Surgeons turned to an unlikely place for inspiration and developed a technique to get patients back on their feet faster.
Just like a mechanic jacks up a car, surgeons are jacking up backs.
Dr. Hyun Bae is an orthopedic spine surgeon at St. John's Health Center in Santa Monica, California. "A car jack imparts lift, and what we do in this procedure is we mechanically impart lift between two vertebral segments."
The back jack surgery helped Janie Lee. She went from doctor to doctor with no diagnosis for 10 years. "I actually didn't have a life. I couldn't sit for more than five minutes. I couldn't walk for more than five minutes."
Bae diagnosed her with stenosis, a narrowing of the spine that puts pressure on nerves. In the past, patients like Lee needed a spinal fusion.
"We put the screws in and we put the rods in. We do have to dissect quite a bit, and it tends to be a pretty big procedure," Bae said, describing the surgery.
Instead, Bae chisels out bone to relieve pressure on the spinal cord and nerves. Then he places a jack to prop up the spine, stopping the bone and pain from coming back.
"That's exactly what the car jack does. It tries to elevate and lift so people can work under it. Well, that's exactly what we're doing. We elevate. We distract those two segments, and then we place a spacer in between to hold that in place so the nerves have a good working environment."
It shortens hospital stays from three nights to one. Patients don't have to wear a back brace and it cuts recovery from two months to two to four weeks. A year after surgery, Lee is fulfilling a dream her pain forced her to abandon.
"I haven't been able to read or sit still for a longer time. Now that I could, I want to finish my bachelor's degree that I couldn't finish before."
Usually, spinal fusions patients have to wear back braces and can't do many activities for at least two months.
Back jack patients go to physical therapy for two to four weeks with no brace and can then resume normal activities.
BACKGROUND: Almost everyone will experience low back pain at some point in their lives, and a common cause is spinal stenosis. Stenosis occurs when the space around the spinal cord narrows, putting pressure on nerve roots. Lumbar spinal stenosis -- stenosis of the lower back -- is often a normal part of aging since soft tissues and bones harden as we age. According to the American Academy of Orthopaedic Surgeons, 95 percent of people experience degeneration of the spine by age 50, and stenosis most often occurs in people over 60 years old. Symptoms of spinal stenosis include back pain, burning pain in the buttocks or legs (sciatica), numbness or tingling in the buttocks or legs, and weakness in the legs. Another symptom is "foot drop," or the sensation of the foot slapping on the ground while walking.
TREATMENT: If treatment with physical therapy and anti-inflammatory medication fails, patients with poor quality of life because of stenosis may be candidates for surgery. For stenosis, surgeons often perform a laminectomy -- or spinal decompression -- which involves removing the bone, bone spurs and ligaments that are pressing on painful nerves. In patients with arthritis that would cause the spine to collapse after decompression surgery, spinal fusion is performed as well. In spinal fusion, surgeons fuse together two or more vertebrae using a graft from another area of the body. Rods and screws may also be put in place to fuse the bone together. Tradition spinal fusion can leave a patient in pain afterwards due to the placement of screws and rods. Some surgeons are combining minimally invasive decompression surgery with placement of a new plate instead of screws and rods. The plate works like a car jack. "Basically, a car jack imparts lift, and what we do in this procedure is we mechanically impart lift between two vertebral segments," Hyun Bae, M.D., orthopedic spine surgeon at St. John's Health Center in Santa Monica, Calif., told Ivanhoe.
Dr. Bae says patients can walk the day after the surgery and resume most of their normal activities after about three weeks. After the initial healing time, patients are put into physical therapy for two to four weeks and can then get back to all normal activities.
FOR MORE INFORMATION:
Trace Longo
Public Relations
Dr. Hyun Bae
trace.longo@sbcglobal.net
