Posts Tagged ‘foraminotomy’

Viewer Question from Austrailia re: Surgery

Wednesday, September 8th, 2010

karen

Ordinarily, I wouldn’t go into such detail in an MRI report when responding to a viewer question, but in this instance, it actually served a purpose: The issues discussed in the MRI sounded really complicated, but in fact they were only describing 2 simple issues- There was a disc bulge pressing on the spinal cord, and there was a reduction in the size of the hole through which a nerve exits the spine. SOOOOO….all that complicated medical jargon provides us physicians with good specificity so we know exactly what we are looking for, and where it is- but the problem the report is describing is actually pretty straight forward.

Karen, I hope some of this information is helpful. Please let us know how you move forward with this.

All my best wishes for your speedy recovery, however you proceed.

-Andy

Spinal Surgery for Back Pain: Part 1: Introduction

Wednesday, February 17th, 2010

I received so many questions about the post I did a couple of weeks ago on the surgical procedure known as a foraminotomy, and many of those questions had to do with other surgeries as well. I thought I would take the opportunity to review the basics of some of these procedures in order to get a better understanding of how these procedures work.

Surgery is the most aggressive treatment option available for relief from back pain, and should be considered only after all more conservative options have been weighed. Many patients in my own practice have come to me as a last resort before deciding whether or not to have surgery.

If you google information about the outcomes of spinal surgery, you may find that the statistics are a little discouraging. The overall statistics for patients in my own practice who have had surgery for their back pain is not too different from most of the numbers you see out there- I have observed that about 30% of patients get some relief from the surgery, 30% have virtually no improvement, and about 30% report that they actually felt worse following surgery. Now, while these numbers sound kind of dismal, they improve significantly when patients are well screened, and when you are dealing with a particularly talented surgeon (and no, I ain’t namin names!)

In the next posts, I will review a few of the more common surgical procedures for treating back and neck pain as well as radicular pain such as sciatica. We will review the foraminotomy, spinal fusion, disc repair, and disc replacement.

Now, in this introduction, let me give you some basics that apply to all types of spinal surgery;

-If you have exhausted all conservative approaches to your pain, and you are considering surgery- as with any surgery, when possible get a second opinion.

-In your area, try to find people who have had surgery, and gather information about their experiences- not only about their own outcome, but about their experiences with the surgeon, their hospital, recovery, therapy, etc…

-As with any surgery, there are inherent risks such as hemorrhage, infection, etc… I am wary of any physician which describes anything as ‘risk free’ or ‘minor surgery.’ In the world of spinal surgery, there is no such thing as minor surgery- only degrees of ‘major.’

-Be prepared to do any post operative therapy your surgeon recommends- for many procedures, the follow up is just as important as the procedure itself when it comes to a favourable outcome.

-Try and recruit friends and family members to provide a network of support both pre and postoperatively. There can be significant anxiety as well as pain & discomfort associated with any of these procedures. Having emotional support before and after surgery can help hasten recovery.

These are just a few considerations when gearing up for surgery. Over the next few installments, I hope to provide you a basic understanding of what these procedures entail. If you have had surgery for back or neck pain, please share your experiences.

Best,

Andy

sugery

VIDEO: Viewer Question re: Foraminotomy & Siatica

Wednesday, January 20th, 2010

foraminotomy

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A response to a viewer question regarding the surgical procedure known as a foraminotomy. In this procedure, the hole where a nerve exits the spine is enlarged in an effort to relieve impingement of the nerve, and subsequent pain. Stenosis, or reduction in the size of this hole is a common source of sciatica, and other radiating types of nerve pain. Below is an image of the neural exit foramina between two vertebrae.

foramina

Stay tuned for updates on the Fitness Challenge, and coming next week Pilates instructor Amanda Mitchell shares her One Thing.

Thanks for all of the great feedback, and be well.

-Andy