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Spinal Fusion Options

Spinal fusion has become a very common surgical procedure in the United States over the past 10 years. There are many diagnoses that range from fractures of the spine to severe degenerative disc disease that prevent patients from being able to stand or walk are best treated with a surgical remedy.

This article is intended to provide a basic review of the many spinal fusion options that are available. It is best to talk to a fellowship-trained spine surgeon who will be able to give you a complete picture of all of the devices available that are recognized for quality and reliability or to help you rule out those that are not recommended.

As the number of spinal fusions has increased, the variety of procedures and hardware alternatives that are available has also increased. It may be easier to understand why there are so many types of fusions if you consider how fractures need to be fixed with fusion. With broken bones, there is usually little question about the wisdom of providing casts or plates and screws to stabilize bones that need to be realigned or stabilized. Spinal fusion provides the same stability for the spine as is used for other fractured bones. What is a spinal fusion? Screws and rods in the spine are used to keep bones from moving as the bone graft that is placed allows the stabilized bones to form a connection across a previously mobile disc space. The growth of bone between 2 previously mobile bones is called fusion.

Standard fusion technique: Initially, fusion of the vertebral bones was done by laying bone graft between the bones, to provide a scaffolding across which the native bone cells could grow. As the patient s bone cells move across the bone graft, they are able to incorporate the bone graft into the patient s own bone structure, forming a complete connection called a fusion. Bone graft is of primary importance in allowing the vertebral bones to fuse across a previously mobile segment. Studies of patient s with fusions done with bone graft alone have shown a relatively good rate of incorporation when patients are placed in back braces for 3 months or more. Because of the inconvenience and discomfort of the bracing, pedicle screws and rods have been added to provide an internal support that obviates the need for external supports.Internal screws and rods have increased successful fusion rates, as well as allowed patients to become mobile quickly after the spinal fusion.

Interbody fusion cages: As the skill of the surgeon has grown when applying screws and rods to the spine, we have, in turn, looked for better ways to gain improved results. Now, we are able to put bone graft around the back of the spine, as well as into the disc spaces. With these improved grafting methods, we are able to safely access the lumbar disc from the back of the spine. Adding bone graft to the disc increases the surface area for healing and should improve the overall success rate of the spinal fusion. Interbody grafting can be done from several different approaches, as access to the disc space can be achieved from multiple directions.

XLIF: This acronym stands for extreme lateral interbody fusion. XLIF is a newer device designed to provide a carrier for bone graft and support to the disc space. It is placed through an incision on the patient s flank.By making an incision on the patient s side, the abdominal contents can be moved out of the way for a very good view of the spine. Unfortunately, there are some significant nerves in the front of the spine that are very sensitive to being moved.This type of access to the spine can lead to weakness in one leg because of the nerve sensitivity.At this time, there are no long-term studies that demonstrate that this procedure is a success.

AxiaLif: This is another fusion device that has received some attention, due to its being touted as the least invasive spine fusion .This device is placed across the lowest disc space by access from the front of the sacrum (a large, triangular bone at the base of the spine, wedged between the two hip bones). By placing instruments through a small incision near the rectum towards the spine, the disc is accessed through a series of cannulas (hollow surgical tubes) and drills. This allows the disc material to be removed from the disc space.After the disc material is removed, bone grafting can be put into the hole that is created. This disc space is then supported by a tapered screw placed into the bones. So far, this device has had minimal post-surgical study and is most likely best done in conjunction with standard screw and rod fusion techniques.

Flexible Rods: There has been some recent excitement around rod and screw systems that are so-called non-fusion fusion devices. This confusing name infers that, although the intent of the screws and rods is for the bones to not move, these devices are designed to allow some movement. As was discussed earlier in this article, fusion is the solid connection of bones that had previously moved. The idea of these flexible rods is to provide enough stability to allow the bones to fuse together, but not enough to change the forces in the spine. This is termed a soft-fusion .At this point, there is no concensus as to how much or how little support is needed to achieve this. It is known that current screw and rod systems provide enough support to allow a fusion to occur while providing complete immobility of the vertebrae. Other than this complete connection, the amount of support less than complete immobility has not been defined and at this point is still under investigation.

Disc Replacement: Disc replacement was developed as an alternative to fusion and is suggested for those discs that have ruptured, but in which the bone structure is still good. If only the disc has gone bad, removal of the disc leaves a space that we normally fill with bone graft to promote fusion in the neck or lower back. With the development of the disc replacement, the space that is left from disc removal can be filled with a device that allows motion, rather than fusion.This is a complete reversal in the approach to disc removal; from complete immobility to total mobility. Disc replacement is intended to maintain the motion in the spine. This reconstruction of the spine should maintain the forces across the discs in the spine to prevent the other discs from deteriorating any more rapidly than their normal degenerative process. Disc replacement in the lumbar spine has met with some success in well-selected patients. It has not been a panacea for all patients with low back pain or degenerative disc disease. Disc replacement in the cervical spine has had good success, as most neck fusions are done for bad discs with the bones being in good condition.

Improved training, including advanced specialty training in fellowship programs, as well as improved implants, has decreased most surgical procedure times to 2 hours or less.Historically, older techniques have been known to take 4-6 hours for just the operation. By decreasing operative times, surgeons have seen decreased complications from the anesthesia, as well as decreased risks of infection and blood loss. Most surgeries under 2 hours will not require a blood transfusion.

A well-informed patient, who understands the benefits and the risks of their surgery, can fully participate in the choices that need to be made about their surgery. If you have been told that you need a spine fusion, ask questions and do your research. It is appropriate to ask your surgeon about their experience performing spinal fusions, how many of the fusion procedures they perform, how long the operation will take and the likelihood of needing a blood transfusion. Selecting a well-qualified surgeon can help ensure the best outcome for you and the success of your spinal fusion.

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Pediatric Spinal Fusion To Correct Scoliosis

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Minimally Invasive Lumbar Spinal Fusion Surgery Information

Lumbar spinal fusion is an operation that causes the bones of the spine in the lower back to grow together. The goal of the lumbar fusion is to have the two vertebrae fuse (grow solidly together) so that there is no longer any motion …

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Medtronic Introduces the VERTEX SELECT(R) Reconstruction System

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Integra LifeSciences Launches Integra Mozaik Moldable Morsels

A spinal fusion is successful when the bones grow together biologically and form a solid mass. Bone grafts, and bone graft substitutes, such as the Integra Mozaik™ line of products, are frequently used by surgeons to aid and promote …

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A New Approach To Serious Back Pain

Spinal decompression is a relatively new treatment for persons with serious back pain and many former back pain sufferers swear by it as the above video attests. Yet most insurance companies don’t cover this procedure. The result is many of these sufferers don’t get the back pain relief they are seeking and may turn to other solutions, even surgery, that prove to be ineffective. Here’s an account from two chiropractors who make a pretty compelling case for spinal decompression. And who knows what will be covered in the health care arena in the coming months!

We’ve been treating back pain in our San Antonio spine clinic for several years now, and one thing is for certain: chronic back pain is incredibly common and due to the failure of the typical treatments, a large number of people are living in pain needlessly.

The most commonly utilized treatments for chronic back pain have a poor success rate statisitically, but new treatment methods are now providing relief for even back pain sufferers who have suffered for many years.

One of these new breakthroughs that we use in our San Antonio office is spinal decompression. Spinal decompression is a high-tech form of spinal traction that reduces spinal disc bulging, enhances disc hydration and nutrition, and mobilizes spinal joints and connective tissue. When used appropriately, the results are often nothing short of amazing.

Unfortunately, spinal decompression remains underutilized as a back pain treatment for a couple of reasons. First, the early marketing for spinal decompression was often hype-filled and factually inaccurate. Although decompression is statistically the most effective treatment currently available for most serious types of back pain, the early marketing for it promoted it as a panacea for all back pain sufferers. Spinal decompression does enjoy an excellent success rate, but it is not effective in every patient and it is simply not appropriate for every back pain sufferer.

Another reason that spinal decompression continues to be underutilized for treating back pain is due to the usual challenges that all new health care procedures face in the United States.

Basically, insurance companies usually refuse coverage for health care procedures that do not have an established procedure code. In the U.S., the American Medical Association is responsible for producing the procedure codes, but they don’t make new codes until there are reasonably high numbers of doctors utilizing a given new procedure. Doctors are usually reluctant to invest the money in the equipment and/or training necessary to provide one of these new treatments unless they know they will be reimbursed for the treatment by health insurance companies. This brings us full-circle to the insurance companies not covering procedures that don’t have an established procedure code. Because of this system, most new medical treatments are not widely used for several years until consumer demand gradually pushes more doctors to start providing the treatment.

Because of the lack of insurance coverage for spinal decompression, many of the back pain patients we consult with at our san antonio spinal decompression clinic will opt to first pursue other treatment modalities that are covered by their insurance. Sadly, many of these patients go for months or years in pain, spending many thousands of dollars in insurance co-pays and deductibles on the standard back pain treatments without any results to show for it.

Many of these back pain sufferers finally opt for surgery looking for a cure for their symptoms. Statistically, about half of the patients who do seek a surgical treatment for their back pain discover that the surgery either does not help or makes things worse.

Although spinal decompression is not effective in every case, it does get good to excellent results for the vast majority of back pain patients. Some patients we’ve consulted with have opted to go the surgery route because they think it will be less expensive due to it being covered by insurance, but most back surgeries wind up being more expensive to the patient than spinal decompression.

What many back pain patients fail to realize is that the co-payments for a high-priced medical procedure like back surgery will usually run several thousand dollars. Even with no insurance coverage at all, spinal decompression typically costs the patient less out of pocket than an average back surgery, and a lot less than a complicated back surgery.

In most cases, spinal decompression is statistically the most effective treatment available and in the long-run is also usually the most cost-effective treatment available.

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Spinal Decompression Centers

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By sidestepping invasive procedures all together, spinal decompression offers a more affordable and practical solution to ongoing back pain. Traction therapy is fast becoming a popular method of spinal decompression that has proven to …

Spinal Decompression Or Back Surgery?

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Treating Back and Neck Pain with Spinal Decompression.

Back pain and neck pain are two of the most difficult conditions to treat. Often times a patient may end up going to several different providers to get relief…

Non-Surgical Spinal Decompression Treatment

Spinal decompression therapy is a non-surgical treatment for chronic back pain. Decompression treatment works by slowly and gently stretching the spine, which takes the pressure off compressed discs, vertebrae, and pinched nerves. …

Dr. Ronald Fielden, D.C. and Dr. Michael Golab, D.C. are the treating doctors at South Texas Non Surgical Spinal Center. Visit their website for more about spinal decompression and their San Antonio back pain treatment program.

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Top Chronic Back Pain Relief Tips

Free Back Pain Relief eBook and Videos

The simple act of exercising is a underutilized tool for people looking for effective back pain treatment, that will make more of a difference to your sense of well-being than pretty much everything else – including the gourmet food and wine, the greatest sex, and even the most exhilarating fun. The main drawback is that you have to take action for it to work.

No doubt, if you’re like most people in need of chronic back pain relief, you don’t have a great deal of time outside of work. There’s no window of opportunity for less than half an hour of stretching and strengthening exercises, not to mention the three quarters of an hour to an hour, three times a week that would satisfy the aerobic exercise requisite of a normal exercise program.

Relief For Back Pain

Well, the good news is I’m going to show you how to find the opportunity in your busy day – in some way – because, again, people who have experienced back pain releif everywhere know that simple and painless back exercises will prove to be more helpful and pain relieving to you long term, for alleviating back pain for you, than any other method you can try.

We’ll begin with the distinct lack of time you have available. What if I told you that taking a little time before you eat breakfast to execute some low impact back strengthening and stretching exercises is probably even better than buying an insurance policy covering you against the next time you’ll go through all that pain and suffering due to that chronic back pain?

As time is money for all of us, then the time you invest in exercise, which costs you nothing, it will definitely pay for itself when it saves you what you could easily spend on chiropractic, osteopathy, acupuncture, and so on – when your back muscles next seize up and bring back that flood of excruciating back pain.

Not sure if it will work out for your situation? You’re saying that you’re so overloaded that there’s barely enough time left to get some sleep each night, and you can’t remember the last time you didn’t feel tired all day? That’s no excuse, either. Rest assured, if you make the time, you’ll see that, exercise, especially regular aerobic exercise, can boost your health, well being and mood literally in a matter of minutes. If you take the plunge, you’ll be forgiven for thinking that your remaining energy will drain away, but, regular exercise actually gives you more energy. We know exercising burns off calories and helps you lose weight, it doesn’t make you lethargic. In actual fact, regular exercise makes you feel more alert and alive – and as exercise helps improve your sleep patterns, you’ll get a much deeper sleep from fewer sleeping hours.

Published by Stenosis Advisor

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Relieve Back Pain With Chiropractic Management

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How Do You Spell Relief?: Back Pain Massage Therapy

Additionally, water therapy for back pain utilizes an exercise program that is conducted in water. Specifically, because of the fact that water helps to buoy the body, the muscles are not relied on as much.

Help For Back Pain

Exercise balls, mini back-a-traction spinal decompression, whale backbench, mini-stepper, twist stepper, inversion tables, and pilates equipment are some of the back pain products available. … Topical pain relief creams or patches containing the chemical capsaicin are effective in providing temporary relief from back pain.

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I’m going to help you make the time in your day – one way or another – because, again, people who have known chronic back pain relief everywhere know that regular exercise will prove more beneficial to you in the long run, for relieving …

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