Back and Spine Treatments
At MedStar Health, our goal is to relieve your back pain and restore your ability to enjoy your favorite activities. One of the best ways to ensure you get the most successful back and spine treatment is to describe your pain accurately and in detail—where it is, when it starts, what helps to relieve it. This way, our back and spine doctors can understand what you are dealing with. Consider the following questions when thinking about describing your pain to your MedStar back and spine specialist:
- When does the pain happen?
- How long does it last? Does the pain come and go? Or is it there all the time?
- Is this pain new? Have you ever had this pain before?
- Does it hurt in more than one place?
- Does it feel like it's on the inside or on the outside of your body?
- Does the pain keep you from doing certain things?
- Does pain interrupt your sleep? Does it change your mood? Affect your appetite?
- What makes the pain better? What makes it worse? What have you tried to relieve the pain?
Once your doctor understands and diagnoses your pain, they can focus on treating your back and spine problems with a combination of these approaches:
- Multidisciplinary collaboration: We combine our expertise with guidance from any other relevant specialists for the most comprehensive care options.
- Conservative management: Whenever possible, we encourage you to try non-surgical options, and focus on resolving your pain with non-surgical options like physical therapy and medication.
- Patient Education: We teach you and your family about your condition and answer all of your questions. We take time to discuss the possible treatment options and weigh the risks and benefits of each one. Together, we will decide which treatment option will be most appropriate for your needs.
Kyphoplasty and Vertebroplasty- Spine Surgery Options
Kyphoplasty and vertebroplasty are minimally invasive spine surgery procedures used to relieve the pain from a vertebral fracture, especially if it does not improve over a number of weeks with pain medication and treatment with a brace. Both vertebroplasty and kyphoplasty procedures involve placing cement into the fractured vertebra through small incisions in the skin under x-ray guidance.
Kyphoplasty can also be very helpful when there is severe collapse of the broken vertebra or wedging. By correcting the wedging, kyphoplasty may help restore the spine to a more normal alignment and prevent severe kyphotic (hunchback) deformity to the spine. In someone who has had multiple fractures with previous wedging, kyphoplasty can prevent further worsening of the deformity.
- A bone cement is injected under pressure directly into the fractured vertebra.
- Once in position, the cement hardens in about 10 minutes, congealing the fragments of the fractured vertebra and providing immediate stability.
- A balloon catheter is guided into the vertebra and inflated with a liquid under pressure.
- As the balloon inflates, it can restore the collapse in the vertebra and correct abnormal wedging of the broken vertebra.
- Once the balloon is maximally inflated, it is deflated and removed, and the large cavity created is filled with bone cement.
- The cement then hardens in place, maintaining any correction of collapse and wedging.
Non-Surgical Treatments for Back and Neck Pain
Different kinds of pain respond to different kinds of treatment. Your doctor or nurse may want to include these non-surgical therapies in your treatment plan:
- Epidural steroid injections are anti-inflammatory and anesthetic medications injected into the spinal canal. They're used to decrease swelling and the pain associated with it. Candidates for this procedure suffer from herniated/bulging or degenerated discs.
- Epidural lyses of adhesion are injections of medication at an affected nerve root to dissipate scar tissue and help decrease chronic low back pain.
- Facet joint blocks are anti-inflammatory and anesthetic medications injected into a facet joint, which are located on the back of the spine where the vertebrae overlap and help guide the movement of the spine. Patients with degenerative disc disease and increased weight and pressure on the joint will benefit from the procedure.
- Nerve root blocks are injections to relieve pain in the nerves that exist directly off the spinal cord. The nerve that's causing the pain is pinpointed and blocked.
- Radio frequency ablation heats a nerve to eliminate its function, thereby eliminating the pain triggered by that nerve.
- Sacroiliac joint injections reduce inflammation and discomfort in the hip joint.
- Intradiscal electrothermal therapy heats a needle inserted into a painful disk to eliminate the pain receptors there. This procedure can help patients with chronic disc pain who wish to avoid surgery, or for patients whose previous surgery has been unsuccessful.
Every patient who walks the doors at MedStar Health gets a personalized education on their own back condition and the surgical options available. We have multidisciplinary teams of back and spine specialists throughout the central Maryland and Washington region, including neurosurgeons, physiatrists, rheumatologists, orthopedic surgeons, and physical and occupational therapists. Our experts are trained in the latest techniques for the diagnosis and treatment of disorders, conditions, and injuries of the spine. Together, we determine the source of your pain and treat it as effectively as possible.
Cervical, Thoracic, and Lumbar Spine Surgery
Pain in these areas is generally first treated with some combination of medication and physical therapy. If the pain does not improve after some months of these treatments, surgery can become an option. Surgery can help a variety of back conditions, including:
- Arm and Leg Pain
- Back Pain
- Herniated Disks
- Neck Pain
- Spinal Stenosis
Microscopic and Minimally Invasive Spine Surgery
During minimally invasive techniques, MedStar Health surgeons make a small incision and use advanced computer technology and specialized instruments to repair back and spine conditions. In microscopic spine surgery, we combine minimally invasive techniques with highly sensitive, cutting-edge surgical microscopes to access even the most delicate areas with precision.
Minimally invasive techniques offer patients:
- Faster recovery time than traditional spinal surgery
- Reduced infection
- Reduced blood loss
- Faster return to your regular lifestyle
Motion-Sparing Spine Surgery
Traditional fusion surgery merges the vertebrae, which relieves pain and pressure, but also restricts your ability to move. Motion-sparing spinal surgery gives you the best of both worlds—it relieves pressure on your spinal cord and preserves your range of motion. Motion-sparing techniques can be used in cervical artificial disk replacement and laminoplasty (removing spinal cord pressure from cervical spine stenosis)
Spinal Deformity Surgery
If you or your child suffers from a spinal deformity, the orthopaedic spine surgeons at MedStar Health will work to correct the problem with braces and other non-surgical approaches. In most cases, we try not to treat scoliosis and other spinal deformities with surgery, but if more conservative treatments do not improve the deformity, surgery may be the best option. MedStar Health orthopaedic surgeons always take time to explain the risks and benefits of any procedure and help our patients come to a decision that feels right. We also work with any other specialists involved, so treatment is multidisciplinary and comprehensive. Surgery to treat spinal deformities, including scoliosis and kyphosis, straighten the spine and/or release the pressure on spinal nerves. This often requires uniting the vertebrae using special implants to keep the spine together.
The unique spine care program at MedStar Health features talented physical therapists working closely with a variety of physicians to obtain the best outcome for conservative treatment. Our therapists are continually enhancing their knowledge with up-to-date techniques regarding back and neck care.
- Back School: This rehabilitation program is a group setting and is designed to educate individuals to take control of their back and/or neck pain.
- Aquatic Therapy: The therapist and patient use the qualities of water and heat to decrease pain and swelling and to increase movement. The pool is heated and handicapped accessible.
- Manual Therapy: Our therapists have taken many additional courses to provide highly skilled services using their hands. This may include massage, mobilization of joints, and more.
- Exercise: Therapists and patients work together to develop an individualized exercise program to stretch or strengthen appropriate muscles. Emphasis is placed on the patient continuing these exercises at home.
- Arthritis Foundation Exercise Program: This is a six-week program where patients can exercise in a group setting specially designed for people with arthritis. Our therapists have been trained by the Arthritis Foundation to teach this course.