More to Consider with COVID
By Admin | August 11, 2020
There's no doubt that the COVID-19 pandemic has affected almost every aspect of our daily lives, from working to seeing others and buying groceries. One other consequence of COVID-19 is how and how much we sit, which has had significant impacts on lower back health.
While lower back pain may seem to be a strange consequence of living through the COVID-19 pandemic, it's unfortunately true. Many people were forced to work from home for a period (or are still working from home) in less than ergonomic conditions — such as sitting on the couch hunched over a laptop all day — that can contribute to lower back pain and problems.
But, lower back pain is not just a consequence of COVID-19; 2007 study in the journal Neurologic Clinics revealed that nearly 80 percent of the United States population will experience back pain at some point in their lifetime.
Statistics from Georgetown University's Health Policy Institute show that nearly 16 million adults, or 8 percent of the adults in the U.S., have persistent or chronic back pain that affects their day to day living.
In pre-COVID-19 years, back pain caused more than 264 million lost workdays in a year, according to the American Chiropractic Association.
In most cases, lower back pain symptoms include pain in areas such as a back, hip, or leg. This pain can impact both the muscles and the bones in these areas. Other symptoms include leg numbness, tingling, and "pins and needles."
These symptoms are what caused a 46-year-old woman to seek help and surgery.
The patient had a history of pain from her back to her left leg, numbness, and tingling. She also reported burning sensations and hypersensitivity in her lower back, which stretched from her pelvis to her lumbar region and left hip.
The patient was diagnosed with lumbosacral region radiculopathy, spondylolisthesis, spondylosis and intervertebral disc degeneration, and underwent L4-S1 decompression procedure and hardware removal.
During her procedure, the patient was monitored by AXIS Neuromonitoring, to track her upper and lower Somatosensory Evoked Potentials (SSEP), lower limbs Electromyography (EMG) and Train of Four (TOF), a diagnostic test designed to monitor the level of muscle relaxation during the surgery..
Right before the initial incision, the AXIS Neuromonitoring technologist in the operating room observed a decrease in SSEPs in the patient's right ulnar nerve. While exposed, responses from bilateral ulnar were nearly undetectable.
The AXIS technologist informed the surgeon and anesthesiologist of the patient's poor SSEP responses, which occurred in the patient in a previous procedure.
The patient was given fluids and albumin intravenously, and her left ulnar response returned to baseline. Her right ulnar required further investigation, despite fluids and albumin. After repositioning multiple times, the right arm's ulnar response returned to baseline, and the patient's SSEPs were stable at closing.
"Without neuromonitoring, the patient would have been left with negative neurological consequences including a permanent brachial plexus injury, muscle weakness, numbness and tingling, and pain," said Dr. Faisal R. Jahangiri, of AXIS.
Intraoperative neuromonitoring, also known as IONM, is an extra layer of protection in the operating room that helps prevent injuries.
"Surgical complications can be reduced by adding neuromonitoring. It's another way to add peace of mind for patients and providers," Jahangiri said.