
By Peter Miller, MD PhD
Almost everyone at some time in their life will experience episodes of back pain. It can disrupt your daily routine, cause you to miss work and diminish your quality of life. While surgery is just one option available for treatment, the latest advancements in medicine can provide relief from pain more safely and effectively than ever before.
What Causes Back Pain?
Back pain can have several causes, one of which is general wear and tear. Also, sudden, strenuous activity can lead to injury. What I find causes the most trouble is people making demands on their back, but not regularly. Let’s say you have a job that requires heavy lifting, but not on a consistent basis. If you are not used to that kind of activity, you may be more likely to injure your back. The same goes for people who may only play a sport on the weekends or go skiing once or twice a year. Also, excess weight can put tremendous stress on the spine.
If you have chronic back pain, tests like an X-Ray or an MRI can help determine the source of the problem. The problem could be an irritated nerve, particularly if you have back pain in addition to leg or nerve pain. For subtle causes of nerve compression, a test called the myelogram uses a special dye to show if any of the nerves along the spinal column are under pressure. After testing the best option for treatment can be determined.
Options for Treatment
Certain types of pain that do not require spinal surgery can be helped with a Spinal Cord Stimulator. A Spinal Cord Stimulator is a flexible electrode placed over the covering of the spinal cord. It is connected to a tiny computer with a battery that sits underneath the skin. The stimulator literally drowns out the pain information as it travels toward the brain.

Advancements in Minimally Invasive Surgery
The field of minimally invasive spinal surgery has flourished in the past few years. CAT scanners help me to perform surgery less invasively, with fewer risks of complications like blood loss or infection. We get a CAT scan before the patient wakes up from surgery, so they do not leave the operating room until I am satisfied everything is perfect.
I typically perform surgeries, including spinal fusions, through a narrow tube using computer-assisted guidance. More traditional surgical approaches to the spine involve very large incisions and stripping extensive amounts of muscle off the spine. I focus on going between the muscle by spreading it with a narrow tube.
This minimally invasive approach to surgery allows the patient to return home more quickly, often the same day. They have less blood loss and less chance of infection with this minimally invasive approach. And, with this approach, they get back to their lives and their work much more quickly.
There have also been great improvements in artificial disks for the spine. In the cervical spine, for instance, these preserve normal neck motion and have less impact on a patient than a traditional cervical fusion.
If you are suffering from chronic back pain, know that help is available. A neurosurgeon can find the root cause of the pain and help you to decide the course of treatment that is right for you.