Spondylolisthesis
Non-surgical treatment of spondylolisthesis is usually effective. Surgery may occasionally be required if conservative care fails. Surgical options include a minimally invasive primary repair of the bone defect if the patient is young and/or has a healthy intervertebral disc and facet joints, or, spinal fusion surgery if advanced degeneration and spinal instability is present along with foraminal spinal stenosis. When treating spondylolisthesis, Dr. Biscup takes a very careful review of the anatomy and clinical symptoms to determine the most appropriate and least invasive procedure to perform. If fusion surgery is deemed necessary, considerable variation in approach and technique exists. There is also controversy regarding the need to correct the deformity or leave it in position. Don’t be afraid to seek different opinions.
If surgery is required, the majority of spine surgeons today will suggest a laminectomy and spinal fusion and not offer a minimally invasive alternative.
An alternative minimally invasive micro decompression laminaplasty procedure for the surgical management of Type III degenerative spondylolisthesis can be performed successfully avoiding the need for more aggressive decompression and fusion procedures. It is an operation that can “give you your life back”. If the condition is stable, why fuse it? Always ask your spine doctor and surgeon if there is an alternative to spinal fusion surgery. If they say no, get another opinion.
A selective nerve block, or more specifically a selective nerve root block is performed as both a treatment and a diagnostic tool for a pinched nerve.
An epidural block is one of the most common pain management procedures and has been around for quite some time.
A transforaminal epidural injection is similar to the standard epidural but differs in that access to the epidural space is gained through the foraminal canal.
OTC meds for back pain (over the counter medicine) may be used to combat some of the inflammation and pain felt in the early stages of back injury.
In the initial stages of injury ice should be used to help treat pain, inflammation and alleviate swelling.
When treating an injury, heat has a very limited use. It actually promotes an increase in blood flow and encourages swelling.
Massage therapy including back massages, medical massages and trigger point massages help by passively stretching an injured muscle.
Back traction can come in many forms. Cervical traction and lumbar traction are believed to work by stretching the back muscles to relieve chronic spasm as well as reversing the effects of gravity.
Participating in water exercises in a low or zero gravity environment allows individuals to work muscles or joints without having to support them at the same time.
"Core" Exercises help with lower back pain by building up your lower back muscles that provide support for the spine structure.
Physical therapy programs are usually tailored towards the individual as directed by the referring doctor.
In modern medicine orthopedic neck braces and lumbar support braces are often incorporated in the recovery plan for spinal fusion surgery.
Minimally invasive percutaneous fusion surgery involves placing screws into the vertebral pedicles percutaneously through small incisions using television x-ray.
Spinal fusion surgery is considered one of the “gold standard” operations in spinal surgery and has been performed for close to 100 years.
If a spinal fusion needs to be performed, we know that screw instrumentation increases fusion success rates. This is the procedure performed by the majority of spinal surgeons today, especially if a laminectomy is also performed.
Major spine reconstruction surgery is a further extension of an instrumented spine fusion that usually involves more than one level of the spine.
