It is important for patients to understand there are no quick fixes for pain. Those who have back or neck pain can become out of shape, gaining weight in areas that affect the neck and spine. A spine doctor and spine therapist may want you to make your back stronger, more flexible and more resistant to future injury. (and more here about surgery but make it quick)
Vertebral Augmentation (Kyphoplasty) Kyphoplasty is a type of Vertebral Augmentation for Compression Fractures. A kyphoplasty is a surgical procedure designed to treat a compression fracture of the spine and stabilize a vertebral bone, resulting in back to normal spinal stability and stopping the pain caused by the fracture. Kyphoplasty surgery is performed under local or general anesthesia and typically takes 45-60 minutes for each fractured vertebra. The surgery consists of a small incision made in the back and a narrow tube is inserted toward the facture site guided in real time by fluoroscopy. A specialized small balloon is inserted into the vertebrae and very carefully inflated which moves the factured bone pieces back into their normal resting position. The balloon is then removed and a hard cement-like material called polymethylmethacrylate (PMMA) is filled into the cavity, which hardens and gives strength and structure back to that individual vertebrae. Patients will be observed in the recovery room immediately following the procedure and may spend one day in the hospital. You should arrange for transportation home from the hospital and should not drive until given permission by your physician.
What is Flatback Syndrome A healthy spine has a natural spinal curve that requires minimum energy to stand or walk. When the spinal curve has been removed, the result is a condition called “Flatback Syndrome.” Some of the symptoms of Flatback Syndrome include having trouble maintaining one’s posture, low back pain and upper leg pain. Since the person has trouble maintaining proper alignment, the symptoms can increase throughout the day causing extreme pain and fatigue. Patients might also have upper back and neck pain due to constantly trying to realign themselves. With some people, the pain symptoms can result in dependency on painkilling drugs. Flatback Syndrome was originally used to describe Harrington Rods recipients who had scoliosis correction during the 1960s up to 1990. The early technology used during this period involved using metal rods that were straight and were unable to mimic the natural curve of the lower back. This in turn caused the spine to flatten out. This unnatural spinal curve in turn would cause discs to herniate resulting in more pain symptoms. Since that time, scoliosis research has produced far more advanced spinal instrumentation that untwists the scoliotic spine and achieves a more natural correction with the proper spinal curve. Other conditions that may cause flatback syndrome include having a collapsed vertebrae. Arthritis can also contribute to flatback syndrome and cause inflammations in the spine, which may cause pain and stiffness. Most patients with flatback syndrome will complain of pain while standing upright. If the doctor determines you might have flatback syndrome, he or she will order a full-length X-ray of the spine. An MRI or CT scan might also be taken to help the doctor better understand the health of the spine and discs.
Surgery to correct flatback syndrome Patients diagnosed with Flatback Syndrome will initially be treated with an individualized physical therapy program and anti-inflammatory medication. If all non-surgical options have become exhausted, then surgery will be performed to remove the Harrington Rods, treat the herniated discs and to address other pain symptoms. During flatback surgery, an incision is made in the back so the surgeon can access the vertebrae and install the necessary instrumentation, rods, hooks and screws. In some cases an anterior incision may be made to access the front of the spine. Flatback surgery is based on a two-rod instrumentation system with hooks that attach to each vertebral level, to de-rotate and straighten the abnormal curve. The instruments are left inside the body attached to the spine even after the spinal fusions heal to provide additional support. After the surgery, the patient’s spine will appear much straighter. The surgical procedure may require a five-day hospital stay. Even after leaving the hospital, the patient will limit movement to allow the spine and incisions to heal. After three months most patients can begin to return to most normal activities with the exception of any contact sports, or sports like skiing that could result in a fall or trauma. Because the spine and spinal cord is being repositioned during surgery, paralysis is a real risk involved. Consequently, the patient should seek out a very experienced surgeon.
Dr. Rachid Assina MD, RPh, FAANS,
Prime Neuro Spine Institute
115 Horseneck Road. Suite 3.
Montville NJ 07045
Phone: (973) 970-2686