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Are there different types of back pain?
Back pain is categorised as acute or chronic. Acute pain usually lasts only six weeks. When back pain continues for more than six weeks, it is considered chronic. During this time, the individual will create new muscle patterns that compensate and circumvent the weak and painful area.
Chronic back pain is divided into two main types – mechanical or compressive pain.
Mechanical back pain results from inflammation due to an irritation or injury to the disc, the ligaments or the muscles of the back. A normal muscle strain or lower back strain may also trigger mechanical-type symptoms. Mechanical pain usually originates near the lower spine and spreads to include the buttocks and thigh areas. This type of pain usually does not extend past the knee.
Compressive pain happens when the nerve roots that leave the spine are either irritated or pinched. A herniated disc is a common cause of compressive pain. For example, the sciatic nerve controls and provides sensation to the muscles of the lower leg. When the nerve roots are irritated or pinched, the individual will feel a numbness, tingling or pain in the leg muscles, but not in the back itself.
Compressive pain may also occur in the cervical spine due to herniated discs. This is often manifested in arm pain or numbness.
Back pain is categorised as acute or chronic. Acute pain usually lasts only six weeks. When back pain continues for more than six weeks, it is considered chronic. During this time, the individual will create new muscle patterns that compensate and circumvent the weak and painful area.
Chronic back pain is divided into two main types – mechanical or compressive pain.
Mechanical back pain results from inflammation due to an irritation or injury to the disc, the ligaments or the muscles of the back. A normal muscle strain or lower back strain may also trigger mechanical-type symptoms. Mechanical pain usually originates near the lower spine and spreads to include the buttocks and thigh areas. This type of pain usually does not extend past the knee.
Compressive pain happens when the nerve roots that leave the spine are either irritated or pinched. A herniated disc is a common cause of compressive pain. For example, the sciatic nerve controls and provides sensation to the muscles of the lower leg. When the nerve roots are irritated or pinched, the individual will feel a numbness, tingling or pain in the leg muscles, but not in the back itself.
Compressive pain may also occur in the cervical spine due to herniated discs. This is often manifested in arm pain or numbness.
There are a number of conditions that can cause pain and affect movement, including spinal stenosis, scoliosis, tumour, infections, fractures and degenerative disc disease . People with low back conditions may have symptoms such as pain or numbness that travels down one or both legs, weakness in their leg muscles, and problems or pain when they urinate. The pain often occurs when the nerves that run through the spine become pinched.
Degenerative disc disease (DDD) is one of the common causes of back pain. As people age, the discs can lose their elasticity, flexibility, and their ability to serve as shock absorbers for the spine.
DDD happens when the soft centre of the disc dries out and shrinks. This narrows the openings through which the nerves run, pinching the nerves between the vertebrae (see Illustration B). Most people have very few problems when this happens. But for others, the pressure on the nerves is very painful.
People with degenerative disc disease may have symptoms that include back pain, leg pain and weakness in their legs.
DDD happens when the soft centre of the disc dries out and shrinks. This narrows the openings through which the nerves run, pinching the nerves between the vertebrae (see Illustration B). Most people have very few problems when this happens. But for others, the pressure on the nerves is very painful.
People with degenerative disc disease may have symptoms that include back pain, leg pain and weakness in their legs.
There are many treatments for spine conditions and degenerative disc disease. You may have already tried some or all of the non-surgical treatments, and they may have helped you for a time. Non-surgical treatments include rest, ice or heat, medication, steroid injections, exercise and physical therapy.
If these non-surgical treatments do not bring relief after a period of time, you and your doctor may decide that a surgical treatment, may be right for you.
If these non-surgical treatments do not bring relief after a period of time, you and your doctor may decide that a surgical treatment, may be right for you.
Spinal fusion surgery takes pressure off of the nerves that are causing pain. This is done by restoring the alignment of the spine or the space between the vertebrae, and then stabilising and fusing the spine. A spinal fusion is when bone grows between the vertebra, stopping any motion in the area, which reduces pain.
Depending on the condition of the spine, the doctor may use an anterior approach, which means the incision will be in the abdomen, or a posterior approach, which means the incision will be in the back.
Sometimes the doctor may choose to use a combination of the two. If the doctor uses a posterior approach, then a pedicle screw system is used to stabilise the spine while it fuses and heals. The pedicle screw system may be used alone or it can be combined with another stabilising device.
During surgery, the doctor may relieve the nerve compression by removing the disc (called a discectomy). The doctor may also relieve pressure on the nerve by trimming or removing the roof, or lamina, of the vertebra to create more space for the nerve (called laminectomy ). The doctor then restores the space around the nerves and prepares to stabilise the spine with the pedicle screw system. There are a number of components in a pedicle screw system, and the doctor will choose the ones that will work best for your spine.
The screws are placed through each side of the vertebrae in the part of the part of the bone called the pedicle. Rods are then attached to connect the screws and hold the spine in its restored position. The pedicle screw system is now secure. In the last step of the surgery, the doctor places bone graft (small chips of bone) alongside of the vertebrae to be fused or puts the graft in and around a device that's placed between the vertebrae. Bone graft can come from the patient's hip bone, from a bone bank, or from a combination of both.
Depending on the condition of the spine, the doctor may use an anterior approach, which means the incision will be in the abdomen, or a posterior approach, which means the incision will be in the back.
Sometimes the doctor may choose to use a combination of the two. If the doctor uses a posterior approach, then a pedicle screw system is used to stabilise the spine while it fuses and heals. The pedicle screw system may be used alone or it can be combined with another stabilising device.
During surgery, the doctor may relieve the nerve compression by removing the disc (called a discectomy). The doctor may also relieve pressure on the nerve by trimming or removing the roof, or lamina, of the vertebra to create more space for the nerve (called laminectomy ). The doctor then restores the space around the nerves and prepares to stabilise the spine with the pedicle screw system. There are a number of components in a pedicle screw system, and the doctor will choose the ones that will work best for your spine.
The screws are placed through each side of the vertebrae in the part of the part of the bone called the pedicle. Rods are then attached to connect the screws and hold the spine in its restored position. The pedicle screw system is now secure. In the last step of the surgery, the doctor places bone graft (small chips of bone) alongside of the vertebrae to be fused or puts the graft in and around a device that's placed between the vertebrae. Bone graft can come from the patient's hip bone, from a bone bank, or from a combination of both.
The Dynesys Dynamic Stabilisation System is a new concept in the surgical treatment of lower back and leg pain -- one that uses flexible materials to stabilise the spine and offers another approach to traditional fusion.
The Dynesys System is a pedicle-screw fixation system, an implant device consisting of a spacer, cord and pedicle screw. It offers a unique approach to stabilisation and mobilisation of the spine and pain relief -- a "dynamic" approach -- that relies on flexible materials and preserves much of the spinal anatomy.
The Dynesys System can be used in skeletally mature patients to provide immobilisation and stabilisation of spinal segments. It is used as an adjunct to fusion to treat degenerative slipped disc(s) (spondylolisthesis) in the thoracic, lumbar or sacral regions when there is evidence of resulting neurologic impairment or in the case of a previous failed fusion (pseudarthrosis).
The Dynesys System should not be used in the cervical spine or for patients that are obese, pregnant, abuse alcohol or other drugs, or who have:
an active or systemic infection
mental illness
severe osteoporosis or osteopenia
sensitivities or allergies to metals, polymers, polyethylene, polycarbonate urethane and polyethylene terephthalate
soft tissue deficit
congenital abnormalities
tumors
inadequate pedicles of the thoracic, lumbar and sacral vertebrae
The Dynesys System is also not appropriate for individuals with any medical or mental condition that puts them at high risk from surgery of this severity, those with a condition that will not allow them to benefit from the surgery or decrease the useful life of the device, and those who are unwilling or unable to follow post-operative instructions.
The Dynesys System is compatible with conventional surgical techniques, and in some cases can be implanted using a minimally invasive approach. On average, the procedure to implant the Dynesys System takes two to three hours which is similar to the time required for traditional fusion procedures.
During the procedure, the surgeon removes portions of the affected disc(s) and bone from the spine. The Dynesys System is then attached to the bony extrusion (pedicle) on each side of the affected vertebrae. Once in place, the components create a dynamic push-pull relationship that stabilises the affected joints and keeps your vertebrae in a natural position. Bone is the most commonly used material to help promote fusion and will be added to achieve the desired fusion.
Surgery always involves some risk. General surgical complications may include:
reactions to anesthesia
heart attack
infection
blood vessel damage/bleeding
bruise (hematoma)
pneumonia
blood clots
wound closure problems
death
Potential risks associated with the implantation of the Dynesys System are similar to those associated with any spinal fusion procedure and those risks specific to the implantation of other pedicle-screw systems. They may include:
tear in the outer lining of the spinal cord which may result in spinal fluid leakage
temporary decreased or absent intestinal function
implant migration
leg pain
nerve complications
fractured sacrum
Please consult with your surgeon for a complete list of all warnings and precautions.
The safety and effectiveness of the Dynesys System has not been established for indications beyond those stated here -- including spinal stabilisation without fusion.
© 2007 Zimmer, Inc.
Frequently Asked Questions
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Yes: acute and chronic | |
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One of the common causes of back pain | |
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Non-surgical treatments and surgical treatments | |
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Surgery that takes pressure off of the nerves that are causing pain | |
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Dynesys® Dynamic Stabilisation System | |
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Should not be used in the cervical spine or for patients that are …… | |
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The procedure to implant the Dynesys System takes 2-3 hours on average….. | |
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Surgery always involves some risk. Complications may include… |
