Written by Jeffrey R. Carlson, MD
The people of America are getting older. This is not a judgment on the age of our populace, but a fortunate consequence of better medical treatment, health consciousness and standard of living. We have more information about the requirements of our bodies later in life and have well-prepared ourselves for our “golden years”.
However, our longer lifespans come with some physical consequences. As is the case with any machine, the human body has working parts that will eventually wear out. We all know people who had hip or knee replacements because the cartilage in their joint deteriorated and they felt significant discomfort. Those individuals took action to decrease the pain of their worn-out joint and to return to a state of activity that they once enjoyed.
Our backs and necks wear out as well. The disc material, between our spinal bones (vertebrae), is a soft cartilage pad that cushions the bones and allows them to move. This soft cartilage pad will break down with time and provide less support. In fact, as the disc becomes stiffer, it will lose its height, start to collapse on itself and bulge. This is where we get the term “disc bulge”. The disc bulge can then put pressure on or pinch the nerve roots and spinal canal nearby. This is part of the natural process of aging and disc degeneration.
It isn’t always painful, but at times, the nerve pressure can be quite debilitating. It may even be part of a larger process called spinal stenosis. Spinal stenosis refers to pressure placed on the spinal canal which limits the ability of the nerves to transmit information from the brain to the legs. This stenosis causes painful and tired legs, which will impede a person’s ability to walk. Some patients may also be forced to use a cane or walker for balance due to the nerve dysfunction.
The pain and decreasing ability to walk is what brings most patients to the doctor. As we have noted, our bodies get older and start to exhibit wear, but our minds still expect the physical performance we had 20 years ago. As the spinal stenosis gets worse, our activity level will continue to decline. Younger patients generally get to the doctor sooner when they see their activity levels worsening. Unfortunately, older patients sometimes think or are told that they should accept a decline in their ability to walk as an unfortunate reality of aging. Although there is some truth to this, a recent study from Switzerland brings some hope to the older patient with spinal stenosis.
Swiss spine surgeons studied patients, over 80 years old, who had symptoms of spinal stenosis. These patients reported leg pain, achiness, nerve pain and a decreased activity level, due to the pressure on the nerves in the spine. All of these patients underwent surgery to relieve the pressure on the nerves in spine. Post-surgery, the patients were studied for any positive or negative effects. All patients showed significant improvement in their quality of life, decreased pain and improved activity levels. The surgeons noted a 70% improvement in the patient’s well-being after surgery.
This study is remarkable for any patient who suffers from spinal stenosis and has been told they are “too old” for spine surgery. These researchers found that spine surgery resulted in profound improvements on their function and quality of life, even in those patients over 80 years old. The good news is that patients who are “young at heart”, but limited by their leg and back pain due to spinal stenosis, have a great opportunity to make their lives better by having surgery to remove nerve pressure in the spine.
Dr. Jeffrey R. Carlson is a Fellowship-trained, Board-certified, Orthopaedic Spine Specialist who practices at Orthopaedic & Spine Center in Newport News, VA. Dr. Carlson has been voted a “Hampton Roads Top Doc” in 2012, 2013, 2014 & 2018. For an appointment with Dr. Carlson, call 757-596-1900.