Why Choose Cedars-Sinai Marina del Rey Hospital for Lumbosacral Spondylosis Treatment?
At Cedars-Sinai Marina del Rey Hospital, dedicated spinal surgeons help you deal with your low-back pain through various conservative and minimally invasive treatment methods. Each patient is evaluated carefully using advanced diagnostic techniques to determine the exact source of pain.
Lumbosacral spondylosis refers to spondylosis that involves both the lumbar and the sacral spine. It occurs in the midline just below the lumbar spine (lower portion of the spine). Spondylosis is a medical term to describe the general deterioration or age-related wear and tear that occurs in the spine. With advancing age, the spine is subjected to constant stress through bending and twisting movements, most of the time associated with weight gain. This causes compression of the spinal components, which leads to the degradation of vertebral discs and joints.
While any portion of the spine may be affected by spondylosis, it occurs more commonly in the lowermost portion of the spine, where the lumbar vertebra meets the sacrum or the tailbone. This is classified as lumbosacral spondylosis or L5-S1 spondylosis as it occurs between the last vertebra of the lumbar spine (L5) and the first vertebra of the sacral spine (S1). The lumbar spine largely supports and stabilizes the body by bearing most of the body weight. Therefore, the lumbar spine is subjected to most of the compression and resultant deterioration.
Surgical Procedures Performed at Cedars-Sinai Marina del Rey Hospital for Lumbosacral Spondylosis
Surgery for spondylosis may be considered if the pain persists even after several weeks or months of conservative treatment.
At Cedars-Sinai Marina del Rey Hospital, spinal surgeons strive towards accomplishing their goal of providing sufficient pain relief with minimally invasive options. There are two surgical methods to treat spondylosis: minimally invasive stabilization and minimally invasive decompression. The choice of surgery is based on the severity of your condition or whether associated spinal conditions have developed because of spondylosis. This will be reviewed on an MRI or CT scan.
Minimally Invasive Stabilization Surgery
The minimally invasive stabilization surgery provides a more precise alternative to traditional open back fusion surgery. The procedure involves the placement of a tiny cut in the back or side. Through this opening, the surgeon moves the surrounding muscles aside so as to avoid any tearing of the muscle tissue. With the muscles retracted, the surgeon removes the worn-out disc or vertebra and places an implant or bone. This will provide immediate stability to the spine and pain relief. The surgery is performed on an outpatient basis and you can return home on the day of the surgery.
There are several techniques for this procedure, and the one suitable for your condition will be decided by your surgeon after looking at your MRI reports. The surgical techniques include:
- Transforaminal lumbar interbody fusion (TLIF): This procedure is less invasive than open surgery. The surgeon removes the worn-out disc followed by the insertion of an implant into the disc space to provide stability to the spine.
- Decompression with Interlaminar Stabilization® device: This procedure helps relieve the pain present with spinal stenosis. A small incision is made through which the surgeon performs decompression of the involved nerves of the spine. By doing this, the source of pain is eliminated. Then, the surgeon will place the coflex® device to stabilize the spine and maintain the decompression without limiting the range of motion.
- Lateral lumbar interbody fusion (LLIF): This is a minimally invasive approach with the incisions placed on the side of the body to avoid cutting the low back muscles, bone, and moving aside blood vessels. During this lateral access, spinal surgery a spacer is used for the restoration of proper disc height, and bone grafts are placed in order to fuse the adjacent vertebrae.
- Sacroiliac (SI) joint fusion: This is performed at the place where the sacrum joins the pelvic bone. The surgeon performs a fusion of the sacrum and the pelvis to enhance the stability of the spine. It is performed through a small incision with the help of fluoroscopic guidance.
Minimally Invasive Decompression Surgery
This surgery is generally performed when spondylosis leads to nerve compression along the spinal cord that causes local and radiating pain. The minimally invasive techniques allow the surgeon to enter the affected portion of the spine through a tiny, less than 1-inch long incision. The surgeon will remove the part of the bone or disc that compresses a spinal nerve. This is an outpatient procedure and you can leave the hospital on the same day of your surgery. The spinal nerve decompression techniques include – foraminotomy, laminotomy, discectomy, and facet thermal ablation (laser-based) to weaken the painful nerves in the facet joint. Small cameras are used to find out the cause of the nerve compression and the problem is tackled without destabilizing the spine.
Advantages of Minimally Invasive Spine Surgery
- Minimally invasive procedures are performed on an outpatient basis
- Small incision, usually less than 1-inch in length
- Surrounding musculature and soft tissue remain intact
- Shorter recovery span
- Greater patient satisfaction
- Reduced risk of postoperative complications such as infection
Drugs & Other Treatment Needed for Lumbosacral Spondylosis
There are several types of treatment available if you have been diagnosed with lumbosacral spondylosis. Initially, conservative treatment is suggested for the treatment of chronic pain and other symptoms of spondylosis. These treatments include hot/cold therapy, physical therapy, and pain medications. The conservative treatment methods are often used in combination in order to accelerate pain relief and achieve positive results. Most mild cases of spondylosis respond to conservative methods well.
Physical Therapy »
Hot/Cold Therapy »
Lifestyle Changes »
Symptoms of Lumbosacral Spondylosis
Lumbosacral spondylosis itself may not cause any symptoms, but it can lead to other conditions of the spine that cause back pain, stiffness, and limited range of motion. It generally affects people above 50 years of age, and most patients will have a mild to a progressive form of spondylosis without any symptoms. But, if you experience low back pain, stiffness, and restricted mobility, or inability to bend or move, you may need to consult your physician to find out whether you have progressive spondylosis.
Spondylosis can cause further deterioration of the spine due to the development of other spine conditions such as stenosis, spondylolisthesis, hernia, bone spurs, and degenerative disc disease. Usually, mild lumbar spondylosis does not cause additional spinal disorders. It is only when the spondylosis becomes progressive that there is a higher risk for the development of other spinal disorders.
Diagnosis of Lumbosacral Spondylosis
During your appointment, your physician will ask you questions regarding your pain and other symptoms along with your medical history. This allows your physician to determine the cause of pain and suggest the most suitable treatment plan.
The diagnosis of lumbosacral spondylosis is made through radiology tests namely, plain X-rays, magnetic resonance imaging (MRI) scan, and computed tomography (CT) scan. X-rays reveal bone spurs present on vertebral bodies in the spine, thickened facet joints, and narrow intervertebral disc spaces.
A magnetic resonance imaging (MRI) scan or computed tomography (CT) scan may be ordered to have a closer look at the spine. An MRI scan helps visualize the vertebrae, the facet joints, the nerves, and ligaments and is able to show a pinched nerve. CT scan reveals spinal stenosis or narrowing of the spinal canal.
Risk Factors for Lumbosacral Spondylosis
There are several risk factors associated with the development of spondylosis, which includes:
- Age: With advancing age, the natural process of wear and tear causes a gradual breakdown of the spine. The spinal discs become brittle due to water loss.
- Family history: The genetic makeup of certain individuals may make them predisposed to spondylosis. You are more likely to develop spondylosis if other closely related people in your family have this condition.
- Obesity: Being overweight puts an extra load on your spine making it more susceptible to wear and tear.
Causes of Lumbosacral Spondylosis
The L5-S1 vertebrae in the lower back bear most of the body weight and maintain the stability of the body. Over the years, the spine is involved in repetitive motion such as bending and lifting heavy objects. With a possible increase in weight as a person ages, the vertebrae of the lumbar spine get compressed and exert pressure onto the discs and joints. This continuous pressure causes a gradual degradation of the discs and the development of other spine conditions such as spinal stenosis and spondylolisthesis.
The other major cause of lumbosacral spondylosis is arthritis of the spine. Generally, arthritis of the spine develops at a later stage of life and is associated with gradual spinal degeneration.
At Cedars-Sinai Marina del Rey Hospital physicians recognize the potential benefits of alternative and complementary spondylosis treatment. There has been a great deal of evidence that techniques such as chiropractic therapy, deep tissue massage, and even herbal formulations can be beneficial in the management of spondylosis. You may be advised to try alternative medicine treatments before considering the surgical means of treatment. Alternative medicine therapies include:
- Acupuncture: This ancient method of Chinese medicine involves pricking fine needles to various depths into certain specific areas of the body.
- Yoga: Yoga helps restore muscle strength in the core. In a way similar to physical therapy, Yoga strengthens the core muscles and helps maintain spine alignment, and slows down wear and tear. Certain yoga poses are designed to stretch the core and back muscles.
- Chiropractic care: Chiropractic spinal manipulation can be of benefit to some people during the first month of pain. It is not recommended for patients with associated inflammatory arthritis of the spine, such as ankylosing spondylitis and rheumatoid arthritis, because of the risk of damage to the spinal cord.
- Therapeutic Massage: Massage, when done regularly in a proper way provides relief from chronic low back pain. Massage therapy is not suitable for people with conditions such as osteoporosis, open wounds, skin infections, deep vein thrombosis, and arthritis.
The only preventable cause of spondylosis is obesity. Therefore, it is very important to maintain a healthy body weight. Certain tips that can be followed to reduce your risk for lumbosacral spondylosis include:
- Exercise: Increasing your muscle mass while reducing body fat helps weight loss.
- Eat nutritious food: A diet rich in vitamins and minerals helps in maintaining healthy cartilage and bone. This helps your spine withstand the age-related wear and tear and resist degeneration.
- Regular stretching: Relieves pressure on the spine that occurs due to tense muscles.
If you need more information regarding our spondylosis treatment options, consult our specialty-trained spinal surgeons at Cedars-Sinai Marina del Rey Hospital.