The Link to Lumbar Degeneration
July 02, 2019
Love to golf? While you may love the game, you may find that hitting the links regularly may have unintended consequences: repetitive traumatic discopathy.
In February 2019, doctors from Barrow Neurological Institute published an article in the Journal of Neurosurgery: Spine focusing on the biomechanics of golf and its consequences on the body.
In their article, the researchers highlight that "among professional and amateur golfers, back disorders remain the most common injury, comprising 55 percent and 35 percent of injuries in these groups, respectively."
The researchers also mentioned that many modern-day professional golfers experience back pain and problems at much younger ages than regular people.
One of the reasons this happens is that there is a significant compressive force directed on the spinal discs and facet joints of the lumbar spine during the downswing.
This force is applied asymmetrically on these structures, causing minor traumatic injuries the researchers call repetitive traumatic discopathy (RTD).
Another contributing factor in RTD identified by the researchers was that more professional golfers are lifting weights and strength training to get a more powerful swing.
The researchers contend that RTD causes early-onset breakdown, instability and pain - which can sideline golfers.
The article also discusses treatment options for individuals living with this type of repetitive spinal injury, which includes rest, pain relievers, nonsteroidal anti-inflammatories, steroid injections, occupational and physical therapy, and weight loss.
If patients living with lumbar disc degeneration do not respond to these interventions, surgery is often the last resort.
Surgery for lumbar disc degeneration is the lumbar spine fusion procedure. Spinal fusion is designed to eliminate motion in affected discs and vertebrae. During the spinal fusion procedure, an incision is made in the affected area, muscles and other spinal structures are moved, the damaged discs are removed, and the joints are fused.
Then screws, rods or bone grafts are inserted in the treatment area to connect the discs and vertebrae.
"The result of spinal fusion is reduced back pain due to the immobilization of that treated section of the spine," said Dr. Faisal Jahangiri of AXIS Neuromonitoring in Richardson, Texas.
Another treatment for lumbar spinal pain is a discectomy, designed to treat herniated discs. The surgery removes damaged parts of the disc, which results in less pressure on the nerve.
Both procedures are relatively common - for both golfers and the general public. But, that doesn't mean they're not without their risks.
"Spinal fusion and discectomy procedures have the general risks associated with surgical procedures, such as blood clots, infection and bleeding," Jahangiri said.
They also have the risk of damage to the nerves and spinal cord.
"There is a risk of pain and numbness associated with any spinal procedure," said Jahangiri. Pain and numbness can cause lifelong complications and discomfort for patients.
To lower the risk, Jahangiri and his team at AXIS offer patients and their surgery providers peace of mind with intraoperative neuromonitoring services.
"Intraoperative neuromonitoring is a way to monitor patients during surgery to see the effects of surgery on their nervous systems," Jahangiri said.
When a patient is having a surgical procedure with intraoperative neuromonitoring, AXIS has highly trained technologists present in the operating room. These technologists work alongside surgeons, nurses and anesthesiologists, and analyze the data with special equipment to monitor the patient's nerves, spinal cord and brain functions.
"We can see how placing a rod into the spine may affect neural activity," Jahangiri said.
Intraoperative neurophysiological monitoring, or IONM, is an added layer of safety for the patient and is increasing in use in operating rooms across the country. It has been used for a wide range of surgical procedures, including both brain and spinal surgeries, cardiac procedures, ENT surgeries, and interventional neuroradiological (INR) procedures.
"Patients and surgeons are asking for IONM at increasing rates because they want to improve patient outcomes," Jahangiri said.
Source: Journal of Neurosurgery Publishing Group. "How a golf swing can lead to early lumbar degeneration." ScienceDaily. ScienceDaily, 5 February, 2019.
