Spinal Pain Pump FAQ

An intrathecal pump implant (spinal pain pump) is used to decrease the amount of pain medication that a patient must take to experience relief. The pump is implanted under the skin. A catheter is run from this pump to the location of pain in the spine. By administering the pain medication directly, a more potent effect is experienced and the amount of medication needed can be reduced. Spinal pain pumps are used by doctors, including Dr. Solomon Kamson of the Spine Institute Northwest, as a way to alleviate chronic back pain.

What is a Spinal Pain Pump?
An intrathecal drug pump is a round, metal, hockey puck-sized device that is inserted under the skin of the abdomen. A small plastic tube is run from the device into the fluid-filled space around the spine. The pump is programmed to release specific amounts of medication slowly, throughout the day. The doctor can easily raise or lower this amount.

How Does a Spinal Pain Pump Work?
There are three parts to a pain pump: the catheter, the receiver, and the external controller. The external controller is used by your doctor to turn the pump on and off, or to adjust the level of medication that is released throughout the day. The receiver, which has a reservoir full of pain medication, releases the medication at the rate specified by the doctor. The medication then travels through the catheter and into the cerebrospinal fluid (CSF). The CSF flows through the area around the spinal cord and both bathes and protects the brain and spinal cord. By administering the pain medication into this fluid, only 1/300 of the pain medication needs to be administered.

What are the Benefits of Spinal Pain Pumps?
There are many benefits to intrathecal drug delivery. One of the biggest benefits is that it reduces the need for oral medications. Because less medication is needed, the side effects that are often associated with pain medication are reduced. In some instances, a patient-controlled programmer is used. This allows the patient to adjust the dosage of their device within certain parameters. The spinal surgeon closely monitors the patient’s pain levels to determine if the pump is working, or if a different amount of medication is needed. Finally, the intrathecal pump can be removed at any time. It is performed as an outpatient procedure, and doesn’t require much time for recovery.

How is a Spinal Pain Pump Implanted?
The intrathecal drug implant is placed under the skin in a simple, minimally invasive procedure. This is done under anesthesia. The surgeon places the catheter first. A small incision is made in the back, through which the catheter is placed into the intrathecal space. It is secured in place with sutures. Then, the surgeon will pass the catheter under the skin, from the spine to the abdomen. Next, the surgeon makes a 4 to 6 inch incision in the side of the abdomen, creating a pocket between the skin and muscle layers. Then, the surgeon attaches the extension catheter. The catheter is placed under the skin and sutured to the fascia layer over the stomach muscles. Last, the surgeon closes the incisions in the back and stomach using staples or sutures. Often, the patient can be discharged two to three hours after the procedure.

Bone Spurs and Degeneration of the Spine

When Solomon Kamson MD tells patients they have bone spurs, or osteophytes, they often do not understand the implications of the condition, he says. Bone spurs themselves are indicative of degeneration of the spine. Despite the name, bone spurs are actually smooth, solid structures that form over a prolonged period of time, according to Dr. Kamson.

Osteophytes are very common, particularly once an individual reaches the age of 60. Unless another spinal condition is present, osteophytes are usually found on an X-ray or MRI scan for another issue. They are enlargements of the normal bony structure. When bone spurs occur before the age of 60, an underlying problem such as osteoarthritis, traumatic injury, or other spinal conditions may be present.

What Causes Bone Spurs?
Bone spurs can be formed as a result of traumatic injury, degeneration in the discs, or degeneration in the joints. When age, injury, and poor posture factors in, there can be cumulative damage to the bone or joints. This may cause bone spurs to form.

First, the disc material begins to wear down. When the material wears down, ligaments begin to loosen. This allows excess motion at the joint. The body has a natural reflex to thicken the ligaments holding the bones together. However, these thick ligaments often calcify, resulting in flecks of bone or bone spur formation. Once the bone spur has formed, it may press against the spinal canal and the foramina. The compression of nerves in the spinal canal and foramina is what causes clinical symptoms.

Are There Nonsurgical Treatments for Bone Spurs?
The presence of bone spurs rarely needs treatment, unless the patient is experiencing symptoms as a result of the bone spur pressing against the spinal column or foramina. In these instances, surgeons may first recommend a nonsurgical option. Nonsurgical options may include stretching and strengthening exercises for the back, yoga, or alternative therapies such as acupuncture. If the patient chooses to use alternative therapies, they may do this under the supervision of a naturopathy doctor. If the patient wants to try complementary, or surgical options, they should do so under the care of a back care specialist such as Dr. Solomon Kamson of the Spine Institute Northwest.

Can Surgery Treat Bone Spurs?
When a patient experiences pain, numbness, or other spinal problems that do not improve with the use of complementary or alternative medicine, a back specialist like Solomon Kamson MD, PhD may recommend spinal surgery. The goal of spinal surgery for bone spurs is to relieve pressure by giving the spinal canal and foramina extra space.

Dr. Kamson performs minimally invasive spinal surgery on patients who go under general anesthesia. The surgeon begins by making a small incision near the afflicted area along the spine or neck. Then, they pull back the underlying muscles and tissues. This allows them to access the bone spur, and other troubling areas. They can either shave or remove the bone and connected tissues. Once these have been removed, the surgeon moves the muscles and tissues to their place. The surgeon sews the skin shut. The use of minimally invasive spine surgery lessens recovery time and post-operative pain.

Herniated Discs and Minimally Invasive Spine Surgery

Doctors will often interchangeably use the terms herniated disc, slipped disc, pinched nerve, and bulging disc. Though this affliction has several different terms, either the slipping or degeneration of a spinal disc causes all of these issues. The type of pain associated with a herniated disc will be determined by its cause. It can easily be diagnosed, and then treated with either nonsurgical or surgical procedures depending on the severity of the condition.
MRI showing herniated disc
Symptoms of a Herniated Disc
The symptoms associated with a herniated disc vary depending on the patient’s specific problem. There are two types of pain that can be caused by a herniated disc, axial pain and radicular pain. When a disc has degenerated, a patient will often experience axial pain, which is pain felt in the disc space itself. Axial pain can also extend down into the lower back or the legs.

When a disc has slipped or dislocated itself in some way, radicular pain is often experienced. A herniated disc pinching a nerve in the back causes radicular pain. This leads to radiating pain that can be felt in several areas of the body, depending on the problematic disc’s location. Radicular pain can either shoot from the neck down, in the neck, or through the legs. When radicular pain shoots through the legs, it is often referred to as sciatica.

Doctors can often reach a determination on the likely cause of back pain by conducting a physical examination and reviewing the patient’s symptoms and medical history. Once a doctor has reached a diagnosis, further testing is done for confirmation. Some tests that may be used are a CT scan, an MRI scan, and a discogram. A computerized tomography (CT) scan works like an x-ray, but the image is reformatted to show cross sections of the spine. A magnetic resonance imaging (MRI) scan can be used to assess the spinal nerves, disc alignment, height, hydration, and configuration of the spine. A discogram is often used if surgery is being considered. In this test, a dye is injected into the disc to recreate normal pain. This is used to determine which disc is causing the problem.

After diagnosis, the patient’s primary care physician will often refer them to a spine specialist, such as Dr. Solomon Kamson of the Spine Institute Northwest. Additional testing may be performed to determine if the correct diagnosis has been made. Some nonsurgical options for treating a herniated disc include rest, pain management, and physical therapy. However, in severe cases or when more conservative treatment options have not been enough to alleviate pain, surgery may be performed to remove the offending disc.

One common surgery for a herniated disc is a minimally invasive procedure known as a lumbar discectomy. A lumbar discectomy requires only a small incision, often less than one inch. This incision is made over the herniated disc. Then, the surgeon inserts a retractor, to remove a small amount of the lamina bone and allow the surgeon a view of the spinal nerve and disc. Next, the surgeon retracts the nerve and removes the damaged disc. Finally, bone graft material is used to replace what was removed and the incision is closed up. The Spine Institute Northwest specializes in minimally invasive spine surgery procedures like the discectomy.

Doing Yoga to Reduce Back Pain

Suffering from back pain can affect every aspect of your life, from properly performing your job to cleaning your house. A wide variety of treatments are available through mainstream medicine, ranging from pain medication and muscle relaxers to a variety of surgery options. Before beginning any treatment regime, it is a good idea to see an experienced back doctor like Dr. Solomon Kamson to ensure that you have an accurate diagnosis.

Often, the back pain people experience is a result of stressed muscles. Yoga is designed to strengthen and stretch muscles without causing pain or undue stress. Practicing yoga exercises every day can reduce stress on the spine, as well as the stress caused by everyday life problems. Yoga is a well-known stress reliever for all muscle pain and stiffness, which is the precursor to back pain. Yoga is also good for a meditative technique, which is another stress reliever. Try yoga to make your life a little more flexible. Before you begin any exercise regimen, make sure you check with a specialist like Dr. Kamson to make sure your body can handle the yoga poses and that you will not be exacerbating an underlying condition.

An easy pose to start with requires you to stand on a yoga mat with your feet apart and bend at the waist with your arms crossed. Your fists should be touching the opposite elbows. Bend all the way down while keeping your legs straight, then relax your back and neck while squeezing your fists. Squeezing your fists while your elbows are bent will trigger your central nervous system to open your back muscles.

Stretching your hamstrings can also help relieve back pain. Try lying flat on the floor or a mat and raising one leg while bending the knee until it reaches your chest. Place a strap or towel around your foot, holding it with the hand on the same side. Now, straighten your leg all the way up in the air, and hold it there for at least three minutes, but no more than five minutes. Repeat the exercise with the other leg.

Exercises aimed at relaxing your back muscles will also help to relieve back pain. A good way to relax your back muscles is to lie down on the floor with your legs straight up against a wall. This will relax your muscles while allowing bodily fluids to drain from your feet. Hold this position for at least five, but no more than 10 minutes at a time. This is also a yoga exercise used to cool down after a strenuous exercise session.

Relieving the tension in your upper back and neck will help alleviate back pain. A good yoga exercise to help relieve this tension starts with getting down on your hands and knees on the floor. Take a deep breath, then point your toes out while exhaling. Now, round your back while pressing your palms down and tilting your head down, then relax. Repeat this exercise for six breaths.

Back pain can result from a wide range of problems that cannot always be alleviated by conservative therapies like exercise. If you are experiencing chronic back pain, consult a specialist like Dr. Kamson to get a proper diagnosis and an effective pain management plan.

Exercises to Lessen Osteoarthritis Pain

Osteoarthritis of the spine is a condition that causes chronic back pain. While there is no cure for osteoarthritis, there are many ways to lessen the pain, particularly those involving physical activity. Though these exercises have helped many individuals suffering from osteoarthritis of the spine, it is important not to enter into any exercise program without the guidance of a spine and neck specialist, such as Dr. Solomon Kamson of the Spine Institute Northwest.

Practice Good Posture
While this is not necessarily an exercise, practicing good posture is one way to alleviate back pain. Good posture can be practiced while standing or sitting by aligning the spine and the hips and keeping the shoulders back and relaxed. Good posture can also help to strengthen the core muscles of the body.

Light Strength-Training Exercises
Light strength training of the back will help to keep muscles strong. As the muscles of the back become stronger, they can help to protect the spine more effectively. This can alleviate pain from causes such as osteoarthritis.

Side Stretches
One simple strength-training exercise is side stretches while holding dumbbells (though if that’s not comfortable, side stretches can be performed with or without dumbbells). Stand straight, and then stretch an arm down your side as far as possible. Slowly release to the starting position and repeat on the other side.

W Stretches
This stretch is also arthritis-friendly, helping to strengthen the muscles of the back. First, place the arms at the sides of the body. The elbows should be in, and the palms of the hands should be facing outward. This will leave the arms in the shape of a “W.” Stretch the arms back until a stretch the muscles of the shoulders can be felt. Hold this position for three seconds, slowly release, and repeat.

Walking is often used for rehabilitation, to help alleviate back pain, and to improve cardiovascular health. It is one of the lowest impact activities that can help to strengthen the muscles of the back. There are several things to consider to get the most benefit from a walking regimen. First, practice good posture and use core muscles when walking. It is also important to wear proper shoes; orthotics can be good for this. Finally, try to walk lightly on the ground, and avoid concrete and pavement when possible.

Tai Chi
Tai chi and yoga are both often recommended to alleviate back pain; however, tai chi may be more helpful to those suffering from back pain because of osteoarthritis. Yoga is a great option for building strength and flexibility, but tai chi does this without stressing the joints. Tai chi was originally a fighting technique but has transformed into a continuous stretching exercise. The movements in tai chi are very gentle. It also focuses on poses from the waist, which places emphasis on spinal stretching.

Other Tips
Taking steps to improve back pain while doing chores or work can also help to alleviate pain from osteoarthritis. When moving throughout the day, place emphasis on the movements of core muscles. This will increase strength in the back. Additionally, be sure to protect your back by bending with your knees and tensing your stomach muscles. This can be practiced every day and is a form of exercise that will not take extra time out of a busy schedule.

Back Injury and Basketball

Basketball and other sports have a variety of great benefits. However, with these benefits comes the risk of injury. In basketball, back injury is quite common. Disc herniation and lumbar strains are two frequent causes of back injury in basketball players, with lumbar strains being the third most frequent orthopedic injury type in the NBA.

Frequency of Injury
Lumbar strains affect basketball players more than disc herniation. It is estimated between 7% and 8% of total injury in the NBA is caused by lumbar strains. Lumbar strains are actually the cause of between 6% and 7% of missed games. Disc herniation can also affect basketball players. In early April 2014, Dwight Howard was pulled out of a basketball game because of a herniated disc.

The pain from lumbar strains can be alleviated with a variety of treatments. This includes rest, chiropractic care, massage, pain medication, and anti-inflammatory medication. Chiropractic care and massage work, which increase blood flow to the pained area, can sometimes help to alleviate pain. Pain medication and anti-inflammatory medication are often prescribed to help with discomfort. A lumbar strain will often go away once the body heals, so managing the symptoms will be helpful.

Herniated discs are also treated using a few different methods, including physical therapy, medication, epidural injections, and surgery. Epidural injections and other pain-managing techniques are often prescribed to treat the symptoms of the herniated disc, rather than the actual cause. Physical therapy will help the patient learn how to work the muscles around the herniated disc, while simultaneously strengthening the back.

When non-surgical methods do not work, surgery may become an option. There are two common minimally invasive surgical options for treating a herniated disc, microendoscopic surgery and microdiscectomy. Speaking to a spine specialist such as Dr. Solomon Kamson of the Spine Institute Northwest can help a patient decide if surgical or non-surgical treatment is the best option for their specific case.

The best treatment is prevention. There are several steps basketball players can take before a lumbar strain or herniated disc makes them sit out on practice or games.

Basketball players spend a lot of time on gym floors, whether they are in the game or practicing. This time spent on hard gymnasium floors can be hard on the back. This is especially true when a player is jumping repeatedly. To protect the back, it is important to wear high-quality, supportive shoes. Wearing proper footwear will decrease the likelihood of injury from strain.

Warming up with stretches before practice and doing strength-training exercises to maintain conditioning can make a major difference for back health. Stretching will increase the flexibility of the muscles, and prepare them for use. Completing regular strength-training exercises can strengthen the muscles of the back, to allow them to better protect the spine.

Last, basketball is a sport where players may fall. In some instances, this falling can cause trauma to the back, which may result in injury. Players can reduce injury by avoiding falling on areas that can easily receive trauma, such as the tailbone. While falling always comes with some risk of injury, injury to areas such as the tailbone can be very damaging. Learning to fall the “right” way can be the difference between staying in the game and sitting on the sidelines.

Reduce Lower Back Pain with Minimally Invasive Lumbar Spine Surgery

After multiple attempts to relieve your back pain, including medication, physical therapy, and steroid injections, is your lower back still so sore that you are unable to perform the normal activities of daily life? If that sounds like you, it’s time to consider minimally invasive lumbar spine surgery to repair the pain at its source and help you begin to get back to your old self. A clinic that specializes in this type of procedure like the Spine Institute Northwest can help you get back your life.

The lumbar spine refers to the lower back or the lower portion of the spine below the rib cage. It is the most common source of back pain due to the fact that people often put a lot of stress on this area when performing jobs that require lifting and bending. (That old advice to lift with your legs, not with your back? It’s trying to help you spare your lumbar spine.) Lower back pain is common in older individuals due to degenerative arthritis that causes the cartilage to wear away over time. For minor levels of pain, most patients will see an improvement in with a conservative pain management plan of medication and/or physical therapy after six months.

If the pain stays the same or worsens after six to twelve months, you may need to start considering surgery on the lumbar spine. It is imperative that the pain source be accurately identified for any type of surgery to be effective. The location of the pain source will determine what type of surgery will be performed.

The major advantage to having the minimally invasive procedure is that smaller incisions are made and less muscle is disrupted, resulting in faster recovery time and less pain after surgery. The surgeon makes small incisions in the patient’s abdomen, and small dilator tubes are placed in each incision to separate the muscles. A tiny fiber optic camera is inserted to help the doctor see the spine clearly, and small instruments are used to perform the cuts and insert the bone graft.

If you are looking for a solution for your lower back pain, get in touch with an experienced doctor like Solomon Kamson at the Spine Institute Northwest to go over your options. You may be a candidate for minimally invasive lumbar spine surgery and no longer have to live with debilitating lower back pain.

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.