A healthy spine is a spine in motion, and there are alternatives to back surgery.
Healthy Spinal Motion
The “functional unit of the spinal column” is called the motion segment, which is made up of soft tissue and bony structures. It is the facet joints and intervertebral disc that allows for flexion, extension, rotation, and side bending motions. The lower spine allows for the greatest motion, and it “bears the most weight”. The lumbar spine needs to be mobile and stable. With age, weakening and tearing can happen in the discs, called disc degeneration. This can lead to a reduction in disc height, bone spurs, and other issues, such as decreased range of motion and instability.1
What is a Spinal Backboard?
Patients may have severe back and spine problems as a result of a trauma, such as a vehicular accident. A spine board (spinal board, long spine board), or EMS backboards, are used to handle patients who have had trauma and suspected limb or spinal injuries. They can be used by emergency technicians, lifeguards, and paramedics. In general, when spinal injury is suspected, these boards are now used “primarily as an extrication device”, but there are “problems associated with extended use” and patients are often transferred to a “vacuum mattress instead”. Spinal boards can lead to the development of pressure sores, and they are often not adequate in immobilizing the spine. The respiratory system may become compromised, radiological imaging could be affected, and there is discomfort and pain associated with spine boards. In fact, patients should not spend more than a half hour on a spinal board. Typically the spinal backboard is used along with straps for securing the head, side head supports, and a cervical collar. The switch to the vacuum mattress in trauma care affords comfort, better stability, and more immobilization for a longer periods of time.2
Alternatives to Spinal Fusion Surgery
After trauma, or after many years of back troubles, some patients are referred for surgery. There are alternatives to spinal fusion. In spinal fusion, two (or more) vertebrae are joined together using “supplementary bony tissue” via autograft (“from the patient”) or allograft (donated) along “with the body’s natural bone growth”. Spinal fusion is more commonly performed on the lumbar region and for spinal deformities or to “eliminate the pain caused by abnormal motion”. If there are deformities, spinal fusion may be performed in the thoracic spine. Cervical spinal fusion is another surgery. In order to bridge adjacent vertebrae, “bone, metal plates, or screws can be used”.3 An alternative to spinal fusion surgery is intradiscal electrothermal coagulation (IDET), where a needle is inserted in the “lumbar disc space…(for) heating up the annulus”. Another option is using artificial discs to replace painful discs. Researchers are looking into gene therapy for stimulating disc regeneration. Posterior dynamic stabilization is a treatment option that “seeks to preserve motion in the spine while also taking pressure off” of the disc.4 Of course, before discussing any surgical or medical options, many patients may wish to explore the conservative treatment of chiropractic care, including adjustments, physiotherapy, trigger point and muscle procedures, education, rehabilitation, and exercise programs. Often, chiropractors work in conjunction with medical doctors in order to make sure that patients examine all of their healthcare options.5