Back Pain

It follows patient education video, which explains back pain.

Back pain is one of the most frequent medical problems, only preceded by a common cold. We speak of “low back pain” when the pain is located in the lower region of the back and “sciatica” when the pain is felt in the lower back, buttock, and/or different parts of the leg and foot. Lower back pain and sciatica can appear separately or simultaneously.

Around 80% of the population will experience this type of pain at some point in their life, and many times it will happen in a recurrent fashion.
In the acute phase, the pain may limit the normal daily activity. Fortunately, 80% of patients will spontaneously improve within four to six weeks often with the help of medication and rest. Only 4% of patients will experience back pain for more than 6 months.

It is for these recurrent cases of chronic pain that a CT or MRI needs to be performed in order to achieve a proper diagnosis.

It is estimated that low back pain may be caused by an array of different situations such as obesity, smoking, poor posture, lack or excess of physical activity or even due to heavy weight lifting. There are over 50 diseases responsible for causing back pain but the most frequent ones are: lumbar disc herniation, degenerative disc disease, lumbar spinal stenosis and spondilolysthesis.

Degenerative Disc Disease

It follows patient education video with regards to Degenerative disc disease.

In the degenerative disc disease (DDD) there is a gradual dehydration and progressive degeneration of the intervertebral discs which as a result loose resistance and elasticity. These changes may lead to the inability of the disc to absorb mechanical stresses within the spine. This causes low back pain which can be severe and affect the quality of life. Spinal “arthrodesis” or “fusion” is still the surgical gold standard in these cases. The goal is to achieve immobilization and fusion at the pathological spinal level.
In some cases of “early degeneration” motion sparing device may be implanted.

New surgical instruments have been developed in recent years that enable us to perform these surgeries through minimally invasive approaches. One of these techniques is Minimally invasive lumbar fusion.
Back pain from a degenerative disc disease (DDD) may be treated with a lumbar fusion. This is performed through MIS approaches placing intervertebral cages filled with bone graft supplemented by percutaneous screws and rods. Performed under general anesthesia and discharged on day 2 or 3 after the surgery.
In some cases, back pain can be solved with Facet Radiofrequency (Radiofrequency Ablation). Back pain may be caused by facet degeneration. In those cases patients may benefit from facet injections or even facet radiofrecuency. Performed under local anesthesia. Patients discharged on the same day.

Sources:

Dr. Vicenç Gilete, MD, Neurosurgeon & Spine Surgeon.

Neurosurgery volumes I–III. Edited by Robert H. Wilkins and Setti S. Rengachary. McGraw-Hill.

Handbook of Neurosurgery. Mark S.Greenberg, Seventh Edition. Thieme.

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