Ever have that nagging pain in your lower back when you crawl out of bed in the morning? How about when you get up from your chair at work? That discomfort can be more than just a sign that the years are catching up with you. In fact, lower back pain affects four out of five people, according to the American Academy of Orthopaedic Surgeons. Pain can result from a strain or sports injury, from carrying around extra weight, or from lifting a heavy object; but in some cases, a disc may be the culprit.
Discs are soft, rubbery shock absorbers between the hard bones (vertebrae) in the spine that allow the back to bend. Ninety percent of the time, the pain will subside with nonsurgical solutions such as rest, pain relievers, muscle relaxers, cold or hot compresses, or, in some tougher cases, epidural injections.
But persistent pain, leg weakness, tingling, loss of bladder control, or a burning pain in the shoulders, neck, or arm is your body’s way of telling you that it’s time to see an orthopedic surgeon. Doctors can get the inside view of your disc or degenerative spine changes via a spinal X-ray, magnetic resonance imaging (MRI), or computed tomography (CT) scan. Back pain can be caused by sciatica or pressure on the spinal nerve, resulting in a shooting pain from the buttocks down the side of the leg, or a herniated or ruptured disc that is putting pressure on the nerves.
When nonsurgical alternatives don’t alleviate the pain, surgery comes into play. Patients with back pain between the ages of 30 and 60 may be experiencing a “slipped disc,” also known as spondylitis or degenerative disc disease. In some cases, the cartilage has rubbed away, causing the vertebrae to rub together.
Several different surgical options are available. The traditional 360-degree spinal fusion requires an abdominal incision and movement of blood vessels to get to the disc, which is removed through the front of the patient. After the first part of the operation, the patient is turned over and another incision is made in the back, allowing the surgeon to remove the muscle from the bone. An alternative type of surgery, the TLIF, only needs the back incision. However, there are risks to both.
An innovative, minimally invasive surgery available at Azalea Orthopedics is the XLIF (extreme lateral interbody fusion) procedure. “The XLIF procedure is designed for people who need spinal fusion,” said Michael E. Russell II, MD, an orthopedic surgeon with Azalea Orthopedics who specializes in the treatment of spine injury, deformity, and degeneration. During the XLIF surgery, Dr. Russell accesses the spine through two small incisions in the patient’s side. “I use dilatators to tunnel through the muscles; but I don’t cut them, and there’s no scraping muscle from the bone,” he said. “Smart” probes used during the procedure direct him away from the nerves. The doctor fills the newly opened disc space with a small spacer filled with a bone regenerative protein and fastens it in place with surgical screws.
The XLIF procedure results in less postoperative pain, reduced blood loss, smaller incision scars, faster recovery, and a shorter hospital stay. “Patients have 24 to 48 hours less in the hospital after surgery and are up and walking right away,” Dr. Russell said. “In one or two weeks, they can be back to work, depending on what they do for a living.”
Surgeons today are doing all they can so that patients can have equal or superior results with smaller incisions, causing the least amount of distress to the body. Doing this lets patients get back to living life. “With so many new technologies on the horizon,” Dr. Russell said, “minimally invasive techniques are truly the wave of the future.”
Before you hop out of bed ...
Give your back a break with these morning exercises to help stretch your back and decompress your discs
Put a flat pillow or towel under your chest, which will allow your head and neck to relax down toward the bed. You could also turn your head to the side. If you need support for your low back, place a pillow under your abdomen.
Lengthen the spine
Similar to the yoga pose Cobra, lie on your stomach with your feet extended. Gently raise your upper body, keeping your arms from your hands to your elbows flat on the bed.
healing... no ifs, ands, or butts
Smoking can damage tissues in the lower back by slowing down circulation and reducing the flow of nutrients to joints and muscles, causing lower back pain. In a study of people with broken legs, complete healing took an average of 269 days in smokers, as compared to 136 days in nonsmokers. Nicotine plays a significant role in lack of oxygen to the tissues, interfering with healing of bone graft surgery such as a spinal fusion. Smokers are more prone to injuries such as sprains, strains, tendonitis, bursitis, and fractures.