Year: 2017

Revision Spine Surgery

Every year, almost 600,000 Americans undergo back surgery.

Some surgeries are the result of trauma. Other patients are hoping the surgery will end their chronic back pain.

The unfortunate truth is, for many, the pain continues even after surgery.

A study published in Spine revealed that almost half of back surgery patients have post-surgery pain.

The study examined more than 700 patients who underwent surgery for lumbar fusion.

Use of painkillers increased after surgery for 41 percent of patients. After two years post-surgery, only 26 percent of patients had returned to work.

Of those patients, 27 percent had to have additional surgeries.

Revision spine surgery is common.

Surgery is always a risk. For some people, having additional surgeries to reverse effects of a previous surgery sounds like an unnecessary risk.

But if you’re living with excruciating back pain, it’s a risk worth taking. If you’re still not convinced, keep reading to learn 8 reasons why revision spine surgery may be for you.

1. You’re experiencing complications with hardware put in place during a previous surgery

Various hardware is used for some back surgeries. This is especially common in surgeries aimed at re-fusing the spine.

Screws may be put into place to apply pressure to the spine and promote fusion.

Like any piece of hardware, those used in back surgeries may fail from time to time. If they aren’t placed correctly, they may not aid with fusion, or they may cause discomfort for the patient.

In either case, surgery may be necessary.

Without effective hardware, it is unlikely that the initial surgery will be successful. Therefore, revision spinal surgery would be the only chance to treat the injury and reduce pain.

2. Your bones did not re-fuse post-surgery

While the risk of hardware failure can be a concern, without screw, clamps, or other devices some patients may not heal properly after surgery. Proper fusion between bones requires pressure. Hardware can assist with this.

If your spine doesn’t re-fuse after surgery, you may have needed extra pressure.

With revision spine surgery, hardware may be added to help promote fusion.

Without the surgery, healing is unlikely in this case. As a result, a patient may experience the same pain that existed before the initial surgery.

3. You didn’t follow post-surgery recommendations and a complication arose

Patients sometimes choose not to follow all post-surgery recommendations from their doctor. Doing so may render the initial surgery ineffective.

For instance, not resting following some back surgeries will prevent proper healing.

Even smoking or taking certain drugs, such as corticosteroids, after lumbar fusion surgery can cause your bones not to fuse properly.

4. You’re experiencing adjacent segment degeneration

Some patients never experience pain relief following a back surgery. Others don’t need revision spine surgery until several years later when the pain returns.

That is the case with patients who experience adjacent segment degeneration, or ASD.

ASD involves anatomical changes to the spine after surgery that cause pain.

Surgeons and experts aren’t sure whether ASD is the result of pre-existing conditions worsening or other causes.

This condition is most common after spinal fusion surgeries.

A patient could go two or more years with no pain before ASD occurs. When it does set it, it can be very painful. Revision spine surgery is often the only treatment option.

5. You’ve had a second disc herniation

When a patient undergoes surgery for a herniated disc, the surgeon will often remove onlypart of the damaged disc. Sometimes, the remaining part may herniate as well.

When this occurs, a revision spine surgery will be necessary. During surgery, the surgeon will remove the remaining damaged pieces of the disc. Until those parts are gone, pain will continue.

6. A preexisting problem has persisted or worsened post-surgery

Surgery for deformities such as scoliosis and kyphosis may be onlytemporary fixes.

Depending on the patient’s condition, an initial back surgery may only temporarily reduce pain or deterioration.

Non-surgical treatments may help reduce pain or keep a condition from worsening. But these treatments are not always enough.

Some patients may need surgeries every few years to keep up with the deterioration.

Additionally, conditions that cause poor bone quality may lead to deterioration and pain after surgery. Sometimes, revision spine surgery can reverse the effects these conditions have on treated areas.

7. You develop an infection or nerve pain after surgery

Infections are not uncommon following any kind of surgery. The causes for them vary, as do the complications that infections can cause.

If you develop an infection around a piece of hardware used for back surgery, a revision spine surgery might be necessary to remove or replace it.

Another complication that isn’t uncommon following back surgery is nerve pain.

Nerves may become compressed after an operation on the spine. In this case, the pain can be severe. Medications and other non-surgery treatments may reduce pain, but won’t fix the problem.

8. Your initial surgery wasn’t successful

Surgery for chronic pain isn’t always an exact science. Sometimes, surgery is performed on the wrong site. In this case, the patient still experiences pain.

A patient’s initial diagnosis could be wrong. Other times, the pain a patient is feeling is from several injuries or conditions. As a result, one surgery isn’t enough.

In either case, revision spine surgery may be necessary.

Are you a candidate for revision spine surgery?

There are many treatment options for back pain. Sometimes, pain can be treated by non-surgical techniques. Other times, the only effective way to treat conditions and reduce pain is through additional surgeries.

If you are experiencing any of the above complications, you may be a candidate for revision spine surgery.

If revision spine surgery is required, a minimally invasive procedure may be possible. Other times, however,a more complex surgery is necessary.

Differences Between Neurological Surgery And Spine Surgery

When facing the possibility of undergoing neurological surgery and spine surgery, we know you have countless questions.

In the following, we outline the differences between neurological surgery and spine surgery inour list of the top 7 facts you need to know to feel safe and empowered before your operation.

Fact 1: Neurological Surgery And Spine Surgery—The Numbers

When you’re going in for an operation, you’ll likely need to weigh your options about whether you’re going to choose a neurosurgeon or an orthopedic surgeon.

Fortunately, the vast majority of surgeries can be completed by both neurological surgeons and spine surgeons.

62% of all surgeries completed in 1 year by neurosurgeons are spine surgeries – over 1.3 million surgeries in total.

Orthopedic surgeons complete about 29 procedures every month, and the majority of orthopedic surgeons work within private practices.

Both are certified by their respective boards, but there is not yet an overarching board related to spine specialty.

Neurosurgeons train for between 6-7 years after medical school, and orthopedic surgeons train for an additional 4-5 years after medical school.

The takeaway here? No matter which option you choose, both types of surgeons will have had lots of experience in the field of spine surgery—one not necessarily better than the other.

Fact 2: What Are The Most Common Reasons For Spine Surgery?

Most patients need spine surgery to heal:

• Tumors
• Herniated discs
• Spinal Deformities
• Fractures
• Spinal Stenosis
• Spinal Instability

In most cases, spinal surgery is the “last resort” after all other treatment options have been exhausted for those whose quality of life is significantly on the decline due to spinal problems.

If you begin having severe weakness in your legs and arms, notice problems with bladder function and control, or have persistent pain, talk to your specialist right away.

Fact 3: What Are The Main Differences Between Neurological Surgery And Spine Surgery?

As we stated above, there aren’t as many major differences between these two types of surgeons as one might initially suspect.

Neurosurgeons are either Medical Doctors or Osteopathic Doctors of Medicine. They are trained to diagnose and treat disorders of the spine and spinal cord, the brain, the nerves, and intracranial and intraspinal vasculature.

They usually have a specialization in brain surgery, spine surgery, or occasionally both.

Neurosurgeons are usually the most qualified option when it comes to intradural surgery (that’s surgery inside your spinal cord’s dura) like thecal sac tumors.

Orthopedic surgeons may also be Medical Doctors or Doctors of Osteopathic Medicine,and their residencies usually focus on treating musculoskeletal conditions. They’re also experts in lots of bone and joint disorders such as arthritis, bone tumors, hand injuries, joint replacement, and spinal disorders.

Like neurosurgeons, their practice can focus on a few specific disorders, or only one.

Orthopedic surgeons are usually more qualified to work on spinal deformity issues like scoliosis.

Fact 4: How Much Pain Can I Expect?

Of course, the amount of pain you’ll feel will be influenced by individual pain tolerance and the type of surgery you’re having. How you manage this pain will also depend on your individual experience with surgery.

Likely, your doctor will offer to prescribe medication to help with pain management, but as always, be sure to use it only as directed.

The majority of patients who have undergone spinal surgery say they feel much better, even right after surgery, than they did before the procedure. Usually, you’ll feel the most amount of discomfort in the three or so days immediately following your surgery.

Pre-existing medical conditions can also influence the amount of pain you feel.

Fact 5: What Plans Should I Make For Immediate Aftercare?

How you recover from your surgery will affect the length of recovery, and can prevent you from having to undergo another procedure. For both neurological surgery and spine surgery, make sure you’ve delegated tasks to members of your family.

If your recovery is slated to be especially tough, consider in-home care or a brief stay in a Transitional Care Unit. Of course, if you have children, plan for appropriate childcare.In any case,make sure you have someone to drive you to and from your surgery.

Fact 6: What Are The Most Common Risks of Neurological Surgery And Spine Surgery?

We know you’re concerned about what could go wrong when undergoing spine surgery, but fortunately, certified surgeons are highly unlikely to make a mistake. Still, these risks are one of the reasons why it’s so important to ensure your surgeon is properly certified.

Risks include:

• Weakness
• Paralysis
• Numbness
• Leaking of Spinal Fluid
• Hypertension
• Diabetes
• Requirement of Additional Surgery
• Bleeding
• Infection

These risks also emphasize how crucial it is for you to follow your doctor’s orders to the letter before and after your surgery.

Fact 7: What Will My Recovery Time Be Like?

There’s no single formula that can speed up your recovery time; everyone recovers at a different pace. Plus, recovery time will also be influenced by the extensivenessof your surgery and the issue you needed the surgery to correct.

Factors influencing recovery include:

• Age
• Health
• Pre-existing medical conditions
• Your attitude and motivation

Recovery periods can range from about 4-6 weeks to 6 months.

Many patients are shy to ask when they can resume sexual activity after spine surgery. For many, when you’re ready to go back to work, you can also get back to work in the bedroom.

Most doctors suggest letting the amount of pain you feel be your guide, but if your doctor has given you a timeline to avoid strenuous activity, follow those same guidelines for when it’s safe to resume intercourse.

Neurological Surgery And Spine Surgery: You’re Ready For Your Procedure

Now that this quick guide has helped you to learn the differences between these types of surgeries, and has informed you about the things they have in common, it’s time for you to talk to your doctor and let his/her opinion influence your final decision.

For more facts, advice, and frequently asked questions about spinal surgery, please keep reading our blog or feel free to contact us.

Cervical Kyphosis Treatment: What You Need to Know

Have you recently been diagnosed with cervical kyphosis?

This spinal disorder can be a little pain in the butt, but there are some great treatment options available.

We put together a guide to understanding cervical kyphosis and what some of the best cervical kyphosis treatment options are. Check out what we found!

What Is Cervical Kyphosis?

When one views the cervix from the side, a healthy cervical spine will point inwards to a certain degree.

This curve is known as lordosis.

When an abnormal curve in the spine occurs, it is known as kyphosis. This curve typically is in the shape of a crescent moon pointing towards the front of the cervix.

There are several causes that lead to cervical kyphosis.

Sometimes surgery, especially a laminectomy, can cause pockets of space between vertebrae and a lack of stability that can cause the curving of the spine.

Cervical kyphosis can also be a congenital defect. Degenerative disc disease and physical trauma can also cause cervical kyphosis, as well as many other bone and back problems.

So what makes cervical kyphosis so dangerous? There’s a laundry list of symptoms that could affect your quality of life:

• Minor to severe deformities in the spine
• Brain problems and  neurological restrictions
• Chronic, intense pain
• Little to no neck movement
• Spinal cord stretching that could lead to weakness in the limbs, inability to walk, loss of bowel control, and possible paralysis

Once diagnosed, you’ll absolutely need to undergo cervical kyphosis treatment as soon as possible.

Everything You Need To Know About Cervical Kyphosis Treatment

In order find the proper cervical kyphosis treatment, it’ll need to be established what form of cervical kyphosis you have.

Here are some of the basic forms of cervical kyphosis and their respective treatments.

Osteoporosis kyphosis

This cause is the most common one for adults and is caused by osteoporosis, which weakens the vertebrae.

To treat this form of cervical kyphosis, the osteoporosis will have to be treated first to prevent more fractures from happening.

Pain medication or shots will be administered, and there may need to be surgery to fix the fracture itself.

Congenital kyphosis

A common for of kyphosis in babies and children.

Simply put, a malformation in the spine while in utero leads to kyphosis.

To treat this type of kyphosis, doctors will almost certainly suggest surgery– this would be the one type of kyphosis that is pretty much guaranteed to require surgery.

Typically, the surgery will include realigning the spine and several more surgeries throughout the child’s growing life will be likely.

Degenerative kyphosis

Disc degenerations and spinal arthritis can cause this form of kyphosis.

Most sufferers of this type of kyphosis will take regular pain medication and physical therapy, as well as regular exercise, to treat the pain-related symptoms of degenerative kyphosis.

Surgery is an uncommon result.

Neuromuscular kyphosis

Children and babies with neuromuscular disorders like muscular dystrophy may suffer from neuromuscular kyphosis due to their preexisting conditions.

Surgery may be recommended.

Get Cervical Kyphosis Treatment Today

How was our guide to cervical kyphosis treatment? We want to hear what you think in the comments below.

Causes and Treatments of Spinal Cord Tumors

A spinal cord tumor is a growth that develops within the spinal cord itself or between the spinal cord and its protective sheaths. They can be either benign or malignant (noncancerous or cancerous) and affect approximately 10,000 people in the United States each year.

If you or a loved one have been diagnosed with a spinal cord tumor, you’re sure to have questions.

Why did this happen? Where do we go from here?

Read on to learn all you need to know about spinal cord tumors and the best treatment options.

Causes of spinal cord tumors

Though it is often unknown what causes the tumors to develop in the first place, it is thought that defective genes may be at the root of the problem.

It is unclear whether genetics play a role, if the cells are reacting to something in the environment, or if these tumors are developing spontaneously.

Spinal cord tumors are split into different groups based on where and how the tumor first develops.

• Benign primary spinal cord tumors: Most benign spinal cord tumors originate in the cells next to the spinal cord or within the spinal cord itself, rather than having spread from another part of the body.
• Malignant primary spinal cord tumors: A malignant tumor will rarely originate in the spinal cord, but it is unlikely to spread to other parts of the body like many other types of cancer.
• Malignant secondary spinal cord tumors: More often than not, the cancer will have started elsewhere in the body and spread to the spinal cord if the spinal cord tumor is found to be malignant. Lung, prostate, and breast cancer are often the sources of these secondary tumors.

Symptoms

Depending on the size and exact location of the tumor, different patients may have different symptoms.

Symptoms may include:

• Back pain
• Weak muscles
• Difficulty walking
• Loss of control of bowel and bladder functions
• Loss of sensation in different areas, such as the arms and legs
• Decreased sensitivity to hot, cold, and pain

These symptoms overlap with several other medical conditions, so be sure to talk with your doctor if you are concerned.

Treatment Options

Treatment should be sought as soon as possible. The sooner treatment is started, the less likely the risk of permanent damage becomes.

The first concern with spinal cord tumors is often whether or not the tumor is compressing the spinal cord, which can lead to permanent loss of sensation or mobility. If this is the case, medications can be given to help reduce the swelling upon diagnosis.

This will be followed by surgery to remove the tumor.

If a surgical removal of the tumor is not possible due to the location of the tumor or other health concerns, radiation therapy will be used. This is a common treatment for secondary spinal cord tumors.

Sometimes the treatment plan will call for both surgery and radiation therapy.

Recovery

Recovery varies from case to case and depends largely on the tumor itself.

Smaller tumors that were caught early usually lead to a much faster recovery. If the tumor was not detected early, the recovery is likely to take longer.

In some cases, the damage done from the nerves being compressed may be long lasting or permanent even after the tumor is removed.