Easing Chronic Lower Back Pain with Spondylolisthesis Surgery

Patients come to the Spine Institute Northwest to see Dr. Solomon Kamson every day complaining of lower back pain, and it is up to him to accurately diagnose and treat the problem. One cause of lower back pain is spondylolisthesis, a condition where one of the vertebrae slips onto the vertebrae below it. The slipped bone will often press on a nerve, causing severe pain the back and hamstrings. There are five major types of spondylolisthesis: dysplastic, isthmic, degenerative, traumatic, and pathologic. Once it is diagnosed, spondylolisthesis surgery can be performed to correct the problem and ease the persistent pain.

Diagnosing Spondylolisthesis
The symptoms of spondylolisthesis cannot be seen on the outside of the body, so the physician must do a thorough physical examination to see if the symptoms match the condition. He then orders tests like an x-ray, MRI, and a CT scan to get a view from the inside. The x-ray will show if the bone is out of place. The MRI or CT scans are needed to show which bones and nerves are affected.

Treating Spondylolisthesis
After the doctor diagnoses the problem, a treatment plan is developed. In less severe cases, rest, NSAIDs, prescription pain medication, steroid injections, and physical therapy are the initial course of treatment. A back brace is another option to help stabilize the spine. If these treatments fail or the case is extremely severe, then the surgeon might recommend surgery to ease the pain.

Spondylolisthesis Surgery
The main goals of performing surgery for this condition are to ease the pain from the compressed nerve, stabilize the spine, and restore the patient’s ability to function normally. There are two types of surgery performed to help correct the symptoms of spondylolisthesis, and the surgery performed depends on which of the five types of the problem the patient suffers from.

A decompressive laminectomy is a procedure that involves removing part of the bone that is compressing the nerve. The surgeon will open up the spinal canal, giving the nerves more room to breathe. This is often followed by a spinal fusion to stabilize the area where part of the bone was removed.

When the patient has isthmic spondylolisthesis, a spinal fusion is performed. Surgery is only considered when the patient has tried other methods of non-surgical treatment with no success for at least six months. Surgeons use an anterior approach, going in through the abdomen to get the best access to the disc space. Part of the bone is removed and replaced with a bone graft. The bones are then fused together using metal rods, screws, and hooks.

The outlook for patients who have spondylolisthesis surgery is good because the laminectomy and fusion relieve the pressure on the nerve roots, easing the back pain. When nonsurgical treatments fail, patients still have hope for a pain-free life from surgery. The first step is to see a spine specialist and get the problem accurately diagnosed.

The Risks and Benefits of Cervical Spine Fusion

If you are experiencing chronic neck pain due to injury or the wear and tear that comes with aging, your condition may require surgery to ease or eliminate the discomfort. Cervical spine fusion, also known as arthrodesis, is a procedure in which bones in the neck are fused together to prevent the painful rubbing together that is typically causing the pain.

The cervical spine consists of seven bones known as the C1-C7 vertebrae. These vertebrae are separated by intervertebral discs, which serve as shock absorbers and help the spine move without much restriction. When these discs start to wear away due to age or injury, the bones can start to rub together, causing neck pain. Fusion is frequently performed at this point to eliminate the painful movement segment in the neck and allow the patient to live more comfortably.

In this minimally invasive procedure, the surgeon makes a small incision, usually at the back of the neck, in order to see the affected area. A bone segment is then inserted where the disc has worn away and the vertebrae are coming into painful contact. Once the bone graft is put in place, the area is “fused” together to prevent the piece of bone from moving. This also allows the graft to grow naturally, forming one solid piece of bone, which then eliminates the original problem. The fusion is performed using metal rods and screws to hold the vertebrae and bone segment together.

In the past, most fusions were performed using bone grafts taken from the patient’s hip, but that involved more incisions and pain. There are several other options available now. One option is to insert a metal implant. There are also other manmade materials that are very much like actual bone that can be used to serve the same purpose. In severe cases though, it may be necessary to remove a vertebra or spinal disc and then fuse the surrounding vertebrae together.

At first glance, it could seem that patients who go through this procedure would be expected to suffer from very limited neck movement after the surgery, but this is not typically the case. Most patients are able to move their necks more or less freely after going through recovery and physical therapy. There are risks involved, however, including implant breakage, continued pain, blood clots, spinal cord injury, infection, and bleeding.

When deciding if this surgery is the right option for you, speak to your surgeon, and make sure you have explored all other options. A qualified spine specialist like Dr. Solomon Kamson of the Spine Institute Northwest can help provide advice that comes from experience. Find out what type of implant your surgeon prefers to use and how long he or she expects your recovery to take. Since there are serious risks involved, it is important to know all of your choices before deciding if a cervical spine fusion is right for you. After you weigh all of your options, you may find this surgery to be the solution that will help you live a more active life with less pain.

Easing the Effects of Scoliosis

Scoliosis can be one of the most disfiguring and disabling back problems that spine specialists treat. The fact that the spine curves abnormally can cause trouble with standing, walking, and living an active lifestyle. Luckily, there are treatment options available to help patients recover or live with less pain from this condition. Dr. Solomon Kamson and the surgeons at the Spine Institute Northwest have the specialized training necessary to help patients with scoliosis deal with the condition.

What is Scoliosis?
Scoliosis is a condition where the spine is curved to the side; this is known as a lateral curve. Most people with scoliosis are born with it, but the majority of them do not have a curve that is severe enough to require surgery. Children between the ages of 10 and 16 often suffer from idiopathic scoliosis, which is most likely inherited from a parent. It is believed to only progress during the years when a child has a major change in growth and then stops when they reach adulthood.

Scoliosis is often detected during a routine physical exam at school or by a family doctor. The patient is then referred to a specialist like Dr. Kamson. Signs that the condition may be present include a shoulder blade that sticks out too far, uneven shoulders, or the observation that a child leans to one side.

Other, less common types of scoliosis exist. The neuromuscular type is present in people with cerebral palsy or spina bifida because they have abnormal muscles resulting in paralysis. Degenerative scoliosis is caused by an injury, osteoporosis, or failed back surgery.

Treatments for Scoliosis
The most common type of treatment for scoliosis is having the patient wear a brace, especially for adolescents with curves between 25 and 40 degrees. They are monitored with x-rays every few months to see how well the brace is working. The brace works best on patients whose bones are still maturing.

When curves go beyond 40 degrees, most patients are candidates for spine surgery to correct the curve. This is done with a spinal fusion where a bone graft is placed between vertebrae to create a fused bone that will heal into a straight line. The physician may also place rods and screws to hold the bones in place while the graft allows to bones to fuse. Unfortunately, the surgery does not completely straighten the spine, but it does prevent it from curving any further.

Recovering from Spine Surgery

Once you are through with your spine procedure, it is time for you to recover. During recovery, your body will start to repair the tissue. Even though the minimally invasive spine surgeries performed by Dr. Solomon Kamson at the Spine Institute Northwest tend to have much shorter recovery times than traditional back surgeries, it still takes time for the body to completely repair itself.

Be Patient 
Solomon Kamson, MD, will provide you with the proper information that you will need to optimize your recovery. It is essential to follow the instructions you were given during and after the surgery. Keep in mind that, although you would like to get back to normal as soon as possible, for a quicker recovery time you need to take it easy during the time you are required to follow your doctor’s instructions. It is also important to realize that recovery time is different from patient to patient.

Emotional Repercussions
Recovery may take a toll on the patient’s mental stability. It can bring on bouts of aggravation, helplessness, and other negative feelings. The patient can become moody, and at times it can cause emotional distress for the family and friends around them. This is to be expected. Temporary anxiety or mild depression is often brought on due to being incapacitated, and a helpless feeling can be brought on by having to rely on others to do basic tasks. It is not the patient or family’s fault; however, planning ahead will help reduce the emotional difficulties for both parties.

Pain Management after Surgery
It is completely normal to endure pain after surgery. Every person who undergoes surgery must expect recovery time and some pain. There are many patients who report pain and aches that run down the backs of their legs. They may even experience muscle spasms that go across the back and the backs of the legs, as well. Your doctor will prescribe medicine to help reduce any pain and discomfort the patient will have to tolerate during the recovery time. It is important to take the medicine at the times required. Keeping the pain away is easier for the individual if no pain medicine is skipped. Keep in mind that you may feel like you are recovering faster, which means less pain. However, if you skip taking your pain pills, the pain may come back and become more intense.

Recovering at Home
The recommendations that the Spine Institute Northwest provides you will help you in recovery time. One important recommendation is to avoid sitting or standing for long periods of time. The patient should change positions often to avoid spasms in the muscles and cramps in the legs.

Another highly recommended recovery requirement is to get plenty of rest. The body depends on rest to help itself repair bodily tissues. Since it is recommended to change positions frequently, short naps are recommended, as well. Sleep on one side, and use a pillow between your knees to keep the spine from twisting. Spinal alignment is important. Follow the recommendations from your doctor to shorten your recovery time.

Learning More about Lumbar Spinal Stenosis

You may have heard of spinal stenosis, which is a condition where the spinal nerves are choked or crushed. When this condition occurs in the lower back, it is known as lumbar spinal stenosis. This is a condition that Dr. Solomon Kamson deals with quite often, so he can help his patients find a treatment that works best for them.

Symptoms
In most patients, lumbar stenosis is first detected due to pain in the legs while they are walking. When they are at rest, the pain subsides. Some people suffer from sciatica where the pain shoots down one leg. Others feel numbness or tingling that radiates from the lower back down to the buttocks and legs. It most often appears in patients over 50 years of age.

The problem with this is that not all patients have severe pain all the time. It can come and go, and the severity of the pain can differ with each flare up. This makes it difficult to treat. The level which lumbar stenosis affects a person’s quality of life will dictate the type of treatment involved.

Diagnosis
Usually, a doctor will not be able to properly diagnose lumbar stenosis by just doing a physical exam. He will request that an MRI or CT Scan be performed. The CT Scan will be done along with a myelogram, which involves inserting a dye into the spinal sac. After a diagnosis is reached, the doctor will need to dig deeper to find out what type of lumbar stenosis it is. This is the only way to come up with an appropriate treatment plan.

There are three types of this condition. The lateral type, which is the most common, occurs when a nerve is compressed by a bulging or herniated disc. Central stenosis occurs when the lower back canal is choked. Foraminal stenosis involves a nerve root in the lower back that is trapped by a bone spur.

Non-surgical Treatment
Solomon Kamson will most likely want to try every non-surgical option possible to manage pain from lumbar stenosis before opting to perform surgery. Patients can be provided with a cane or walker so that they can lean forward when they walk. They can also visit a physical therapist to get a specialized exercise program like stationary biking to alleviate pain. If these options do not work, a patient can take ibuprofen or naproxen. Epidural injections involve injecting steroids into the epidural space. This can reduce pain and swelling from stenosis.

Lumbar Stenosis Surgery
When all else fails to relieve pain, or if it is a very bad case of stenosis, then surgery is the only option. The most common type of surgery for lumber stenosis is a lumbar laminectomy. This works by decompressing the pressure on the spinal cord or nerve. Other types of surgery include a foraminotomy, laminotomy, and microendoscopic decompression. The best course of action is to discuss all of the options with a professional like Dr. Solomon Kamson and decide what will bring the most relief in each unique situation.

When Is Spine Surgery Considered to be Outpatient?

There are many individuals that have the misconception that having spinal surgery is a major surgery and they must stay in the hospital for an extended visit. With minimally invasive spine surgery, this is no longer the case. You will be recovering and relaxing in your own home, in your own bed.

Lumbar Miscrodiscectomy
Lumbar microdiscectomy is a non-abrasive surgery that provides excellent results to those who must undergo surgical treatment to help recover from their lumbar spinal condition. Those who suffer from foot or leg pain, certain amounts of weakness, or even numbness, may have a lumbar condition and may even need this surgery.

When Surgery is the Final Step
Those who exhibit the symptoms of a lumbar spinal condition may have one or more symptoms. There are pain management plans that Dr. Solomon Kamson will set into place in order to minimize the pain and difficulty for you. If one pain management plan does not seem to be working, then Dr. Kamson will try another method to help.

Performing Lumbar Microdiscectomy
This surgery will take approximately an hour to perform. In order to reduce the time needed for recovery, anesthesia that was designed for outpatient surgery is used. The surgeon will use x-ray technology in order to guide him without having to make a larger incision. The smaller the incision that is made, the less muscle and tissue is cut, and the less time it will take to recover from the surgery. This also makes it possible to be an outpatient surgery.

Once Surgery is Complete
Recovery time is cut in more than half compared to what the typical surgery recovery time used to be. When the surgery is done, you will return to your home. The patient is able to walk and even participate in non-strenuous activities. You will have relief from the pain that you have felt for so long. You will be free of the pain that has put difficulty in performing typically daily activities like grocery shopping and cleaning your home.

After Care
It is important to know that even though this surgery is an outpatient surgery, you will need to make preparations to your home prior to the surgical treatment. Placing daily necessities within reach is important. For example, any clothing that will be needed out of the bottom drawers of your bedroom dresser will need to be placed in a more convenient spot. If this is the case, then it is suggested to place a basket on top of the dresser and add the daily clothing to it so less bending is performed. Dr. Solomon Kamson will provide you with other instruction on how to prepare for an easy recovery time and it is highly suggested you follow the instructions and tips.

Failed Back Surgery Syndrome: Does It Really Exist?

Failed back surgery syndrome (FBSS) may sound like something that is a figment of a patient’s imagination. However, it is actually referring to chronic back or leg pain that continues after having spine surgery. There is no guarantee that any surgery will be 100 percent effective, and spine or back surgery is no exception. Dr. Solomon Kamson is there for his patients through every step of the process and can address continued pain and come up with a solution.

Background
Any back surgery only comes with up to a 95 percent effective rate. There are really only two issues that spine surgery can definitively correct, which are to decompress a pinched nerve root and stabilize a joint that is causing pain due to movement. The doctor can only predict what he or she thinks is causing the pain and perform the surgery on that area.

Lingering pain is often a result of the fact that the pain the patient is feeling was actually the result of another problem and not caused by the area of the spine that was operated on. The focus of the surgery is to work on a lesion or injury on the spine. It is only evident after the surgery if that part of the anatomy was truly the cause of the patient’s pain.

Other Causes
Failed back surgery syndrome can be a result of issues other than operating on the wrong spot. When a patient had a spinal fusion, there might be a failure to fuse or the implant might not work as it should. The pain may also shift to another part of the spine after a fusion. In the case of spinal stenosis, it may be a recurring problem that cannot be remedied permanently. When decompression is performed, the nerve damage might not heal or new nerve damage might occur during spine surgery. Scar tissue may form around the surgical site, which can make pain return. There is also the possibility that a patient may reinjure themselves, causing the pain to come back even worse that it was before. This often happens when patients do not stick to the rehabilitation plan laid out by the physician.

Overcoming Obstacles
Most patients need to realize that spine surgery is not a cure for back pain. It is a common misconception that it is a permanent fix and that there will be no pain after the recovery period has ended. Each patient must carefully follow the rehabilitation plan that is established. This often includes months or years of physical therapy to keep the back in the best shape. It is also important not to push physical activity before the back has had a chance to heal, or this may cause more pain or further injury. Continued visits to Dr. Kamson will allow him to monitor the patient’s progress and see if any new therapies or medications need to be added to the plan. With continued therapy and monitoring, most patients should be able to manage pain with failed back surgery syndrome.

Differences between Herniated and Bulging Discs

One who suffers from herniated or bulging discs not only experience loss of flexibility and motion, he or she will endure intense pain and can fall victim to other conditions and repercussions. For instance, relationships and work will be subject to the effects of the condition. There are certain activities that they are not able to participate in due to the spinal condition. Solomon Kamson understands this issue and works to fix the condition so his patients will get right back out to the active world.

The discs in the spine act as shock absorbers or cushions for the protection of the vertebrae. The discs are composed of a layer on the outside for strength and a center of softer cartilage for the shock absorption. They are round with an opening in the middle, sort of like a doughnut. Each disc is perfectly proportioned to fit within the spine.

What is a herniated disc?
A herniated disc is quite different from a bulging disc. A herniated disc is a fracture to the outer layer of the disc. The fracture allows the cartilage to protrude through the outer layer. This is typically in one area of the disc. Other names for this condition are ruptured discs or slipped discs. Dr. Solomon Kamson will be able to repair the problem and render you pain free. There are pain management systems available for those who suffer from the pain. After the proper diagnosis and consultation about treatment; the next step is decided on by the patient and the doctor.

What is a bulging disc?
A bulging disc is a disc that extends past the limits of where it is supposed to be located. Normally, this issue will affect a large portion of the disc. This is also a condition that is brought on by the average aging process. Other age groups do fall victim of this condition, due to injuries most commonly, so it is not limited to the older generations.

Bulging discs are more widely known among those who have one or the other of these conditions. There are even some lucky individuals who do have one of these conditions and are unaware of it because they do not experience any pain. Although they are lucky to have no pain, these sufferers will go on to develop pain, and the condition may be worse if they wait too long to get the disc corrected.

In order to discover which condition you may have in your spine, you will need to see Dr. Kamson. He will perform testing and ask questions in order to properly diagnose the issue. Once the diagnosis is known, he will educate you on the choice for your pain management. The team at the Spine Institute Northwest will be able to help you return to a healthier state.

Causes and Symptoms of Spinal Stenosis

Those who suffer from spinal stenosis are no strangers to the pain that comes along with this debilitating condition. It is the narrowing of the spaces that are located in the spine. This causes a certain amount of pressure on the spinal cord and the nerves. In approximately 75% of cases, this condition is located in the lumbar section of the spine (the lower back). In most cases, there is a narrowing in the spine that is associated with compression on the nerve root. This will cause pain that shoots down the back of the leg.

There are many causes for this condition. Many individuals fall into more than one of the groups. If you find that you fall into more than one group, this means that the risk for this condition increases, and it is imperative that you speak with a qualified surgeon like Solomon Kamson.

Aging: Over a certain amount of time, the human body will be subject to wear and tear. With greater age comes more damage to the body’s ligaments, which are the tough connective tissues between the bones in the spine. These ligaments will thicken. Bone spurs can and often times will develop. Also, the vertebrae will start to deteriorate over years.

Arthritis: There are two types of arthritis that will affect the spine: osteoarthritis and rheumatoid arthritis. For a proper diagnosis, see Dr. Solomon Kamson at the Spine Institute Northwest.

Heredity: If there are x-rays done at a young age and the spine is considered to be small, this may mean that spinal stenosis will show up at an earlier age. There may be structural deformities that are apparent and will cause narrowing in the child’s spinal canal.

Trauma: Many accidents or other types of injuries can cause an individual to develop spinal stenosis. The injury may cause discs in the spine to dislocate, leading to the disorder. The injury may even result in fractures and cause bone fragments to penetrate the spinal canal.

Tumors: In some cases, those who suffer from spinal stenosis will have another health condition they may be unaware, including tumors on the spine. Any such growth on the spinal canal will cause extra pressure and less space, which results in the spinal stenosis condition. Removal of the tumor should alleviate the pressure that the tumor causes, which will result in the spinal stenosis condition being reversed.

Spinal stenosis can cause different symptoms in certain cases. Typically a spinal stenosis sufferer will endure more than one of the symptoms. The symptoms that are typically reported are frequent falling or clumsiness, pain, difficulty while walking, numbness, hot or cold feelings in the legs, and tingling. Dr. Solomon Kamson and the team at the Spine Institute Northwest can help with a proper diagnosis and a pain management system. Not only will he be able to set a pain management system into place, he will do testing and find a solution to the condition itself.

Artificial Disc Replacement

The spinal column has discs inside to provide the spine with a type of cushion to limit spinal pressure. An artificial spinal disc is man-made to offer replacement for a disc that has been damaged and is causing lack of movement and debilitating pain to the patient. Solomon Kamson will be able to counsel you on whether this is an option for your personal case.

Artificial Discs
An artificial disc replaces the inner part of the vertebra called the nucleus. This allows the spine to move and bend appropriately. It provides the spine with the flexibility that is required for daily living. At times, it is extremely necessary to have disc replacement surgery. Dr. Solomon Kamson will be able to hold a consultation and discuss the next step into recovery from the artificial disc replacement.

Two Types of Artificial Discs
Artificial discs are ground breaking in the surgery industry, so much so that there are two different types of replacement surgeries that can be performed. The first is the replacement of the entire disc. The disc tissue is taken and replaced by a new implanted disc. The other type of artificial disc surgery is the replacement of the disc nucleus. In this surgery, only the nucleus is replaced.

Materials
Artificial discs are made with different materials. Metal or biopolymer (plastic-like) materials are the two materials that are used when making artificial discs. At times, both materials are used to make a disc. The total replacement of the disc was started in Europe in the 1980s. There are artificial disc replacements made for the discs in the neck as well.

Who Can Use a Replacement Disc
Different patients will have to have different variations of the materials previously mentioned. Dr. Kamson will suggest the most appropriate step forward with the surgery. Those who have a degenerative disease will end up having this surgery performed in most cases. Those discs that have proved to be causing intense pain are normally the ones that will have discs replaced. Those patients include those who need a fusion.

Some patients are unable to receive artificial discs. Certain health conditions will prevent a patient from undergoing the surgery. One condition is spondylolisthesis, which is slipping of vertebrae. Others include osteoporosis, fracture of vertebral bodies, tumors on the spine, infection of the spine, and being obese. A common condition for not performing the surgery is if the patient has an allergy to one or more of the materials that are used in making the artificial discs.

Patients who have endured pain for over six months have the potential to undergo the surgery. Typically in most cases the surgery will reduce the amount of pain the individual endures by a large percentage. For those who have a certain percentage of pain left or who cannot undergo the artificial disc surgery, Dr. Kamson will be able to help them with a pain management plan and assist in them in regaining their quality of life.