Treating Complex Spine Problems in the Elderly: My Approach
One of the reasons spine surgery can be so challenging is that sometimes it is difficult to determine exactly where in the back or neck the pain is coming from. After all, the spine consists of a complex mechanism of bones, discs, nerves and ligaments all of which can cause pain. In addition, many of the patients who present with spine problems are elderly, making the decision process over surgery even more challenging. Procedures with a lengthy recovery process are undesirable or impossible for this age group. I try to get over both of these challenges by getting to know my patients, their goals and carefully interpreting not only their medical imaging such as an MRI but also their physical exam.
In this video I discuss a case where my patient was in her 80’s who presented with severe back and hip pain that came on gradually. She was previous healthy and vibrant but had many percolating things wrong with her back that been worsening over time. For example, she had degenerative disc disease, scoliosis (curvature of the spine) and stenosis (narrowing of the spinal canal compressing nerves).
Where was her pain coming from? Through a careful examination, and other diagnostic tests we were able to narrow it down and performed a targeted surgery that gave her lasting relief with only minimal down time. Many spine patients do not realize how minimal or maximal spine surgery can be, which is why I spend so much time trying to educate. The goal for me is to completely treat the problem with as little surgery as possible. Sometimes this is just a decompression, and other times this is a Fusion.