Understanding Back Pain
Back Pain Facts & StatisticsA number of facts and statistics about back pain.More than 86 million Americans suffer from pain.One Third of all adult Americans have had back pain in the last 30 days.The cover and feature story of Newsweek issue dated April 26, 2004 was Treating Back Pain: The New Debate Over an Affliction Shared by 65 Million Americans.The back pain epidemic continues to grow year by year. According to the National Institute of Health: Back pain is the #2 reason why people visit a doctor.Back pain is also the #1 reason why people will stay home from work.85% of ALL people will suffer some moderate to severe back pain at some point in their lives.Back pain is the #2 reason for hospitalization (2nd to pregnancy).Each year, low back conditions cost an estimated $100 billion in medical costs and loss in productivity.The most common form of back pain is caused by symptoms from Degenerative Disc Disease—including disc herniations (ruptures) and disc bulges.Over 90% of disc herniations (ruptures) occur in the lowest two levels of the lumbar spine, between L4/L5 and L5/S1.North American Spine’s AccuraScope™ Procedure is the least invasive and most effective way to treat problems in the lumbar spine.
Basic Spine AnatomyA quick crash-course introduction to the spine.
The spinal column extends from the base of the skull to the tailbone and is made up of thirty-three bones known as the vertebrae. The first seven vertebrae (the cervical vertebrae) are in the neck and are numbered C1 through C7. Nerve compression in this area can cause neck pain, which may radiate down the arms to the hands and fingers.
The next twelve vertebrae make up the thoracic region (T1 through T12); the ribs attach to these vertebrae and protect the heart and lungs. Few spinal problems can occur in this region; it is usually very stable due to its support from the ribcage.
The lumbar region is the lower back, which contains five vertebrae (L1 through L5). The lumbar spine plays a significant role in motion and flexibility. It is the source of most motion and supports most of the body weight. Overload or taxing movements may strain the structure, compress the nerves and cause back pain, which may radiate down the legs to the feet.
The regions beneath the lumbar spine are the sacrum (S1 through S5) and coccyx (a series of small bones often called the tailbone). These are fused, and they do not have discs between them.
Each vertebra is composed of a body and a spinous process which protect the spinal cord and nerve roots. The vertebrae in the cervical, thoracic and lumbar regions are separated by discs. Discs serve as cushion between the vertebrae, helping to protect them and the nerves that run from the spinal cord to the rest of the body.The regions beneath the lumbar spine are the sacrum (S1 through S5) and coccyx (a series of small bones often called the tailbone). These are fused, and they do not have discs between them.
Common Spinal ProblemsThe most common spinal problems occur in the lower back.
Lower Back Problems (lumbar):
Disc Herniation occurs when a disc extrudes into the spinal canal. It is also referred to as a bulging disc, ruptured disc or slipped disc. As a disc degenerates, it can herniate (the inner core extrudes) back into the spinal canal. A lumbar herniated disc can cause pain to radiate all the way down the legs and into the foot. In the area of the cervical spine, the pain would radiate from the neck down the arm into the fingers.
Degenerative Disc Disease refers to the gradual deterioration of the disc between the vertebrae. As we age, the water and protein content of the body's cartilage changes. This change results in weaker, thinner and more fragile cartilage. Because both the discs and the joints that stack the vertebrae (facet joints) are partially composed of cartilage, these areas are subject to wear and tear over time (degenerative changes).
Spondylolisthesis is the slippage of one vertebrae upon another. There are multiple "types" of slippage. The degenerative type is commonly seen in the elderly population and the "isthmic" type is commonly seen in the younger population. In the degenerative "older" type, the patient usually has symptoms of spinal stenosis with increased chance of back pain. If the slippage is unstable, back pain becomes more significant. The isthmic (younger) type of slippage is likely present from early adulthood; patients tend to become symptomatic in their 20s or 30s.
Spinal Stenosis is a common problem noted in the elderly population. Stenosis is basically a fancy term for a narrowing of the spinal canal. As we age, the joints in the spine become arthritic and form bone spurs; the ligaments "thicken" and the discs collapse and "protrude" into the spinal canal. The spinal canal has a limited amount of space, and as the bony spurs, discs and ligaments invade the canal, the nerves have less room available to them. The increasing pressure on the nerves causes some back and mostly leg pain which usually worsens with standing or walking; the leg pain is usually relieved by sitting or lying down.
Spinal Issues Addressed by North American SpineDo any of the following issues sound too close to home? We can help.
Problems in Cervical, Thoracic, and Lumbar/Sacral regions of the spine, including:
- Back pain with or without radiating leg pain
- Back pain that involves the hips, buttocks, and legs
- Numbness in the leg(s) or feet
- Weakness of the muscles of the leg(s)
- Bulging Disc
- Spinal Stenosis
- Degenerative Disc Disease
- Arthritis of the Spine
- Pinched Nerve
- Scar Tissue
- Foraminal Stenosis
- Facet Disease
Ruptured or Herniated Disc
Small, spongy discs cushion the individual bones that form the spine, or backbone. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. When a disc breaks down, or is damaged, it may tear, bulge or break open. This is called a herniated disc. It may also be called a bulged, slipped or ruptured disc.
The AccuraScope™ ProcedureNorth American Spine is the world's sole provider of the AccuraScope™ procedure.
The AccuraScope™ Discectomy and Neural Decompression (“D.N.D.”) Procedure:
- The AccuraScope™ D.N.D. is a Minimally Invasive, Natural Opening procedure used to both diagnose and treat Inter-vertebral discs and Spinal Stenosis of the lumbar spine.
- Using live x-ray for guidance, the physician inserts an endoscopic fiber optic scope, like a small tube, through a one-quarter inch incision in the skin, into a natural opening at the base of the spine.
- The doctor examines the inside of the spine and the discs of the lower back, from both sides of the spinal canal, to identify any tears, ruptures, herniations, bulges, or other abnormalities.
- The doctor actually finds inflammation and actually diagnoses the source of pain.
- The doctor then uses a number of instruments to shrink the damaged disc(s), or spinal stenosis, and relieve pressure on the spinal nerve(s).
- The procedure is usually completed in 30-45 minutes. Many patients experience immediate relief.
- Patients are returned to a recovery area and are usually discharged approximately one hour after surgery. Patients can walk the same day as their procedure, and can start gentle physical therapy exercises the next day.
- Many patients can return to work and resume normal activities the following day, and most can return within one week.
North American Spine is the world’s sole provider of the AccuraScope™ procedure.
AccuraScope™ BenefitsBenefits of the AccuraScope™ Discectomy and Neural Decompression ("D.N.D.")
D.N.D. is a Minimally Invasive, Natural Opening procedure that results in:
In layman's terms, the primary difference between the AccuraScope™ and traditional Laserscopic procedures is that the AccuraScope™ procedure follows laterally, along a natural opening in the spinal column, thereby allowing both the diagnosis and the treatment along the entire lumbar path (L1–L5). No one else can treat multiple levels in a single procedure.
- One tiny incision
- Diagnosis of the cause / source of the pain
- Earlier treatment
- Potentially immediate relief
- Less chance for recurrence
- Minimal scarring
- Minimal risk of damage to muscles, bone, nerves or blood vessels, especially when compared to “minimally invasive” procedures
- Maintenance of the normal structure of the disc
- Less pain after the procedure
- Rapid recovery
- High rate of success (82%, based on published clinical research)
Alternative Procedure ComparisonsCompare the relative invasiveness of the most common back surgery alternatives.
Most people are unaware that it is back surgeries that cause much or most of patients recovery issues. The actual “fixes” at the source are generally similar among the procedures (i.e. the removal of unwanted tissue), but the invasiveness and associated trauma of the procedure dictates 90% or more of the outcome. The pictures below depict the relative invasiveness of the three most common back surgery alternatives:
3-Day ProcessSo, you want to schedule for the procedure - what now? This is how the process works:
e-Operative Consult, Full History & Physical, Formulate and Confirm Treatment Plan
Recommended Out-Patient Procedure
Post-Op Care; Evaluate Need for Potential Follow-Up Procedure
Follow-Up Procedure, If Needed
Kelly Will, M.D. - Dr. Will has been in Pain Management private practice since 1989, where he has performed innovative treatments tailored to each patient. He was named one of the Best Doctors in Dallas by D Magazine in 2009 and 2010.
Kenneth Alo, M.D. - Dr. Alo remains active as the Director of the Section of Neuro-Cardiology at the Institute of Cardiology and Vascular Medicine - Monterrey Technical University and is participating in clinical research at the Methodist Hospital Research Institute in the Texas Medical Center.
Vladimir Redko, M.D. - In practice for more than 40 years, Dr. Redko has been noted by patients for his exceptional post-operative follow-up care and approach to pain treatment, including use of spinal cord stimulation, for which he has also published research.
Damon Noto, M.D. - Dr. Noto is the president of the Spine and Joint Centeral Medicine & Acupuncture in Hackensack, New Jersey. He was awarded the 2012 Patient Choice Award for his compassionate approach to his patients.
Jason A. Williams, M.D. - Dr. Williams helps patients with a wide range of pain management interventions ranging from spinal injections to the AccuraScope® procedure. He been recognized for being at the top of his class throughout his education and has gained extensive experience.
Forest Park Medical Center11990 North Central Expressway
Dallas, Texas 75243
Victory Medical Center2001 Hermann Dr.
Houston, TX 77004
Hackensack Surgery Center19 Kotte Place
Hackensack, NJ 07601