As we age, problems such as back pain, sciatica and pain shooting down one’s thighs become common for many of us. According to Charles Nalley, MD, orthopedic surgeon at the AdventHealth Tampa Spine Center, age progression can naturally lead to a degenerative process that creates changes in the spine. Unfortunately, these changes often put pressure on the spinal nerves, causing pain.
Sometimes these spinal changes can be staved off by having a healthy body weight and a strong and flexible core and hips. Regular participation in aerobic exercises such as walking, hiking, swimming or cycling helps with both of these things. However, when it’s not possible to walk without back and leg pain, it’s time to see a doctor.
Diagnosing Back Pain & Early Treatment
“An MRI can show us stenosis – a Greek word that means ‘narrowing’ – and where this is putting pressure on a person’s nerves,” says Dr. Nalley. The goal of the back surgery he offers patients is to correct spinal stenosis. This will remove pressure from the nerves in the spine, relieving pain.
Even though some patients come to Dr. Nalley wanting to have back surgery right away, he and his colleagues at AdventHealth Tampa encourage them to first try a more conservative treatment approach such as physical therapy.
“By using nonsurgical, holistic care and a core strengthening program, many patients see improvement in their pain,” Dr. Nalley explains. This relief from pain may be good enough that the patient no longer wants surgery. Even so, some symptoms will remain, and more severe pain may flare up from time to time.
Back Surgery at AdventHealth Tampa
If a person’s quality of life is particularly poor because of the pain in the back, buttock or thigh, he or she may require more aggressive treatment in the form of an epidural or surgery. An epidural for back pain is a steroid injection that is delivered into the epidural area of the spine. This shot provides temporary pain relief, allowing people to resume their normal daily activities and continue physical therapy to prevent future pain. How long this pain relief lasts varies. Some patients find the epidural shot works for only a few days or weeks while, for others, it may keep pain away for years. When epidural injections no longer work or aren’t right for a patient, it may be time to consider surgery.
Dr. Nalley says that the “gold standard” procedure for severe spinal stenosis is called laminectomy, sometimes known as lumbar decompression surgery. This approach widens the spinal canal so it can no longer put pressure on the nerves of the spinal cord. If a patient has stenosis and also a bad alignment of the spine, sometimes a surgeon may perform fusion surgery. In this procedure, two vertebrae are fused together to create stability. Spinal fusion may also be used when stenosis is caused by a herniated (damaged) disc that the surgeon needs to remove.
An ultrasonic bone scalpel is a new tool used by AdventHealth Tampa’s orthopedic surgeons that has dramatically reduced the amount of time patients spend in surgery.
“Procedures that used to take two to four hours can now be completed in as little as 45 minutes,” says Dr. Nalley. The tool’s other benefit is that is decreases bleeding during surgery.
Recovery After Spine Surgery at AdventHealth Tampa
Many patients at AdventHealth Tampa have spine surgery on an outpatient basis. They can go home the same day as surgery as long as they can get up out of bed and use the restroom on their own. Older patients and those with walking difficulties may benefit from spending one night in the hospital. Before being discharged, patients are evaluated by a physical therapist to ensure they can move well enough to go home.
Dr. Nalley says that, after surgery, patients need to give it time for their scar tissue to completely mature. Some people will be able to go back to work sooner than others. An accountant may be able to return back to her job in two or three weeks, while a mason might require three or four months.
During the recovery time at home, Dr. Nalley stresses that “walking is the best medicine.” He explains that walking helps prevent three postsurgical complications: pneumonia, blood clots and pain.
“I tell my patients to pace the hallways – no speed-walking,” says Dr. Nalley, who advises them to take a gentle stroll of 10 minutes, 10 times a day.
After surgery such as laminectomy, the large majority of patients find relief of their back pain and ready to enter their golden years embracing a more active lifestyle. It will still be important to maintain a healthy weight, exercise and continue physical therapy to lower their chances for future back pain. However, spine surgery can relieve their current pain and set them off to a good start.
If you are experiencing back pain and want to know more about your treatment options, the orthopedic surgeons at AdventHealth Tampa can help. Call Call1-800-899-9608 to speak with our Nurse Navigator and schedule an appointment today!