Will I be able to play sports after spinal fusion?

Spinal fusion is the connection of one spinal vertebrae to another spinal vertebrae though a bony bridge. Eventually the vertebrae and bone bridge join together forming a strong “solid bone”.  During the healing the bones are “braced” or held in position by titanium screws and rods.  The rods and screws prevent the bones from falling apart.   Excessive forces placed across  spinal instrumentations (screws and rods) may break them preventing the spinal fusion from healing. It may take a year or so for the spine to fuse.

You can return to light activity right away.   Most people can return to sports before the spinal fusion heals.

Return to sports depends upon the type of sports, professional or amateur, contact or non-contact, reasons the spinal fusion was needed in the first place, patient’s age, patient’s health, location of the fusion, how many levels were fused and other patient , disease and bio-mechanical factors.

People returning to strenuous, contact and /or professional sports may need to wait 1 year or until the fusion has completely healed.

For more information please see Spinal Fusion and Options.  Please call 908-452-5612 to schedule an appointment or click schedule-an-appointment to discus your problem and see if you are a candidate for endoscopic spinal fusion surgery.

How does spinal fusion help low back pain?

There are many causes of low back pain.  Back pain may arise from the muscles, tendons, joints, disks, bones, nerves and spinal cord.  Rarely back pain may arise from other organs in the abdomen or chest.

Black disks called degenerative disk disease (DDD) may produce back pain.  This may be caused by  injury to the disk called an annular tear.  Scientists believe annular tears cause pain from ingrowth of pain nerves into the disk.  As the disk disease progresses this can lead to weakness in the spine called instability.  Instability produces pain from abnormal movements in the spine.

Facet joint damage can also cause back pain.  The facet joints hold the back of the spine together.  If the joints are injured they can be a source of pain.  This is called facet arthropathy  and is common when people have severe arthritis in there spine.  If the facet joints wears out or break and can no longer hold the spine together then the spine may slip apart.  This is called a spondylolithesis.

If the back pain arises from the torn disk then pain is relieved by removing the painful disk and replacing it with cage and bone. If the problem is instability (that is weakness and abnormal movement) the fusion and instrumentation holds the spine together preventing these abnormal movements.

Today spinal fusion can be done minimally invasively with the spinal endoscope (endoscopic lumbar interbody fusion or ELIF).  This decreases skin and muscle damage, pain and suffering after surgery and allows you to get gong quicker.

Please see Spinal Fusion and Options for more information about spinal fusion or schedule-an-appointment.

Do I need a back brace after spinal fusion?

Spinal fusion surgery is connecting one spinal vertebrae to another spinal vertebrae.  This is done through a bone “bridge”, that is bone is placed between the vertebrae.  The bone is usually placed between the vertebral bodies.  This is called an interbody fusion.  If the fusion is done through your abdomen it is called anterior lumbar interbody fusion (ALIF), through your side/flank  [Direct lateral interbody fusion (DLIF) or extreme lateral interbody fusion (XLIF)] or through your back [posterior lumbar interbody fusion (PLIF) or tranforaminal lumbar interbody fusion (TLIF)].

The surgical approach is important because it relates to pain, disability, muscle damage and complications.  Fusions done through the back tend to be more painful resulting in greater recovery, time off and disability.  This is appears less true for minimally invasive procedures like the endoscopic lumbar interbody fusion (ELIF).  The more muscle damage the weaker the back and the higher chance of future spinal disease and pain.

There are complications related to anesthesia and surgery.  All surgery has risks but the specific risk to fusion surgery is partially related to the approach to the spine:

1.  Surgery done from the abdomen put major blood vessels (like the aorta and  vena cava) and abdominal organs like kidneys at risk.  There is even a chance for errectile dysfunction (E.D.) or retrograde ejaculation (sperm goes into the bladder not out the penis).  These problems can lead to infertility.

2. Surgery from the side can injury the lumbar plexus (these are nerves that supply the legs) causing pain, numbness or weakness in the legs.

3. Surgery done through the back muscles  can injure the muscles causing future pain and new spine problems.  This muscle damage is decreased with minimally invasive surgery.

Most people have to wear a brace after surgery for 1 to 3 months, but it depends on the type of fusion and instrumentation surgery, number of levels fused and the reason for fusion.

For more information on lumbar fusions please click Spinal Fusion and Options or on Dr. Carl Spivak and Executive Spine Surgery please call 908-452-5612 or click Schedule an Appointment.

My lower back is in pain all the time and my doctor did an x-ray of my lower back and it came back fine, what else could be wrong?

Low back pain is a common complaint in America.  It may arise as result of injury but ususally there is no specific cause.  There are many potential causes of low back pain.   The pain may originate from many different structures including your spine bones, disks, facet joints, muscles, ligaments,chest and abdomen, etc.  Please see What Causes Back Pain?  for more information.

X-ray is not a sufficient workup for back pain, most people need at least an MRI scan to properly evaluate their back.  Sometimes they need special diagnostic injections called pain mapping.  This may include diagnostic transforaminal nerve blocks, medial branch blocks and discogram.

Unless a serious cause of back pain is found most doctors recommend to start with conservative treatment, such as rest, physical therapy to improve core muscle strength and flexibility, non steroidal anti-inflammatory medications, pain medicine and steroid injections. Patients who do not improve may benefit from surgery.  Please see When Should I Consider Back Surgery?

Depending on the cause of the pain patients may benefit from disk surgery (What is Sciatica?), lumbar laminectomy (Overview of Spinal Stenosis), lumbar fusion (Spinal Fusion and alternate Options) or vertebroplasty or kyphoplasty (Kyphoplasty – what is it?).

For more information please Schedule an Appointment. Good Luck!

How painful is recovery from lumbar spinal fusion surgery?

Spinal Fusion is the joining of one vertebrae to another vertebrae by a bone graft.  This bone graft acts as a bridge between the two vertebrae.  Spinal fusion is held together with metal screws and rods. It is done for symptomatic degenerative disk disease, spine fractures, cancer, spinal instability and spondylolithesis.  Large open spinal fusions may have incisions many inches long while single level minimally invasive spinal fusion can done through 1 inch incisions.

Recovery from lumbar spinal fusion depends on the patient’s health, pathology being treated  [what is actually wrong with your spine,  the number of levels affected (single vs multilevel disease) and prior surgery and complications] and the lumbar fusion technique.  Minimally invasive surgery tends to be less destructive, painful and have a quicker recovery. Most people will be on pain medication for a week to months as they recover from there surgery.

For more information please Schedule an Appointment! Good Luck!

Do I have to wear my back brace at night?

Back brace is used to stabilize your spine after spinal fusion surgery.   These braces are used to hold the spine together until fusion occurs.  Spinal Fusion is the joining of one vertebrae to another vertebrae by bone bridge.  The two vertebrae and the bone graft eventually become one solid bone.  Spinal instrumentation acts as a internal brace to hold the fusion together.  This may consist of rods, screws, plates, clamps or wires.

The rate of spinal fusion depends on many factors including age, activity, size, location.  Spinal fusion is decreased by smoking and usage of non-steroidal anti-inflammatory medications.

Spine braces can be in the form of a neck collar after anterior cervical discectomy and fusion (ACDF), thoracic lumbar sacral orthosis (TLSO) after treatment of a thoraco-lumbar burst fracture or lumbar sacral orthosis (LSO) after lumbar fusion.

For more information on back braces please see the following blog posts:

Is it bad to use a back brace?

Should I be wearing a back brace if I have a disc injury?

Back braces are not usually worn in bed because there are less forces being applied across the surgical site and less chance of damaging the fusion and instrumentation holding the spine together.

For more information please Schedule an Appointment.   Good Luck!