Stopping Negative Side Effects in Their Tracks
August 05, 2019
Ever bend over to reach something and suddenly experience lower back pain? Is it just the pain of getting older or being out of shape, or is it something more serious?
While lower back pain is a common symptom of several different conditions, including herniated disks and sciatica, it is also a primary symptom of a condition known as spondylolysis.
Spondylolysis is the medical name for a stress fracture in a spinal vertebra.
While the majority of those affected by the condition are over the age of 40, it can also happen in young athletes, particularly those who play football or participate in gymnastics.
Having spondylolysis can make bending over difficult but can also make it hard for you to stand upright, a situation known as spondylolisthesis.
In some cases, spondylolysis develops without symptoms. Spondylolysis can also cause pain in the buttocks and thighs. Pain caused by the condition gets worse with activity and exercise.
Treatments for the condition include rest and the use of nonsteroidal anti-inflammatories (NSAIDs), along with physical therapy and a supportive back brace worn during exercise or physical activity.
If spondylolysis is severe or patients are experiencing severe symptoms, surgery may be necessary. One type of surgery used to treat spondylosis is lateral lumbar interbody fusion (XLIF), a minimally invasive spinal procedure used to treat pain in the lower back.
The XLIF procedure is performed through the patient's side, which allows surgeons to avoid the major muscles of the back, leading to an easier recovery.
As with any spinal procedure, there are serious risks to consider, according to Dr. Faisal Jahangiri of AXIS Neuromonitoring of Richardson, Texas.
"In general, risks associated with spinal procedures include numbness, muscle weakness and negative impacts to body systems," Jahangiri said.
AXIS Neuromonitoring watches for those risks during back and other procedures. Recently, an AXIS technologist observed an XLIF spinal procedure on a 73-year-old woman with a history of lower back problems. The patient, admitted with lumbar spinal stenosis and lumbar spondylolysis, experienced significantly low responses in electromyographic stimulation during the surgery in the left adductor (thigh) muscle.
The cause of the electromyographic changes in the patient was the placement of a lateral dilator.
The AXIS Neuromonitoring technologist saw the changes in the patient and immediately informed the surgeon, who repositioned the dilator. Once the dilator was repositioned, adverse impacts on the left adductor muscles were noted once again.
The attending surgeon decided that the patient could not tolerate the placement of the dilators without putting the patient's quadricep muscles at risk for damage, and the patient at risk of muscle weakness, numbness and other side effects. The surgeon stopped the procedure on the patient's left side and proceeded to insert dilators into the patient's right side without complication.
As a result of intraoperative neuromonitoring provided by AXIS Neuromonitoring, the patient did not suffer neurological side effects.
"Intraoperative neuromonitoring is a critical part of keeping patients safe during surgery and improving patient outcomes," Jahangiri said.
Source: Back pain when bending: What to know. 11 July 2019.
