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Senior Citizen's Guide to South Jersey

New Advances in Spine Surgery

Spine surgery has grown immensely in the last decade. This is true, not only in the number of spine surgeries performed, but also in the spine surgeon’s ability to diagnose the disease process with new technologies and treat problems with new techniques. Most of these techniques include some version of minimally invasive spine surgery, or MIS. These MIS techniques have shown to be superior in the rate of patient recovery, early pain control, and overall patient satisfaction. Although surgery should be reserved until all non-operative treatments have been explored, these newer techniques provide both the surgeon and the patient very good surgical options.

This is particularly true for the aging population. This population is afflicted with diseases such as arthritis, disc degeneration, osteoporosis, stenosis, and others, leading to pain in the neck, low back, or the arms/legs. They can also elicit symptoms such as numbness, tingling, cramping or even weakness of the extremities. These are just some of the problems fellowship-trained spine surgeons treat every day.

One of the most common diagnoses or problems found in the senior citizen population is degenerative disc disease of the lumbar spine (lower spine area), leading to stenosis and radiculopathy. This translates to narrowing around the nerves in the back and producing pain and/or numbness and weakness down the legs. Commonly, this is treated with physical therapy, anti-inflammatory medications, and possibly intraspinal injections. However, sometimes this requires a surgical solution. One of the newer techniques, lateral lumbar interbody fusion or LLIF, has shown to be of particular use. This allows the surgeon to make a small incision on the patient’s flank, remove the painful disc and open up the space available for the nerve roots in the spine. It has been very successful for the osteoporotic spine by providing a large surface area for healing and bony support. Patients usually go home earlier, have less pain, and return to full activity faster than with the older, more traditional surgical procedures.

Another common and more serious diagnosis is cervical myelopathy. Cervical myelopathy is caused by arthritis or disc herniation in the neck that compresses the cervical spinal cord. Symptoms of myelopathy include hand numbness, loss of fine motor skills in the hands, dropping objects, and walking imbalance. This is a progressive and particularly dangerous problem that can only be corrected with surgery. Surgery for myelopathy consists of decompressing the spinal cord, and traditionally has been associated with fusing a large number of vertebrae in the neck. This leads to prolonged use of a cervical collar, loss of head and neck range of motion, and long recovery. For a good percentage of these patients, fusion may no longer be necessary. A newer technique called cervical laminoplasty allows the surgeon to decompress the spinal cord and not have to fuse the neck. The patient does not wear a collar post-operatively, begins moving their head and neck the day of surgery, and is usually back to full activity much earlier than their fused counterparts.

Before opting for a surgical solution for your neck or back problems, your spine surgeon will more than likely begin by recommending non-operative care. No one wants to have spine surgery, but if deemed necessary by your spine surgeon, the techniques mentioned above are proving to be very successful options.

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