Complexities of the Spine

Complexities of the Spine

The spine is a very complex part of your body.  It has disks, nerves, a spinal cord, and 33 vertebrae divided into 5 sections: cervical, thoracic, lumbar, sacrum and coccyx.  There are joints, ligaments, tendons and muscle surrounding it.  The spine supports your body to walk, twist and move and can hinder multiple areas to the rest of your body when something is amiss.  It is no wonder why one size does not fit all for someone who is experiencing spinal pain.  The complexity in treating it alone requires great skill, incredible knowledge of all these parts and how they affect one another.

We have seen dozens of cases for people needing a spinal surgery.  Not a single case was like the other.  They are almost all unique and never a cut and dry issue like someone needing a joint replacement.  A MRI only assists the surgeon in seeing what is creating pain, however, it is the knowledge of how and where the pain is produced in other areas of the body that they can form a true diagnosis and treatment plan.

A pain questionnaire is normally completed first.  It asks you to describe your pain and list where you are having it.  Is it sharp, intermittent, burning, dull, achy, pins & needles etc.  A whole other series of questions are also asked such as: how far can you walk without pain and for how long, can you go up stairs, does your pain go away while sitting or lying down, does your pain radiate or is it stationary, etc.  Neurosurgeons will do a physical exam checking for the strength you have in your arms and legs to pinpoint which area(s) are affected.  They take all of this detailed information to determine what is truly going on and what the best course of action is.  

Surgery is not always necessary and most definitely not the first treatment plan in the majority of cases, unless it was due to a traumatic injury and requires immediate attention.  There are many treatment plans to try prior to jumping into surgery.  Things like physiotherapy,  cortisone injections, facet joint blocks, rhizotomies, etc. are all non-invasive procedures for treatment to try first.  The goal is to attempt and repair the damage without surgery.  That is always a last resort.  Many times, the muscles surrounding the affected area need to be strengthened to allow the area to heal and that is all that’s needed.  Other times, something like cortisone might be appropriate.  

Regardless, spine ailments are tricky and can sometimes take awhile to determine what is going to work best for you.  It is also not something that can be healed over night.  Most treatment plans need to be tried for a minimum of 6-12 weeks before trying something else.

If you are a candidate for spine surgery and do not want to wait, contact us to have one of our facilities provide you with what might be the best course of action.  info@healthvantis.com or 877-344-3544.

 

Health Vantis

www.healthvantis.ca

info@healthvantis.com

877-344-3544

6 Things You Should Not Do When Traveling After a Spine Surgery

Spine surgery is considered a major surgery.  It can take weeks to heal to get your full mobility back.  The surgeon will prepare you for your rehab and how you need to care for your spine but what about your trip home?  This is something surgeons might not always think about so here are 6 tips for you to consider prior to your travel home.

Avoid traveling too soon – Your doctor will tell you when its safe to drive or fly home after your surgery.  If you don’t feel like you are well enough to leave when you’ve been released, then trust your own body and stay an extra day.  It will be worth it in the end if you feel healthier during your travels.

Make your trip comfortable – Flying can present some issues after a surgery.  Any flight over 4 hours can increase your risk for a DVT.   The best way to avoid this is to be sure and get up and move as much as you can, which can be hard right after knee surgery.  You can also ask your doctor for TED hose, which will help with circulation.  Be sure to have your pain medication, bottled water and a blanket or pillow to make the journey as comfortable as possible.

Never take your trip alone – One requirement in traveling for surgery is to take a travel companion.  None of the facilities within the US and Canada will allow someone to have surgery if they do not have a trusted adult staying with them for the first 24 hours after surgery.  Taking an Uber back to your hotel by yourself is not acceptable and not in your best interest should you need immediate care while you are resting in your hotel.  It is also helpful to have someone else there to assist you as you are recuperating in the hotel and on your travels back to help with luggage and getting to and from the gate.

Pack essentials – Packing things ‘just in case’ is always smart.  These should be kept on your person or carry on bag for easy access.  Things like pain medications, blankets, pillows, comfy clothes, headphones and extra bandages are examples of items you might consider taking.

Ask for anti-nausea medication – Anesthesia can make people very nauseous post surgery.  Motion sickness is also very common.  If you have ever experienced either of these in the past, ask your doctor to write you a prescription for an anti-nausea medication and keep it with you in the event you have an episode.  Be sure to pack some crackers, ginger ale or other things that are light on your stomach.  Try not to skip meals as having some food in your stomach will help.  Taking some medications on an empty stomach can also cause nausea or upset stomach problems.

Take it easy – Be sure to take things slowly.  You will have days where you feel great but always follow your doctors recommendations on your limitations so you do not over do or undo what was just fixed.  Surgery creates a lot of swelling and this can take weeks to subside.  Pushing yourself too hard too early can sometimes reverse what was just done.  Give your body the time it needs to heal.

If you are considering a private surgery, give Health Vantis a call.  We have experience in making your journey a safe and successful one.

 

Health Vantis

www.healthvantis.ca

877-344-3544

info@healthvantis.com

Private Spinal Surgery – Lumbar Fusion or Disc Replacement?

Back pain can bring a lot of disruptions to our daily lives. While non-surgical methods should be the first line of treatment, sometimes surgery is needed to address the pain and correct the issue. In this blog, we talk about spinal fusion and disc replacement as two surgeries that address lower back pain. As always, we encourage you to discuss this information with your spinal surgeon to determine which one will benefit you specifically.

Lumbar Fusion

This has been a traditional approach when it comes to treating pain from lumbar degenerative disease. The vertebrae surrounding the painful disc are fused together using a bone graft. Bone graft is placed between the vertebrae causing the two vertebral bodies to grow together into one long bone.

This makes a part of the spine immobile. Metal plates, screws or rods may be used to help hold the vertebrae together while the bone graft heals. Limiting motion in this case eliminates the pain. A couple of surgical approaches exists to this method, such as front, back or both.

Usually, a 2- or 3-day hospital stay is required, however, this is changing and fusions are now done in a minimally invasive way as day surgery.

Lumbar Disc Replacement

During this procedure, the disk that is causing pain is removed and an artificial one is implanted. The natural motion of the spinal segment is preserved.  Disc replacement addresses the pain by reducing instability and muscle tension caused by painful micro-motions at the degenerated disc level.

This is a relatively new procedure as compared to lumbar fusion. It has been available in the US since 2000. Not everyone is a good candidate for a disc replacement, however.

Both Lumbar fusion and disc replacement have their pro and cons. According to the studies, similar rates of complications happen in both. Which one is right for you? Discuss both options with your neurosurgeon, ask what experience they have with both and what they think will work best for you. Then, we always suggest a second opinion when it comes to spinal surgery.

If you would like to explore your private spinal surgery options we can get your diagnostic tests reviewed by a neurosurgeon. Give us a call to find out more toll-free 877-344 3544

Benefits of Private Endoscopic Spine Surgery

Many Canadians will experience back pain at some point in their lives. While non-surgical options should be tried first, sometimes surgery is necessary to eliminate the pain. Spinal surgeries offered in the past were quite involved requiring overnight stay in the hospital and months of rehabilitation. Over the years they evolved and less invasive options with optimal outcomes are now available. One of the recent developments is spinal surgery using an endoscope. Endoscopic spine surgery has many benefits over traditional spinal fusion.

Day Surgery vs Stay in Hospital

Endoscopic spinal surgery allows surgeons to access and address spinal pathology without the morbidity associated with traditional techniques. It allows doctors to perform an ultra-minimally invasive decompression when a fusion might have been necessary. People can be released to go home within a few hours of surgery and only take Tylenol for post-op pain while recovering.

Pain Management Centered Approach

When seeking spinal surgery, patients are most concerned with their pain and eliminating it through surgery. Ultra-minimally invasive surgeries such as endoscopic dorsal rhizotomy eliminate the pain. The surgery uses an endoscope allowing a surgeon to visualize the nerves and ablates the ones that send pain signals from the joint to the brain.

Smaller Incisions Allow Faster Healing

Using a tiny camera inserted through the special tube using a 1-inch incision allows doctors to see the operative site. The camera guides and assists the surgeon during the surgical procedure.  Smaller incision means less tissue and muscle damage, which also means less blood loss and less post-op pain. All that leads to faster overall recovery.

Regional vs General Anesthesia

In most cases this surgery can be performed using regional anaesthesia instead of general, decreasing the overall risks in patients who are older or have other medical conditions that may increase surgical risk. The patient is awake during the endoscopic procedure and does not need intubation, which is an advantage during the COVID-19 pandemic. Avoiding intubation protects staff from exposure to respiratory secretions directly from the lung.

If you have dealt with back pain for a while and non-invasive methods did not help, we will be able to get your diagnostic scans such as MRI reviewed to see if you may be a candidate for private endoscopic surgery. Gives us a call to find out more details toll-free 877 344 3544. *Please note that there are no private surgical facilities in the Maritimes and you will have to travel outside of your home area.

Neurosurgery Wait Times in Canada, 2020

In our previous blog, we brought your attention to 2020 medical wait times for Orthopedic surgery in Canada. In this blog, we will look in more detail at one of the 12 specialities wait times examined by Fraser Institute – Neurosurgery.

Across Canada, the total wait time in 2020 to get neurosurgery was 33.2 weeks. This is an increase of 8.7 weeks, compared to 2019 when the wait was 25.5 weeks. Chart 1 shows Neurosurgery wait times 10 years back and also includes 1993 when it was 12.9 weeks.

The report further breaks down wait times into two different segments. Segment 1 is the wait time from referral by a general practitioner to consultation with a specialist. Segment 2 is the wait time from the consultation with a specialist to point at which a patient receives treatment.

The wait time from GP to a specialist was 21 weeks, again, more than in 2019 when it was 15.7 weeks. The wait time from specialist to treatment was 12.2 weeks, up from 9.7 weeks in 2019. It is the second-longest wait time for the 12 specialities surveyed in 2020.

As far as which province fares the best, the report lists Quebec, where the median patient wait to see a specialist after referral from GP takes 8 weeks, and median wait to get treatment after the appointment with a specialist is 13.7 weeks. In other words, the median time to get neurosurgery in Quebec is 21.7 weeks. Ontario is in the second-fastest, with a total median wait time of 26.9 weeks.

The longest wait time was in Nova Scotia – a total of 70.7 weeks from referral by GP to surgery. Please refer to Chart 2 for the rest of the Canadian provinces numbers.

If you are unwilling to wait and would like to explore your private options, we are here to connect you to a reputable medical facility in the US or Canada. Give us a call to find out your options – toll-free 877 344 3544

Chart 1

Chart 2

Dreal- New Spinal Technique

A new technique called Dreal was developed for posterior unilateral thoracic discectomy.  Dreal is a curved high speed drill that assists in thoracic discectomies.  It removes disc material that can normally be difficult to access, quickly and thoroughly, providing a large clean bony surface for the discectomy.  This reduces removing too much bone and results in a better outcome.

This procedure also allows for the removal of calcified and soft disc fragments without manual maneuvers.  In traditional surgeries, this would require forceful maneuvers done manually by the surgeon, which could manipulate the spinal cord.   By eliminating that, it improves patient outcomes, reduces complication rates and allows for safer treatment of thoracic disc herniations. The design also allows easier, safer access for the surgeon to reduce the chance of trauma, resulting in a better outcome for the patient.  By being able to quickly and precisely remove the bone, operating time is reduced.  This in return reduces complications and/or infection.  

While this is still a fairly new technique and not available in Canada yet, it is available in the US. Contact us for details to find out if you are a candidate for this kind of procedure at 877-344-3544.

 

Health Vantis

877-344-3544

www.healthvantis.ca

Private Spinal Fusion Surgery

Minimally invasive surgery is one of the more common words used to describe newer surgery approaches and techniques. Spine surgeries are not an exception. We even came across ultra-minimally invasive when doing research. Things have definitely moved on in the past few years and spinal fusions are now routinely done on an outpatient basis.

However, the meaning of minimally invasive can be confusing. As we know, any surgery is a bit of a shock to your body. Recovering from surgery can take time.

The recovery from traditional spinal fusion was lengthy and painful. The traditional approach was to make an incision that is 5 to 6 inches long, move the muscles aside so that the surgeon can see the spine. One of the major drawbacks of open surgery is that the pulling of muscle can damage both the muscle and the surrounding soft tissue. Therefore, recovery is lengthy and painful. There is an increased risk of blood loss and infection.

Minimally invasive spine surgery was developed to treat spine issues with less tissue and muscle disruption. Through the use of specialized instrumentation, intraoperative navigation, advanced robotics and microsurgical techniques, surgeons are able to perform many common spinal procedures through very small incisions. These techniques lead to more rapid recovery, shorter hospital stays (often < 24 hours), less pain, lower complication rates, and faster return to work. There is less bleeding, fewer days spent in the hospital (if any) and therefore less risk of infection.

Many spine conditions can now be treated with minimally invasive surgery. Your neurosurgeon will be able to determine if you are a good candidate based on the sources and type of back pain you are experiencing and your diagnostic tests, such as X-ray and MRI.

Health Vantis provides access to no wait spinal fusions in the US. All surgeons are board-certified. Contact us now to find out more details on how you can get better sooner. Toll-Free 877 344 3544

Private Surgery for Spinal Stenosis

The narrowing of the spinal canal is called spinal stenosis. When it occurs, it puts pressure on the nerves inside the canal and causes pain. If you have tried all non-surgical options and the pain persists, surgery may be an option.

One of the surgeries to treat spinal stenosis is called laminectomy. It helps relieve back pain that is caused by nerve pain. The procedure involves removal of the rear portion of one or more spinal bones to create space. Bone spurs or ligaments pressing on the nerves may also be removed. The surgery enlarges the spinal canal to relieve pressure on the spinal cords or nerves.

Spinal fusion can also be performed while doing the laminectomy. If both are done at the same time, your recovery will likely be longer.

This is usually an outpatient procedure, however, there could be reasons that require an overnight stay. Light walking is encouraged immediately after your surgery as you can tolerate it. You will have limitations such as bending, twisting or lifting things over 10lbs for at least 6 weeks. After an evaluation by your doctor, you will most likely be released to begin your physical therapy.

One thing to remember is that after you are released from your doctor, your body is still healing inside and out. It may take your insides several months, up to 18 in some cases, to completely heal or fuse together. Being conservative and erring on the side of caution for certain sports or activities should be considered. Always consult your doctor first.

Please give Health Vantis a call Toll-Free at 877-344-3544 or email at info@healthvantis.com if you would like more information or are considering this surgery.