Posterior cervical fusion
Posterior cervical fusion is a surgical procedure performed from the back of the neck that stabilizes the spine using screws or hooks and rods to provide support for the fusion process.
Understanding spine symptoms
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Pain in the spine
Neck and arm pain
Cervical anatomy
The cervical spine, situated in the neck region, represents a sophisticated framework composed of bones, nerves, muscles, ligaments, and tendons. Functionally delicate, it serves as the protective housing for the spinal cord, which transmits messages from the brain to govern various bodily functions. Simultaneously, the cervical spine demonstrates remarkable strength and flexibility, enabling the neck to articulate movements in all directions.
Comprised of seven vertebrae labeled C1 through C7, the cervical spine establishes a connection with the skull at its upper end and with the upper back around shoulder level at its lower end. Intervertebral disks, acting as shock absorbers, are positioned between each vertebra.
Why do I have neck or arm pain?
Neck pain is a common issue that can disrupt daily routines and significantly affect the overall quality of life. The duration of discomfort varies depending on the underlying cause, ranging from a few days to an extended period. Poor posture, whether from prolonged computer use or leaning over a workstation, along with stress, can strain neck muscles. Osteoarthritis, affecting many individuals, is another significant contributor. Furthermore, neck problems may extend pain into the shoulder or down the arm.
If your condition doesn't improve within a few days, you should seek medical evaluation, typically involving physical examinations and diagnostic imaging such as X-rays, MRI, or CT scans. Now, let's take a look at some causes.
Degenerative Disc Disease (DDD)
Degenerative disc disease (DDD) is a condition associated with the deterioration of the discs located between the vertebrae of the spinal column, mainly due to the aging process. This process leads to a loss of disc height and hydration, resulting in a diminished ability to cushion and provide mobility between the vertebrae. This condition can cause weakness, numbness, and neck pain.
Cervical disc herniation
Cervical disc herniation is a condition in which one of the discs in the neck extends beyond its normal boundary. This can press on nearby nerves, leading to pain, numbness, or weakness in the neck, shoulders, arms, or hands. The condition can be caused by aging, injury, repetitive strain, or poor posture.
Spinal Stenosis
Degenerative spinal stenosis is a spinal condition in which the space where nerves pass through the spine gradually narrows. This narrowing may result from natural aging and “wear and tear” on the spine from everyday activities
Vertebral fractures
Spinal fractures are common and usually caused by osteoporosis, tumors, or trauma like car accidents, falls, or sports injuries. Most spinal fractures won’t need surgery, but you might need to temporarily wear a neck collar. However, severe spinal fractures will need to be surgically repaired. Even if you need surgery to repair your broken vertebrae, you shouldn’t expect to have any long-term effects from a spinal fracture if your spinal cord isn’t damaged.
What are the available solutions?
If conservative measures and non-surgical spine treatment to control your spine pain and limited mobility are not effective in relieving your symptoms, your doctor may recommend you undergo spine surgery. Your surgeon can reach your spine through anterior and/or posterior "approaches" depending on the nature and location of your disease.
Anterior cervical fusion
Anterior cervical discectomy and fusion is a surgical procedure performed from the front of the neck. The damaged disc is removed, and an interbody spacer is inserted into the disc space to facilitate fusion and provide support.
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Pain in the spine
Lower back and leg pain
Thoracolumbar anatomy
The thoracolumbar region encompasses the lower thoracic and upper lumbar vertebrae, vital for stability and movement. Comprising 12 thoracic and 5 lumbar vertebrae, it marks the transition between the mid and lower back. The thoracolumbar spine provides support for the upper body while allowing flexibility for various activities.
Muscles and ligaments in this area aid in posture, movement, and protection of vital organs. Nerve roots stemming from the spinal cord here extend to the lower body, influencing sensation and motor function. The intricate interplay of bones, muscles, nerves, and connective tissues in the thoracolumbar region facilitates essential bodily functions and mobility.
Why do I have lower back and leg pain?
The lower back, also called the lumbar region, is the area of the back that starts below the ribcage. Pain in this area can be caused by osteoporosis, disc diseases, trauma (e.g. car accidents), falls, sports injuries, or tumors. It may last for a short period (acute), a little longer (sub-acute), or a long period (chronic). It can also cause pain to radiate down a leg (sometimes called sciatica).
If your condition doesn't improve within a few days, you should seek medical evaluation, typically involving physical examinations and diagnostic imaging such as X-rays, MRI, or CT scans.
In 2020, low back pain (LBP) affected 619 million people globally and it is estimated that the number of cases will increase to 843 million cases by 2050, driven largely by population expansion and aging. 1
If your condition doesn't improve within a few days, you should seek medical evaluation, typically involving physical examinations and diagnostic imaging such as X-rays, MRI, or CT scans. Now, let's take a look at some causes.
Degenerative Disc Disease (DDD)
Degenerative disc disease (DDD) is a condition associated with the deterioration of the discs located between the vertebrae of the spinal column, mainly due to the aging process. This process leads to a loss of disc height and hydration, resulting in a diminished ability to cushion and provide mobility between the vertebrae. This condition can cause weakness, numbness, and back pain.
Spondylolisthesis
Spondylolisthesis is a spinal condition where one of your vertebrae slips forward above the vertebrae below. This displaced vertebra can apply pressure to the nerve, causing lower back or leg pain. This type of instability in your spine can occur from degenerative changes, stress fractures, congenital abnormalities, and in rare cases a tumor or trauma.
Spinal Stenosis
Degenerative spinal stenosis is a spinal condition in which the space where nerves pass through the spine gradually narrows. This narrowing may result from natural aging and “wear and tear” on the spine from everyday activities.
Pressure on the nerves may cause pain and damage. Symptoms may include numbness and a “prickly” feeling in your legs, calves, or buttocks; aching, dull back pain spreading to your legs; decreased endurance when standing or walking. Symptoms may improve when sitting, leaning forward, lying on your back, or sitting with raised feet.
Vertebral fractures
Degenerative disc disease (DDD) is a condition associated with the deterioration of the discs located between the vertebrae of the spinal column, mainly due to the aging process. This process leads to a loss of disc height and hydration, resulting in a diminished ability to cushion and provide mobility between the vertebrae. This condition can cause weakness, numbness, and back pain.
What are the available solutions?
If conservative measures and nonsurgical spine treatments are not effective in relieving your spine pain and symptoms, your doctor may recommend you undergo spine surgery. Your surgeon can reach your spine through anterior and/or posterior "approaches" depending on the nature and location of your disease.
Posterior thoracolumbar fusion
Posterior thoracolumbar fusion is a surgical procedure that stabilizes the spine using cages, rods, screws, and bone grafts to fuse vertebrae, addressing instability, deformity, or spinal weakness from injury or disease.
Anterior lumbar fusion
Anterior thoracolumbar fusion stabilizes the spine by accessing and fusing vertebrae from the front, often used to address instability, deformity, or trauma affecting the thoracolumbar region surgically.
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Pain in the spine
Pelvis pain
Pelvis anatomy
The sacroiliac joint (SIJ) occurs twice in the pelvis, connecting the sacrum to the pelvic blades (ilium) on both sides. It is one of the largest joints in the human body. Like other joints, it contains articular cartilage, synovial fluid, a joint capsule, and a ligament apparatus; however, it is very different from all the other joints in that it has minimal mobility.
Why do we have pelvic pain?
Pain stemming from the sacroiliac joint (SIJ) can result from various factors like childbirth, joint malformation, accidents, or conditions like Rheumatoid Arthritis. Additionally, even a healthy SIJ may cause discomfort if it compensates for adjacent painful or blocked joints by moving excessively. Identifying SIJ-related issues can be challenging as their symptoms often mimic other medical conditions, leading to potential oversight.
The manifestation of SIJ-related symptoms is characterized by deep back pain in the pelvic region usually one-sided. Pain may extend to the buttocks, lateral thigh, calf, and occasionally the groin, creating a sensation that differs from the actual source.
Patients may experience restlessness while sitting, the urge to relieve one side of the buttocks, and frequent position changes, often mistaken for nervousness by others. Some report a sense of reduced control over the affected leg while walking, despite normal muscle movement and skin sensation.
At night, discomfort may disrupt sleep when changing positions or lying on the affected side, although falling asleep typically remains unaffected. These symptoms underscore the complexity of SIJ-related issues, often necessitating individualized identification and treatment, especially in cases where no other apparent cause for deep-seated back pain exists.
What are the available solutions?
In the event that surgery is the only option, an SI joint fusion can be achieved with different approaches:
Posterior S2AI
As part of posterior lumbar fixation, it’s possible to stabilize SI joint with an S2AI fixation, providing stability and support for conditions like sacroiliac joint dysfunction or pelvic fractures.
Lateral SI fusion
Through a small incision, just below your waist, the sacroiliac screws are inserted to stabilize your sacroiliac joint, resulting in an improvement in your quality of life.
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Pain in the spine
Deformity
Spine alignment
Spine alignment refers to the proper positioning and arrangement of the vertebrae in the spinal column, ensuring that it maintains a solid and balanced structure.
A healthy spine appears straight if viewed from behind and curved in an “S” shape when viewed from the side.
The natural spine curves work together to provide stability, support, and flexibility.
Optimal spine alignment is essential for maintaining proper posture, preventing discomfort or pain, and facilitating the overall function of the nervous system.
What is Scoliosis?
Scoliosis is a deformity of the spine in which, instead of appearing straight when viewed from behind, it curves laterally in various patterns.
Patients with scoliosis could have curves that look more like a “C” (one curve) or an “S” (two curves) viewed from behind. Depending on the age of the patient, scoliosis can be Adolescent Scoliosis or Adult Scoliosis.
Scoliosis affects less than 1 percent of the world population, mostly children between the ages of 10-16 years. In the elderly, the incidence can be as high as 68.6%. The most common causes include a continuation of adolescent idiopathic (unknown case) scoliosis or a (new) scoliosis due to degeneration of the discs, arthritis of the facet joints, and collapse and wedging of the disc spaces.
Patients may have a variety of symptoms, which can lead to gradual loss of function:
- Low back pain and stiffness are the 2 most common symptoms 2
- Numbness, cramping, and shooting pain in the legs due to pinched nerves
- Loss of sagittal balance, which can cause muscle fatigue
In 90 percent of cases, scoliotic curves are mild and do not require active treatment. 3
What are the available solutions?
In the management of scoliosis, the initial preference is for nonsurgical interventions whenever feasible.
Conservative approaches typically encompass medication, bracing, and engagement in physical therapy and exercise.
Surgical intervention is typically reserved for patients experiencing persistent pain, breathing difficulties, significant disfigurement, or a progressively worsening curve angle.
The goal of surgical treatment is to obtain curve correction and to prevent curve progression by fusing the spine at the optimum degree of safe correction of the deformity. This is generally achieved by placing metal implants into the spine that are then connected to rods, which correct the spine curvature and hold it in the corrected position until the spine elements fuse.
Each case of scoliosis is unique, necessitating a tailored approach for optimal outcomes for this reason your doctor may suggest that you undergo a Patient-Specific Scoliosis Correction using MySpine and NextAR, the latest patient-matched solutions developed by Medacta
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The information contained here is intended for reference only and does not represent or constitute medical advice or a recommendation. Each patient must be examined and advised individually by a physician, and this information does not replace the need for such examination and/or advice in whole or in part. Results are not necessarily typical, indicative, or representative of all patients. Results may vary due to health status, weight, activity, and other variables. Not all patients are candidates for this product and/or procedure. The appropriate postoperative activities and pain management will differ from patient to patient. Talk to your doctor about your condition and about whether the presented procedure is appropriate for you, considering the risks associated. All content is protected by copyright, trademarks and/or other intellectual property rights of Medacta and cannot be used without the written consent of Medacta. In good faith, Medacta asserts that this material does not infringe or misappropriate any intellectual property rights of any third party.
References
1- https://www.who.int/news-room/fact-sheets/detail/low-back-pain - accessed on 12/10/2023.
2- http://www.aans.org/ - accessed on 12/10/2023.
3- http://www.srs.org/ - accessed on 12/10/2023.