osteoarthritis of the spine, or simply as a symptom of aging. The resulting back pain can be severe.
• Osteoarthritis: Arthritis anywhere in the body can be painful, but when osteoarthritis occurs in the back, you may experience pain and muscle spasms. Osteoarthritis can affect the cartilage in the discs, the vertebrae, or both anywhere along the spine, pinching the nerves and causing pain.
• Herniated disc: Also called a ‘slipped disc,’ this condition occurs when a damaged or bulging disc pinches or irritates a nerve root.

Emergency Back Pain Symptoms Requiring Immediate Care

Certain symptoms associated with back pain are considered emergencies and require immediate care to prevent severe complications. These include:

• Sudden back pain that makes it difficult to stand or walk
• Sudden neurological symptoms, including back pain that radiates to the extremities, numbness, or tingling
• Sudden numbness in the legs or pelvis
• Changes in bowel or bladder concern
• Fever
• Severe back pain that develops after an injury
• Unexplained weight loss
• Loss of consciousness

If you experience any of these symptoms, seek immediate medical care. They may be signs of serious conditions like cauda equina syndrome or spinal infections. 

Neurological Symptoms That Shouldn’t Be Ignored

Neurological symptoms arise from problems with nerve tissue, whether from the nerve roots, spinal cord, or brain. If you experience these symptoms with back pain, it’s a sign that you’re dealing with nerve compression in the back, often from symptoms like a herniated disc, spinal stenosis, scoliosis, or even vertebral fractures. 

You should never ignore neurological symptoms, as nerve compression requires prompt care to prevent worsening discomfort. These include radiating back pain, weakness, numbness, and tingling.  

Differentiating Between Common and Serious Back Pain

If you’re unsure, the best way to differentiate between common and serious back pain is to visit a medical professional for an evaluation. But if you’re looking to better understand your condition at home, keep these points in mind:

• Common Back Pain
  • Common back pain, like pain from sprains and strains, often has a clear cause. You may lift a heavy box, for example, and feel an immediate twinge. 
  • Common back pain also tends to feel like stiffness or a dull ache, as opposed to sharp or burning pain. 
  • Common back pain usually starts to improve within a few days or weeks of at-home care, like rest, ice, and heat. 
• Serious Back Pain
  • With serious back pain, it’s often more difficult to pinpoint the exact cause. 
  • Serious back pain feels more severe and is more likely to interfere with your daily activities. It may also radiate to the extremities and occur with other neurological symptoms. 
  • Serious back pain may occur after a traumatic accident, like a car accident, a fall, or another significant injury.  
  • Serious back pain is usually recurring and persistent, even with rest and other home remedies. 

When Conservative Treatment Isn’t Enough

Sometimes, conservative treatment like home remedies, physical therapy, and painkillers isn’t enough. In these cases, a doctor can help you determine the best path forward. 

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When severe back pain occurs, your physician will assess you for various spinal conditions, and you will likely start on a back pain reduction plan that aims to reduce your discomfort, restore your mobility, and manage your back pain flare-ups. Perhaps you and your doctor will decide that spinal surgery is the best solution to remedy the internal causes of your severe back pain, returning you to a better quality of life.

The TOPS System is one such solution. The TOPS (Total Posterior Spine) System provides an alternative to spinal fusion for patients undergoing spinal decompression back surgery. Unlike spinal fusion, TOPS preserves the full range of the spine’s natural motion and has been shown to provide better outcomes than fusion in clinical studies performed around the world.

Questions Your Doctor Will Ask About Your Back Pain

When you visit your doctor to ask about back pain, they’ll ask various questions to gain more information that can help them provide a diagnosis. Examples include:

• Where is your pain located? Does it occur on one side of the body or both?
• What does your pain feel like? Is it dull, sharp, aching, throbbing, burning, or radiating?
• When did your pain begin? Did it start suddenly or develop progressively?
• Can you rank your pain’s severity on a scale of one to 10?
• Are you experiencing any other symptoms?

Preparing for Your Back Pain Appointment

Preparing for your back pain appointment can help ensure all of your questions get answered and that your doctor receives the information they need to make an accurate diagnosis. Get ready by:

• Collecting any relevant medical records, like records of past injuries, spinal conditions, surgeries, and other treatments
• Keeping a pain journal to record your symptoms and provide accurate timelines
• Making a list of your questions and concerns (in the moment, it can be difficult to remember all of the points you want to address – a written or typed-out list can help)

The post When to See a Doctor for Types of Severe Back Pain appeared first on Premia Spine.

Although a slipped disc can typically be managed with non-invasive methods, there are cases that require surgery. Here, we’ll discuss slipped disc surgery, when it’s needed, and what it entails.

Understanding Disc Herniation

The spinal discs act as cushions in the spine. Located in between each vertebra, the discs absorb impact and reduce the stress imparted on the spinal bones. 

Unfortunately, age-related degeneration, repetitive movements, and sudden trauma to the spine can damage the spinal discs. A disc is considered herniated when the tough disc exterior becomes cracked and the soft disc interior extends outward. 

When this injury occurs, fluid from within the disc can leak into the spinal canal. Here, it can disrupt the spinal nerve function.

A slipped disc in the spine is often the final stage in the process of disc degeneration. This process typically begins with a bulging disc, which occurs when the disc exterior weakens and the disc bulges out to one side. This may progress to a protruding disc before the disc finally ruptures. Although the name may be misleading, a “slipped disc” has not actually shifted position.

Slipped Disc Symptoms

Symptoms of a slipped disc can vary depending on the location of the damaged disc and the severity of the rupture. If a slipped disc doesn’t impart pressure on a nerve, it may be entirely unnoticeable to the patient. However, if a slipped disc does press on adjacent nerves, it may cause pain, numbness, weakness, and tingling.

A slipped disc in the neck, which is known as a slipped cervical disc, may trigger symptoms in the shoulders, arms, or chest. A slipped disc in the lower back, which is known as a slipped lumbar disc, may cause sciatica. This refers to pain that radiates downward from the lower back, causing nerve pain in the buttocks, legs, and feet.

What Can Cause a Slipped Disc?

The most prevalent causes of slipped discs are:

• Spinal degeneration from the natural aging process

As people age, the spinal discs naturally become drier and weaker. This, along with accumulated wear and tear on the spine over the course of many years, can lead to a slipped disc. Disc herniated most commonly occurs in patients between the ages of 35 and 50. 

• Injuries caused by excessive stress on the spinal column

Improperly lifting heavy objects and exercising with improper bodily mechanics are examples of activities that may cause a slipped disc. Athletes in sports that place significant stress on the spine, including football and weightlifting, are often at a heightened risk of disc herniation. 

Smoking, excess body weight and a sedentary lifestyle also increase the risk of developing a slipped disc. Sudden trauma to the spine, (which may occur during an automobile accident, for example) may cause a slipped disc, although it’s rare. 

Slipped Disc Treatments

Treatments for slipped disc include:

• Physical therapy

Slipped disc treatment without surgery typically involves physical therapy. Targeted slipped disc exercises and PT can alleviate tension, improve your posture, and strengthen the muscles that support the spine.

Additionally, physical therapy can help reduce the pressure of the damaged disc on your spinal nerves. Your physical therapist may recommend alternative therapies such as massage, acupuncture, and electrostimulation to further enhance your recovery process. 

• Medication to relieve pain and inflammation

Certain medications can be used to manage pain and inflammation from a slipped disc. Over-the-counter options are available, as well as prescription medications from your doctor. Always consult your doctor before starting a new medication. 

• Surgery

In some cases, surgery for slipped discs is required for the patient to make a full recovery.

When Does a Slipped Disc Require Surgery?

As we’ve already mentioned, slipped discs rarely require surgery and heal with non-invasive methods. However, a slipped disc may require surgery if:

• Non-invasive methods have failed after several months
• The patient is experiencing radiating back pain, (known as sciatica), which isn’t responding to conservative methods
• The patient has constant pain that’s diminishing their quality of life
• The patient’s basic mobility is compromised (i.e. trouble standing and walking)
• The patient has neurological symptoms that are noticeably worsening 

Before undergoing an invasive procedure, patients must talk to their doctors and learn about the slipped disc surgery risks. 

Patient Selection Criteria for Surgery

Physicians often follow certain criteria to ensure patients are a good fit for spinal surgery. Along with the points listed above, these selection criteria may involve:

• • The presence of underlying medical conditions, like diabetes, which can increase the risk of surgical complications
• BMI (Body Mass Index), as patients who are overweight or obese are at a higher risk of complications
• Cardiac health, which can help your surgeon determine the risk of a cardiovascular event resulting from the procedure
• Opioid dependency, which impacts the patient’s ability to safely use certain postoperative pain medications
• Psychosocial factors, like the patient’s support system, can impact their recovery 

Surgeons may also use the American Society of Anesthesiologists (ASA) Physical Status Classification System, a standardized tool that can help predict risks during the surgery. It evaluates factors that contribute to this risk, including systemic disease, pregnancy, smoking, alcohol consumption, and obesity. 

What Kind of Surgery is Done For a Slipped Disc?

Decompression surgery is most commonly performed for a slipped disc. This surgical method involves alleviating pressure on the spinal nerves by removing spinal tissue. There are different types of spinal decompression surgery, including discectomy, laminectomy, corpectomy, and foraminotomy. 

Spinal fusion back surgery is often performed in conjunction with surgery for a slipped disc. The fusion stabilizes the spine but eliminates the natural independent motion of the newly-fused vertebrae.

Today, many patients are choosing the TOPS (Total Posterior Spine) System as an alternative to spinal fusion surgery. The TOPS solution provides better clinical outcomes and preserves the independent motion of the vertebrae. This is just one of the medical advancements bringing new, improved therapies to patients worldwide.

Types of Minimally Invasive Disc Surgeries

Minimally invasive disc surgeries involve smaller incisions, less tissue damage, and less trauma to the body overall. This makes them a safer, preferred alternative to more invasive surgeries for eligible patients. Types of minimally invasive disc surgeries include:

• Microdiscectomy is a minimally invasive alternative to traditional open discectomy, involving less trauma and a smaller incision. During the procedure, your surgeon will use surgical glasses or a microscope to visualize the spine, removing damaged portions of disc tissue, ligament, and bone. The goal is to remove tissue that’s impinging on nearby nerve roots to alleviate discomfort. 
• Endoscopic discectomy involves using an endoscope (a long, thin tube with a tiny camera on the end) to visualize the inside of the body through a small incision. Endoscopes can be used in various procedures, including discectomy for a lumbar herniated disc. 
• Percutaneous discectomy is another minimally invasive technique that involves extracting portions of the disc’s center through a needle and a small incision in the skin. The surgeon uses X-ray technology and a special probe to visualize the spine without disturbing large amounts of tissue. 

Technological Advancements in Disc Surgery

Technological advancements in disc surgery continue to pave the way for new techniques and procedures. Along with the minimally invasive methods listed above, examples include surgical navigation systems, robotics, and 3D printing. 

• • Navigation systems are a technological innovation involving real-time insights, guidance, and imaging to guide surgeons throughout the procedure. They can provide greater precision and improved outcomes with smaller incisions and less tissue disruption. 
• Robotics is gaining traction as an advanced tool to support surgeons in spinal surgery. Robotic guidance can improve instrument placement precision and stability to reduce the risk of accidental tissue damage. 
• 3D printing in spinal surgery allows surgeons to print spinal implants that fit the patient’s unique spinal structure. Additionally, some surgeons are choosing to print a 3D replica of the patient’s spine as a preoperative planning tool, which can improve accuracy during the procedure. 

Along with these innovations, for patients with lumbar spinal stenosis and spondylolisthesis, the TOPS (Total Posterior Spine) System is a modern alternative to spinal fusion surgery. It’s a dynamic implant device that provides superior clinical outcomes and preserves the independent motion of the vertebrae after decompression. This is just one of the medical advancements bringing new, improved therapies to patients worldwide.

Comparing Surgical Approaches for Slipped Discs

If your physician has advised you to consider surgery for a slipped disc, you may be weighing the pros and cons of different procedures. Minimally invasive techniques offer a clear advantage over traditional open discectomy, as they involve less tissue damage, less scarring, a lower risk of complications, and a shorter recovery period. 

But if you’re a candidate for minimally invasive discectomy, you may need to take your comparison a step further by contrasting microdiscectomy and endoscopic discectomy. 

• Microdiscectomy considerations:
• • Proven success rate, with a study published in Medical Principles and Practice reporting a success rate of 84.3%
  • Longer track record, having been around since the 1970s
  • Return to normal activities within eight weeks
• Endoscopic discectomy considerations:
  • Even less invasive than microdiscectomy, with a smaller incision, less tissue disruption, and a shorter recovery period 
  • High success rate, with a study published in the Journal of Clinical Medicine reporting a success rate of over 95%
  • Not appropriate for all cases and spinal conditions
  • Return to normal activities within four weeks

Ultimately, it’s up to you and your doctor to determine the best surgical approach for your needs.

How Long Does it Take to Recover From a Slipped Disc Surgery?

Spinal fusion surgery for a slipped disc involves an extensive recovery period. The procedure itself generally takes 4 to 6 hours to complete, and patients typically remain in the hospital for 2 to 4 days. The complete slipped disc surgery recovery time with spinal fusion may take anywhere from 6 months to a year. 

With the TOPS system, the slipped disc surgery recovery period is much less involved than that of spinal fusion. The procedure is considered minimally invasive and typically only lasts for 60 to 120 minutes. 

Patients can generally walk and move around just one day after TOPS surgery. After 4 to 6 weeks, patients reach their expected level of mobility. This recovery time for slipped disc surgery can be further aided by physical therapy and a nutrient-dense diet. 

Post-Surgical Rehabilitation Process

Post-surgery rehab for a slipped disc helps you regain strength and mobility while allowing your body to heal more effectively. In the long run, this can help prevent recurrent pain and other signs of failed back surgery. 

Common rehab techniques include:

• Pain management
• Activity restrictions
• Physical therapy
• Diet optimization and hydration 
• A gradual return to exercise 

What Is The Success Rate of Slipped Disc Operation?

Surgery for slipped discs involving spinal fusion can improve back pain and symptoms at a rate of anywhere from 60% to 90%, depending on the study. For TLIF surgery with spinal fusion, studies have shown that the procedure improves patients’ pain by 60% to 70%, with an 80% satisfaction rate among patients. 

With that said, it’s difficult to determine the success rate of slipped disc surgery with fusion without considering the risks. Patients may lose a significant degree of mobility in this procedure, which can diminish their quality of life.

Additionally, the risk of increased degeneration around the fused segment, which is known as adjacent segment disease, must be taken into account. The prevalence of adjacent segment disease in patients who undergo lumbar spinal fusion ranges from 2% to 14%.

To evaluate the success rate of the TOPS System for slipped disc surgery, we can consider the results of a 7-year follow-up study. The study evaluated 10 patients suffering from spinal stenosis with degenerative spondylolisthesis who underwent spinal decompression with TOPS. 

• The visual analog scale score for back and leg pain dropped from 56.2 before surgery to 19 7-year post-op mark. 
• The Oswestry disability questionnaire, which is often used to measure back pain, fell from 83.5 before the procedure to 8.8 at the 7-year post-op mark. 
• An MRI examination 7 years after the procedure didn’t show spinal stenosis adjacent to the stabilized segment. 

Although spinal surgery for a slipped disc is widely considered to be a last resort, it can help patients achieve pain relief, improved mobility, and a higher quality of life. If you’re experiencing symptoms of disc herniation, schedule an appointment with your doctor for an evaluation.

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All patients undergoing back surgery should actively ensure that the healing process goes as smoothly as possible. In doing so, you can attain the best possible results from the procedure while avoiding complications that could compromise your health. 

Proper incision care is a key step in the process of adopting healthy habits and positive lifestyle choices to promote healing. As an aspect of your spinal surgery recovery, incision care will benefit your overall health. 

Here, we’ll discuss how to care for a spinal incision to ensure a successful surgical recovery and back pain relief. Additionally, we’ll explore innovations in the field of spine surgery that allow for smaller incisions and, as a result, a lower risk of complications. 

How Are Incisions Closed After Spinal Surgery?

After spinal surgery, the incision may be closed with Steri-Strips, staples, or sutures, including dissolvable sutures. Most often, spinal surgeons use a combination of these closure methods.

Since spinal surgery is performed beneath the layers of skin and muscle in the back, the incision must be closed at various layers. Your surgeon will suture the muscle layer together before closing the skin. 

• Sutures are also commonly referred to as stitches. This wound closure method involves using sterile surgical threads, which are stronger than the threads most people are familiar with. The surgeon uses these threads with a needle to suture the incision closed, and certain types of sutures will dissolve within a few weeks of the procedure. 
• Staples are metal clips. They allow for fast wound closure but don’t dissolve. So, you’ll need to return to your surgeon to have them removed after the procedure (typically seven to 14 days post-op). 
• Steri-Strips are adhesive bandages that may be used to help close an incision after spinal surgery. They may be applied over dissolvable stitches to help keep the skin closed or to help the wound heal after the sutures are removed. 

Preparing and Recovering From Back Surgery

In preparing for back surgery, patients should begin on a path of improving their diet and physical activity. These practices will improve your overall health to ensure that the spinal surgery goes off without a hitch. 

With that said, implementing healthy habits is not only essential for the surgery itself but also for the recovery process following the operation. While continuing the positive lifestyle changes that you applied before the procedure, make sure to rigorously follow your doctor’s orders, including those about what medications to avoid. Certain medications can interfere with the healing process, namely including NSAIDs. NSAIDs, like aspirin, ibuprofen, and naproxen, are blood thinners and can impair the body’s repair processes.

How Do You Treat an Incision After Back Surgery?

Proper care for the surgical incision is one of the most important aspects of post-operative home recuperation following back surgery. 

Immediately After The Procedure

You won’t be permitted to apply any ointments or lotions to the incision while it’s healing. You also shouldn’t bathe in a tub, swim, or use a hot tub until your incision is healed. Immersing the incision in water before your surgeon clears you to do so may increase your risk of infection and inhibit the healing process. 

Additionally, you’ll need to keep the incision clean after spinal surgery. You can clean the incision site with soap and water, then gently dry it with a clean cloth. This helps prevent infection as the incision heals. 

Two Weeks After The Procedure

In most cases, non-dissolvable sutures and staples are removed 14 days following the spinal surgery. At this point, the incision is usually fully healed. 

Six Weeks After The Procedure

Many spinal surgery patients are eager to reduce scarring by applying scar treatments and vitamin creams to the incision. However, you must wait to get the go-ahead from your surgeon before doing so. Typically, surgeons allow patients to start applying scar creams six weeks after the procedure. 

Signs of Proper Incision Healing

Signs that your incision is healing properly after spinal surgery include:

• A steady decrease in redness and swelling
• Scabbing
• Scar formation:
  • Incision edges draw closer together
  • Thickening around the edges
• Some sharp or shooting sensations in the incision region, indicating nerves in the area are regaining sensation
  • Note: This sensation should become less intense and less frequent over time. If it persists, talk to your doctor. 
• Thinning and flattening of the scar
• Scar returning to your normal skin color

Incision site swelling and redness are to be expected in the first few days after the procedure—your surgeon can provide a more precise time frame. However, if this inflammation lingers beyond the expected time period or is accompanied by other warning signs, it’s time to contact your doctor. 

When to Call Your Doctor: Warning Signs

Ideally, your incision will transition from a wound to a scab to a scar, eventually healing completely. But in some cases, incisions don’t heal properly and become infected. Keep an eye out for these infection warning signs and contact your doctor promptly if any of them appear:

• Redness, swelling, warmth, or pain that persists beyond the expected period without improvement (typically around a week)
• Oozing pus
• Odor coming from the incision
• Fever and/or chills

Infected surgical wounds may be superficial (involving only the skin), deep (involving the muscle and deeper tissue), or go even deeper and affect the spine. The infection depth will impact the proposed treatment plan, although many cases can be resolved with antibiotics. In some cases, surgery may be required to fully clean out the infected wound. 

Managing Incision Pain and Discomfort

Some incision-site discomfort is normal after spinal surgery. Although it should improve within about a week as your body recovers, proper wound care and at-home remedies can help ease your pain. 

Incision care tips to manage discomfort:

• Keep the incision clean and dry, being careful to avoid submerging it in water until cleared to do so by your surgeon. 
• Only apply ointments, lotions, or other topicals as advised by your surgeon. 
• Follow all post-operative instructions for incision care, including attending a follow-up appointment for suture or staple removal. 

At-home remedies to help with incision-site discomfort:

• Pain medication, as prescribed by your surgeon
• Cold therapy, making sure to wrap ice packs properly to protect your skin and keep the incision dry
• Compression bandages may help prevent swelling, fluid accumulation, and discomfort (when used as recommended by your surgeon) 

Products to Avoid on Your Healing Incision

Various topical products can irritate, dry out, or otherwise compromise your healing incision. These include:

• Lotions and creams, unless recommended by your physician
• Harsh topicals:
  • Rubbing alcohol
  • Hydrogen peroxide
  • Iodine
  • Antibacterial soaps
  • Other harsh cleansers
• Chemical sunscreens
• Retinoids
• Herbal topicals
• Perfume, cologne, and other fragrances

When it comes to applying topical products, stick to your surgeon’s recommendations. They may prescribe a topical or recommend a petroleum jelly-based ointment to keep the incision hydrated, which can support the healing process. 

Long-Term Scar Care and Management

Scarring is often a major concern among patients heading into surgery. While scarring is an inevitable side effect of surgery, which requires an incision, long-term care can ensure it fades as quickly as possible. 

These scar care and management tips can help your skin heal effectively after spinal surgery. Keep in mind that these tips should only be implemented once your incision has fully closed and healed, leaving behind a flat scar. This may not occur until months after the procedure. 

• Protect it from the sun. A scar on your lower back, for example, may often be protected by clothing. But if you’re headed to the beach or pool in a swimsuit that leaves it exposed, apply sunscreen (and reapply every few hours) to prevent UV damage, which can darken the scar. 
• Try a gentle massage. Gently massaging your scar using circular motions can help keep the tissue beneath the skin flexible, leading to a smoother, softer scar. Clean the scar using a gentle cleanser before massaging it, and apply a few dabs of an unscented moisturizer. Begin with light pressure and gradually increase to deeper pressure (as long as it doesn’t become painful). 
• Consider silicone gel patches. Once the incision is fully closed and healed, wearing a gel patch over the scar can support healing by creating a hydrating, protective environment. This can help bring down redness and flatten the scar, making it less noticeable. Just make sure to talk to your doctor before applying any new product to the scar, including silicone sheets, and note that they shouldn’t be used on open wounds. 
• Maintain a healthy lifestyle. Positive lifestyle habits like quitting smoking, eating a nutritious diet, and staying hydrated support your body’s overall healing process, which may help with post-operative wound healing and scar reduction. 

How Long Does It Take For a Spinal Incision To Heal?

It generally takes about two weeks for a spinal incision, including a spinal stenosis incision, to completely heal. At this point, your surgeon will remove sutures and staples, as well as clear you to take baths and swim. However, this timeline can vary from patient to patient. 

Spinal incision infections typically appear two to four weeks after the procedure. Your surgeon will advise you to be aware of infection symptoms, which include fever, worsening redness at the incision, and changes in the infection drainage. If any of these symptoms occur, make sure to reach out to your surgeon immediately.

Additionally, if the surgeon places any hardware or devices during the procedure and an infection develops, they may need to be removed. This also applies to patients with an implantation spinal cord stimulator incision or spinal fusion incision. 

How Long Does It Take For Spinal Nerves to Heal After Surgery?

Immediately after the spinal nerves are decompressed in surgery, the healing process can begin. But, nerve tissue heals far slower than other types of tissue in the body, namely muscle tissue. So, while some patients will experience an immediate improvement in nerve pain after spinal surgery, other patients may need more time to notice a difference. 

In the weeks and months after spinal surgery, patients should notice a gradual improvement in neurological symptoms such as numbness, tingling, and weakness. By adopting healthy lifestyle habits, such as engaging in low-impact exercise, eating healthily, and refraining from smoking, you can ensure that the spinal nerves heal as quickly as possible. 

Spinal Surgery Advances For Smaller Incisions

Surgeons always aim to create as small an incision as possible while successfully carrying out the procedure. This is because a smaller incision leads to less blood loss, less scarring, and a lower risk of infection. 

Fortunately, the last several years have seen a revolution in back surgery procedures and outcomes. Now, more minimally-invasive procedures are available to patients that require spinal surgery. These procedures allow for much smaller incisions, among other advantages over traditional open back surgery.

Spinal Fusion Alternatives

One procedure that can now be replaced with minimally-invasive alternatives is spinal fusion back surgery. This procedure was traditionally performed in conjunction with spinal decompression surgery for spinal stenosis, spondylolisthesis, and related conditions. 

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Spinal fusion involves positioning an implant containing bone graft material in between the affected vertebrae. Over the course of several weeks after the procedure, the bone graft will trigger the fusing of the vertebrae, turning them into a single bone. As a result, the patient can avoid spinal instability after decompression surgery. 

Unfortunately, spinal fusion requires a long recovery period and eliminates the natural movement of the individual vertebrae. It also creates the risk of adjacent segment disorder, or ASD, which occurs when the vertebrae surrounding the fused segment degenerate more rapidly than they otherwise would. 

The TOPS System From Premia Spine

Thankfully, a spinal fusion alternative has emerged to improve outcomes and preserve patients’ range of motion: the TOPS (Total Posterior Solution) System. The TOPS System is an implant that facilitates a minimally-invasive spinal surgery. It’s been shown in clinical trials around the globe to provide superior outcomes for patients who undergo treatments such as lumbar laminectomy or other spinal decompression procedures for various causes of lower back pain. 

As the example of the TOPS System indicates, these advances in minimally-invasive back surgery allow for not only fewer complications in surgical incision healing, but also improved outcomes overall.

Don’t hesitate to discuss concerns surrounding post-op incision care with your surgeon, and make sure to explore all of your spine surgery options.

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Ancient medical experts believed that back pain was brought on by a fluid imbalance. Therefore, many patients with back pain were treated with bloodletting.

Today, we know that back pain can have a variety of causes. Muscle and ligament sprains cause many episodes of back pain. Problems in the internal organs or tumors can also lead to back pain by affecting nerves that emanate from the spinal column. Stress can even trigger back pain by tightening the back muscles.

In this article, we’ll discuss some of the key types and causes of back pain to help you more effectively find professional pain care. 

What Are the Types of Back Pain?

The main types of back pain are:

• Acute back pain
• Subacute back pain
• Chronic back pain

Acute back pain occurs suddenly and typically resolves after a few days or weeks. It’s most often caused by abrupt injuries to the muscles or ligaments that support the spine, such as muscle strains, tears, or spasms. 

Subacute back pain may occur suddenly or gradually and typically resolves after one to three months. This type of back pain can be caused by either abrupt injuries, like muscle strains, or overuse/degenerative injuries, like a herniated disc. 

Chronic back pain is often considered the most severe. It’s defined as pain that develops quickly or gradually, persists longer than three months, and occurs every day. Some of the most common causes of chronic back pain include spinal arthritis, herniated disc, spinal stenosis, spondylolisthesis, and degenerative disc disease.

What Organs Can Cause Lower Back Pain?

The organs that can cause lower back pain include the kidneys, colon, appendix, gallbladder, liver, pancreas, uterus, and reproductive organs. 

Let’s explore how these organs can lead to lower back pain in more detail:

• Kidneys

Kidney stones and kidney infections can both cause lower back pain. Kidney stones can trigger pain on one or both sides of the back, typically in between the ribs and hips.

Kidney infection is a severe form of urinary tract infection also referred to as acute pyelonephritis. It may cause pain on the side of the back with the infected kidney (if the left kidney is infected, the left side of the lower back will hurt). This pain may be intense or dull and can be accompanied by fever, nausea, vomiting, and pain during urination. 

• Colon

Ulcerative colitis, a form of inflammatory bowel disease, can lead to lower right back pain. It’s caused by chronic colon inflammation and, in addition to back pain, can trigger weight loss, fatigue, rectal pain, and diarrhea. 

• Appendix

Appendicitis occurs when the appendix is infected or inflamed. Patients with appendicitis may have sudden pain in the lower right side of the back, possibly with fever, vomiting, and/or nausea.

• Gallbladder

Pain in the right side of the back and upper right portion of the abdomen with serious indigestion can indicate gallbladder inflammation or dysfunction. This condition more commonly affects women than men. 

• Liver

Back pain can stem from liver issues like liver scarring, inflammation, hepatocellular carcinoma, liver abscess, liver failure, or an enlarged liver. These conditions can also cause pain in the upper right portion of the abdomen, fatigue, reduced appetite, jaundice, and nausea. 

• Pancreas

Pancreatitis, or inflammation of the pancreas, can trigger pain that spreads from the upper abdomen to the lower left area of the back. It may be described as a dull pain that worsens with fatty food consumption. 

• Uterus and female reproductive organs

Lower right back pain can stem from one of many female reproductive organs. Endometriosis, for example, develops when cells akin to the uterine lining are located outside of the uterus, often on the fallopian or ovarian tubes. This may lead to pelvic pain that can spread to the lower right back. 

What Can Cause Lower Back Pain?

Muscle or tendon injuries, degenerative spinal conditions, arthritis, and disc problems can cause lower back pain. 

• Muscle and tendon injuries can lead to lower back pain. These injuries most commonly include strains, which occur when a muscle or tendon in the back is stretched. With a lower back strain, you may experience stiffness, muscle spasms, and lower back pain that resolves within 10 to 14 days. 
• Degenerative spinal conditions like degenerative disc disease, spinal stenosis, and spondylolisthesis can trigger chronic lower back pain. These conditions most often affect the lower spine because it bears significant impact and is more flexible than the upper or mid-spine. 
• Osteoarthritis of the spinal joints can cause chronic pain and inflammation in the lower back. Known as “wear and tear” arthritis, osteoarthritis occurs as a result of repeated impact on the joints.
• Disc problems, like a herniated disc, can lead to spinal nerve impingement. This can cause pain that radiates from the lower back down to the leg and foot. 

Lifestyle-Related Causes of Back Pain

Lifestyle-related causes of back pain include poor posture, smoking, obesity, and being sedentary. 

• Poor posture increases the forces on your spine’s structures, making it one of the most common mechanical causes of back pain. 
• Smoking is a known back pain risk factor – research confirms that smoking leads to a higher likelihood of developing back pain, including chronic and debilitating lower back pain. 
• Obesity is another strong back pain risk factor, with one study showing that obesity increases the risk of chronic lower back pain by over 1.7 times. Being overweight increases the risk by over 1.3 times. 
• A sedentary lifestyle can cause back pain by:
  • Contributing to weak back and core muscles, along with tight hip flexors, leading to more impact on the spine
  • Increasing the pressure on your spine throughout the day
  • Reducing blood circulation to your back

Age-Related Changes That Can Cause Back Pain

Age-related changes like weaker intervertebral discs, thicker spinal ligaments, less spinal joint cartilage, and weaker muscles can all contribute to back pain over time. 

• The discs that cushion the vertebrae get weaker, thinner, and drier with age, increasing the risk of herniation and pain. 
• Spinal ligaments naturally get thicker over time, taking up more space in the spinal canal. This can lead to spinal stenosis, a common cause of chronic back pain. 
• Cartilage in the facet joints of the spine tends to wear away with age, leaving the joints vulnerable to friction and inflammation. 
• Muscles get weaker over time in a process called sarcopenia. As a result, your back and core muscles can’t absorb as much impact, leaving the spine vulnerable to damage. 

Occupational Risk Factors for Back Pain

Occupational back pain risk factors include repetitive movements, heavy lifting, awkward positions, and prolonged sitting. 

• Repetitive movements, like bending down repeatedly, can strain your back and contribute to spinal wear and tear. This is a concern for mechanics, construction workers, and cleaners, among other occupations.
• Heavy lifting – especially without proper posture – subjects the spine to excessive impact that can lead to pain and injuries. Warehouse and construction site workers are among the most vulnerable. 
• Having to work in awkward, twisted, bent, or arched positions can significantly raise your back pain risk. Athletes (including golfers and gymnasts) fit within this category. 
• Prolonged sitting can lead to poor posture, immobility, and weakened muscles, all of which contribute to back pain. 

Work-related chronic stress can also contribute to back pain, although the link isn’t as direct as the mechanical causes listed above. 

Medical Conditions Contributing to Back Pain

Medical conditions contributing to back pain include:

• Arthritis, a key cause of inflammatory back pain
• Scoliosis
• Spinal stenosis
• Degenerative disc disease
• Infections
• Cancer (in rare cases) 

What Causes Hip and Lower Back Pain?

Sprains, strains, arthritis, and nerve impingement can cause hip and lower back pain. 

When a muscle, tendon, or nerve that extends over both the hip and lower back is injured, the patient may experience hip and lower back pain at the same time. Most commonly, this is a sign of a sprain or strain, which can resolve with at-home care. However, if hip and lower back pain doesn’t go away within a few weeks, becomes worse, or starts to inhibit your day-to-day activities, seek out professional medical care. 

What Can Cause Severe Lower Back Pain?

Severe lower back pain can be caused by disc problems, structural spinal issues, arthritis, spinal tumors, and spondylolisthesis. These conditions can all worsen with age and overuse, leading to severe pain and even disability. 

• Disc problems like a herniated disc can irritate the surrounding spinal nerves, inducing radiating pain, numbness, weakness, and tingling. Without prompt treatment, this common condition can cause severe lower back pain. 
• Structural spinal issues like spinal stenosis and scoliosis can trigger chronic pain and, eventually, lost mobility. Spinal stenosis occurs when the spinal canal gradually narrows, while scoliosis refers to an abnormal spinal curvature. 
• Osteoarthritis, as aforementioned, can affect the facet joints of the spine. As the cartilage that protects these joints wears down, patients may experience worsening pain and stiffness. 
• Spinal tumors can impinge on the spinal nerves, leading to various neurological symptoms and severe lower back pain. 
• Spondylolisthesis is a condition that develops when a vertebra slips out of its proper position, falling onto the vertebra below. This misalignment in the spine can cause nerve impingement and worsening back pain.  

How Can You Tell if Back Pain Is Muscular or Something Else?

You can tell if your back pain is muscular if it worsens when you move, feels like a dull ache, and is accompanied by stiffness and/or soreness. Additionally, muscular back pain typically starts to go away after resting for a few days. 

Your back pain may not be muscular and indicate something else if you’re experiencing pain that radiates into the extremities. This, along with numbness, weakness, and tingling, indicates spinal nerve inflammation, which occurs with conditions like a herniated disc, spinal stenosis, and spondylolisthesis. This is also known as neuropathic pain. 

Additionally, if back pain isn’t muscular, the problem could be bone-related. This is less likely than neuropathic pain but can occur if the patient has developed bone spurs, osteoarthritis, osteoporosis, cancer, or a bone infection. 

Muscular, neuropathic, and bone pain all require different back pain treatments. If your pain doesn’t go away with rest and at-home methods, your doctor can provide a diagnosis and treatment plan. 

Prevention Strategies for Back Pain

Prevention strategies for back pain include good posture, regular low-impact exercise, weight maintenance, stress management, and quitting smoking. 

• Maintaining good posture is one of the most crucial preventative measures for lower back pain. It keeps your spine in proper alignment and prevents excessive impact on your spine, a key contributor to spinal degeneration. 
• A low-impact exercise routine keeps you strong and mobile while increasing blood flow to the back, ensuring it receives ample oxygen and nutrients. Research shows that regular exercise can decrease recurring back pain episodes by nearly 50%.  
• Weight maintenance is key to back pain prevention, as excess weight increases the impact on your spine with every movement.  
• Stress can negatively affect back pain by increasing muscle tension and your sensitivity to pain. Proactively keeping your stress levels in check by taking regular breaks from work, journaling, meditating, exercising, and speaking with a therapist can help you avoid stress-related back pain. 
• Quitting smoking allows you to avoid nicotine’s negative impact on spinal health (and overall well-being).  

When Does Back Pain Require Surgery?

Many people suffer from back pain as a result of traumatic and degenerative spinal disorders. These spinal disorders, such as spinal stenosis and herniated disc, put pressure on nerves within or emanating from the spinal column. This pressure on the nerves – commonly referred to as a pinched nerve – causes pain and other problems associated with these conditions.

When pinched nerves do not resolve with conservative treatments, such as physical therapy or medications, spinal decompression surgery is an option to consider. This procedure can relieve pressure on spinal nerves and dramatically reduce the patient’s back pain.

In the past, spinal fusion back surgery was routinely performed in conjunction with spinal decompression surgery to stabilize the spine. It involves fusing adjacent vertebrae at the surgical site.

Alternatives to Spinal Fusion for Back Pain

Spinal fusion back surgery eliminates the independent motion of the fused vertebrae, potentially leading to reduced mobility. Thankfully, patients today no longer need to surrender spinal motion to benefit from decompression spinal surgery.

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The TOPS System from Premia Spine enables spinal decompression patients to maintain their natural range of spinal motion. Instead of fusing adjacent vertebrae during surgery, the surgeon implants the TOPS System and preserves pain-free flexion, extension, lateral bending, and axial rotation at each vertebra.

From simple conservative treatments to advanced surgical procedures, whatever the cause of your back pain, it’s comforting to know that effective treatments are available from qualified spine specialists.

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This spinal disorder can occur in the lower, or lumbar, region of the spine, which is known as lumbar spinal stenosis. Or, it may occur in the neck, or cervical, region of the spine, which is known as cervical spinal stenosis. Lumbar spinal stenosis is the most common form of this condition, and it’s the topic of our article. 

What is Lumbar Spinal Stenosis?

Spinal stenosis is a common condition, especially among patients who are aged 50 and over. It occurs when the spinal canal abnormally becomes narrower. The word “stenosis” can be traced back to ancient Greek and refers to narrowing, or constriction.

As the spinal canal progressively narrows over time, it strains the nerves that extend outward from the spine and travel into the extremities. This can cause a range of symptoms.

What Are Lumbar Spinal Stenosis Symptoms?

The symptoms of lumbar spinal stenosis can differ from patient to patient. However, pain, tingling, and numbness in the extremities are among the most common signs of this spinal disorder. 

Other symptoms of lumbar spinal stenosis may include:

• Numbness or tingling in a foot or leg
• Weakness in a foot or leg
• Pain or cramping in one or both legs
• Lower back pain

There might be other non-specific symptoms of spinal stenosis. So, please consult with your doctor for a precise diagnosis.

What Causes Lumbar Spinal Stenosis?

Most cases of spinal stenosis occur for unknown reasons. However, the causes of lumbar spinal stenosis are rooted in specific parts of the spine’s anatomy, such as: 

• The intervertebral discs

An intervertebral disc is located between each of the bones in the spine. It provides cushioning for the bone and prevents damage by absorbing impact. These discs break down with age and may even become herniated, meaning that the disc interior protrudes from a crack in the disc interior. 

A damaged intervertebral disc can take up extra space in the spinal canal, potentially leading to spinal stenosis. 

• The facet joints

The facet joints connect the vertebrae of the spine to one another. These joints support a large amount of weight and undergo a significant amount of stress. As a result, they’re vulnerable to wear and tear, as well as various injuries. Damage to the facet joints (and the cartilage within these joints) can trigger spinal stenosis.  

• The spinal cord

When the spinal cord and/or the nerve roots become compressed, it may trigger pain and neurological symptoms. When the spinal cord and nerve roots are involved in spinal stenosis, the patient is rarely asymptomatic. 

What is Inherited Spinal Stenosis?

The narrowing, or tightening, of the spinal canal, may result from abnormal bone and/or tissue growth. or due to a hereditary disorder. This is referred to as inherited spinal stenosis. 

Some people are born with a spinal canal that’s narrower than average. This can cause the patient to experience spinal stenosis symptoms much earlier in life than the average patient. Additionally, patients who are born with scoliosis may experience spinal stenosis.

Scoliosis is an atypical, sideways curve of the spine. It’s commonly recognized and diagnosed in children and adolescents. In patients with scoliosis, the curved spine may place stress on the spinal cord, potentially leading to spinal stenosis. 

What is Degenerative Spinal Stenosis?

Degenerative spinal stenosis refers to cases of this condition that are caused by wear and tear on the spine. This is the most common type of spinal stenosis. 

Spinal degeneration is a normal effect of aging. It occurs as the intervertebral discs and facet joints weaken from repeated strain over time. Factors including a sedentary lifestyle, poor posture, obesity, injuries, smoking, and other spinal disorders (such as scoliosis) can speed up the process of spinal degeneration.  

Effects of aging that can contribute to the development of degenerative spinal stenosis include:

• The cartilage in the facet joints gradually wears down, which increases friction in the spine and may cause bone spurs to form. 
• The intervertebral discs become drier, flatter, and weaker. The discs may become damaged, leading to a slipped or herniated disc. 
• As the cushioning in the spine from intervertebral discs decreases, the spinal cord and/or nerve roots can become strained. 

Leading a healthy lifestyle by exercising, eating a nutritious diet, and maintaining an optimal weight can help prevent spinal stenosis.

How to Prevent Lumbar Spinal Stenosis

To prevent lumbar spinal stenosis, you can implement an active lifestyle, use good posture, maintain a healthy weight, quit smoking, use proper lifting techniques, and limit high-impact activities. 

• Active lifestyle

An active lifestyle helps prevent lumbar spinal stenosis by preserving spinal mobility and enhancing back and core muscle strength. It also helps prevent excess impact on the lumbar spine from being sedentary. If you have a desk job, try to stand up and walk around at least once per hour, and exercise daily to keep up your physical fitness. 

• Good posture

Maintaining good posture is key to preventing spinal problems, as it keeps your weight distributed evenly across the spine. To practice proper posture, position your head above your shoulders and your shoulders above your hips. Maintain the natural curve of the lumbar spine. 

• Healthy weight

Remaining at a healthy weight for your height prevents lumbar spinal stenosis because extra pounds place extra impact on the spine. By losing weight, you can alleviate pressure on the lumbar spine while preventing systemic inflammation—a common complication of obesity. 

• Quit smoking

The nicotine in cigarettes constricts blood vessels, leading to restricted blood flow throughout the body. This makes you more susceptible to tissue degeneration over time. It also dampens your body’s ability to repair damaged tissue, which can accelerate the progression of spinal stenosis. Quitting smoking permanently is the best way to prevent these negative health effects and preserve your long-term spinal health. 

• Proper lifting techniques

Whether you’re an avid weightlifter or occasionally use free weights during your workouts, you need to use proper lifting techniques to prevent spinal stenosis. Lift by bending your legs at the knees and keep your back straight—never twist or round your spine. 

• Limit high-impact activities

Certain high-impact activities, including running and contact sports, place a high amount of impact on the spine. Try to limit these forms of exercise, especially if you have multiple risk factors for spinal stenosis. Low-impact alternatives include swimming, walking, water aerobics, and dance workouts. 

Lumbar Stenosis Pain Management Strategies

Lumbar stenosis pain management strategies include heat/cold therapy, stretches, massage therapy, acupuncture, and pain medications. We’ll discuss pain medications for spinal stenosis in a later section. 

• Heat/cold therapy

Heat therapy, either by using a heating pad or taking a warm bath, helps calm tight back muscles and improves blood flow to the spine. These benefits can help reduce pain from lumbar stenosis flare-ups. Cold therapy, on the other hand, brings down local inflammation and provides a temporary numbing effect, which can help manage pain in the short term. 

• Stretching

Stretching regularly (and gently) can help reduce lumbar stenosis pain by improving back mobility and reducing muscle tension. This can help curb painful spasms. Just make sure to avoid intense stretches that involve significant spinal twisting or bending. When in doubt, talk to a physical therapist about the best stretches for your case of lumbar stenosis. 

• Massage

Massage therapy is an effective pain management strategy for lumbar stenosis because it relaxes tight muscles, boosts circulation, and stimulates the release of pain-reducing neurotransmitters, like endorphins. In combination with other spinal stenosis treatments, like physical therapy and pain medications, it can help you effectively manage your symptoms without surgery.  

• Acupuncture

Acupuncture is an alternative remedy that’s commonly included in holistic treatment plans for lower back pain. It involves inserting tiny needles into particular points on the body (called acupuncture points) to reduce tension and restore bodily balance. It’s a natural option for patients struggling to achieve relief from conventional lumbar stenosis treatments. 

What Are The Best Treatments For Lumbar Spinal Stenosis?

Options for spinal stenosis treatment include:

• Spinal stenosis exercises

Various exercises can help with spinal stenosis by improving strength and mobility in the affected areas. You can perform these exercises at home to support your lumbar spinal stenosis recovery. 

Examples of spinal stenosis exercises include:

• Bridges

This exercise engages the glute muscles, which support the pelvis and can help reduce the strain on the lumbar spine. 

• Pelvic tilts

This simple exercise engages the transverse abdominis, which is a deep abdominal muscle that promotes proper spinal alignment and helps protect the lower spine. 

• Knee-to-chest exercise

This exercise stretches and helps relieve tension in the lower back muscles. It also flexes the spine, which relieves pain from spinal stenosis by temporarily creating more space in the spinal canal. 

• Physical therapy

Physical therapy may improve symptoms of lumbar spinal stenosis by relieving pressure on the spinal cord. For lumbar spinal stenosis, physical therapy typically involves stretches for the lower back, legs, and hips, as well as strengthening exercises for the abdominal muscles, which support the lower spine. Your physical therapist may work with you on mobility exercises to improve your range of motion in the lower back. 

Additionally, physical therapy may involve treatments that can help with pain, tension, and inflammation. These treatments include heat/cold therapy, electrostimulation, massage, etc. 

• Medication

Both over-the-counter and prescription medications may be used to reduce pain and inflammation from lumbar spinal stenosis. Talk to your doctor before starting a new medication for spinal stenosis symptoms in the lumbar spine.

Surgery For Lumbar Spinal Stenosis

In extreme cases, surgery for lumbar spinal stenosis may be recommended. Typically, doctors don’t recommend lumbar spinal stenosis surgery unless the patient has first undergone at least 6 months of conservative treatment. 

For lumbar spinal stenosis, spinal decompression surgery is often performed. This type of surgical procedure involves removing portions of the vertebrae that are impinging on the roots of nerves emanating from the spine. By relieving this pressure, the procedure gives patients symptom relief and provides the spinal nerves with enough space to heal. 

Laminectomy is the most common form of spinal decompression surgery for spinal stenosis of the lumbar region. In this procedure, the surgeon removes all or part of the lamina, which forms the ceiling of the spinal canal. Other types of spinal decompression surgery include foraminotomy and discectomy.   

Spinal Fusion in Lumbar Spinal Stenosis Surgery

Following the spinal decompression procedure, spinal fusion back surgery has traditionally been performed to stabilize the spine. Spinal fusion involves placing bone graft material in between the affected vertebrae. Over time, the bone graft will cause the vertebrae to permanently fuse.

Unfortunately, this stabilization procedure eliminates the independent motion of the fused vertebrae and can contribute to the deterioration of adjacent vertebrae. Patients can lose a significant amount of motion in the lower back after spinal fusion.

Alternatives to Spinal Fusion 

Spinal fusion alternatives, such as non-fusion implants, can offer stability without limiting the patient’s mobility after spinal stenosis surgery. The TOPS System, for example, provides an alternative to spinal fusion that maintains the spine’s natural range of motion. It’s been proven in clinical studies conducted worldwide to provide superior outcomes than spinal fusion following spinal decompression surgery. 

Patients seeking surgical relief for an abnormal narrowing of the spine now have access to a wider range of treatment options than ever. Talk to your doctor about the best course of treatment for your needs. 

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Lower back pain is among the most common medical problems affecting the human population. One reason this problem is so common is that back pain can have many different causes. So, if you’re wondering if there’s a cure for your lower back pain, the answer depends on what is causing it.

Muscle and ligament strains can cause intense back pain. Many times these strains can be cured with simple rest. Where rest alone won’t relieve the back pain, non-invasive treatments such as medications, steroidal injections, and physical therapy will often ameliorate the symptoms, if not provide an outright cure.

In this article, we’ll discuss key talking points surrounding a cure for lower back pain, including common treatment options, prevention, and when to seek professional care. 

What Is the Main Cause of Lower Back Pain?

The main cause of lower back pain is spinal degeneration, whether from osteoarthritis, degenerative spinal conditions, or age-related wear and tear. 

With age, the spine undergoes a variety of changes. The intervertebral discs become thinner and drier, spinal ligaments thicken, bone tissue weakens, cartilage breaks down, and spinal joints stiffen. Osteoarthritis (also known as wear and tear arthritis) can also develop, potentially causing bone spurs, stiffness, and spine. 

In addition to osteoarthritis, a variety of degenerative spinal conditions can cause lower back pain, including:

• Degenerative disc disease affects around 27% of all adults over age 65. This chronic condition occurs when the spinal discs break down, becoming thinner and drier. These discs are crucial for cushioning and shock absorption in the spine, so as they degenerate, you may experience back pain, tingling, numbness, or weakness. 
• Degenerative spinal stenosis develops when the spinal canal gradually narrows, typically due to thickened spinal ligaments, damaged spinal discs, or bone spurs. With less space around the spinal cord and nerves, spinal stenosis can lead to nerve impingement, back pain, and neurological issues. 
• Degenerative spondylolisthesis occurs when age-related spinal changes cause a vertebra to slip out of position, falling onto the vertebra beneath it. The misaligned vertebra can press on adjacent nerves, causing back pain and neurological symptoms. 

How to Avoid Lower Back Pain

You can avoid lower back pain by improving your posture, maintaining a healthy weight, remaining active, warming up your back before exercising, avoiding overlifting, and managing stress. 

• Improve your posture

Prioritizing good posture is one of the most important steps you can take toward lower back pain prevention. Proper posture keeps your spine in its natural alignment, preventing undue impact on the spinal discs and other structures. Especially if you sit at a desk for most of the work day, make sure to align your head over your shoulders and your shoulders over your hips while keeping the natural curve in your lumbar spine. 

• Maintain a healthy weight

Staying at a healthy weight provides countless health benefits, from preventing diabetes to improved heart health. It can also help you avoid lower back pain by alleviating excessive weight on your spine. By shedding extra pounds, you can reduce the impact on your spine when you sit, stand, and move throughout the day. 

• Remain active and warm up before exercise

Exercising regularly helps prevent lower back pain by strengthening your muscles, which improves support for the spine. It also boosts mobility and blood flow to the spine, encouraging your body’s tissue repair process. Just make sure to gently warm up your back before exercising to prevent strains and other injuries. 

• Avoid overlifting

Lifting more weight than you can handle or weightlifting with poor posture can lead to lower back pain. If you do add weightlifting to your workout routine, learn the correct posture for each exercise and start with small weights. If you have to lift heavy objects in a move, for example, use a dolly and enlist help when needed.  

• Manage stress

Did you know that stress can contribute to lower back pain by increasing inflammation and muscle tension. When you’re feeling stressed-out, you may also forget to maintain good posture, potentially leading to back pain and stiffness. 

How Do I Make My Lower Back Pain Go Away?

You can make your lower back pain go away by resting, applying a heating pad or cold pack, seeing a physical therapist, taking pain medication, or adjusting your lifestyle. 

These conservative treatments help make back pain go away by:

• Reducing inflammation
• Strengthening muscles that alleviate pressure from the spine
• Curbing pain signals sent from the lower back to the brain
• Addressing lifestyle factors that can worsen lower back pain, like smoking, nutrient deficiencies, and sitting for prolonged periods

At-home remedies are often sufficient to make mild to moderate lower back pain go away within a few weeks. However, if your lower back pain is severe or from a chronic condition, you’ll need professional medical care to achieve relief. 

How to Ease Lower Back Pain Fast?

You can ease lower back pain fast by using heat or cold therapy, stretching, taking pain medication, or getting a steroid injection.

Keep in mind that getting rid of lower back pain fast isn’t always the best way to alleviate it in the long-term. For example, while steroid injections can offer rapid pain relief, they don’t address the source of the pain. If these injections are overused, they can lead to tissue atrophy in the treatment area. 

If you’re struggling with lower back pain that doesn’t improve with a few weeks of rest and at-home remedies, the best option is to get checked out by a physician. Receiving a diagnosis and starting a professional treatment plan will address the root cause of your back pain, leading to a faster recovery. 

What Treatment Is Best for Lower Back Pain?

The best treatment for lower back pain depends on the source of your pain. 

For back sprains, strains, and other mild injuries, the best treatment is generally rest, cold therapy, heat therapy, and physical therapy. Medications may be needed in the short term for pain management. 

For degenerative spinal conditions and spinal nerve compression, the best conservative treatment is often a combination of physical therapy, pain medications, and lifestyle adjustments, like improving your diet and exercising regularly. If these remedies fail after several months, spinal decompression surgery may be considered. 

For spinal conditions such as spinal stenosis and related disorders of the spine – common causes of lower back pain, with onset typically after the age of 35 – non-invasive treatments may provide relief. In some cases decompression spinal surgery may be performed to relieve pressure on affected spinal nerves. During this surgery, a surgeon trims away portions of a vertebra that impinge on a nerve. (This impingement is commonly referred to as a pinched nerve). 

Spinal decompression surgery can have a dramatic and immediate impact on reducing back pain, providing patients with some level of a “cure.” Traditionally spinal fusion back surgery has been performed in conjunction with spinal decompression, to stabilize the vertebrae where the operation was performed. However, spinal fusion eliminates the natural flexion between the fused vertebrae and can contribute to the deterioration of adjacent vertebrae. Today, spinal decompression patients have a superior alternative to spinal fusion. The TOPS System from Premia Spine preserves the natural motion of the spine and has been proven to provide superior results to spinal fusion in clinical trials conducted worldwide.

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Can Lower Back Pain Ever Be Cured?

Lower back pain can be cured, in most cases, with prompt treatment. 

Early intervention is often the key to curing lower back pain. The sooner you receive treatment, the sooner you can start on the path to healing. If you wait to seek treatment, your condition may worsen and can even lead to lasting tissue damage, in some cases. 

If you experience lower back pain, the priority is to identify its cause. Whatever the root of the problem, you will likely have a number of options for effective treatment that will relieve the pain, and in many cases cure the condition.

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Medical terminology doesn’t go out of its way to be complicated or hard to understand. It’s simply that the language has to be very precise, and that much of it comes from Latin. Hence, it can be difficult to decipher some med-speak without a little help. Take the term “lumbar laminectomy,” a fairly common surgical procedure that can help alleviate the pain, mobility limitations, and other symptoms that often accompany medical conditions of the lower spine. Indeed, the word “lumbar” refers to the lower spine. The lumber portion of the spine comprises the lowest five vertebrae of the spinal column, which bear the designation L1 through L5 – “L” standing for lumbar.

Every vertebra in the spinal column is covered in a bony sheath called the lamina, which helps protect

the nerves that run through the spinal column. But sometimes, due to injury, disease, degenerative changes, or other causes, the lamina can put pressure on nerves emanating from the spinal column, a condition referred to as a pinched nerve. Problems within the vertebrae, such as an unnatural narrowing of the spinal canal, a condition called spinal stenosis, can also result in pinched nerves.

When surgery is performed to relieve pressure on a pinched spinal nerve, a procedure called spinal decompression, it requires cutting away the portion of the lamina that is impinging on a nerve or to gain access to the interior of the vertebrae to address a condition such as spinal stenosis. In medicine, the suffix “ectomy” refers to excision or removal. Thus, cutting away a portion of the lamina is a procedure called a laminectomy. So a lumbar laminectomy is an operation in which a portion of the lamina on one of the first five vertebrae is trimmed away. A lumbar laminectomy can achieve dramatic results in alleviating the symptoms of pinched nerves. Traditionally, spinal fusion back surgery was performed in concert with a laminectomy to stabilize the spine at the point of the operation. Now lumbar laminectomy patients have an alternative that provides better outcomes than spinal fusion surgery while preserving the full range of the spine’s motion: The TOPS (Total Posterior Spine) System procedure. If you’re a candidate for a lumbar laminectomy or other spinal decompression procedure, make sure you understand all your treatment options.

What is a Laminectomy 

Lumbar Laminectomy is a spinal surgery involving the removal of the vertebral bone to alleviate symptoms of spinal stenosis. Laminectomy surgery is relatively common for major surgery. Its main function is to reduce spinal pressure on the cord and nerve roots when they are being unnaturally restricted. This surgery is for those suffering from various ailments, including those sustained from past injuries, herniated disks, spinal stenosis, and tumors. While there are alternative methods to try before getting to this point, such as physical therapy, medication, and even injections, some may find this is the only path to relief.

While determining what is a laminectomy, we should deconstruct the name. Lamina is the scientific name for the vertebral bone. This surgery, Lumbar Laminectomy, is the process of removing the vertebral bone to lift pressure surrounding the spinal canal. Pressure is created by things like impacted bone injury, bone overgrowth, or growing tumors. A decompressive laminectomy increases available space and therefore alleviates any pain sufferers may be experiencing. While the surgery itself is great, so are the results. 

What is a Laminectomy? 

Lumbar laminectomy is a spinal surgery involving the removal of vertebral bone, called the lamina, to alleviate symptoms of spinal stenosis.

The lamina is a piece of bone that covers the back of the spinal canal. It protects the spinal cord and supports the canal as a whole. In removing some of all of it during a laminectomy, your surgeon can decompress impinged spinal nerves, offering relief from conditions like spinal stenosis.

Laminectomy surgery is a relatively common spinal decompression procedure. Its main function is to reduce spinal pressure on the cord and nerve roots when they’re impinged, compressed, or inflamed. This procedure is implemented for those suffering from various ailments, including those sustained from past injuries, herniated discs, spinal stenosis, and spinal tumors.

It’s worth noting that several non-invasive, alternative methods exist and are typically recommended before laminectomy. These include lifestyle changes, physical therapy, medication, and even steroid injections. However, after trying these remedies for several months to no avail, some may find that surgical laminectomy is the only path to relief.

When answering the question “what is a laminectomy?”, we should deconstruct the name. Lamina is the scientific name for the vertebral bone that covers the back of the spinal canal. This surgery, lumbar laminectomy, is the process of removing this vertebral bone to alleviate pressure within the spinal canal.

Pressure may be created by various factors, including an impacted bone injury, bone overgrowth, age-related spinal degeneration, or growing tumors. A decompressive laminectomy increases available space within the canal, therefore alleviating pain and neurological symptoms that you may be experiencing. While the surgery itself is well-documented and considered safe, the results are equally as compelling. 

According to a 2022 study, patients who underwent laminectomy for lumbar spinal stenosis experienced less disability and pain after the procedure. These patients were also able to be more physically active after laminectomy. The rate of reoperation in this study was 14%. 

Laminectomy and other spinal decompression procedures are conventionally performed with spinal fusion to restabilize the spine. However, modern innovations like the TOPS System can improve outcomes from spinal decompression by stabilizing the spine without permanently fusing the vertebrae. These remarkable advancements are available to today’s laminectomy patients, boosting treatment safety, satisfaction, and results. 

What is Spinal Stenosis

If you are considering spinal laminectomy you may likely be suffering from spinal stenosis. Spinal stenosis is one of the most common spinal ailments. Since stenosis means narrowing or restricting, this condition refers to the unnatural narrowing of the spinal canal. This condition often develops for unknown reasons but can be caused by an overgrowth of either bone or tissue. Some cases may be hereditary, while others arise from an unhealthy lifestyle. 

Options Before Surgery

Everyone can benefit from a healthy lifestyle, including those suffering from spinal stenosis or other spine stemming pain. Simple solutions like a healthy diet, regular exercise, and maintaining a healthy BMI can all reduce pain and symptoms. While these are idealistic options, they also are not the solution for everyone. It is possible that someone’s back pain is so great they are limited in the forms of exercise they can partake in.

Physical therapy is another noninvasive option that patients can try before getting a lumbar laminectomy surgery. Because most patients suffer from pain in their back and legs, it can be helpful to have a physical therapist to assist in teaching the body how to move through these debilitating pains in a way that can offer some relief. Physical therapy assigned exercises to have the ability to release pressure similar to surgery, though the effects are often not as long-lasting. 

Medication is also available to those suffering from inescapable pain. Some medications offered can help with both pain and inflammation so that those suffering from spinal stenosis are able to manage their symptoms throughout their day.

While these solutions can help manage and relieve pain, ultimately, they do not offer more stability to a destabilized spine, nor do they permanently create space in the spine where the pressure afflicts. In cases of long-term relief, most find that surgery is necessary to moving forward into a pain-free life.

Laminectomy Surgery

In deciding if surgery is right for you, it helps to know exactly what is to be expected during the procedure. A doctor uses general anesthesia to put the patient under for the duration of the surgery. In the process of the surgery, the surgeon makes a small cut into the back, right over the affected area. They then enter through this cut with small tools to lift the muscle away from the spinal column. The lamina is then removed to create space in the narrowed spinal canal.  In the case of a herniated disk, the doctor can then remove the parts of the disk that have herniated. 

Traditionally after this, the vertebrae would be fused to create stability in the spine to supplement the removed lamina. This is done with either bone graphs, screws, or metal rods. While efficient in rendering the spine functional post-operation, it does create limited mobility that can impede some physical activities.

How to Prepare for Laminectomy Surgery

Laminectomy Surgery is major surgery. Many are intimidated by spinal surgery because it is such a crucial part of our body and people often have a fear of how their life changes after. Here is how to prepare for optimal recovery.

• Consider your new mobility while you recover. With a limited range of motion, you should consider buying a pair of slip-on shoes to avoid bending down and straining.
• Ensure frequently used items are in easy-to-access spots. This may look like lowering things from high shelves as well as heightening objects that previously required bending over to reach them. Remember, this is temporary.  Once healed you should be able to reach all these things again without any pain or discomfort. 
• Do some meal prepping. The less work you have to do while recovering the quicker you heal. This also means you can rely less on others and be more self-sufficient in a time when you may feel dependent on others.
• Finally, on the day of the surgery, make sure you fast before going in. Like most surgeries that require general anesthesia, you are advised to stop eating and drinking by midnight the night before. Some water is allowed the morning of the surgery, but a full stomach can pose complications once you are under.

Laminectomy Recovery

Once you wake from the surgery your care team checks to ensure everything has gone smoothly and your body has responded well to the spinal laminectomy surgery. While a short hospital stay is typical, some people are released the same day. This means that no matter the case, the comforts of home are not too far away.

Upon returning home, rest! Though it is healing in the long run, your body has just sustained a major injury and needs time and care to recover. Give yourself grace and let people help with things like meals and keeping the house running. Letting yourself rest at this time is crucial for long-term recovery.

It is recommended that you do not work for the first few weeks following a decompressive laminectomy. Those with less physically demanding jobs return to work sooner than those with more labor-intensive jobs. If you have a spinal fusion laminectomy recovery takes longer.

How to Make Spinal Surgery Less Traumatic

The results of lumbar laminectomy, while impressive, may take a while to work. There are records of patients taking up to a full year to complete their laminectomy recovery. Those who do go through with the surgery are also sometimes recommended physical therapy as a part of their recovery process.  This leads to a long and involved path back to normalcy.

If you are looking for a way to make your laminectomy surgery and recovery less traumatic, consider a spinal implant. TOPS system uses an implant after decompression is completed to prevent the necessity for spinal fusion. Where traditionally vertebrae are fused after laminectomy surgery, TOPS implants hold the space where the vertebrae were removed, combining the relief of the surgery with all the mobility and freedom you had before. 

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Patients who have had a TOPS System implant report faster and easier laminectomy recoveries than those who received traditional spinal fusions. Because the spine is the foundation of the human body it is important you take the path offering the greatest recovery and mobility post-surgery. Does this look like a spine that has been fused together, or upgraded with an implant?

Life After Laminectomy

While it is a big decision to make, ultimately it comes down to regaining your life. Those who have spinal laminectomy are choosing a life free of debilitating pain and getting back the body they once knew. Lumbar laminectomy patients are often happier and healthier, having chosen the care right for them.

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While scoliosis can develop with no apparent cause, it can also form as a result of age-related spinal degeneration. Although wear and tear on the spine is inevitable with age, it can diminish elderly individuals’ quality of life. 

Here, we’ll discuss scoliosis, its impact on the elderly, and how scoliosis treatment with the innovative TOPS spinal implant can provide symptom relief. 

What is Scoliosis?

Scoliosis refers to an atypical sideways curvature of the spine. Usually, scoliosis appears in childhood or during adolescence.  

The normal curvature of the spine is an S-shape when it’s seen from the side. With this curve, the neck (cervical spine) has a small forward curve, the upper/middle part of the back (thoracic spine) has an outward curve, and the lower back (lumbar spine) has an inward curve. 

From the back, a spine with a normal curvature is straight. The vertebra, which are the bones of the spine, are stacked on top of each other. With scoliosis, some of the vertebrae curve sideways.  

How is Scoliosis Diagnosed?

Most often, scoliosis is diagnosed in patients when they are aged between 10 and 15. Early diagnosis of this condition is ideal, as it allows physicians to implement scoliosis treatments while the body is still developing. In fact, with early intervention, it’s often possible to limit the progression of the abnormal spinal curve.  

With that said, not all cases of scoliosis are diagnosed at a young age. Cases that are seen in adulthood can vary in cause. 

What Causes Scoliosis in The Elderly?

Idiopathic Scoliosis

When scoliosis is idiopathic, it means that there’s no apparent cause for the abnormal spinal curve. This is the same type of scoliosis that’s often found in teenagers. Idiopathic scoliosis can begin during adolescence, but not cause symptoms until the patient is an adult. 

In cases of idiopathic scoliosis, if the spinal curve is significant, it can become more severe over time. This can lead to adverse symptoms in adulthood.

However, cases of idiopathic scoliosis that don’t worsen can still lead to pain and other symptoms in adulthood. This is because the spinal asymmetry can gradually damage the patient’s spinal discs, muscles, and joints. 

Degenerative Scoliosis

Degenerative scoliosis, which is also called adult-onset scoliosis, occurs as a result of spinal degeneration. With this type of scoliosis, the spinal wear and tear that naturally occurs with aging causes the spine to curve sideways.

Many cases of adult scoliosis are at least in part impacted by spinal degeneration. It triggers symmetry in the spine that gradually becomes worse as the patient ages. As degenerative scoliosis progresses, the facet joints and intervertebral discs that support the spine continually break down. 

Degenerative scoliosis can be asymptomatic, especially in its early stages. However, if it does cause symptoms, patients may experience:

• A dull ache in the back
• Sciatica, which is pain that radiates from the lower back down one (or both) legs
• Back pain that’s exacerbating by standing for prolonged periods and gets better with rest

Traumatic Scoliosis

Traumatic scoliosis is a type of scoliosis that occurs after the spine is subject to a trauma, such as a car accident. The sudden trauma can create fractures in the spine, which may compromise spinal strength and alignment. This can result in scoliosis. 

Scoliosis in The Elderly

While scoliosis is commonly thought to primarily affect teenagers, it has a large impact on the elderly. 

In a study that measured the prevalence of scoliosis in adults between the ages of 60 and 90, 68% were found to have scoliosis. 

Symptoms of adult scoliosis can be disabling, especially for elderly individuals. Examples of symptoms of severe scoliosis in the elderly include:

• Fatigue
• Shortness of breath
• Difficulty walking
• Difficulty standing straight
• Having the sensation of being full very soon while eating
• Bone spurs

Ultimately, scoliosis in the elderly can lead to reduced mobility, difficulty completing daily tasks, and chronic pain. Older adults with scoliosis may no longer be able to participate in activities that they used to enjoy. 

A variety of treatment options can be implemented to help reduce the impact of scoliosis on an elderly patient’s day-to-day life. Physicians generally begin with non-surgical treatments, such as physical therapy and lifestyle modifications.

Exercises For Scoliosis in The Elderly

Targeted exercise for scoliosis in the elderly can help improve spinal flexibility and alignment. Examples of exercises that you can try include:

• Pelvic tilts

Lie on your back and bend your knees so that the soles of your feet lie flat on the ground. Contract your abdomen so that your pelvis tilts up to the ceiling, with your lower back flat against the ground. Hold it for 20 seconds, release, and repeat. 

• Latissimus dorsi stretch

This stretch can support the lat muscles, which often become tense in patients with scoliosis. Stand up straight and place your hands above your head. Begin to bend at one side of your body, leaning gently until you feel a stretch along your side. Hold for 10 seconds, return to the original position, and repeat to the other side. 

• Child’s pose

This yoga posture can help release tension in the back. Kneel on the floor, placing a blanket beneath your knees and shins if needed. Move your hips towards your heels, reach your arms forward, and place your hands flat on the floor. Breathe and relax in the stretch. 

If non-surgical scoliosis treatment methods fail after several months, consider spinal surgery to improve scoliosis symptoms. 

Spinal Surgery For Severe Scoliosis in The Elderly

For cases of degenerative scoliosis in the elderly, spinal decompression surgery is a viable treatment option.

Decompression surgery involves removing a portion of a spinal bone (vertebra) along with other spinal tissues, if needed. This relieves pain and sciatica symptoms caused by nerve compression. 

By creating more space in the spinal canal, decompression surgery is often a successful treatment for degenerative scoliosis. It encourages the healing of damaged tissues while relieving pressure on nearby nerves. 

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However, after decompression surgery, there’s a risk of spinal instability. So, this scoliosis treatment is generally paired with spinal fusion to restore spinal stability. The TOPS System is a spinal fusion alternative that can stabilize the spine without many of the downsides associated with fusion. 

Spinal Fusion in Scoliosis Surgery

Spinal fusion is commonly completed at the same time as spinal decompression. It involves placing bone graft material in between two vertebrae in the treatment area. After the procedure, the bone graft will gradually cause the vertebrae to fuse into one bone. 

By fusing the vertebrae, spinal fusion prevents spinal instability. However, it also prevents motion in the fused portion of the spine. Especially in elderly individuals, spinal fusion can diminish mobility and hold you back from participating in various activities. 

Additionally, the healing process for spinal fusion requires the bone to heal. This makes for a lengthy, often painful recovery. 

Spinal Implants

TOPS is a spinal arthroplasty system that replaces the spinal tissues that are removed during decompression surgery. Unlike spinal fusion, this mechanical implant device preserves the motion of the spine while preventing spinal instability. 

After spinal decompression is performed, a surgeon can place the TOPS spinal implant into the targeted area. This system is designed for use between the segments L2 and L5 of the lumbar spine. Once implanted, the TOPS device controls the motion of the spine without inhibiting its flexibility. 

Patients who undergo spinal decompression with the TOPS System for degenerative scoliosis can bend and twist the spine soon after the procedure. Additionally, the recovery process for decompression surgery with TOPS is much shorter than that of spinal fusion. 

To learn more about the TOPS System in spinal decompression surgery for scoliosis treatment, contract Premia Spine today. 

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Although it’s not as common as spinal stenosis or a herniated disc, spondylolysis is near the top of the list of conditions that can cause lower back pain. This spinal condition is relatively common, affecting approximately one out of 20 people. You may also hear it referred to as a stress fracture or pars defect.  

Learning about spondylolysis can help you better understand the factors that could be behind your back pain. In this article, we’ll provide a detailed overview of spondylolysis, including modern treatment options for this condition.  

What is Spondylolysis?

Spondylolysis is a stress fracture in a vertebra, which is a bone in the spinal column. The fracture occurs at the point where the vertebra connects to the vertebra above it, known as the pars interarticularis.

The pars interarticularis is a thin piece of bone that links the upper and lower segments of the facet joints. It connects the vertebrae and facilitates the movement of the spine. 

The fracture in the pars interarticularis can allow a vertebra to move out of its usual position and press against, or compress, the spinal cord. This condition is called spondylolisthesis. Spondylolisthesis can cause several symptoms, with lower back pain being the most common.

Spondylolysis isn’t rare, affecting an estimated 3% to 7% of Americans. Many of the patients who are diagnosed with spondylolysis are younger than traditional spinal patients. In fact, in one orthopedic series, spondylolysis accounted for 47% of cases of acute lower back pain in teen athletes.

What Causes Spondylolysis?

Spondylolysis is rooted in a weakness in the pars interarticularis. The exact cause of a weakness in the pars interarticularis isn’t known. 

With that said, factors that can influence the weakness in the vertebrae that characterizes spondylolysis include:

• A genetic defect

Genetics are believed to play a role in some cases of spondylolysis. Some children are born with this spinal condition. 

• Overuse

Repetitive spinal trauma may also lead to spinal trauma. This commonly occurs in young athletes who frequently stress the spine. In two prospective studies, the incidence of lower back pain in athletes with spondylolysis was 72.5 % in high school rugby players, 80.5% in college football players, and 79.8% in high school football players.  

Symptoms of Spondylolysis

The good news is that many people with spondylolysis remain asymptomatic. Asymptomatic patients have no symptoms and are usually unaware they even have spondylolysis.

When the spondylolysis does cause lower back pain, it usually spreads across the lower back. Spondylolysis pain often feels like a muscle strain and is generally exacerbated by exercise or vigorous activities.

In adolescent patients, spondylolysis symptoms often appear during growth spurts. This makes the most common age of diagnosis for teenage patients with spondylolysis 15 to 16. 

Comparing Spondylolysis to Related Conditions

Spondylosis vs Spondylolysis

Spondylosis and spondylolysis are often confused, and it’s easy to see why. The names of these spinal conditions are very similar. But, each is a distinct ailment with different causes and symptoms. 

The spondylosis diagnosis is used for degenerative osteoarthritis of the spine. With this condition, the cartilage that protects the ends of the vertebrae breaks down. As a result, the space between the vertebrae shrinks. 

Spondylosis may also involve age-related degeneration of the spinal discs and bone spurs. This condition differs from spondylolysis, which specifically involves a stress fracture in the pars interarticularis. 

Spondylolisthesis vs Spondylolysis

We’ve already mentioned spondylolisthesis and how it can result from spinal instability caused by spondylolysis. Similar to spondylosis, spondylolisthesis is commonly confused with spondylolysis. Additionally, spondylolysis can often cause spondylolisthesis, which further adds to the confusion. 

Ultimately, spondylolisthesis involves vertebral misalignment due to spinal instability, while spondylolysis is a stress fracture of the pars interarticularis. 

How is Spondylolysis Treated?

Most cases of lumbar spondylolysis are resolved with non-surgical treatment methods. Non-surgical spondylolysis treatment often involves lifestyle modifications, medications, and physical therapy. 

Spondylolysis is a common injury in young athletes, namely those who are involved in sports that involve spinal hyperextension. So, physicians generally recommend that spondylolysis patients take a break from sports to give the spine time to heal.  

Simple over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can often relieve mild spondylolysis symptoms.

Spondylolysis Physical Therapy

Physical therapy is one of the most effective non-invasive treatment options for spondylolysis. Your physical therapist can help you regain a high quality of life and safely go back to your usual activities. 

The goals of physical therapy for spondylolysis are to:

• Help you manage lower back pain with methods including heat/ice therapy, electrical stimulation, and physical manipulation. 
• Help you adopt lifestyle changes that will benefit your recovery process. These changes may include losing excess weight, starting a new exercise routine, and improving your posture. 
• Improve and correct your body mechanics to prevent pain with day-to-day activities. 
• Teach you stretching and strengthening exercises. These exercises can bolster the muscles that support the spine and alleviate muscle tension. 

Spondylolysis Exercises to Avoid

In general, patients with spondylolysis should try to avoid all high-impact activities, such as running, as well as activities that put added stress on the lower spine. Heavy lifting, football, diving, and competitive swimming can all strain the lower spine.

With spondylolysis exercises to avoid in mind, it’s important to stay active with spondylolysis. Physical activity improves blood flow to the damaged and irritated spinal tissues, which facilitates the healing process. Additionally, gentle exercise will help you maintain muscle strength and mobility throughout your recovery. 

Is It Possible To Prevent Spondylolysis?

Many patients, especially young athletes, are eager to avoid spending time on the bench due to spondylolysis. While genetic factors that may make you more susceptible to spondylolysis can’t be altered, certain tactics may help you prevent this spinal condition.

First off, consider a sports injury prevention program, which may be available from your local physical therapist. This type of program focuses on safely building muscle strength and increasing flexibility. Together, strength and flexibility can help prevent excess strain on the spine.

Additionally, avoiding repetitive motions that strain the back can help prevent lumbar spondylolysis. Unfortunately, this may not be possible in specific sports, such as gymnastics and weightlifting. Athletes who are predisposed to spondylolysis should consider talking to their coaches about their unique needs.

As a general rule of thumb, practicing proper posture can help avert spondylolysis and a host of other spinal conditions. Try to be mindful of your posture while you sit, stand, and lift heavy objects. Keeping your spine straight with your shoulders back and head levels allows for proper spinal alignment. 

Treatment For Severe Spondylolysis

In moderate to severe spondylolysis cases that don’t respond to conservative treatments, spondylolysis surgery may be required. There are a few different surgical approaches that your physician may recommend.

Surgical Repair

Surgery may be implemented to repair the spinal stress fracture. During this type of procedure, the surgeon will likely use a titanium screw to secure either side of the fracture together. For additional support, your surgeon may also place bone graft material in the affected area. 

Spinal Decompression

Patients with spondylolysis and nerve compression from spondylolisthesis may benefit from spinal decompression surgery. Spinal decompression involves removing a portion of the defective vertebra that’s compressing the spinal nerve.

Typically, spinal fusion surgery is performed following the decompression procedure to stabilize the spine. Spinal fusion involves placing bone graft material in between the affected vertebrae. This process, over several months, permanently fuses the targeted vertebrae. 

Unfortunately, while spinal fusion can successfully prevent spinal instability after decompression surgery, it also eradicates the independent motion of the vertebrae. This leaves patients’ mobility seriously compromised and increases the risk of degeneration in the neighboring vertebrae. 

With these downsides (among others) in mind, many modern spondylolysis patients look for spinal fusion alternatives. Recently, an advanced alternative to spinal fusion, the TOPS posterior arthroplasty procedure, has gained prevalent in the United States. Having been approved and successfully used for years in Europe and other countries, the TOPS System provides better clinical outcomes than fusion while preserving the patient’s full range of back motion.

Back pain is one of the world’s most common and debilitating medical conditions. As pioneers of advanced surgical treatments for spinal disorders, we at Premia Spine encourage anyone suffering from back pain, including spondylolysis pain, to learn about all the treatment options available today.

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