Surgery for Back Pain Focuses on Preserving the Motion of the Spine

Back Pain Treatment

As new innovations emerge in the treatment of chronic back pain, surgeons are focusing on more effective techniques to relieve pain while also preserving the natural motion of the spine. The Spine and Back Center at Rush University Medical Center is now offering a new technique, the Dynesys Spinal System, to stabilize the spine without fusion.

One of the primary problems causing back pain is the degeneration of one or several discs that provide a flexible cushion between the vertebrae. As the disc move or collapse, the space between the vertebrae narrows. This narrowing can pinch nerves causing pain and numbness in lower back and the legs.

For many years, the main surgical solution has been traditional fusion surgery, which generally includes removal of the affected discs and fusion of the vertebral segments. Over time, the bone grows fusing the vertebrae together. The result is stopping any motion in the area, which reduces pain.

The Dynesys system uses the same surgical approach of traditional fusion surgery, but employs flexible materials instead of rigid stainless steel or titanium typically used in spinal fusion. The flexible material supports the spine and preserves anatomical structures without rigidity.

During the procedure, a small device is attached to both sides of the affected vertebrae. The Dynesys device is comprised of titanium alloy screws and external spacers made of flexible plastic tubing surrounding a nylon-like cord. Once in place in the spine, the dynamic push-pull relationship between the spacer and the cord stabilizes the affected joints, sharing the load and relieving pressure on the nerve.

"Obviously when you do a spinal fusion, the bone never moves again. This flexible system helps the spine to function more normally," said Dr. Frank Phillips, an orthopedic surgeon at Rush. "The long term benefit is the soft tissues and muscles will be intact and functioning, while the spine is better supported."

For patient Gary Baxter, of Chicago, the biggest attraction of the new surgery is the shorter recovery period. Compared to a six to nine-month recovery period for spinal fusion surgery, the recovery period for the Dynesys System is about three months.

"Even though Dr. Phillips wanted me to wait for three months, I felt ready to hit the golf course just two weeks after surgery," said Baxter. "I followed my doctor's advice and didn't golf right away, but I was able to resume my active life and return to riding my bike and exercising within four weeks of surgery."

Phillips is interested to see more studies on the potential advantages of the flexible system compared to fusion over the long term. When the vertebrae are fused, the stress is transferred to the next level and the adjacent vertebrae wear out more quickly.

"Clearly your spine is designed to move. Theoretically, by still allowing some movement, the load transmission to the next vertebral level is more normal and it should delay or prevent the next level from wearing out," said Phillips.

Dr. Phillips has been performing the surgery on patients who are experiencing a mild degree of instability in the lumbar region. Such patients experience pain in the back and nerve pain in the legs, or a numbness and heaviness in the legs. These are patients that would typically undergo fusion surgery but would not be candidates for artificial disc replacement.

"My patients have all done even better than I anticipated following surgery using the Dynesys System," said Dr. Phillips. "I see it as another tool, along with disc replacement, in our move toward motion preservation."

The Spine and Back Center at Rush University Medical Center is home to highly trained orthopedic spine surgeons, neurosurgeons, and physiatrists offering the most advanced treatment options in the region. Many treatment advances were pioneered at Rush, including minimally invasive techniques for lumbar discectomies and fusions, and clinical research trials for artificial discs. Rush is the only center in Chicago participating in the largest orthopedic research study ever supported by the National Institutes of Health to find the most effective treatment for back pain.