Archive for category cervical fusion
CERVICAL DISC REPLACEMENT
The spinal discs (shock-absorbing pads between our vertebrae) help us manage the shocks and stresses of daily movement. Our spines are heavily involved in most kinds of motion (sitting, standing, bending, lifting, twisting, etc.). As such, the facet joints that link our vertebrae as well as the spinal discs between them need to be extremely durable and operate with low back and neck pain levels during normal motion. Unfortunately, this is not always the case. Spinal structural deformities, trauma, heavy lifting, and inactivity can all play their part in compromising parts of the spinal column. The natural aging process compounds these factors due to the fact that spinal discs naturally degenerate over time. Spinal and cervical discs become thinner, harder, and less pliable as we age, and as a result they are far less capable of managing the stresses of daily life. We are also more likely to experience back and neck pain as a result of these changes.
All of these problems may create problems in the cervical discs in our necks. Since the neck is routinely engaged in movement, compromised cervical discs can severely affect mobility by causing pain during routine motion. Fortunately, there are a variety of strategies patients can use to mediate pain levels. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) can help mediate pain levels while restoring enough mobility for patients to explore other treatment options. Physical therapy focuses on developing muscles along the spinal column and surrounding the neck to offer support to cervical discs and relieve some of the weight they would otherwise have to bear during routine movement.
For more serious cases, such as severe structural deformity, trauma, or extreme neck pain not resolved by more conservative treatments, cervical disc replacement or cervical fusion may be the best option, depending upon the specific findings, recommendations of the surgeon, and desires of the patient. Since this surgery may be both serious and financially costly, physicians typically do not recommend it unless the compromised cervical disc is threatening other functions in the body (causing a loss of sensation, impinging on nearby spinal nerves, causing muscle weakness, etc.). Bone spurs and compromised cervical discs are the most common causes and physicians operate primarily to maintain the patient’s long-term health, as opposed to simply seeking to reduce pain levels. Of course, indications for surgery may vary from patient to patient.
Recovery for cervical disc replacement, like many types of spinal surgery, can be brief to more prolonged . Rest, a healthy diet, and regimens of physical therapy are necessary to re-develop damaged muscles and relieve some of the pressure on cervical discs. Your physician will likely order several checkups to maintain a sense of your progress and to readjust your course of treatment as needed.
The Kraus Back and Neck Institute (KBNI) in Houston TX cares for patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.
Keywords: cervical disc, spinal disc, pain levels, neck pain, Houston, Woodlands, Katy, Spring, Sugarland, Sealy, Pearland, Baytown, Beaumont, Tomball, Galleria, Humble, Conroe, Kingwood, Port Arthur, Memorial City, Galveston, Texas Medical Center (TMC), Dallas, Fort Worth, San Antonio, Austin
Recover from Spinal Fusion discussion by KBNI Houston, Katy, Woodlands, Sugarland, Galveston, Texas Medical Center
Posted by admin in back pain, baytown, beaumont, cervical fusion, chiropractic, chiropractor, chiropractor near me, core strengthening exercise, fusion, healthy diet, houston, katy, lifting techniques, low back pain, lumbar fusion, neck pain, pain, physical therapy, post-operative care, recover, sciatica exercises, smoking, spinal fusion, spinal injury rehabilitation, spine surgery, sports injury, sugarland, woodlands on June 26, 2014
Spinal fusion is a back or neck surgery in which vertebrae within the spinal column are fused together to eliminate movement at points of articulation (joints) between them. This can lower spinal mobility overall, but often spinal fusion can have a net positive effect for a patient due to decreased pain levels and increased spinal stability. When a spinal fusion is performed in the cervical spine (neck), it is known as a cervical fusion. When the spinal fusion is performed in the lumbar spine (low back), it is called a lumbar fusion. It can take some time to recover after this type of surgery.
To recover from a spinal fusion can be difficult based on the invasiveness of the surgery itself and the length of the post-operative care period. To recover, patients may need to make significant lifestyle changes in order to aid recovery and ensure that a stable fusion takes place as the bones of the spinal column grow back together. Eliminating smoking entirely is absolutely essential. Cigarettes contain elevated levels of nicotine, which is a chemical shown to be highly toxic to bone growth. Nicotine kills the body’s osteoblasts (bone-growing cells), while leaving our bone-eating cells (osteoclasts) alive. Spinal fusion patients who smoke during post-operative recovery are much less likely to maintain a stable spinal column, and may restrict bone growth while extending their less successful recovery by several months. If a patient wants a stable spinal fusion that minimizes the possibility of subsequent corrective surgeries, eliminating smoking is possibly the single greatest factor that aids recovery.
To recover, patients must also be certain to follow guidelines regarding physical therapy, exercise, and motion during their post-operative care period. Core strengthening exercises can be guided by a chiropractor or physical therapy. Physical therapy or chiropractic guidance and education can also help to teach about how to prevent future spine injuries. Spinal fusion is one of the more intensive varieties of back surgery, and physicians must document the recovery process accurately to ensure that the patient’s spinal column is stable enough for everyday motion. This requires subsequent visits for imaging tests (typically X-rays, in the case of spinal fusion) to monitor bone growth. There may be strict guidelines for the amount a patient can lift or the length of time in which the patient may stand, sit, or walk during the course of their daily routines. The amount of time needed to recover may vary widely depending on how old the patient is (younger patients generally re-grow bone more quickly than older patients) as well as the physical requirements of their occupation.
In some cases, the physician who performed the spinal fusion may have the patient wear an external brace to help recover. This will help support the body, and reduce movement of the fused area of the spine, while new bone is attempting to grow, and accomplish the spinal fusion.
Some patients may wear an external bone growth stimulator, if prescribed by their doctor. The bone growth stimulator provides an electric current around the body, which stimulates bone growth.
Physician experts at the Kraus Back and Neck Institute (KBNI) in Houston TX have significant experience at taking care of patients and helping them to recover after undergoing spinal fusion. Many times, surgery can be avoided, but when necessary, the neurosurgeons at the KBNI have the most current techniques in minimally invasive spine surgery available when appropriate.
The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.
Patients suffering from a cervical stenosis or lumbar stenosis, or who have been told they may require a lumbar laminectomy or cervical laminectomy, can contact the Kraus Back and Neck Institute at
……. Or visit www.SpineHealth.com to schedule an appointment online
Keywords: spinal fusion, recover, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center, TMC, Texas, TX, Dallas, Fort Worth, San Antonio, Austin
Spinal Fusion including Lumbar Fusion and Cervical Fusion for Pain and Nerve Compression in Houston, Katy, Woodlands, Sugarland, Memorial City, Texas Medical Center, TMC, Humble, Kingwood, Conroe and Beaumont
Bone fusion (also called arthrodesis) (when performed in the low back spine is called lumbar fusion, when performed in the neck is called cervical fusion) is the procedure by which bones are joined at specific joints, most often to alleviate pain. The new fused bones are allowed to grow together. This lowers pain levels because at common bone fusion sites (lumbar or lower spine, wrists, ankles, or thumbs, neck or cervical spine) there are often nerves nearby that are responsible for sensation, as well as recognition of joint position and movement. Bones on either side of the deteriorating joint can compress these nerves and cause extreme pain. Fusing these bones significantly lowers the incidence of nerve irritation, and when bone spurs are removed, can reduce nerve compression.
Causes for a patient desiring bone fusion surgery, or spinal fusion surgery can include rheumatoid arthritis and osteoarthritis, as well as severe back pain due to tumors or herniated (slipped) discs. Like other joints in the body, the discs (shock-absorbing pads) between our spinal vertebrae, can wear out. Nerve compression in the spine occurs much more frequently when these spinal discs have been thinned or ruptured by age and activity. The arthritis, as well as the chronic herniated discs, can compress nerves passing next to them. As in other regions of the body, bone fusion is a possible solution for reducing pain, but it will eliminate mobility at that particular joint.
Neurosurgeons at the Kraus Back and Neck Institute, in Houston, have a significant experience with utilizing spinal fusion (lumbar fusion, cervical fusion) to treat neck pain and low back pain in patients. They have offices located in Houston and surrounding areas of Katy, Woodlands, Sugarland, Memorial City, Texas Medical Center (TMC), Humble, Kingwood, Conroe, and Beaumont.
Bone fusion is somewhat unique in that in many cases, it seeks to mimic the body’s natural healing response. In one version, bone is taken from another region in the body and inserted between the two or more bones that are being fused together. This “foreign” bone stimulates bone growth during post-operative care, as it is placed under pressure and adjacent to other bone, which has been prepared to grow into the new bone graft. Other versions of bone fusion or spinal fusion may include implantation of wires, metal plates, screws, and other devices to accurately position the new joint, and keep it immobile, while the new bone is trying to grow into the bone graft. Adequate rest and physical therapy during post-operative care are absolutely essential to ensure that a proper bone fusion takes place. If the new joint is displaced by excessive movement, subsequent corrective surgeries may be necessary to re-set the bone.
The technique of lumbar fusion or cervical fusion (spinal fusion) can be performed in several ways. The general principle is to have bone grow across the currently mobile disc space. A number of techniques are possible. One approach is to try to achieve this fusion on the sides of the spine, between what are known as transverse processes, which project outward from the vertebral bodies. In doing so, the surgeon exposes these transverse processes during the operation, and removes the outer coating of the bone, known as the cortex, thus exposing the inner cancellous bone, which is the honeycomb type of bone seen when one breaks open a chicken bone. With the outer hard cortex removed, the inner cancellous bone will attempt to grow into the bone graft which it is in contact with. This bone graft can be placed on the side of the spine, which is known as a lumbar posterolateral fusion. It can also be placed between the vertebral bodies, which is known as an interbody fusion. When this type of lumbar fusion is performed, it is called a lumbar intervertebral body fusion. When this type of cervical fusion is performed, it is called a an anterior cervical discectomy and fusion (ACDF). In the cervical spine, this type of fusion is generally performed through an anterior approach, which means going in through the front of the neck. When this interbody fusion is performed in the lumbar spine, it can be performed from the back of the spine (known as a PLIF (posterior lumbar interbody fusion) or a TLIF (transverse lumber interbody fusion), the front of the spine (known as an ALIF (anterior lumbar interbody fusion). It can also be performed from the side of the spine, known as an XLIF (extreme lateral interbody fusion) or a DLIF (direct lateral interbody fusion) (these different names utilized basically the same lateral approach, but were given different names by two different manufacturers of the spinal hardware equipment (Nuvasive and Medtronic). It can also be performed through an approach going straight up the spine, through an incision made next to the tail bone, known as an AXIALIF (axial lumbar interbody fusion), the instruments of which are manufactured by TranS1.
There are also a number of different grafts which can be used for promoting the bone growth in a spinal fusion. Cadaver bone can be used, which is harvested from cadavers. This is known as allograft. Bone can be taken from the patient undergoing surgery, either from a different site or from the same site. This is known as autograft. Substances known as bone morphogenic protein (BMP) ( Medtronic manufactures Infuse) can be used locally to promote bone growth. Stem cells, taken from the patient’s own blood which has been spun down in a centrifuge, can be placed over the graft to help promote bone growth.
Candidates for bone fusion / spinal fusion also need to be aware of the effects of smoking on the procedure. Osteoblasts (bone-growing cells) are needed in droves to ensure a speedy recovery. One of the addictive chemicals in cigarettes, nicotine, is toxic to osteoblasts and can substantially lengthen the time necessary for a complete bone fusion, or even make it impossible to achieve. Smokers are advised to abstain before and after the procedure.
Patients suffering pain in the neck, low back, or other portions of the spine, can call the Kraus Back and Neck Institute in Houston, TX. They will be evaluated and appropriate tests will be ordered. No imaging studies are required for patients to be seen.
Key Words: spinal fusion, lumbar fusion, cervical fusion, nerve compression, pain, Houston, katy, woodlands, sugarland, memorial city, texas medical center, TMC, humble, kingwood, Conroe, beaumont
Smoking and Spinal Fusion Surgery
Patients often ask about the effects of smoking on spinal fusion surgery. Nicotine has a significant negative impact on the human musculoskeletal system by lowering bone mineral density, contributing to intervertebral disc degeneration, and limiting the restoration of the blood supply to bone grafts. Numerous studies have shown that smoking also (1) slows the production of bone-forming cells (osteoblasts) thereby increasing the time required for healing, (2) impairs the absorption of calcium, and (3) increases the risk of bone fracture. Other studies have found a direct link between smoking and low-back pain independent of surgical intervention.
Spinal fusion, the permanent surgical immobilization of two or more adjacent bones (vertebra) of the spinal column, has become the standard of care in the United States with more than 500,000 spinal fusions performed annually on the neck and low back. The effects of smoking should be of particular concern for individuals who undergo a fusion in the lumbar and cervical regions of the spine. Smoking causes an increased rate of pseudarthrosis, the failure of bone to fuse following spinal fusion surgery. This leads to increased postoperative pain. Studies of lumbar and cervical fusions consistently show that successful fusions occur in a significantly higher percentage of nonsmokers than smokers.
Finally it should be noted that cigarette smoking is a significant risk factor for the development of postoperative complications such as deep wound infection, improper healing and bone graft pain.
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