Back and Spinal Problems

Medical Scientists Need Your Help To Find A Better Treatment For Axial Spondyloarthritis



People with axial spondyloarthritis have chronic back pain which is usually treated with painkillers and anti-inflammatory medications. Although these provide some relief, the disease continues to progress in some patients while others notice their back pain has returned.

A new research study seeks to give a better understanding of how long-term treatment with the study drug compares to the standard of care treatments provided to these patients.

As a CureClick Ambassador I want to share this information with my readers because it could be helpful for medically treating people who have axSpA. Visit the research sponsor's website to learn more about it.

CureClick Axial SpondyloArthritis image

For those of you whom are not familiar with clinical trials, here's some information that you can use:

What Are Clinical Trials?

Clinical trials are research studies to determine whether investigational drugs or treatments are safe and effective for humans.

All investigational devices and medicines must undergo several clinical trials, often times these clinical trials require thousands of people.

Why participate in a clinical trial?

People whom are eligible will have access to new investigational treatments that would be available to the general public only upon approval.

People whom are eligible for clinical trials will also receive study-related medical care and attention from clinical staff at research facilities.

Clinical trials offer hope for many people and gives researchers a chance to find better treatment for others in the future.


Disclaimer: I am not participating in this clinical trial. I am providing this information to my readers as a CureClick Ambasssador. Click on the links below to learn about my relationship with Cureclick and why I'm talking about clinical trials.


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Pregnancy and Lower Back Pain, What Every Pregnant Woman Should Know

Pregnancy and Lower Back Pain, What Every Pregnant Woman Should Know

Pregnancy and Lower Back Pain, What Every Pregnant Woman Should Know
By Hannah Bajor

Back pain and pregnancy, tips on what you can do to make your pregnancy and lower back pain a little easier to deal with.

Normal weight gain in pregnancy is about 35 pounds, but lots of women I have met over my twenty-year midwifery career gained 35 pounds to 70 pounds during pregnancy. The stress of sudden weight gain during the short cycle of pregnancy can cause back pain and pregnancy misery.

Pregnancy posture change:

Pregnancy and lower back pain happens because of pregnancy weight gain and the automatic adjustments your body makes in posture to accommodate the growing womb. This change in posture is called pregnancy lordosis. Upper and lower back pain and pregnancy lordosis go hand in hand because your spine becomes super curved, elongated, and your breast and buttocks stick out pulling and stretching your back muscles.

Pregnancy hormones:

On top of this, back pain and pregnancy go hand in hand because of the higher levels of pregnancy hormones you produce. Pregnancy hormones have a relaxing effect on many of the muscles in your body to accommodate the muscle stretching that is required during pregnancy. Relaxed muscles are not as supportive to the spine and abdominal muscles, therefore many women complain of back pain and pregnancy shoulder stress.

Pregnancy pelvic changes:

The female pelvis is made up of many different bones. When you get towards the end of your pregnancy, a baby cannot fit to a normal-sized woman's pelvis without the pelvis opening and expanding. The pelvis has two major joints; one towards the right and one towards the left of your lower back along with a hinge joint at the very tail end of your spine.

Back pain and pregnancy ligament pulling and stretching is a direct result of your pelvis opening, which will allow your baby's head to engage or enter into the cavity of your pelvis. Pregnancy and lower back pain is also caused by the excess pressure felt deep within your pelvis as your baby sits and waits for labor to commence.

All of these factors taken together, it is not unusual for pregnant women to get backache. So if you get a backache straight away start doing things to prevent your backache from getting worse or getting out of control.

How to help minimize symptoms associated with pregnancy and lower back pain:

I definitely recommend having nice warm bath soaks, putting nice warm compresses on your back, or even better still having back massages to help with your pregnancy and lower back pain.

I would absolutely recommend that every pregnant woman go to see a chiropractor during pregnancy. A lot of traditional obstetrician, gynecologist and midwives are a little afraid of sending the women to a chiropractor because they are just not informed as to what chiropractors actually do. A chiropractor can help your spine accommodate easier to all the posture changes that happens during your pregnancy and relieve pain associated to pulled and stressed muscles associated to pregnancy and lower back pain

Apart from that, let us look at what things can you do to your own body to help minimize back pain and pregnancy. Wearing a good supporting bra during your pregnancy will support the increased breast weight and uplift your breasts so they do not feel so heavy. This will alleviate a lot of the upper back stress associated with pregnancy and lower back pain.

There are also a lot of pregnancy stomach binders that have been created to help support the weight of your growing womb which can help relieve back pain and pregnancy ligament discomfort.

Many women are focused on fashionable shoes and wear ridiculous footwear during pregnancies that do not support their posture and feet. I cannot believe how many pregnant women out there are wearing ridiculously high shoes or low shoes. Remember, as you become more and more pregnant all the bones and muscles within your feet are stressed.

Take a good look at the shoes you are wearing during your pregnancy and ask yourself these questions to evaluate the importance of your feet:

Do your shoes have a good supportive arch in them?

Are your shoes nice and wide to accommodate the increasing growth and widening of my foot associated to extra blood volume and swelling that occurs during pregnancy?

Can your foot easily slip out of your shoe? If so you could trip and fall and injure yourself or your baby.

The more informed you are about pregnancy the better choices you will make. Better choices mean a happier healthier mom and baby. Pregnancy can be an extraordinary experience for a woman. It is far more than growing a baby and understanding pregnancy and lower back pain.

Pregnancy has a huge emotional, mental, spiritual, and energetic side to it. The more you understand these aspects, the easier and less symptomatic your pregnancy will be. Learning how to connect with the emotions of your unborn child will allow you to enhance your pregnancy experience and surrender to its normal physiological process of pregnancy and lower back pain.

Midwife Hannah Bajor C.N.M., M.S.N. is founder, CEO and Visionary behind the Lumalove® brand of getting pregnant, pregnancy, infertility and miscarriage educational support products and services.

Hannah says "knowing my life's purpose gives one a hug advantage". Her 30 years midwifery experience along with her personal journey through ten years of infertility, having personally experienced a 16 week miscarriage and a near death experience delivering her second child has lit a fire in her soul that NO ONE can put out and that is to "change childbirth education as we know it".

Lumalove LLC helps couples globally access new and dynamic prenatal education and in doing so lays the foundational blueprints for a happier, healthier pregnancy outcome and gives their unborn child the opportunity of unlimited potential.

Take advantage of her FREE offer and experience her ability to help you connect deeper with your growing baby. To get your FREE pregnancy guided visualization mp3 then click on []

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Consider Mattress Reviews Before Buying A Mattress To Avoid Back Pain

Consider Mattress Reviews Before Buying A Mattress To Avoid Back Pain

Submitted by: Saurabh Jain

There is nothing more welcome than a comfortable mattress after a tough day at office. A good mattress provides support and comfort, which are prerequisites of sound sleep. The right kind of mattress also helps to be away from back pain. If you intend buying a mattress, you may visit a store and ask for Mattress Reviews from the salesperson. Mattress Reviews are handy tools to help you decide on the type of mattress you should buy.

You would find a wide variety of mattresses at the mattress store. Look into some Mattress Reviews to ascertain their benefits. If you are seeking a mattress that gives maximum support and firmness, you should opt for innerspring mattresses. The growing number of young people with back pain can find a good ally in an air mattress. Air mattresses are known to provide relief from back pain. You will be amazed to note that you can actually purchase a mattress to help your allergy. Memory foam mattresses eliminate allergens to ensure a good night’s sleep night after night.

While going through mattress reviews, take a good look at mattress sizes. A single mattress is 75” in length and 39” in width. This smallest sized mattress is also known as twin sized mattress. A variation of the twin sized mattress, the twin extra long mattress, comes with 5 inches of extra length. Its dimension is 39” x 80”. Full sized mattresses are also known as double sized mattresses, which measure 54” x 75”. These mattresses can accommodate two people, with each person having a space of 27”. This space is even lesser than that of a twin mattress. Queen sized mattresses are sized 60” x 80”, while king sized mattresses measure 76” x 80”.

Firmness of a mattress defines comfort levels. Apart from the type and size, your Mattress Reviews should include the firmness factor as well. The resistance a mattress provides to body weight can be termed as firmness. It also includes proper distribution of body weight, support and comfort level. The proper balance of body weight and support is essential to keep away the back pain. Make sure that you consider the aspects mentioned here before buying a mattress.

About the Author: Saurabh Jain is the Executive Editor of He has developed this site to provide valuable information to people suffering from back pain. The site enumerate different causes and factors related to back pain, guides through the different type of backpain. Visit for more.

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Posture Improvement Is The Cure For Chronic Back Pain

Posture Improvement Is The Cure For Chronic Back Pain

Submitted by: Janice Novak

Back Pain Statistics from the National Institute of Health:

1. Thirty one million Americans have low back pain at any given time.

2. Ninety percent of back problems are due to poor posture. It is the number one cause.

3. Back pain is the second most common cause of work days missed due to illness.

4. Back pain is the most common disability in the United States.

5. The cost that back pain has is estimated to be a staggering fifty billion dollars yearly.

The number one cause of back and neck pain is not overdoing it with a sport, workout or household chore but rather poor standing or sitting posture.

The spine consists of twenty-four interlocking bones called vertebrae. Stacked one upon another, these small bones support the weight of the body. Each vertebra contains four little joints with pain-sensitive linings. Between the vertebrae are circular pads, called disks, composed of a soft jelly enclosed in a tough, fibrous shell. The disks separate the bones and cushion the impact of walking, running, and moving. They're the spine's shock absorbers. In a healthy back the disks are plump and thick.

Inside this column of bones is the spinal cord, a thick bundle of nerves. Smaller nerves pass between the vertebrae and branch out to the rest of the body.

The spine has three slight curves, in the neck (the cervical curve), upper back (thoracic curve), and lower back (lumbar curve). These curves absorb shock and give the spine flexibility, while keeping the column balanced over the center of gravity. When the spine curves just the right amount, the vertebrae are stacked up properly. They glide against each other without friction. When the curves are too exaggerated, however, the spinal joints no longer fit together properly and thus press into one another. The joint linings can become irritated and inflamed. Also, because the space between the vertebrae is narrowed when the spinal curves are too great, the nerves that pass between them don't have enough room and become pressed upon and pinched, causing anything from a dull ache to throbbing, searing pain.

If the joints no longer fit together well, then the muscles surrounding those joints have to contract and tighten in an effort to keep further damage from occurring. The tighter the muscles become, the more the joint surfaces are squashed together, resulting in, you guessed it, even more wear and tear, more pain and discomfort.

You'll know if your spinal curves are too exaggerated if, from a side view, your head hangs too far forward from your shoulders, or your upper back is too curved or your shoulders round forward or your lower back has too much sway.

When you improve your posture, you take tremendous stress and strain off of bones, muscles and joints.

What is good posture?

Your spine and joints are in good alignment, when, from a side view:

• Your ear, should, hip, knee and ankle are in a straight line.

• Your head is directly on top of your shoulders.

• Your upper back is fairly straight, not slouched.

• Your shoulder blades are lying flat against your back.

• Your shoulders are straight and relaxed.

• Your pelvic is in a neutral position, meaning the little bony protrusions toward the top of the pelvic bones line up vertically with your pubic bone.

• Your knees are unlocked.

Try Posture, Get It Straight!'s One Minute To Better Posture Technique. It will have you standing straighter instantly.

1. Stand with your fee hip-width apart. Your knees should be soft and neutral, not locked.

2. Pull in your abdominal muscles as if you're zipping up a tight pair of pants. Think of pulling your belly button toward your back. Don't hold your breath.

3. Lift the front of your rib cage up as if there were a string connected from your breastbone to the ceiling, pulling you up. Try to elongate your midsection by pulling the bottom of your rib cage away from your hip bones.

4. Pull your shoulder blades back, towards your spine and then press them down, as if you wanted to tuck them into your back pockets.

5. Keep the position for a few moments, trying to relax into it and breathing normally. Then shake yourself a bit, walk around the room for a few minutes, and go through the steps again.

Correct Seated Posture

You may think that sitting is easier on your back than standing, but the truth is, when you sit, there is 40% more pressure on the disks in the small of your back. Sitting too long and improperly can be the cause of much back distress.

When you sit, you want to maintain the natural curves of your spine. You are sitting correctly when:

• Your ear, shoulder, and hip are in a straight line.

• Your head is centered over your shoulders, not dropped forward.

• Your rib cage is lifted.

• Your arms are supported by armrests. This takes 25% of the pressure off the lower back.

• Your bottom is against the back of the chair. Your lower back is not bowing out behind you.

• Your thighs are fully supported by the chair seat – meaning your knees don’t extend beyond the chair seat more than several inches.

• Your feet are flat on the floor or a stool.

About the Author: Janice Novak has a Master's Degree in Health & Physical Education and is an internationally acclaimed author, speaker and wellness consultant. Her program improves health, decreases sick days and improves productivity, alertness, energy and motivation. Visit Improve Your Posture

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Mental Fitness as Chronic Back Pain Remedy

Mental Fitness as Chronic Back Pain Remedy

Submitted by: Dr. Rose Windale

The total being is generally viewed as an interrelation between mind, body and spirit in essence with one having absolute influence over the other. With the intangible having the propensity to gain significant control over the tangible, much can be said about the influence of the mind on physical health as in the case of auto-suggestion and meditation. A perceptive question to mull over pertaining this theory is: Does the brain control chronic back pain or does chronic back pain control the brain? Researches have obtained findings that as much as 11% of shrinkage in the brain was indicated among sufferers of chronic back pain.

When afflicted by this constantly nagging and potentially debilitating irritant, such findings likewise manifested that the total quality of the brain undergoes major alterations. Compared to healthy individuals, chronic back pain sufferers’ brains age 20 times faster and the longer one suffers from the distress of this condition, the greater the damage is instigated. Experts suggest that chronic back pain is associated with the brain’s limbic system thereby affecting emotional states. This may be evident with the negative moods and vibrations and the sullen attitude experienced by those afflicted with chronic back pain. Such morose perspective is aggravated by the unfortunate assumption that chronic back pain is untreatable and can only degenerate.

Once beset by this potentially incapacitating condition, the nerve cells are unduly overworked and are in a perpetual state of negative activity. Researchers are of the view that chronic back pain sufferers can be motivated once they get a glimpse of their own live brain scan. By doing so, they can gain a better understanding of both pain perception and modulation which could aid them in controlling and managing chronic back pain. Once the individual instigates the initiative to send strong signals to the brain and goad it into creating positive results, that energy can come into realization. The brain is, after all, receptive and submissive to power of suggestion.

The same can be said about hypnosis and other mind practices. Adapting a positive attitude towards chronic back pain healing can trigger a beaming positive energy that can substantiate into beneficial physical outcomes when potent enough. Such is possible despite the fact that chronic back pain is hereditary. Just because the condition is within your gene pool doesn’t necessarily mean that it is irremediable. A healthy dose of optimism is therefore well worth incorporating into any health and medical regimen as much remains to be said about the influence of motivation and positivism on total wellness and a good quality of life.

Instilling a strong sense of belief that one will not be overwhelmed by their condition will eventually emerge as a positive energy that can only manifest when compelling enough. Such philosophy is applicable to chronic back pain and for other conditions as well. It is well not worth it to carry the unnecessary burden of a negative and gloomy mind set and a medical condition at the same time. Physical and metal fitness can well be the core treatment measures for chronic back pain. In accordance with your physician’s advice, breathing and physical exercises can be carried out as well.

A gradual, step-by-step process of addressing chronic back pain just might be one of the guaranteed means to remedy the condition.

About the Author: Dr. Rose Windale is a Health and Wellness Coach who has been successful with several natural health programs for many years. Rose decided to share her knowledge and tips through her website You can sign up for her free newsletter.

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Infrared Benefits For Back Pain Relief

Infrared Benefits For Back Pain Relief

Infrared Benefits For Back Pain Relief
By Adriana J Noton

Back pain can prevent you from enjoying the things you like to do and taking medication alters your mood and can be addictive. There are also many side effects from long-term pain medication. Infrared benefits for back pain relief are very effective, and the FDA has found that there are no harmful side effects.

Relief from migraines, headaches, gout, joint pain, back pain, shingles, bursitis, sciatica, arthritis and muscle pain can be achieved with Infrared heat that is natural and safe. Approximately 80 percent of the population will suffer from back pain at some point in their lives, it is the second major reason people visit the doctor and is the number one reason for disability in people 45 years old and younger. More than 25,000 surgeries are performed in the United States annually and many of them are not necessary. Many people report that after a few years the condition resumes.

Infrared heating can penetrate up to 3 1/2 inches releasing nitric-oxide into the body's hemoglobin which stimulates micro-circulation. Higher levels of oxygen and nutrients are delivered to the damaged cells. This eliminates cellular waste and toxins. The heat will go to the level of the muscles, blood vessels, nerves, ligaments, bones and joints.

There are three types of infrared light waves that include far, medium and near. The far waves are the best for this application and have been clinically proven to be the most beneficial in humans. Damaged cells in the body are negatively charged. The heat waves change the charge to a positive one nearly instantly.

It gently warms the tissues, joints and bones in the damaged area. The body goes into homeostasis meaning it tries to maintain temperature and to do this the blood vessels expand to allow more blood to flow to the area. The more blood that is brought to the damaged area, the more nutrition and this also means that lactic acid and toxins are carried away which causes the discomfort. When this is done inflammation is reduced.

The tissue expands relieving tension on the nerves. Muscles relax and tension is relieved. The synovial fluid in the joints is healthier which in turn lubricates the joints. This fluid contains an enzyme, if it is out of balance it will damage the cartilage in the joints. The Infrared heat balances the enzyme so that it will only do beneficial things. This form of heat has been tested in hospital and university studies and it has been found that it is safe to use as long as you desire on adults, children and pets.

The cost of Infrared heating is much lower than prescription drugs. And with drugs you will often have side effects such a bleeding and nausea. It is a better idea to use a natural method of relief.

Infrared benefits for back pain relief include reduction of muscle spasms and an increase in endorphin production. Infrared heat radiates through the skin and not just on the surface therefore providing lasting relief. It is direct and efficient. Professional athletes have used this treatment option to speed up healing from sport injuries. It has also been used to help relieve anxiety, skin problems and help with weight loss. People with eye problems, skin allergies and those taking certain medications that interact with the light should not use this treatment. Your doctor can advise you what is best for your individual situation.

Leading manufacturer of state of the art infrared saunas, traditional saunas, Infrared portable heaters in North America. Guaranteed for pain relief.

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Chiropractic Effective And Natural For Back Pain

Chiropractic Effective And Natural For Back Pain

Chiropractic Effective And Natural For Back Pain
By Nathan E Leavitt

Several people seek chiropractic as a natural and safe method for the treatment of back pain. About 22 million Americans visit the chiropractor each year and thirty five percent of these are seeking the chiropractor for the treatment of back pain. Other common complaints that people visit them for are neck pain, headaches and arm and leg pain.

Chiropractors go through several years of schooling including both undergraduate and post graduate studies. Chiropractic school is a four year program. Students are trained on theory and knowledge in the classroom and then receive hands on training in the clinic. In the United States, chiropractors are required to have a license in the state they reside in order to practice. They are also required to take continuing education courses regularly to stay current in their education and techniques.

Chiropractic treatments involve hands-on methods to manipulate the spine in order to correct problem areas in the spine and other joints in the pelvis, arms or legs. The theory behind these adjustments is to remove nerve interference and restore normal function in the body. By removing this interference, the body is then able to do what it knows best, heal itself. Chiropractic adjustments are beneficial for injuries such as from car accidents, sporting injuries, falls, slips and chronic stress such as from slouching at the desk or sitting without proper back support.

Chiropractic is also helpful for injured muscles and connective tissue such as ligaments, tendons and cartilage. These are often injured in conjunction with misaligned spinal bones. Restoring motion of the vertebra often heals and relieves these surrounding structures. When visiting the chiropractor, they will perform a medical history, perform an evaluation and may also use diagnostic imaging to diagnose the problem and help determine the treatment that is most effective. Chiropractic is often used with conventional medicine. Chiropractors also refer to other healthcare providers when necessary.

Chiropractic treatment involves specific hands on adjustment to one or more problems areas of the spine to improve range of motion and alignment. The goal of the adjustment is not only to provide relief of symptoms, but to also restore normal function and prevent future problems.

Chiropractic is well known to be a safe and effective method of treatment for back pain and other musculoskeletal problems. Research also demonstrates its effectiveness for other conditions such as headaches, neck pain, arthritis and fibromyalgia. Chiropractors also incorporate other healthcare services such as nutrition and physical therapy to provide a multi-disciplinary approach.

- Nathan Leavitt DC

Dr. Leavitt has been a licensed chiropractic physician since 2003. He currently resides in Knoxville, TN His deepest commitment is to help improve the health and quality of life of others. To learn more effective ways to improve your health naturally go here: knoxville tn chiropractor

You can also see patient reviews and see where Dr. Leavitt's clinic is located by clicking here: knoxville tn chiropractor

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Back Fat Can Hurt Your Spine



Excess back fat might seriously damage your spine, researchers warn. In a study published in the journal Arthritis & Rheumatism, researchers have discovered that obesity greatly increases the risk of spinal injury.

Chinese and Finnish researchers made the discovery after studying 2,599 men and women in southern China. The volunteers were recruited for an experiment which was designed to learn if being overweight or obese contributed to lumbar spinal degeneration in adults. To find the answer, they chose 1,040 men and 1,599 women (median age of volunteers was 41.9 years) and compared those with lumbar disc spinal degeneration to those who had healthy spines.

Using magnetic resonance imaging, the investigation revealed that 1,890 of the volunteers suffered from spinal degeneration. Scientists found that the majority of these subjects had higher BMI than healthy controls (23.3 kg/mvs. 21.7 kg/m2). In fact, the damage was even more profound among overweight and obese volunteers.

This study, one of the largest of its kind, proves just how dangerous excess body fat is to the health of the skeletal system. Three of the skeletal system's most important jobs is to protect the internal organs, provide structural support and mobility. Bones and cartilage are very strong and flexible, able to withstand tremendous force, but as with all living things, being subjected to constant stress, will eventually wear them down. 

The Chinese and Finnish research team wrote "In one of the largest studies to systematically assess lumbar disc degeneration on MRI, our study noted a significant association between the presence, increased extent, and global severity of disc degeneration in overweight and obese adults. "

Their conclusions shouldn't come as a surprise to anyone. It's not uncommon for obese and overweight people to suffer from arthritis and inflamed joints. Over time, their bones begin to buckle under the strain.

Last December we wrote about a government survey which found that arthritis sufferers were less likely to participate in physical activities than people without arthritis. Other studies show that oveweight and obese people with arthritis endure constant pain and have a lower quality of life.

This newest report deals with dangers that excess weight can do to the bones that protect your spinal cord. If you lose functionality in this vital region, many parts of the body will be affected.

Bottom line: obesity and overweight pose serious threat to your health and wellbeing. Now that you have this information, it's up to you to decide what you'll do with it.


Don't be afraid, the Lord our God has overcome the world!

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Article Sources 

Samartzis, D., Karppinen, J., Chan, D., Luk, K., & Cheung, K. (2012). The association of lumbar intervertebral disc degeneration on MRI in overweight and obese adults: A population-based study Arthritis & Rheumatism DOI: 10.1002/art.33462

Arthritis Interferes With The Physical Activity Of Millions Of Americans

Obesity Worsens Osteoarthritis Pain, Lowers Quality of Life in Older Americans

Arthritis Made Worse By Rising Obesity Rates - CDC Report


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To Fuse or Not to Fuse: The Spinal Question

To Fuse or Not to Fuse: The Spinal Question
By Dr. Jeffrey R. Carlson

Spinal fusion is one of the most feared and misunderstood
surgical procedures for the spine. Everyone has heard some kind
of frightening story about a distant family member who had back
surgery and was never the same afterward. Many patients think a
spinal fusion will cause their spine to become completely rigid,
and they envision a future of robot-like stiffness with the
inability to bend their backs or touch their toes, after
surgery. Over the past decade, spinal fusion has also had a less
than bright reputation as a treatment for pain. Given the
overall perception that fusion of the spine is a delicate
surgery with questionable outcomes, patients are quite concerned
about proceeding with a fusion. This article will help to dispel
many of the misconceptions that surround this treatment and why
it is important to understand the procedure, when it should be
performed and who might benefit from a spinal fusion.

What is Spinal Fusion?

Spinal fusion is a surgical procedure designed to provide
stability to an area of the spine that has too much movement or
movement that causes pain, tingling, numbness or weakness in the
arm or leg. The object of a spinal fusion is to connect the
bones (vertebrae) that were previously too mobile and form a
connection of bone in the spine that is more rigid.

A History Lesson

Orthopaedic surgeons have long applied casts to broken bones to
provide support to fractures and allow the bones to heal. The
addition of this external support keeps the bones from moving.
Why is this important? When there is too much movement between
broken bones or bone fragments, the repair cells are prevented
from being able to connect the bone fragments together, so their
process of healing will stop.

As orthopaedic surgeons have progressed in the use of
technology, plates and screws, called internal fixation devices,
are now applied to fractured bones. These rigid internal
fixation devices are stronger and add more support to the
fractured bone. Plates and screws have been able to replace
bulky external casting in a large group of fracture types.

The same treatment principles are used by the orthopaedic spine
surgeon . There was a time when fusions were supported with
external bracing. This external support, provided by casting or
rigid bracing, has now been replaced with internal rods and
screws. Using these internal supports provides stronger bone
connections that decrease motion even more. As a result, the
number of successful fusions has increased. The internal support
of the spine is stronger, allowing patients to get up and out of
bed and walk the day of surgery and to return to their usual
activities in 6 weeks. This is a far cry from the days of
original spinal fusions that were supported with a cumbersome
hard plastic brace or cast, leaving patients with limited
mobility or bed rest for many months.

Spine surgeons are now better able to determine which patients
will be helped with a spinal fusion. Advanced imaging studies,
including MRI and bone scans, as well as the use of diagnostic
injections, help today’s spine specialist more accurately
diagnose patients whose conditions would benefit from spinal
fusion. Advances in surgical techniques and components,
including the development of better screws and rods, also have
greatly improved patient results. Improved diagnostic and
surgical training, including advanced training in spine
fellowship programs, has helped spine surgeons interpret and use
these advances in technology to obtain better outcomes for

Who Needs a Spinal Fusion?

As with all surgeries, there are proper uses that will result
in good outcomes for patients with spinal fusion.
In patients where the spinal bones have begun to slip and cause
pressure on the spinal nerves (spondylolisthesis), this
excessive movement may need to be stopped to prevent worsening
of the nerve pressure. During surgery, these patients will have
the bone spurs and disc protrusions removed from around the
nerve roots and spinal cord, which may destabilize the bones of
the spine and cause the bones to slip more. Inserting screws and
rods in these bones will prevent the bones from slipping any
further after surgery and also may be used for correction of the
original slippage.

Use of screws and rods can also provide stability and
correction for patients with scoliosis. Scoliosis is the bending
of the spine in an abnormal direction. The curve of the spine
may increase with time or may be painful as the curvature of the
spine increases. If the patient has a large curve or the curve
is continuing to get worse, screws and rods are used to correct
the position of the spine and prevent the curve from worsening.

In patients with obvious bone destruction from fracture, tumor
or infection, stabilizing the bones with screws and rods will
provide the support that is needed so the underlying disease can
be addressed. The structure of the spine can be improved while
the patient receives chemotherapy or radiation. By removing the
tumor in the spine, the back pain related to an expanding tumor
can be relieved and the patient can remain mobile, which helps
to prevent pneumonia and blood clots. Being ambulatory, while
receiving chemotherapy and radiation, also improves the
patient’s mood and outlook while coping with their disease.

Who is Not a Candidate for Spinal Fusion?

Most patients with disc herniations or pinched nerves will not
need a spinal fusion. These conditions can be treated with
simpler procedures that allow the removal of pieces of discs or
bone spurs that do not increase the movement in the bones.

The more difficult indication for spinal fusion is in the
patient with severe pain in the back. Degenerative disc disease
is still the leading cause of back pain in the United States,
but back pain can have many underlying causes. One of the
reasons that spinal fusion developed a bad reputation is that
they were performed as a remedy for back pain that did not
respond to other forms of treatment. Older fusion methods and
inadequate diagnostic approaches left surgeons with few options
for treating these patients, so some patients were given fusions
as a last attempt to improve their pain . Most patients with
lower back pain and degenerative disc disease will not need a
spinal fusion.

What Can Be Expected From Spinal Fusion?

It is expected that most patients will be back to their usual
state of health and activity at approximately 6-8 weeks after
their fusion surgery. Most patients will be pain-free after
their spinal fusion. It is important to choose a well-trained
surgeon to make educated decisions about your diagnosis and
treatment. With the combination of the proper diagnosis and
properly applied spinal fusion most patients will have very good

About the Author: Dr. Jeffrey R. Carlson is doctor at the
Orthopaedic and Spine Center, a leading provider of Hampton Roads orthopedics services such
as Newport News
spine surgery,
Newport News custom fit knee replacement, and many other
services. The Orthopaedic and Spine Center can be found online
at: .


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Spinal Fusion Options: Roads to Recovery

Spinal Fusion Options: Roads to Recovery
By Dr. Jeffrey R. Carlson

Spinal fusion has become a very common surgical procedure in
the United States over the past 10 years. There are many
diagnoses that range from fractures of the spine to severe
degenerative disc disease that prevent patients from being able
to stand or walk are best treated with a surgical remedy. This
article is intended to provide a basic review of the many spinal
fusion options that are available. It is best to talk to a
fellowship-trained spine surgeon who will be able to give you a
complete picture of all of the devices available that are
recognized for quality and reliability or to help you rule out
those that are not recommended.

As the number of spinal fusions has increased, the variety of
procedures and hardware alternatives that are available has also
increased. It may be easier to understand why there are so many
types of fusions if you consider how fractures need to be fixed
with fusion. With broken bones, there is usually little question
about the wisdom of providing casts or plates and screws to
stabilize bones that need to be realigned or stabilized.  Spinal
fusion provides the same stability for the spine as is used for
other fractured bones. What is a spinal fusion? Screws and rods
in the spine are used to keep bones from moving as the bone
graft that is placed allows the stabilized bones to form a
connection across a previously mobile disc space. The growth of
bone between 2 previously mobile bones is called fusion.

Standard fusion technique: Initially, fusion of the vertebral
bones was done by laying bone graft between the bones, to
provide a scaffolding across which the native bone cells could
grow. As the patient’s bone cells move across the bone graft,
they are able to incorporate the bone graft into the patient’s
own bone structure, forming a complete connection called a
fusion. Bone graft is of primary importance in allowing the
vertebral bones to fuse across a previously mobile segment.
Studies of patient’s with fusions done with bone graft alone
have shown a relatively good rate of incorporation when patients
are placed in back braces for 3 months or more. Because of the
inconvenience and discomfort of the bracing, pedicle screws and
rods have been added to provide an internal support that
obviates the need for external supports. Internal screws and
rods have increased successful fusion rates, as well as allowed
patients to become mobile very quickly after the spinal fusion.

Interbody fusion cages: As the skill of the surgeon’s has grown
when applying screws and rods to the spine, we have, in turn,
looked for better ways to gain improved results. Now, we are
able to put bone graft around the back of the spine, as well as
into the disc spaces. With these improved grafting methods, we
are able to safely access the lumbar disc from the back of the
spine. Adding bone graft to the disc increases the surface area
for healing and should improve the overall success rate of the
spinal fusion. Interbody grafting can be done from several
different approaches, as access to the disc space can be
achieved from multiple directions.

XLIF: This acronym stands for extreme lateral interbody fusion.
XLIF is a newer device designed to provide a carrier for bone
graft and support to the disc space. It is placed through an
incision on the patient’s flank. By making an incision on the
patient’s side, the abdominal contents can be moved out of the
way for a good view of the spine. Unfortunately, there are some
significant nerves in the front of the spine that are very
sensitive to being moved. This type of access to the spine can
lead to weakness in one leg because of the sensitivity of these
nerves. At this time, there are no long-term studies that
demonstrate success of this procedure.

AxiaLif: This is another fusion device that has received some
attention, due to its being touted as the “least invasive spine
fusion”. This device is placed across the lowest disc space by
access from the front of the sacrum (a large, triangular bone at
the base of the spine, inserted like a wedge between the two hip
bones). By placing instruments through a small incision near the
rectum towards the spine, the disc is accessed through a series
of cannulas (hollow surgical tubes) and drills. This allows the
disc material to be removed from the disc space. After the disc
material is removed, bone grafting can be placed into the hole
that is created. This disc space is then supported by a tapered
screw placed into the bones. So far, this device has had minimal
post-surgical study and is most likely best done in conjunction
with standard screw and rod fusion techniques.

Flexible Rods:  There has been some recent excitement around
rod and screw systems that are so-called “non-fusion” fusion
devices. This confusing name infers that, although the intent of
the screws and rods is for the bones to not move, these devices
are designed to allow some movement. As was discussed earlier in
this article, fusion is the solid connection of bones that had
previously moved.  The idea of these flexible rods is to provide
“enough” stability to allow the bones to fuse together, but not
enough to change the forces in the spine. This is termed a
“soft-fusion”. At this point, there is no concensus as to how
much or how little support is needed to achieve this goal. It is
known that current screw and rod systems provide enough support
to allow a fusion to occur while providing complete immobility
of the vertebrae. Other than this complete connection, the
amount of support less than complete immobility has not been
defined and at this point is still under investigation.

Disc Replacement: Disc replacement was developed as an
alternative to fusion and is suggested for those discs that have
ruptured, but in which the bone structure is still good. If only
the disc has gone bad, removal of the disc leaves a space that
we normally fill with bone graft to promote fusion in the neck
or lower back. With the development of the disc replacement, the
space that is left from disc removal can be filled with a device
that allows motion, rather than fusion. This is a complete
reversal in the approach to disc removal; from complete
immobility to complete mobility. Disc replacement is intended to
maintain the motion in the spine. This reconstruction of the
spine should maintain the forces across the discs in the spine
to prevent the other discs from deteriorating any more rapidly
than their normal degenerative process. Disc replacement in the
lumbar spine has met with some success in well-selected
patients. It has not been a panacea for all patients with low
back pain or degenerative disc disease. Disc replacement in the
cervical spine has had good success, as most neck fusions are
done for bad discs with the bones being in good condition.

Improved training, including advanced specialty training in
fellowship programs, as well as improved implants, has decreased
most surgical procedure times to 2 hours or less. Historically,
older techniques have been known to take 4-6 hours for the
operation alone. By decreasing operative times, surgeons have
seen decreased complications from the anesthesia, as well as
decreased risks of infection and blood loss.  Most surgeries
under 2 hours will not require a blood transfusion.

A well-informed patient, who understands the benefits and the
risks of their surgery, can fully participate in the choices
that need to be made about their surgery. If you have been told
that you need a spine fusion, ask questions and do your
research. It is appropriate to ask your surgeon about their
experience performing spinal fusions, how many of the fusion
procedures they perform, how long the operation will take and
the likelihood of needing a blood transfusion. Selecting a
well-qualified surgeon can help ensure the best outcome for you
and the success of your spinal fusion.

About the Author: Dr. Jeffrey R. Carlson is a doctor at the
Orthopaedic and Spine Center, a leading provider of Suffolk
orthopedics services such as Suffolk spine surgery, Suffolk knee
surgery, and Suffolk pain management. The Orthopaedic and Spine
Center can be found online at:


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