Cargando…

Low Back Pain: Current Surgical Approaches

Low back pain (LBP) is a worldwide phenomenon. The UK studies place LBP as the largest single cause of absence from work; up to 80% of the population will experience LBP at least once in their lifetime. Most individuals do not seek medical care and are not disabled by their pain once it is managed b...

Descripción completa

Detalles Bibliográficos
Autores principales: Baliga, Santosh, Treon, Katrina, Craig, Niall John Angus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Spine Surgery 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522460/
https://www.ncbi.nlm.nih.gov/pubmed/26240729
http://dx.doi.org/10.4184/asj.2015.9.4.645
_version_ 1782383954428428288
author Baliga, Santosh
Treon, Katrina
Craig, Niall John Angus
author_facet Baliga, Santosh
Treon, Katrina
Craig, Niall John Angus
author_sort Baliga, Santosh
collection PubMed
description Low back pain (LBP) is a worldwide phenomenon. The UK studies place LBP as the largest single cause of absence from work; up to 80% of the population will experience LBP at least once in their lifetime. Most individuals do not seek medical care and are not disabled by their pain once it is managed by nonoperative measures. However, around 10% of patients go on to develop chronic pain. This review outlines the basics of the traditional approach to spinal surgery for chronic LBP secondary to osteoarthritis of the lumbar spine as well as explains the novel concepts and terminology of back pain surgery. Traditionally, the stepwise approach to surgery starts with local anaesthetic and steroid injection followed by spinal fusion. Fusion aims to alleviate pain by preventing movement between affected spinal segments; this commonly involves open surgery, which requires large soft tissue dissection and there is a possibility of blood loss and prolonged recovery time. Established minimally invasive spine surgery techniques (MISS) aim to reduce all of these complications and they include laparoscopic anterior lumbar interbody fusion and MISS posterior instrumentation with pedicle screws and rods. Newer MISS techniques include extreme lateral interbody fusion and axial interbody fusion. The main problem of fusion is the disruption of the biomechanics of the rest of the spine; leading to adjacent level disease. Theoretically, this can be prevented by performing motion-preserving surgeries such as total disc replacement, facet arthroplasty, and non fusion stabilisation. We outline the basic concepts of the procedures mentioned above as well as explore some of the novel surgical therapies available for chronic LBP.
format Online
Article
Text
id pubmed-4522460
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher Korean Society of Spine Surgery
record_format MEDLINE/PubMed
spelling pubmed-45224602015-08-03 Low Back Pain: Current Surgical Approaches Baliga, Santosh Treon, Katrina Craig, Niall John Angus Asian Spine J Review Article Low back pain (LBP) is a worldwide phenomenon. The UK studies place LBP as the largest single cause of absence from work; up to 80% of the population will experience LBP at least once in their lifetime. Most individuals do not seek medical care and are not disabled by their pain once it is managed by nonoperative measures. However, around 10% of patients go on to develop chronic pain. This review outlines the basics of the traditional approach to spinal surgery for chronic LBP secondary to osteoarthritis of the lumbar spine as well as explains the novel concepts and terminology of back pain surgery. Traditionally, the stepwise approach to surgery starts with local anaesthetic and steroid injection followed by spinal fusion. Fusion aims to alleviate pain by preventing movement between affected spinal segments; this commonly involves open surgery, which requires large soft tissue dissection and there is a possibility of blood loss and prolonged recovery time. Established minimally invasive spine surgery techniques (MISS) aim to reduce all of these complications and they include laparoscopic anterior lumbar interbody fusion and MISS posterior instrumentation with pedicle screws and rods. Newer MISS techniques include extreme lateral interbody fusion and axial interbody fusion. The main problem of fusion is the disruption of the biomechanics of the rest of the spine; leading to adjacent level disease. Theoretically, this can be prevented by performing motion-preserving surgeries such as total disc replacement, facet arthroplasty, and non fusion stabilisation. We outline the basic concepts of the procedures mentioned above as well as explore some of the novel surgical therapies available for chronic LBP. Korean Society of Spine Surgery 2015-08 2015-07-28 /pmc/articles/PMC4522460/ /pubmed/26240729 http://dx.doi.org/10.4184/asj.2015.9.4.645 Text en Copyright © 2015 by Korean Society of Spine Surgery http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Baliga, Santosh
Treon, Katrina
Craig, Niall John Angus
Low Back Pain: Current Surgical Approaches
title Low Back Pain: Current Surgical Approaches
title_full Low Back Pain: Current Surgical Approaches
title_fullStr Low Back Pain: Current Surgical Approaches
title_full_unstemmed Low Back Pain: Current Surgical Approaches
title_short Low Back Pain: Current Surgical Approaches
title_sort low back pain: current surgical approaches
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4522460/
https://www.ncbi.nlm.nih.gov/pubmed/26240729
http://dx.doi.org/10.4184/asj.2015.9.4.645
work_keys_str_mv AT baligasantosh lowbackpaincurrentsurgicalapproaches
AT treonkatrina lowbackpaincurrentsurgicalapproaches
AT craignialljohnangus lowbackpaincurrentsurgicalapproaches