Spine Lumbar

The Value of Minimally Invasive Spine Surgery

The value of Minimally Invasive Spine Surgery (MISS) is more than surgeon assumption or a marketing whim. That sounds very poetic, but what does it mean exactly? The author answers that question in this review article on the topic of minimally invasive spine surgery.




I've been told that in California, they have the latest and best ways to do spinal fusions. I heard there's only a tiny incision and I can go home in a day or two. I live in Washington state but would be willing to travel there if that's true. What can you tell me about this new operation?

You may be talking about a relatively new approach to spinal fusion called extreme lateral interbody fusion (XLIF). Interbody fusion refers to the fact that after removing the disc, the surgeon inserts a metal cage, spacer, or bone graft material in the empty space. Bone is packed in and around the area to help the fusion process along.




I saw a short videotape at the surgeon's office about spinal fusion using a tiny incision from the side of the person. The idea is to avoid cutting into the back muscles to get to the bones of the spine. Can you tell me how this method compares to the regular way of doing the surgery?

There are many different ways to treat low back pain. When surgery is needed, there are different options as well. Spinal fusion may be necessary in the case of degenerative disc disease, tumor, infection, deformity, or spinal instability. Just like everything else, fusions can be done in different ways with different approaches.




I am a piano teacher with scoliosis. I sit for long hours each day. By the end of the day, I am more twisted than ever and suffer a lot of pain. I don't want major surgery with long rods to hold my spine straight. But I was looking through the magazines in the orthopedic surgeon's office. I saw a little metal plunger unit that is supposed to hold two of the spine bones together without doing a fusion procedure. Could they use something like this for me?

There is an interspinous spacer on the market for the treatment of back pain from spinal stenosis that may eventually be approved for use with scoliosis (curvature of the spine). Interspinous means the spacers are placed between two spinous processes. Those are the bumps you feel along your back. They are knobs of bone that extend out from the vertebral bodies.




I'm very excited because my doctor showed me a device called an X-stop that could help my mother. She has spinal stenosis so bad, she is always bent forward and can no longer stand up straight because of intense pain. Are these safe for 80-year-old women?

The X-stop is an interspinous spacer which means it is placed between two spinous processes and holds them apart. Those are the bumps you feel along your back. They are knobs of bone that extend out from the vertebral bodies.




I have several lumbar discs that are causing me problems. Eventually they will have to come out or I'll need a spinal fusion. I'm anxious for the new central disc replacements to be perfected. That way, maybe I can escape the bad results my father had with his fusion operation. The surgeon told me this isn't really ready for general use -- too many complications. What kind of problems are they encountering?

Advanced technology now allows the surgeon to remove the damaged or degenerated nucleus pulposus and insert an implant in its place. Usually the entire disc is removed and replaced. But efforts to replace just the central nucleus of the disc are being investigated.




After I had a disc replacement in my lumbar spine, I found out they are making replacements just for the inner portion of the disc. That's probably what I really needed. How far are we from having that technology ready?

There's been a lot of talk about stem cell research. Many scientists are convinced that the results of aging-related degeneration of the spine can be altered with stem cells. For example, the breakdown of disc material between the vertebral bones could be repaired by regenerating discs with stem cells.




I'm very excited that when I have the disc removed in my low back next week, there will be the tiniest scar. I can even have the area tattooed to cover it up. The surgeon was very clear that this is a better way to do things. Why isn't everyone doing surgery this way?

There's no doubt that smaller incisions during spine surgery (called minimally invasive spine surgery or MISS) has many advantages. Besides the tiny scar left behind, patients experience less tissue trauma. There is faster recovery of muscle strength when muscles don't have to be cut away and reattached at the end of the operation.




The Benefits of Homeopathic Care for Chronic Low Back Pain

No matter what causes low back pain, homeopathy may be able to help reduce symptoms, eliminate the need for pain relievers, and improve quality of life. These are the results of a study from Germany where the use of homeopathy is more widely accepted than in the United States.




Evidence Against the Use of Shoe Insoles to Prevent Low Back Pain

Can putting a simple pair of insoles inside your shoes prevent low back pain? What about using them to treat back pain once it starts? After conducting a systematic review of all the evidence, the conclusion was No to prevention and Not enough evidence to say for treatment.




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