Spine General (involves multiple spine areas)

What's a graded functional rehab program for a spine fracture? That's what I'm headed for in the next few weeks. I kind of wanted to know what I'm getting into with this.

Any kind of graded exercise means you'll start out slowly and gradually increase the frequency, intensity, and duration of any exercises given. With a spine fracture, this often takes the form of spinal stabilization exercises that include the entire trunk (back and abdomen). Most rehab programs are designed, administered, and/or supervised by a physical therapist.




I am scheduled for a spinal fusion in two weeks. As part of the preliminary work-up, my surgeon ordered bone scans and blood tests to look for osteoporosis. I'm worried now that if it turns out I have osteoporosis they won't do the surgery. Is that possible?

You are in good hands if your surgeon is routinely screening for osteoporosis and pretreating patients who might be at risk for fractures from brittle bones associated with osteoporosis. You may not be cancelled for surgery. It depends on a number of different factors. Your age, the quality of bone density, your levels of calcium and vitamin D, and your overall general health are all important factors in the decision.




Spine Surgeons Practice Regarding Preoperative Osteoporosis Screening

Medical doctors rely on evidence from scientific studies to help guide their treatment decisions. Without evidence, they fall back on consensus-based best practice. That means they do what they have seen works well and what others have reported based on surveys and questionnaires. Sometimes there's a gap between what the evidence shows and what the current practice is. As this study shows, that's what may be happening for patients undergoing spinal surgery who have osteoporosis.




What is pseudarthrosis? The surgeon tells me this is what is causing my back pain after I had spinal fusion surgery. I thought my pain was going to be better but instead it's worse and pseudarthrosis is the reason why.

Pseudarthrosis is another word for false joint and refers to movement that occurs at the fused site. It can occur without symptoms so the patient doesn't even know he or she has it. Or it can cause back and leg (or arm) pain, depending on whether the fusion is at the cervical (neck) or lumbar (low back) level.




I'm debating between using donor bone material for a neck fusion and my own bone. I've heard that bone bank grafts aren't alive, so I should use my own bone. But I've been told to be prepared for more problems from the donor site than at the actual fusion. Is all this true?

Surgical fusion of the spine for degenerative disease is becoming a popular way to treat this problem. And that's because surgeons now have at their disposal better ways to perform the surgery and improved hardware such as pedicle screws and locking plates to hold the bones together. Bone graft is also a commonly used material to help get a solid fusion.




When Spinal Fusion Fails: What's Next?

Surgical fusion of the spine for degenerative disease is becoming a popular way to treat this problem. And that's because surgeons now have at their disposal better ways to perform the surgery and improved hardware such as pedicle screws and locking plates to hold the bones together. Even so, there is a major concern about the number of failed spinal fusions requiring revision (a second) surgery.




My 77-year-old mother just suffered her third vertebral compression fracture. She's starting to get more and more hunched over. The back brace they gave her after the second fracture is impossible to get on her. She's not in any great pain but she's uncomfortable and really slowing down. Isn't there anything else that can be done for this condition?

Almost one million adults in the United States suffer vertebral compression fractures (VCFs) each year. When that many people are affected by a condition, doctors and scientists take a closer look to see what can be done to improve treatment and save money.




Vertebroplasty and Kyphoplasty: How Are They Holding Up?

It's time. It's been 20 years since surgeons started using vertebroplasty (VP) to treat vertebral compression fractures and 10 years since kyphoplasty (KP) was developed. It's time to take a look back and see how well these treatments are working. In this article, researchers from The Johns Hopkins Department of Neurosurgery review all the published articles on VP and KP. They summarize the level evidence (fair to good) for both of these minimally invasive procedures.




When I told my doctor 'no surgery' for my aching back, he suggested I at least talk to a surgeon about some of the minimally invasive procedures that are available now. He called these mini-operations 'interventional'. But I really don't know what I'm asking about. Can you help me out here with at least a description I can take with me so I know what to say?

Interventional procedures involve a minimally invasive operation. The surgeon inserts a long needle through a tiny incision in the skin and advances it to the spine in order to carry out the procedure. This approach is called percutaneous. A special real-time X-ray called fluoroscopy is used to guide the surgeon.




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