• Thursday, January 8, 2009

Jason M. Highsmith, M.D.

Back surgery used to mean undergoing hours of painful surgery and a long difficult recovery.  That made it unappealing to elderly patients, especially those with limited mobility and complex medical problems.  Now there are less invasive options.

Two common problems in the aging spine can now be treated with MIS (minimally invasive surgery).

Lumbar Stenosis

Lumbar stenosis is a form of arthritis in the spine that causes low back and shooting leg pain.   Unlike other forms of arthritis which typically cause pain only in the joints, arthritis in the spine can cause pinched nerves with pain radiating in the thighs, legs and even feet.

When patients have stenosis their ability to walk or stand for prolonged times is markedly impaired.  They often have to stop and rest, or even sit down. One classic sign of lumbar stenosis is leaning over the grocery cart in the store to relieve pain in the legs. 

In the past treating this condition meant a complex surgery with risky complications or immobilizing rods and screws. Now small spacers can be inserted between the bones of the spine to prop open the nerve channels.  These spacers allow patients to regain mobility and even return to activities such as running and golfing.  They can even be inserted under local anesthesia in as little as fifteen minutes.

Compression Fractures

Spinal fractures are more common in the elderly, especially among women.  Several risk factors have been associated with these fractures including:  osteoporosis, low bone mineral density, hunch back, loss of height of two inches or more, and chronic steroid use.

Fractures of the spine can occur with minimal trauma such as coughing, sneezing, reaching, bending and twisting.  Often the signs of a fracture go unnoticed or the patient attributes it to old age.  However, the acute onset of low back pain in the elderly should trigger physicians to look for compression fractures.  New back pain in a patient with risk factors should be evaluated.  Left untreated, these fractures can lead to further hunch back, more fractures and worsening pain as well as the potential for spinal cord and/or nerve injury.  Severe progression of fractures can lead to difficulty walking and even trouble breathing.

 One in four women over 50 will suffer an osteoporosis-related spinal fracture.
If it is diagnosed early, a fracture can be treated with minimal pain and risk.  A treatment called Balloon Kyphoplasty can restore lost height, correct spine deformity and significantly reduce back pain.  Most patients feel relief the same day and can return to their normal activity very quickly.

If you think you have either of these conditions talk with your doctor.  A simple x-ray or MRI scan can confirm the diagnosis and you can resume your life much quicker with less pain once you are treated.

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