Back & Neck
Diagnosis, Treatment & Rehabilitation
Back and neck pain are common conditions that result from injury, arthritis, or wear and tear associated with the aging process or repetitive use. In many cases, back and neck pain, as well as movement limitations, can be helped with nonsurgical treatments such as medications, physical therapy, and lifestyle adjustments.
Back and Neck Care
When nonsurgical measures cease to help, surgery may be necessary for pain relief and optimal quality of life. Rest assured that the compassionate board-certified, fellowship-trained orthopaedic surgeons at Orthopaedic Associates of Central Maryland are the trusted surgeons that patients and referring doctors have turned to for more than 50 years.
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CONDITIONS WE TREAT
Low back pain is one of the most common medical issues. Muscles, tendons, and ligaments can strain from overexertion, poor posture, lifting activities, physical stress, and injury.
Degenerative diseases such as arthritis can cause the spinal structures to break down and put pressure on the spinal cord or nerves. Nerve pressure in the lumbar spine can cause symptoms to spread to the buttocks, legs, and feet. This is because the nerves that exit the spinal cord at the lumbar spine travel to these areas.
The majority of people with low back pain find relief with nonsurgical treatments. However, if your symptoms progress or persist, back surgery can be an effective treatment.
The neck is a vulnerable part of the spine. Neck pain may be caused by abnormalities in the muscles, tendons, ligaments, nerves, discs, or vertebrae of the neck. Motor vehicle accidents, sports, falls, or violence can cause neck injuries and pain. Changes in the intervertebral discs, which occur in osteoarthritis, osteoporosis, degenerative disc disease, and herniated discs, can also cause neck pain.
Neck pain can spread to the head, shoulders, arms, and hands. It can be acute or chronic. Acute neck pain begins suddenly, usually after an injury, and resolves as the injury heals – usually within several days or weeks. Chronic neck pain lasts longer than three months. It may be constant and caused by structural changes in the spine from degenerative diseases.
The sciatic nerve is the thickest and longest nerve in your body, extending from your lower back down to your feet. If the sciatic nerve is compressed or inflamed, it can cause sciatica. Symptoms of sciatica include shooting pain, tingling, weakness, and numbness that may travel from the lower back, through the back of one leg, and into your foot.
Trauma, spinal conditions, or medical conditions that irritate the sciatic nerve cause sciatica. The majority of people with sciatica experience relief with nonsurgical treatments. Those who don’t may benefit from surgery that eliminates the pressure on the sciatic nerve.
Scoliosis is an abnormal curvature of the spine. A healthy spine has a natural front-to-back curve. Scoliosis is a condition characterized by side-to-side curvatures of the spine, and often, rotational deformities. Some people are born with scoliosis, or it may result from neuromuscular conditions, osteoporosis, or for unknown reasons (idiopathic scoliosis).
Scoliosis is a progressive condition that can become worse over time. Untreated severe spinal curvatures can cause medical complications. Scoliosis may be monitored or treated with back bracing or surgery.
This is a collapse of vertebral bone. It can affect one or more vertebrae. Compression fractures typically develop in your mid or lower back. This can change the shape of your spine.
The spinal column contains open spaces that create passageways for the spinal cord and the spinal nerves. Spinal stenosis is a narrowing of (or an intrusion into) these openings. This can cause a compression of the nerves. Spinal stenosis most commonly affects the cervical and lumbar regions of the spine.
Neck surgery is recommended when nonsurgical methods have provided minimal or no improvement of your symptoms. Surgery may also be required in cases where a herniated disc is pressing directly on a nerve or the spinal cord and causing loss of function. An anterior cervical discectomy and fusion (ACDF) is the type of surgery most frequently used for a herniated cervical disc.
ACDF involves removing all or part of a herniated disc or discs. The surgeon also fuses or secures two or more vertebrae together to stop movement and relieve pain caused by the disc herniation. The surgeon performs the procedure through a small incision on the anterior (front) part of the neck.
Endoscopic spinal decompression is a minimally invasive procedure that can alleviate back pain caused by pressure on the spinal cord and nerves. It can be performed as outpatient surgery with just a small incision being made, usually no larger than 1 cm, which can then be closed with a small bandage. A small tube with a camera is inserted into the spinal canal, and through that one tube, herniated tissues can be removed.
Interlaminar decompression and stabilization is a minimally invasive procedure that opens up spinal stenosis and can help stabilize the spine. It is typically performed as outpatient surgery, meaning the patients can go home the same day, and results in a much shorter recovery time compared to traditional spine surgery. Within the first few weeks, patients will notice that they are able to stand up for longer, walk a farther distance before getting tired, and not be hunched over.
This minimally-invasive procedure repairs a vertebral compression fracture. It helps restore the spine's natural shape. Some patients experience rapid pain relief after the procedure.
A lumbar discectomy is a type of surgery used to remove the part of the disc in the low back area that is putting pressure on the spinal cord or nerves. It may be required if a herniated disc is pressing directly on a nerve or the spinal cord and causing considerable pain. Surgery may also be necessary to remove broken pieces of a disc or surrounding bone. You may be a candidate for back surgery if conservative treatments no longer provide relief of your symptoms.
In select cases, a discectomy can be performed arthroscopically. However, an open discectomy is the type of surgery most frequently used for a herniated lumbar disc. Also called a microdiscectomy, this procedure is often done through a small incision and with a microscope.
This procedure treats lumbar spinal stenosis. That's a narrowing of the space around the spinal nerves in your lower back. The mild procedure makes more room for these nerves, relieving painful compression.
Lumbar fusion may be performed to alleviate pain caused by spinal stenosis, a condition that causes a narrowing of the spinal canal and puts pressure on the spinal cord and nerves.
Your doctor may recommend a lumbar fusion if nonsurgical treatments are no longer effective for relieving your spinal stenosis pain, if your leg weakness becomes progressively worse, or if you experience associated bowel and bladder problems.
During a posterior lumbar spinal fusion, your surgeon uses bone graft from your pelvis, or from another source, to make the spinal levels heal to each other, forming a single block of bone and eliminating painful motion. Surgical hardware, such as screws and rods, secures the vertebrae together and allows the bone grafts to heal.