Medical Breakthroughs: Better Back Surgery

CAUSES OF BACK PAIN: Many people with chronic back pain have problems related to the spine. The body relies heavily on the spine for support and mobility. Several structures in the spine are capable of producing back pain, such as nerves, discs, joints, ligaments and bones. Frequent causes of back pain can be muscle or ligament/tendon sprains.

BACK PAIN IN THE U.S.: According to the American Academy of Orthopaedic Surgeons, four out of five adults experience low back pain at some point during their lives. After the common cold, low back pain is the next leading reason for missed workdays for people under age 45.

The American Association of Neurological Surgeons reports more than 65 million Americans suffer from low back pain each year, and one-half of all patients who suffer from an episode of low back pain will have another occurrence within one year.

THE STANDARD TECHNIQUE: Lumbar spinal fusions are performed to treat common spinal conditions, such as degenerative disc disease and spondylolisthesis, or misaligned vertebrae. Spinal fusions "weld" unstable vertebrae together to eliminate pain caused by their movement. With standard surgeries, large bands of back muscle are stripped free and retracted from the spine, potentially causing considerable pain and permanent muscle scarring and damage. In addition, screws and rods are applied directly to the spine through an open approach requiring incisions up and down the middle of the back.

THE NEW TECHNIQUE: Sextant back surgery allows surgeons to apply screw and rod implants to the posterior of the spine without the major muscle and tissue disruption that happens in standard spinal fusion surgeries. The device used in the new surgery looks much like the sextant of naval navigation, hence the name, and is the navigation and insertion tool that allows screws and rods to be applied to the spine with minimal invasion.

BENEFITS: Benefits of the new technique include:

  • Shorter hospital stays - one to three days versus up to a week with open surgery
  • Smaller scars - one-inch scars compared to eight-inch scars
  • Shorter recovery periods
  • Less post-operative pain - no muscle cutting or stripping involved
  • Less chance of infection

THE FUTURE: Robert A. Hart, M.D., from Oregon Health & Science University in Portland, says most insurance companies pay for the new procedure, though the cost is slightly higher than standard spinal fusion. At least two other systems are already on the market, he says, and others are in development.

Dr. Hart adds the one disadvantage to the new surgery is the patient's exposure to x-rays. With the closed procedure, an x-ray machine guides doctors on the appropriate location to place screws.


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