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Back Pain

TREATMENT in NEW YORK CITY

Lumbar Laminectomy/discetomy

One of the common reasons of Back pain is Herniated discs.
A lumbar laminectomy/discectomy is a common surgery to remove fragments of an extruded herniated disc.

The Procedure Simplified

  • The surgeon makes an incision through the skin just off the centerline of the spine. The bony area of the vertebra, called the lamina is exposed and a small portion of it is removed (called a laminectomy).
  • A ligament, called the ligamentum flavum, is reflected back to expose the nerves and the extruded disc material.
  • After that the spinal nerve is retracted (moved back) for better exposure of the extruded disc fragments. Then the fragments are removed (this is called a discectomy or removal of the damaged disc fragments).

TREATMENT

Physical therapy should be prescribed after surgery. While rehabilitation for each individual can differ, treatment usually consists of flexibility exercise, lumbar stabilization/core strengthening, and aerobic exercise. Studies have shown that patients that undergo physical therapy after lumbar discectomy have better outcomes than those that do not receive physical therapy.

Spinal Stenosis

Spinal stenosis is the narrowing of the spinal canals. It may involve the central canal, the hollow tube on the backside of the spine through which the spinal cord travels, and/or the transverse foramina, the canals from which the spinal nerves exit.

Narrowing of the spinal canals is usually an age related process (called secondary stenosis). During this process the vertebral discs lose their height (degenerate), the ligaments become stiff, and bone spurs may form. The combination of loss of disc height, hardening of the ligaments, and bone spur formation can cause the stenosis. Other conditions such as spondylolisthesis, trauma, or post-surgical complications, can also cause stenosis.

Because of mechanical compression and blood flow congestion, spinal stenosis can result in severe pain. With lumbar or low back spinal stenosis, symptoms often include low back pain and a diffuse radiation of pain into the buttocks and thighs. Also tingling and numbness and leg weakness may be present as well.

TREATMENT

Symptoms are often worse with standing, walking, and backward bending/extension of the spine. Sitting, forward bending, and unweighting of the body often provide relief. One of the hallmark signs of lumbar spinal stenosis is a decreased walking tolerance.

Conservative care (rehabilitation), may be helpful. Treatment may consist of stretching, strengthening, joint mobilization/manipulation, aerobic exercise, and activity modification. Walking with an “unweighting system” or aquatic exercise may be helpful.

It is important to work closely with your physician and physical therapist.

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