Common or Not, There's Still Risk
By Admin | September 05, 2019
Lower back pain is prevalent; according to statistics from the National Institute of Neurological Disorders and Stroke, nearly 80 percent of adults experience it at some point in their lives.
In most cases, lower back pain stems from a minor injury, an underlying medical condition or overuse. But in some cases, there is no apparent cause.
One of the most common back injuries is what is known as a herniated or ruptured disc.
This type of back injury is caused by a forceful impact or trauma to the back, often delivered in the form of a fall, sports injury or motor vehicle accident.
For many people, pain starts immediately after their injury. Additional symptoms include stiffness, numbness and tingling that radiates down both legs.
Another side effect of a herniated disc is a condition known as cauda equina syndrome, a condition that develops when something damages or compresses the cauda equina, the bundle of nerves in the lower part of the spinal cord.
While rare, cauda equina syndrome is concerning because it can cause sufferers severe pain and numbing or tingling in one or both legs, make walking difficult, or cause bladder and bowel problems.
Cauda equina can also develop as a result of injury or spinal stenosis, a medical condition that causes narrowing of the spinal cord.
When herniated disks occur, treatment often includes rest, nonsteroidal anti-inflammatory medications (NSAIDs), pain relievers, physical therapy, and specific exercises that help to strengthen your lower back and abdominal muscles. Some other patients see benefits of epidural steroid injections into the area around the nerve in the location of the injured disc.
These injections can help provide short-term pain relief by reducing inflammation. But, there's a problem with them: They are short-term.
"In many cases, people living with herniated disks who do not find relief within six weeks of nonsurgical treatment end up with surgery," said Dr. Faisal R. Jahangiri of AXIS Neuromonitoring.
AXIS, located in Richardson, Texas, offers intraoperative neuromonitoring services for patients undergoing surgery - including spinal procedures for herniated discs, spinal stenosis and lumbar fusion.
"These procedures, while often categorized as commonplace and low-risk, still have the potential for complications," Jahangiri said.
That was the case for a 47-year-old man with a history of back and leg pain. The patient was admitted with a herniated disc at L4-L5 level and also co-morbidities of hypertension, diabetes and hypothyroidism.
During his spinal procedure, the patient was monitored using Somatosensory Evoked Potentials (SSEP), Motor Evoked Potentials (TCeMEP), and electromyography (EMG) to track the nervous system response.
During the procedure, AXIS Neuromonitoring technologists noticed a decrease in the patient's right upper limb sensory evoked potentials (SSEP). After alerting the surgeon and anesthesiologist on the procedure, the patient's arm was repositioned, preventing negative neurological consequences such as ischemia, stretching, or compression of the nerves that may have resulted in brachial plexus injury.
These consequences could have included postoperative muscle weakness, numbness, severe pain, burning sensations and limited use.
"By alerting the surgeon during the procedure of the changes to the patient during a 'routine' surgery, we were able to help improve patient outcomes," said Jahangiri.
Source: Medical News Today. What can cause lower back pain? 4 June 2019.
