Back - Thoracic and Lumbar Spine

Five percent of the United States population experiences back pain each year (1). Over your lifetime, you have a 60-80% chance of experiencing at least one episode of back pain. Most episodes are not severe and resolve without medical care. Some, however, are severe and disabling. But even the more severe cases which cause patients to seek medical or chiropractic care are usually transient. It has been estimated that 90% of patients who seek professional treatment for back pain will be pain free within 1-3 months. In this group of patients, after ruling out an underlying systemic cause such as a malignancy or infection, appropriate care consists of providing conservative treatment.

The gold standard of conservative treatment consists of management with NSAIDS (Non Steroidal Anti Inflammatory Drugs) and exercise therapy (chiropractic or physical therapy). If these modalities fail after a 3-6 week trial, referral to a specialist (neurosurgeon or orthopedic surgeon) is appropriate. Often, we as specialists will continue conservative measures. When this fails, surgery can be extremely effective. Surgery is only performed when conservative measures fail and diagnostic tests demonstrate abnormalities.

In our practice, the most frequently encountered causes of nerve impingement in the lumbar spine are herniated disk, spinal stenosis and painful mechanical instability with degenerated disk.

Vertebroplasty / Kyphoplasty

A vertebral compression fracture (VCF) occurs when the vertebral body fractures and collapses. Most VCFs are caused by osteoporosis, a disease that causes bones to become brittle and break easily. Compression fractures can also occur as a result of certain types of cancer or tumors.

Balloon Kyphoplasty is a minimally invasive treatment in which special balloons are used to gently elevate the bone fragments in an attempt to return them to the correct position. X-rays and magnetic resonance imaging (MRI)are used to determine the exact location of the fracture before the procedure is performed.

Compared to the standard Vertebroplasty procedure, Kyphoplasty adds the introduction and inflation of the balloon. This provides the advantage of allowing the cement to be injected into the space created by the balloon under a lower pressure than would otherwise be required. Kyphoplasty also provides, in some cases, the ability to raise the collapsed vertebra and return it to its normal position.

Your doctor will provide details of the procedure that is right for you as well as the benefits and risks. He will also provide instructions for your care before and after the procedure.

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