SPINE CARE

 

Your back has three natural curves, forming an S shape. The cervical curve is made up of the first seven bones, or vertebrae, in your neck and back. The middle of your back is called the thoracic curve, while the lower back is the lumbosacral curve. Below the lumbar vertebrae are five more vertebrae which are fused together called the sacrum. The coccyx is the very bottom structure of the bony part of your spine. It is made of three to five small vertebrae attached to the bottom of your sacrum; the end of your coccyx is sometimes called your tailbone.

Ligaments are strong bands of fibrous tissue that knit your spine together. These ligaments contain pain fibers, and connect the functional units of your spine together. They help control the motion of your spine while providing flexibility.

The sacroiliac joints attach the sacrum to the iliac, or hip bones. The hip bones are also attached to the sacrum by a number of ligaments on either side.

BACK PAIN:

Back pain has physical, mental, and emotional factors. The wide variety of potential causes for back pain can present this pain and discomfort in several different ways, all of which affect your quality of life by limiting your ability or taking away the pleasure when pain accompanies the things you enjoy doing.

Some common causes of back pain are:

• Back sprain and muscle spasms
• Mental stress
• Poor posture
• Arthritis
• Disc Protrusion

SYMPTOMS:

A general back problem or spinal condition can include many different symptoms: Throbbing, aching, shooting, stabbing, dull, or sharp pain; pain down one or both legs with very little pain in the lower back; numbness or weakness in the legs; pain down in the lower back and legs in certain positions such as standing or walking; sleep problems, decreased energy, depression and anxiety; or pain that stress and emotional issues causes or makes worse.

TREATMENT:

In general, the goal of treatment for back pain is simple: To improve the pain symptoms, prevent further injury, and get you back into your life and the activities you enjoy. While specific circumstances will dictate treatment, following an examination, we generally recommend that those experiencing back pain modify their activity for a given period of time and may recommend medication to decrease pain and inflammation. However, complete inactivity such as bed rest is not advised.

Once the pain is eased, your physician may recommend some form of rehabilitative exercise program with the goals of increasing your muscle strength, endurance, flexibility, and aerobic fitness to improve your spinal health and limit future episodes of back pain.

Spinal fusion: Traditional vs. Modern Approach

Traditionally, surgeons have performed spinal fusion as an open procedure, which involves making an incision, stripping bands of muscle and retracting muscle and tissue for a clear view of the spine and easy access to the vertebrae for implantation.

Traditionally, autograft has been “the gold standard” in graft material. However, removal of the bone – usually from the patient’s pelvis or iliac crest – can be very painful. Allograft does not require this extra procedure, but healing often is not as predictable as with the patient’s own bone. BMP, a genetically produced protein, prompts the patient’s own bone cells to make more bone.

Modern spinal fusion can employ less invasive surgical techniques, such as muscle dilation, making the highly invasive posterior fusion approach unnecessary in many cases.

Muscle dilation is achieved by using a series of sequential dilators, or tubes to separate the fibers of the back muscles and create a small tunnel, enabling the surgeon to view the spine through an incision less than an inch long and leaving the muscle virtually intact. Advances in instrumentation allow rods and screws to be inserted via tiny incisions in the skin.

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