Spine Lumbar

Does it make sense to you that a 80-year-old grandmother would need surgery to fuse her spine? She's so stiff, I doubt her spine even moves. But the surgeon is recommending a spinal fusion for a condition they call degenerative spondylolisthesis. What can you tell me about this?

Spondylolisthesis is a condition in which one of the vertebral bones slips forward over the one below it. Spondylolisthesis alters the alignment of the spine. As the bone slips forward, the nearby tissues and nerves may become irritated and painful. In older adults, degeneration of the disc and facet (spinal) joints can lead to spondylolisthesis. Spondylolisthesis from degeneration usually affects people over 50 years old.




Which Surgical Fusion Method is Best for Degenerative Spondylolisthesis?

There are different reasons to fuse the spine and different ways to do the fusion procedure. Surgeons are studying the results of fusion techniques to get an idea of which one works best for each problem. In this study, patients who had a spinal fusion for degenerative spondylolisthesis with one of three fusion methods are compared. Two of the fusion techniques used instrumentation such as screws or metal plates and screws.




I am one of many silent sufferers. With chronic low back pain, I've made the rounds of chiropractors, acupuncturists, naturopaths, and massage therapists with little to show for it except an empty wallet. Is any thing being done in this country for people like us? There has to be a way out of this prison of pain.

Chronic pain such as you are experiencing is, indeed, more common than one might imagine. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) estimates approximately 50 million people in the United States are chronic pain sufferers. Chronic pain is defined as pain that lasts three or more months longer than the expected time for healing.




Dad is 72 and had his first surgery ever less than two weeks ago. They did a laminectomy for spinal stenosis. Although his back pain was better at first, now it's getting worse everyday. Is this normal? How long do we wait for the pain to go away?

Laminectomy is the removal of part or all of the lamina, a column of bone that helps form an arch around the spinal cord to protect it. Spinal stenosis is the narrowing of the spinal canal, the long tube where the spinal cord goes from the brain down to the end of the spine. Anything that can narrow this space can put pressure on the spinal cord or spinal nerve roots. Cutting away the lamina opens up the spinal canal and takes pressure off these neural structures.




I'm having trouble finding someone who will take my back pain seriously and help me. The doctor says to exercise and it will get better. Well, I've tried exercise and the pain always comes back. Is it just me? Or do other people have this experience, too?

A recent study was done investigating patient satisfaction with health care for chronic low back pain. They found that the majority of patients were satisfied with their care. The number of visits didn't seem to affect satisfaction. Those who weren't happy didn't attribute their dissatisfaction with their health care provider. They might not have felt they got an adequate explanation of their problem, so decided to seek other opinions.




I seem to be able to manage my chronic low back pain with Oxycontin. The pain is tolerable and I'm able to put in my three shifts a week at work. My doctor says I'm not improving and would like to see me get off the drugs. Isn't not getting worse an acceptable result? I'm happy with it, but I can't seem to get that across to the doc. What do you suggest?

More and more, patient satisfaction is becoming an acceptable outcome measure of treatment. However, when potentially addictive medications such as narcotics (e.g., Oxycontin) are involved, the physician recognizes that there are other factors to consider.




After six years of suffering with low back pain with no known cause, my doctor tells me I'm just going to have to learn to live with the pain. That's just not acceptable to me. Are there any other options for people like me?

No one doubts that patients with chronic low back pain have pain and even an underlying cause for that pain. But what to do about it can be a baffling challenge. Scientists, researchers, doctors, and physical therapists have not been able to find one individual treatment that's most effective for chronic back pain sufferers.




I have about six weeks to devote to exercise before starting a work-training program for people with low back pain who want to get back on the job. Should I go for Pilates or yoga? I keep hearing my friends say, "Oh you should go to Pilates" or "Oh you have got to try yoga". I can't do both. Which one works best?

There aren't very many studies directly comparing these two forms of exercise. But there are literally hundreds of studies supporting the use of ANY physical activity or exercise for your better health. Even 10 minutes of exercise twice a day has been shown to help.




My counselor has suggested I try yoga to help with my back pain and my depression. I don't really know where or how to get started. I know there are different kinds of yoga. Which one works best for these two problems?

Yoga is a meditative practice based on the Hindu philosophy centered on training the mental, verbal, and physical aspects of life. The discipline started in India around Hinduism, Buddhism, and Jainism. But it has spread to the western world where it is more likely to be practiced as a form of physical exercise without the philosophic or religious focus.




I've been all over the United States looking for someone who can tell me what's wrong with my back. I've had tests and tests and tests with no positive findings. No matter what I try, it doesn't seem to give me lasting pain relief. Please tell me where I can go to get the help I need.

As with many cases of nonspecific low back pain, even when there's a known cause (car accident), tests are negative and no known anatomical reason exists for the pain that continues past the time of healing. Many patients like you who find themselves in this situation expect a medical doctor somewhere to figure out what is wrong and fix it. They have become weak and deconditioned. Their quality of life has plummeted. They feel they have nowhere else to go.





*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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