Monday Medical: Preserving motion in the spine
Doctors have gotten much better at helping people with joint problems over the last 100 years. These days, patients can get hip and knee replacements that preserve joint function and motion.
But, what about the spine?
“The spine is not a rigid structure,” said Dr. J. Alex Sielatycki, a spine surgeon in Steamboat Springs and a member of the medical staff at UCHealth Yampa Valley Medical Center. “By design, it is intended to move. Every time you move – sit, stand, bend, twist – it’s part of a kinetic chain that includes everything from the ground up, from your feet through your legs to your hips and pelvis to the spine.”
Below, Sielatycki shares more about the spine, motion preservation, and what you can do to keep your spine as healthy as possible.
Addressing spine pain
Nerve compression is the source of most pain in the back, said Sielatycki.
“The good news is that most issues don’t require surgery,” he said. “Surgery is actually not the first step for most patients. Rather, we look to physical therapy, anti-inflammatory medications, steroid injections, low-impact aerobics programs or even possibly weight loss before we consider surgery. Only in rare cases where a patient is experiencing rapid progression, has a nerve deficit or an inability to walk would we consider surgery before some of the alternatives.”
If surgery is determined to be necessary, many procedures require removal and replacement of parts of the spine to reduce the pain, such as removing a worn or degenerated disk and replacing it with an artificial disk.
However, when the facet joints, or the connections between the bones of the spine, are removed, fusions are needed as there hasn’t been a good way to reconstruct those joints.
“The spine is one of the last joints of the body that is still being fused for a lot of the conditions patients may experience,” said Sielatycki. “That’s why the advancements in spine motion preservation are so encouraging. There are groundbreaking clinical trials underway now that involve total joint reconstruction in the lower spine.”
Benefits of spine motion preservation
Once a patient has had one spinal fusion procedure, it’s possible that adjacent segment disease may develop. For example, if a fusion is done in the lumbar spine, commonly known as the lower back, Sielatycki said it’s very common to see discs above and below the site undergo more rapid degeneration.
“Initially, the patient does reasonably well, but then it’s possible for the pain or degeneration to propagate,” he said. “There’s a high chance that the patient may need multiple fusions down the road.”
With advancements in spine motion preservation, not only are spine surgeons able to alleviate a patient’s pain, they are preserving and/or restoring motion while preventing the possibility of additional disease and surgery.
“We want to restore normal functioning for our patients,” said Sielatycki. “There will still be times where spinal fusions are necessary and appropriate, but the work that is being done to preserve motion will allow our patients to have even better outcomes.”
Preserve the motion of your spine
Sielatycki encourages people to stay fit and active to preserve spine health. He recommends low-impact aerobic exercise along with flexibility and core strength training.
“Activities that engage the core, such as yoga, Pilates and crunches, really go a long way in preserving a healthy envelope of muscle around the spine and keeping it moving as it should,” said Sielatycki.
Good ergonomics and lifting habits contribute to a healthy spine, too. If you have a sedentary job, ensure you have good lumbar support from your chair. And don’t forget to get up and move frequently.
“We’re not meant to sit or stand in one position,” said Sielatycki. “The body is meant to move, and the spine plays a big part in that.”
Lindsey Reznicek is a communications strategist at UCHealth Yampa Valley Medical Center. She can be reached at email@example.com.
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