Treatment for Spine & Back Pain
Spine and back pain is characterized by any type of discomfort or pain located on the backside of your body between your tailbone and lower neck. Discomfort in your neck or lower back pain may be sudden, sharp and stabbing (acute). Pain in your back or spine can also be dull and achy, build gradually over time (chronic) and last for many months.
UPMC Orthopedics is dedicated to helping people of all ages regain mobility with less pain and discomfort. We work closely with our skilled neurosurgeons to offer life-changing treatments.
Spine & Back Pain Symptoms
The signs and symptoms of spine and back pain may include:
- Anxiety or depression
- Difficulty sleeping or fatigue
- Pain that runs through the buttocks and down one leg
- Pain in the neck, shoulder or hip
- Swelling, redness or burning sensation in the back
- Stiffness and trouble moving
Speak with an experienced orthopedic doctor at UPMC if you’re experiencing severe or persistent spine or back pain, or if discomfort is limiting normal activities.
When to Seek Emergency Care for Spine & Back Pain
You should seek urgent medical attention if you have low back pain with a loss of bowel or bladder control, along with increasing weakness or numbness in your arms or legs. These symptoms are a warning sign of compressed nerves in your lower spine (this can lead to permanent nerve damage).
In rare instances, back pain can be a life-threatening condition if you’re having a heart attack. You should call 911 immediately if you have back pain accompanied by pain in your chest, jaw or abdomen, or shortness of breath.
Spine & Back Pain Causes
If you are experiencing pain in your spine and/or back, it could be caused by one of the following conditions:
- Ankylosing spondylitis
- Degenerative disc disease
- Discogenic back pain
- Low back pain
- Pinched nerve
- Ruptured disc
- Sciatic nerve
- Slipped disc
- Spinal stenosis
- Spine and nerve
- Twisted neck (torticollis, wryneck)
Treating Spine & Back Pain at UPMC
Your orthopedic provider will diagnose spine and back pain by reviewing your medical history, evaluating your symptoms and asking you about your recent physical activity.
Your doctor may perform further testing to get a better idea of what is causing your back problem. Initial tests may include an X-ray, bone scan or MRI to help rule out or confirm a diagnosis. Further testing may be necessary. Your provider will discuss these with you.
Noninvasive treatments for back pain include basic home care, pain medication and back exercises to help strengthen your muscles. If these are unsuccessful at treating your spine and back pain, spine surgeons at UPMC perform a range of minimally invasive surgical procedures to alleviate pain and restore range of motion.
eXtreme Lateral Interbody Fusion (XLIF)
The XLIF (eXtreme Lateral Interbody Fusion) procedure is a minimally disruptive approach to traditional lumbar interbody fusion. During this procedure, the surgeon approaches the spine from the side of the patient’s body, rather than the front or back as in traditional spine surgeries, thus reducing risk of injury to muscles, nerves, and blood vessels. This results in less postoperative pain, and also allows for more complete disc removal and implant insertion compared to approaches from the back.
Some candidates for the XLIF procedure include those with:
- Degenerative disc disease with instability
- Recurrent disc herniation
- Instability after a previous non-fusion surgery
- A need for surgery to repair a disc adjacent to a previous surgery
- A disc that has slipped over another (spondylolisthesis)
- Degenerative scoliosis (curvature of the spine)
- Prior fusion surgeries that did not fuse (posterior pseudarthrosis)
To view XLIF patient testimonials, click here.
Posterior Lumbar Interbody Fusion (PLIF)
A posterior lumbar interbody fusion (PLIF) is performed to remove a disc that is the source of back or leg pain and fuse spinal vertebrae with bone grafts. It is called a posterior procedure because the spine is approached through an incision on the back. Instrumentation is used to provide space for placing the grafts and to help stabilize the spine.
Minimally Invasive PLIF
In patients with spinal instability, instrumentation is used to provide space for placing the grafts and to help stabilize the spine. Using a technique known as minimally invasive surgery, posterior lumbar interbody fusion can, in some patients, be done with a much smaller incision than traditional open spine surgeries and avoids damaging the low back muscles.
Transforaminal Lumbar Interbody Fusion (TLIF)
As in the posterior lumbar interbody fusion (PLIF) procedure, a bone graft is used to fuse the spinal vertebrae after the disc is removed. However, the TLIF procedure places a single bone graft between the vertebrae from the side, rather than two bone grafts from the rear, as in the PLIF procedure. Inserting the graft from the side where the facet joint has been removed is an effort to avoid moving or damaging nerve roots during the procedure.
Minimally Invasive TLIF
In patients with spinal instability, instrumentation is used to help stabilize the spine during the bone graft fusion. Using minimally invasive surgery, transforaminal lumbar interbody fusion can be done in certain patients with a much smaller incision than traditional open spine surgeries, decreasing damage to the low back muscles.
Kyphoplasty is often discussed along with vertebroplasty, another procedure. These are used to treat fractures in the bones of the spine. These bones are vertebrae.
During a vertebroplasty, the doctor injects a cement-like material into the bone to make it more stable. During a kyphoplasty, the doctor first inflates a balloon-like device in the bone to make space. The space is then filled with cement.
Posterolateral Fusion (PLF)
A posterolateral fusion operation is similar to a posterior lumbar interbody fusion (PLIF); however, instead of removing the disc space and replacing it with a bone graft, the disc space remains intact and the bone graft is placed between the transverse processes in the back of the spine. This allows the bone to heal and stabilizes the spine from the transverse process of one vertebra to the transverse process of the next vertebra.
In a posterolateral fusion, pedicle screws and rods also may be implanted to stabilize the spine until the bone graft heals. A single-level fusion fuses two vertebrae and usually uses four screws and two rods. A two-level fusion fuses three vertebrae and uses six screws and two rods.
Spine providers at UPMC provide expert evaluation, diagnosis and treatment for spine and back pain in Williamsport, PA.