Currently, there are more spine surgeries being performed in America than ever before. In fact, in the years 2002 to 2007 the amount of complicated spine surgeries (involving fusions) increased 15 fold. I can guarantee you in those 5 years the population of American did not increase that much. Here’s a look at spine surgery for arthritis.
As an individual shifts in to their 40s and 50s, degenerative arthritis begins to potentially become a problem. Unfortunately, in the spine there are over 20 sets of facet joints, which are the thumbnail size joints containing cartilage allowing spinal movement.
With each joint containing cartilage, the potential for degenerative arthritis at each one is significant. Essentially, most individuals end up with arthritis at more than one level of their neck or back.
This brings us to the main point here. Performing a spinal fusion of one or two levels may work well for a short time period. When you fuse a level, it can no longer absorb any stress that the body sees. Those stresses either go up or down and may contribute to accelerated arthritis at the adjacent levels. At that point, the patient may be facing an add-on fusion surgery, which will continue to escalate as a problem moving up and down the spine.
So it’s a very different scenario than simply performing a hip or a knee replacement, since there’s only one of those on each side of the body. When an individual has spinal instability or degenerative scoliosis due to arthritis, surgery may in fact be extremely helpful.
What is being referred to here is simple degenerative arthritis that is painful. There is no acceptable facet joint replacement like there is for the hip or the knee. Because of this, it is better to exhaust all options with conservative management. This may include physical therapy and chiropractic treatment, spinal decompression therapy, acupuncture treatment, and tens units. There are plenty of research studies showing the benefits of these treatments for osteoarthritis conditions.
Medication management includes over-the-counter anti-inflammatories and Tylenol. For periods of exacerbation, short-term narcotic medications may be helpful. Over the long-term though, the risks of opiates began to outweigh the benefits.
Interventional pain treatments for degenerative arthritis of the spine have been the best options going. This may include medial branch blocks, facet injections or radiofrequency ablation. These treatments may provide 6 to 18 months of pain relief, and then may be repeated once the pain relief wears off.
There are new treatments coming out for the spine including regenerative medicine injections. These may include platelet rich plasma treatment or stem cell injections. While not widely available, there is ongoing research on their potential.
Spinal fusions for strictly degenerative arthritis have never been shown in published studies to be better than conservative treatments. And there are significant risks associated with operative treatments that do not exist with conservative management.
Therefore all attempts at conservative treatment should be undertaken prior to ever considering an elective spinal surgery. The exceptions to this would be, as mentioned, instability or significant scoliosis, and also spinal stenosis.
If you or a loved one is suffering from chronic back or neck pain due to arthritis, Arizona Pain Specialists offers comprehensive nonoperative pain management treatments. These include Board Certified Arizona pain management doctors and chiropractors offering medication management, interventional procedures, spinal decompression therapy, acupuncture, spinal manipulations, tens units and more.
With over 50 insurance plans and 4 locations, there is no better AZ pain clinics to obtain first rate treatment. Call today at (602) 507-6550 for scheduling!