Back procedures lead to quicker recovery
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| Dr. Dirk Franzen performs back surgery at Jackson-Madison County General Hospital. |
“The new techniques are designed to make surgery less invasive and to allow a quicker recovery and faster return to normal activities,” says Dr. Dirk Franzen, a board-certified neurosurgeon. “Over the past few years, we’ve seen some real innovative procedures.”
Dr. Franzen, who practices at the Brain and Spine Institute in Jackson, says he likes to learn how to do the procedures so that he can give patients another surgical option when it’s appropriate. Though he also performs surgery for such conditions as brain tumors and endoscopic surgery for carpal tunnel problems, a good 90 to 95 percent of his medical practice is surgically treating back pain and other spinal problems.
He describes four of the new procedures that he can offer his patients…
• Patients who have degenerative disk disease or slipped disc in the lower back may be candidates for a new FDA-approved procedure that offers a less invasive alternative to currently available fusion procedures. This new device not only leads to a speedier recovery, it also restores the former height of the disc, says Dr. Franzen.
Surgery is performed through small incisions. The center of the diseased disc is removed and replaced with bone growth material. Disk height is restored and the spine is then stabilized with the implant, which consists of a threaded cylinder and screws.
“We make a small incision next to the tailbone and this avoids problems of going through abdominal tissue or muscles in the back. Patients are up after the anesthesia wears off and usually go home the next day rather than spend a few days in the hospital.”
• The standard surgical treatment for herniated discs in the neck for years has been discectomy and fusion; removing the disc and inserting bone graft and possibly a metal plate and screws. The FDA approved the first artificial disc for the neck last summer.
This surgery is similar to the fusion, but instead of inserting a bone graft and metal plate, the artificial disk is inserted. This allows for a quicker recovery and return to work. “Because it preserves normal motion, it may reduce the chance of problems with the adjacent disks in the future,” Dr. Franzen says.
• Patients with lumbar stenosis, a decrease in the size of the spinal canal, can get relief from pain with a new procedure that uses metal spacers to open up the areas around spinal nerves. Dr. Franzen says he was the first in the area to use the procedure. Lumbar or spinal stenosis usually occurs in older patients and in the lower back as the openings around nerves in the spine get smaller as people age.
“Normal surgery calls for removing bone and ligament to give the nerve more room,” Dr. Franzen says. For patients who meet the criteria, however, the new technique uses metal spacers and results in a faster recovery because it does not destabilize the spine, he adds. “It can even be an outpatient procedure.”
• Patients with small disc herniations and mild disc degeneration may be candidates to get relief from pain with a new procedure that uses radiofrequency. The patient is awake during the procedure with a local anesthetic, Dr. Franzen explained. He inserts a tube or cannula in the disc space. A device inserted into the cannula uses radiofrequency waves to vaporize the diseased part of the disk. “This decreases the pressure on the disc and hopefully decreases the back and leg pain caused by the problem.”
About 80 percent of the population will seek medical attention for back problems, Dr. Franzen says. And most will find relief for their back pain without having surgery. He advises patients to see their primary care physician if the pain keeps them from normal activities or is shooting down their legs or arms, if they have problems urinating or walking or if they feel numbness in their hands or fingers. A major diagnostic tool for spinal problems is an MRI.
If appropriate, your physician will refer you to a neurosurgeon like Dr. Franzen.
“Treating back pain can be an inexact science because you can’t always tell where a patient’s pain is coming from,” he says. “With today’s better diagnostic tools, though, it’s easier to pinpoint the source of the problem. And the new surgery techniques help us get the patient back to normal activities faster.”