- By Dennis Douda
Mayo Clinic Minute: Minimally invasive spine surgery
Eighty percent of adults experience low back pain at some point in their lifetime, according to the National Institutes of Health. A recent study found more than a quarter of adults reported having low back pain during the past three months. And those are just complaints about the lower back.
"The overwhelming majority of people will experience back or neck pain at some point in their lives," says Dr. Mohamad Bydon, a Mayo Clinic neurologic surgeon. "Back and neck pain are two of the top-five reasons for [individuals] to see their doctor."
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“The first person that you want to talk to is your primary care provider,” says Dr. Bydon. He says treatments generally begin with the least intrusive therapies first. “You know, rest, ice packs, heat packs, physical therapy, [anti-inflammatory] injections. And if those things don’t succeed in alleviating the pain, then you may need to see a surgeon to discuss the problem.”
If surgery does seem to be the best choice for long-term relief, Dr. Bydon says to ask if a minimally invasive surgical approach may be an option. For the right patients, it can offer several advantages.
Back pain is the most common cause of job-related disability. "There are many joints in the back, and each of them can degenerate and can cause pain. And, so, this is part of the reason that people have so many back problems," says Dr. Bydon.
Pain might originate near a bulge in one of the cushioning discs between the bones, called vertebrae. "Generally, bulging discs don’t cause enough pain that they need surgery. Beyond a bulging disc would be a herniated disc, where the disc actually herniates out of that bulge and can then proceed to directly compress one nerve root or multiple nerve roots."
Surgery has several goals, including relieving pressure on the nerves without adding to the injury. "In minimally invasive spine surgery, we preserve the midline attachments of the muscles to the tendons to the bones," he explains. Surgical access to the spine may be through a small tube or a tiny cut, but Dr. Bydon says either approach offers the same advantages. "Decreased pain, [decreased] length of stay, increased patient satisfaction, a quicker return to work, and, you know, [it reduces] a lot of the issues that people may have around surgery."
Dr. Bydon says a few proactive steps go a long way toward preventing or minimizing back pain. "Certainly, good posture, of course, strengthening – those are important areas – strengthening of the musculature around the back, those are important areas to help prevent back pain and to help slow down the rate of degeneration."