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Spinal Conditions > Arthritis of the Spine
Have you been diagnosed with Arthritis of the Spine?
Are you getting conflicting information? Not sure what to do? Let us provide you with a global consultation and recommend spinal treatment options. All consultations are provided by Dr. Chiu himself.
Most forms of arthritis can occur in any joint in the body, including the joints in the spinal column. Osteoarthritis of the spine, the most common form of arthritis, can lead to lost flexibility; bone spurs (osteophytes), irritated nerves, back pain or spinal stenosis, and sciatica symptoms.
The term arthritis describes many different diseases that cause tenderness, pain, swelling and stiffness of the joints. With Osteoarthritis, the most common form of arthritis, the cartilage around the joint wears out and causes the bones in the joint to rub against each other, creating inflammation and pain. Most forms of arthritis can occur in any joint in the body, including the joints in the spinal column. Osteoarthritis of the spine can lead to lost flexibility; bone spurs (osteophytes), irritated nerves, back pain or spinal stenosis, and sciatica symptoms. Sometimes the terms spondylosis or degenerative joint disease are used interchangeably with osteoarthritis. Arthritis can, in fact, be the underlying cause of several different types of back conditions.
Many things can cause osteoarthritis, but the most common cause is wear and tear and the natural progression of aging. It can affect all levels—the cervical (or neck area), the thoracic (or upper back area), or the lumbar (or lower back region). Because the symptoms are similar, spinal osteoarthritis is sometimes misdiagnosed as degenerative disc disease. Degenerative disc disease (DDD) is the breakdown of the discs between vertebrae rather than the cartilage between facet joints. It also should not be confused with rheumatoid arthritis in the spine, a less common, although potentially more crippling, autoimmune disease of joint tissue. Nor is osteoarthritis the same as osteoporosis, which is the loss of bone mass over time.
Symptoms - General
Degenerative arthritis, or wear and tear of the vertebral joints, causes inflammation, to which your body may respond by causing bone spurs. Inflammation and bone spurs can cause pain by themselves or by irritating other parts of the back, such as muscles, ligaments, spinal column or nerves.
This type of arthritis, sometimes called osteoarthritis, affects the joints of the vertebrae, and primarily the facet joints and between the vertebras themselves. The pain is similar to arthritis in other parts of the body—a dull ache. Like any other arthritic pain, spinal arthritic pain is aggravated by cold and inactivity.
Some of the more common symptoms of osteoarthritis are:
• Diminished joint flexibility
• Intermittent joint pain that eases with movement
• The sensation of bone rubbing on bone
• Numbness or tingling in the arms or hands, as with cervical spine arthritis with spurring
• Weakness or numbness in the legs, as with lumbar spine arthritis with spurring
Symptoms - Lumbar
Symptoms of lumbar spinal arthritis include stiffness or pain in the lower back as well as inflammation and swelling of the joints. Some people also experience pain that radiates throughout the buttocks, thighs, and pelvic area. Often times, spine arthritis symptoms are most pronounced after long periods of inactivity or after prolonged strenuous activities.
Symptoms - Cervical
In addition to neck pain and joint stiffness, patients who suffer from neck arthritis symptoms might also experience:
Numbness or a tingling sensation in the shoulders and arms, loss of sensation in the arms, weakness in the arms, headaches that seem to originate in the back of he skull, loss of balance
Conservative Non-Surgical Treatment
Here at the California Spine Institute we always consider non-surgical treatment first when managing spine arthritis and other neck and back ailments. Non-surgical treatment options are effective at treating the majority of neck and back disease. Some common non-surgical treatments include:
• Physical therapy – Often the first step in managing back and neck problems caused by osteoarthritis, we prescribe physical therapy, which improves flexibility and mobility and increases strength. Typical physical therapy treatments include exercise, massage, electrical stimulation, heat therapy, hydrotherapy (aquatic therapy) and others. The California Spine Institute has a fully equipped, state of the art physical rehabilitation center onsite.
• Chiropractic – Chiropractors typically adjust the spine in order to treat neck and back pain, deploying such techniques as manual manipulation (adjustment), applied pressure, and massage, of the vertebrae and joints. We provide a range of chiropractic services at our physical rehabilitation center.
• Pain management – Pain management covers a wide range of remedies, such treatments as injections, drugs and medications, spinal bracing and others.
• Alternative medicine – We have found that several non-traditional therapies including acupuncture, acupressure, yoga, biofeedback, and more are sometimes viable solutions for relieving back pain. Although supporting research is limited, many of our patients have reported relief from alternative medicine.
In addition to medical treatment, there are a variety of things you can do to delay onset and lessen the severity of spine arthritis. These include:
• Maintain a healthy weight
• Maintain proper posture
• Remain active and avoiding any extended periods of inactivity
• Quit smoking, as smoking impairs blood flow resulting in nutrient and oxygen loss in spinal tissues
• Wear comfortable, low-heeled shoes
• Sleep on a mattress of medium firmness to reduce curvature of the spine
Until recently, the only surgical treatment typically involved a major operation that required general anesthesia, the dissection of muscle, removal of bone, manipulation of nerve roots, and, at times, bone fusion. Often, these types of procedures require large incisions and the manipulation bones and muscle tissue.
Conventional back surgery attempts to solve arthritis and other disc problems with extreme measures—such as removing a spinal disc or fusing parts of the spine together, so that they no longer move independent of one another, significantly decreasing the spine's mobility, or ability to move freely. Too often, considering the risks and sustained trauma, these solutions fail to relieve the patient's pain or make it and the overall spine condition worse.
It hurts just thinking about that. As you can imagine, major alterations like this to your spine (not to mention the huge access wound) take a long time to heal, several weeks or months. Full recovery, or returning to 100 percent original functionality, occurs infrequently. Also, this kind of surgery can require lengthy hospital stays, entails significant blood loss, and renders the patient vulnerable to several possible complications.
As you can imagine, recovering from so severe and operation can take several weeks or months, and frequently does recovery entail returning to 100 percent mobility.
Minimally Invasive Spine Surgery
Minimally Invasive Spinal Surgery (MISS) is a procedure for decompressing nerve roots damaged by arthritis and other back problems The term minimally invasive, of course, speaks volumes. It defines a category of procedures designed to do as little damage—to be as non-invasive and non-intrusive—as possible. Minimally invasive surgery, then, refers to surgical procedures designed to do as little collateral or malingering damage as possible.
In other words, we perform the procedure with minimal disruption to:
• The offending disc, joint, bone, or facet area itself
• The entry point and access path
• The immediate area surrounding the problem area
• The patient’s overall health.
MISS is performed with micro instruments, fiber optics, lasers and digital imaging, as opposed to conventional highly invasive knives, bone saws and other equally trauma-inducing devices. Compared to conventional open back surgery, which usually entails huge incisions, displacing muscle tissue and nerve roots, and sometimes the removal of bone, MISS is without question much less traumatic. Also, it doesn’t destabilize the spine, unlike many conventional back surgeries. It can also be performed on multiple discs or other offending areas, even at widely spaced levels, during the same surgical session. Working on multiple levels with open back surgery often requires additional destructive entry wounds—far too much traumatic damage for patients to endure or recover from.
Arthritis—one of the more common disc problems—for example, can place pressure on the nerves in your spine, causing severe pain. Conventional back surgery attempts to solve this and other disc problems with extreme measures—such as removing a spinal disc or fusing parts of the spine together, so that they no longer move independent of one another. Either method significantly decreases the spine’s mobility, or ability to move freely. Too often, considering the risks and sustained trauma, these solutions fail to relieve the patient’s pain or make it and the overall spine condition worse.
As you can imagine, major alterations like this to your spine (not to mention the huge access wound) take a long time to heal, several weeks or months. Full recovery, or returning to 100 percent original functionality, occurs infrequently. Also, this kind of surgery can require lengthy hospital stays, entails significant blood loss, and renders the patient vulnerable to several possible complications.
MISS, on the other hand, is performed with very small “micro” instruments and tiny cameras inserted through a small tube. We also use x-ray, and other types of visualization technology to help guide the instruments, allowing us to “see” what we’re doing without cutting and clearing obstructing vital tissues and structures. We reach the offending disc through a very small incision. Damage to tissues and other vital structures in the immediate vicinity are, in nearly all instances, so minuscule that within a very short time the access point and path are healed, with little to no impact on the patient’s body and overall health.
There are numerous advantages to MISS compared to open spinal surgery*.
(Note: Patients with large free fragments of disc in the spinal canal, as determined by the x-ray, cannot benefit from the endoscopic** procedure, but might benefit from the arthroscopic*** procedure. However, the laser can shrink the bulging disc further for disc decompression.)
Some advantages are:
•Much less tissue trauma when compared to an open surgical procedure
•Hospitalization is not required, MISS is an outpatient procedure
•Faster recovery, since MISS is an outpatient procedure
•Minimal to no scarring in and around the nerves post operatively
•Earlier return to work and to daily activities
•Patients can begin an exercise program the day after surgery •
•We estimate the cost of endoscopic surgery is 40% less than conventional spine surgery
Advantages of Minimally Invasive Spine Surgery
There are numerous advantages to MISS compared to open spinal surgery, including:
An outpatient or “same day surgery“, no hospitalization
Costs less - approximately 40% less than a open spinal surgery/fusion
Minimal to no scarring in and around the nerves post operatively
Earlier return to work and to daily activities
Patients can begin an exercise program the day after surgery
Multiple level spinal discectomy can be performed at one sitting with minimal risk
Can be done for high risk anaesthesia patients with morbid obesity, emphysema, and cardiac conditions under local anaesthesia/IV sedation at much less risk
Preserves spinal motion
After surgery, most patients require little analgesics
MISS requires no hospitalization, allows for earlier recovery and earlier return to work and return to daily activities, when compared to conventional spine surgery.
Please feel free to contact my staff at (800) 354-8554 or email us at email@example.com any questions you might have concerning these procedures.
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