Lumbar
Spine Surgery: When Conservative Treatments Fail
A
persistent ache in the lower back. Shooting pains down the legs. Muscles so
tight you can't even stand up straight. For the more than 65 million Americans
who suffer from low back pain every year, the symptoms come in different forms,
but the problem is frequently the same: a nerve root near the spine is
irritated.
Approximately, 75 to 85 percent of all people will experience some form of back pain during their lifetime. Back pain is the second most frequently reported reason for visiting a doctor, the fifth most frequent cause of hospitalization and the third most frequent reason for surgery.
The
good news is that not everyone with back pain requires spine surgery.
Often with the use of conservative treatments, such as, medications, bed rest,
heat, message, ultrasonic therapy and physical therapy, back pain in the acute
phase can be controlled. Lifestyle
changes, such as, weight loss, exercise, and good body mechanics can result in
long term relief.
If,
however, the back pain persists and symptoms begin to radiate into the legs then
this may indicate a nerve being irritated or sometimes referred to as “pinched
nerve”. This condition may also
be relieved with conservative treatments but if the symptoms persist and are
associated with signs such as weakness, walking problems numbness/tingling or
difficulty with bladder or bowel function then an evaluation of the spine is
required.
Most
often a MRI (magnetic resonance imaging) is required. Other tests may include a CTS, plain spine X-rays, or
electrical studies such as EMG. Once the conservative treatments have been
exhausted and tests have been completed, a neurosurgeon can discuss your
options. If the testing does not
reveal a surgical cause of your problem then other non-surgical treatments will
be offered.
Pain
therapy is now a subspecialty and often Pain clinics offer a full scope of
treatments for persistent (non-surgery) pain.
These clinics have experts in biofeedback, steroid injection, and other
non-surgical treatments. Occasional
external and/or implantable spinal stimulators are use to override the pain
impulses. And pumps can be
implanted to give mini-doses of pain medication to relieve the pain.
If surgery is required, you will be instructed as to all your options and what the surgery will be. Today, we have many different surgical options to specifically meet your needs. The next sections will review these types of operations.
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© 2008 Tri-State Neurosurgical Associates - UPMC
Last Updated: January 1, 2008