Lumbar Spondylosis Could Mean Surgery
By Admin | August 11, 2020
Living with pain and stiffness in the lower back and shrugging it off as a result of sitting too long, poor posture, or an uncomfortable chair? While these things can certainly contribute to lower back pain, stiffness, and also affect your mobility, there may be something more serious happening: lumbar spondylosis.
Lumbar spondylosis, also known as age-related arthritis in the lower back region of the spine or degenerative disc disease is a common problem. The condition develops because when we age, the discs of our spine lose moisture and shrink. Bone spurs also develop, and our bones become weaker.
Some researchers estimate that more than 80 percent of individuals over the age of 40 have the condition.
Lumbar spondylosis affects about 20 percent of men and 22 percent of women between the ages of 45 and 64 years, and 30 percent of men and 28 percent of women between the ages of 55 and 64 years.
While most of those living with lumbar spondylosis are over 40, the condition can develop in younger demographics, particularly athletes under the age of 18 who participate in sports that involve twisting or backward bending motions of the spine, such as cheerleading and gymnastics.
Some research suggests that while lumbar spondylosis is primarily related to age, there could be a genetic component to developing the condition.
In many cases, lumbar spondylosis has mild symptoms or no symptoms at all. It is often only discovered when an individual is diagnosed with another back condition, such as sciatica, or has sustained a back injury.
Treatment for lumbar spondylosis often depends on a patient's symptoms and the severity of their symptoms. Treatments often include nonsurgical options, such as physical therapy, weight loss, and other lifestyle changes, pain medications, and anti-inflammatory injections. When these treatments do not relieve symptoms, surgery is often the only option.
And it was the option for a 77-year-old patient with the condition and painful symptoms including bilateral hip and calf pain, with left hip pain greater than the right side.
The patient's surgical treatment involved a posterior lumbar interbody fusion at the L5-S1 (also known as the lumbosacral joint) level.
As with any spinal procedure, a posterior lumbar interbody fusion carries some risks. Primarily, these risks include the potential for nerve damage, which can result in partial or complete paralysis, muscle weakness, pain, and mobility changes.
To reduce the complications of the posterior lumbar interbody procedure, the patient was monitored via intraoperative neuromonitoring or IONM.
"Intraoperative neuromonitoring is a way to watch for changes in the patient's nerves and muscle responses to reduce the risk
of post-surgical complications," said Dr. Faisal R. Jainhangiri of AXIS Neuromonitoring in Richardson, Texas.
The patient in question was monitored via upper and lower Somatosensory Evoked Potentials (SSEP), lower limb Electromyography (EMG), Triggered Electromyography (TEMG), Electroencephalography (EEG) and Train of Four (TOF).
During the surgery, an AXIS Neuromonitoring technologist analyzed the patient through these diagnostics and noted changes in that patient after trying to stimulate pedicle screws with T-EMG. The AXIS technologist alerted the surgeon to the patient's difference, and the surgeon was able to reposition the pedicle screw, resulting in improvement in the patient's nerve response.
These changes noted by the AXIS technologist could have indicated a pedicle breach, which, if left untreated, could have resulted in spinal cord or nerve damage and muscle weakness, numbness, pain, foot drop, and other life-changing issues.