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Better Surgery For Back Pain

THE NUMBERS: Between 200,000 and 300,000 Americans have back surgery each year. In the past year, the number of fusions people have has increased, and surgeons perform about 100,000 fusions each year in the United States alone. Neurosurgeon Dr. William Taylor, from the University of California, San Diego, says an increasing number of people do not want to live with back pain. He said, "People who have degenerations in their back or arthritis are now refusing to live with it. They don't want the back pain, and they want to get better. And the fusions really take care of back pain."

STANDARD BACK SURGERY: Surgery can correct only certain back problems and should be used only when necessary. Otherwise, increased and even chronic pain can result. There are two types of back surgery. Decompression can be used on a patient with a disc pressing on a nerve or a nerve affected by intruding bone. Stabilization, also called spinal fusion, is performed to eliminate spinal weakness. With standard fusion, an approximately 15-centimeter incision is made. The muscles are stripped away on the spine for better exposure. Operation time is lengthy, and patients can experience significant blood loss. Taylor said patients can be in a lot of pain from the surgery. Many are on a morphine drip during surgery, so they need IV narcotics post-op. He says many patients rate the pain as "an eight to nine out of 10."

NEW OPTION ADVANTAGES: Taylor performs a new type of surgery that he says is much easier on the patient. He makes an incision between one and three centimeters long, which is just long enough to fit a retractor in. Taylor said the procedure is done in a "minimally invasive space- fashion." The surgery is done from the side, so there is no need to cut through the abdomen, aorta, and other vital body parts. Instead of surgeons trying to visually find things, they locate them on X- rays. Sensors alert the surgeon if the probe approaches one of the delicate nerves that run through the muscles, so they can steer around it. Taylor said there are two parts of the spine connected with surgery. One is the bone anatomy and the other is the central nervous system. He said it is easy to cause significant damage to the nervous system when operating, and this new option reduces some of that risk. Surgery time is also cut down, as a large dissection to remove the muscles and expose a patient's insides is not necessary. Taylor said blood loss is cut by one-tenth of the amount in standard back fusion surgery. Also, instead of the five-night hospital stay typical of back surgery, many patients can go home after one night.

CANDIDATES FOR SURGERY: Also, Taylor said he has performed the surgery on patients whose doctors had told them they were too old for back surgery. He said the new surgery has made him more willing as a doctor to operate on older patients with more medical complications and problems. Taylor said most people are candidates for this procedure.

FOR MORE INFORMATION, PLEASE CONTACT:
Jeffree Itrich
Public Information Officer
University of California, San Diego
200 West Arbor Dr. MC 8230
San Diego, CA 92103
(619) 543-6427
jitrich@ucsd.com

For other medical research, visit Ivanhoe Broadcast News on the Internet at http://www.ivanhoe.com

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