Spine, Adult and Pediatrics

More than 31 million visits were made to physician offices in 2003 because of back problems (Source: National Center for Health Statistics; Centers for Disease Control and Prevention; 2003 National Ambulatory Medical Care Survey.) Eight out of 10 people will experience back pain at some point in their lives. Low back pain is one of the most frequent problems treated by orthopaedic surgeons.

What is the lower back?

Your lower back is a complex structure of vertebrae, disks, spinal cord, and nerves, including:

• five bones called lumbar vertebrae - stacked one upon the other, connecting the upper spine to the pelvis
• six shock absorbers called disks - acting both as cushion and stabilizer to protect the lumbar vertebrae
• spinal cord and nerves - the "electric cables" which travel through a central canal in the lumbar vertebrae, connecting your brain to the muscles of your legs
• small joints - allowing functional movement and providing stability
• muscles and ligaments - providing strength and power and at the same time support and stability
  
  

How does the spine work?

The lower or lumbar spine is a complex structure that connects your upper body (including your chest and arms) to your lower body (including your pelvis and legs). This important part of your spine provides you with both mobility and strength. The mobility allows movements such as turning, twisting or bending; and the strength allows you to stand, walk and lift. Proper functioning of your lower back is needed for almost all activities of daily living. Pain in the lower back can restrict your activity, reduce your work capacity and diminish your quality of life.

What are the common causes?

Low back pain can be caused by a number of factors:

• Protruding Disk
• Age
• Osteoporosis and Fractures
• Low Back Sprain and Strain

The muscles of the low back provide power and strength for activities such as standing, walking and lifting. A strain of the muscle can occur when the muscle is poorly conditioned or overworked. The ligaments of the low back act to interconnect the five vertebral bones and provide support or stability for the low back. A sprain of the low back can occur when a sudden, forceful movement injures a ligament which has become stiff or weak through poor conditioning or overuse.

Prevention

Back pain caused by lifting can be prevented if you use proper lifting techniques and exercise regularly to improve your muscle strength and overall physical condition. The normal effects of aging that result in decreased bone mass, and decreased strength and elasticity of muscles and ligaments, can't be avoided.

However, the effects can be slowed by:

• exercising regularly to keep muscles that support your back strong and flexible
• using the correct lifting and moving techniques
• maintaining your proper body weight; being overweight puts a strain on your back muscles
• avoid smoking
• maintaining a proper posture when standing and sitting; don't slouch

Source: AAOS Research Dept. patient visits for selected conditions, 1998

Pediatric Spine Scoliosis Reconstruction

Your child has had surgery for scoliosis. This is a condition where the spine curves and twists from side to side. It is most often found in girls in their early teens, although boys can have it too. No one is sure what causes scoliosis, but it is not caused by things like carrying heavy bags or playing sports. Scoliosis does tend to run in families (parent, child, siblings). Here's what you need to know about home care after surgery.

Making Movement Easier

• Remove throw rugs, electrical cords, and anything else that may cause falls.

• Use nonslip bath mats, grab bars, an elevated toilet seat, and a shower chair in the bathroom.

• Help your child to use a cane, crutches, a walker, or handrails until his or her balance, flexibility, and strength have improved.

• Arrange your household to keep the items handy for your child. Keep everything else out of the way.

• Encourage your child to use a fanny pack, apron, or pockets to carry things and keep his or her hands free.

Activity

• Encourage naps if your child feels tired, but don’t let him or her stay in bed all day.

• Make sure your child knows that he or she cannot bend at the waist, twist at the waist, or raise hands over the head for the first 2 weeks after surgery.

• Don’t allow your child to lift anything heavier than 4 pounds for the first 2 weeks after surgery.

• Keep your child from sitting for longer than 30 to 45 minutes at a time. Frequent short walks are the key to recovery.

• Encourage your child to sit in chairs with arms. The arms make it easier to stand up or sit down.

Incision Care

• Allow your child to shower as needed, starting 3 days after surgery. Gently pat the incision dry. Don’t rub it or apply creams or lotions.

• Don’t let the child soak the incision in water (no hot tubs, bathtubs, swimming pools, etc.) until the doctor says it’s okay.

• Check the incision daily for redness, tenderness, or drainage.

Other Home Care

• Make sure your child takes his or her medication exactly as directed.

• Make sure your child wears his or her back brace as directed by your child's doctor.

• Avoid nonsteroidal, anti-inflammatory medications. They may delay or prevent proper fusion of the spine.

Follow-Up

• Make a follow-up appointment as directed by our staff.

• Keep appointments for x-rays. They need to be taken regularly to check the status of your child’s surgery and spinal fusion.