Kyphosis (Roundback) of the Spine

Article Featured on AAOS

Kyphosis is a spinal disorder in which an excessive outward curve of the spine results in an abnormal rounding of the upper back. The condition is sometimes known as “roundback” or—in the case of a severe curve—as “hunchback.” Kyphosis can occur at any age, but is common during adolescence.

In the majority of cases, kyphosis causes few problems and does not require treatment. Occasionally, a patient may need to wear a back brace or do exercises in order to improve his or her posture and strengthen the spine. In severe cases, however, kyphosis can be painful, cause significant spinal deformity, and lead to breathing problems. Patients with severe kyphosis may need surgery to help reduce the excessive spinal curve and improve their symptoms.

Anatomy

Your spine is made up of three segments. When viewed from the side, these segments form three natural curves.

The “c-shaped” curves of the neck (cervical spine) and lower back (lumbar spine) are called lordosis. The “reverse c-shaped” curve of the chest (thoracic spine) is called kyphosis.

This natural curvature of the spine is important for balance and helps us to stand upright. If any one of the curves becomes too large or too small, it becomes difficult to stand up straight and our posture appears abnormal.

Side view of the spine

When viewed from the side, a normal spine has three gentle curves.

Other parts of your spine include:

Vertebrae. The spine is made up of 24 small rectangular-shaped bones, called vertebrae, which are stacked on top of one another. These bones create the natural curves of your back and connect to create a canal that protects the spinal cord.

Vertebrae and intervertebral disks

Vertebrae and intervertebral disks in a healthy spine.

Intervertebral disks. In between the vertebrae are flexible intervertebral disks. These disks are flat and round and about a half inch thick. Intervertebral disks cushion the vertebrae and act as shock absorbers when you walk or run.

Description

Although the thoracic spine should have a natural kyphosis between 20 to 45 degrees, postural or structural abnormalities can result in a curve that is outside this normal range. While the medical term for a curve that is greater than normal (more than 50 degrees) is actually “hyperkyphosis,” the term “kyphosis” is commonly used by doctors to refer to the clinical condition of excessive curvature in the thoracic spine that leads to a rounded upper back.

Kyphosis can affect patients of all ages. The condition, however, is common during adolescence—a time of rapid bone growth.

Kyphosis can vary in severity. In general, the greater the curve, the more serious the condition. Milder curves may cause mild back pain or no symptoms at all. More severe curves can cause significant spinal deformity and result in a visible hump on the patient’s back.

Types of Kyphosis

There are several types of kyphosis. The three that most commonly affect children and adolescents are:

  • Postural kyphosis
  • Scheuermann’s kyphosis
  • Congenital kyphosis

Postural Kyphosis

Postural kyphosis, the most common type of kyphosis, usually becomes noticeable during adolescence. It is noticed clinically as poor posture or slouching, but is not associated with severe structural abnormalities of the spine.

The curve caused by postural kyphosis is typically round and smooth and can often be corrected by the patient when he or she is asked to “stand up straight.”

Postural kyphosis is more common in girls than boys. It is rarely painful and, because the curve does not progress, it does not usually lead to problems in adult life.

Scheuermann’s Kyphosis

Scheuermann’s kyphosis is named after the Danish radiologist who first described the condition.

Like postural kyphosis, Scheuermann’s kyphosis often becomes apparent during the teen years. However, Scheuermann’s kyphosis can result in a significantly more severe deformity than postural kyphosis—particularly in thin patients.

Scheuermann’s kyphosis is caused by a structural abnormality in the spine. In a patient with Scheuermann’s kyphosis, an x-ray from the side will show that, rather than the normal rectangular shape, several consecutive vertebrae have a more triangular shape. This irregular shape causes the vertebrae to wedge together toward the front of the spine, decreasing the normal disk space and creating an exaggerated forward curvature in the upper back.

Illustration and x-ray of vertebral wedging

Illustration and x-ray show the vertebral wedging that occurs in patients with Scheuermann’s kyphosis. (Right) Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010

The curve caused by Scheuermann’s kyphosis is usually sharp and angular. It is also stiff and rigid; unlike a patient with postural kyphosis, a patient with Scheuermann’s kyphosis is not able to correct the curve by standing up straight.

Scheuermann’s kyphosis usually affects the thoracic spine, but occasionally develops in the lumbar (lower) spine. The condition is more common in boys than girls and stops progressing once growing is complete.

Scheuermann’s kyphosis can sometimes be painful. If pain is present, it is commonly felt at the highest part or “apex” of the curve. Pain may also be felt in the lower back. This results when the spine tries to compensate for the rounded upper back by increasing the natural inward curve of the lower back. Activity can make the pain worse, as can long periods of standing or sitting.

Clinical photos of a boy with severe kyphosis

Clinical photos taken from the side and front of an adolescent male with an abnormally rounded upper back. His severe kyphosis is most obvious when bending forward. Courtesy of Texas Scottish Rite Hospital for Children

Congenital Kyphosis

Congenital kyphosis is present at birth. It occurs when the spinal column fails to develop normally while the baby is in utero. The bones may not form as they should or several vertebrae may be fused together. Congenital kyphosis typically worsens as the child ages.

Patients with congenital kyphosis often need surgical treatment at a very young age to stop progression of the curve. Many times, these patients will have additional birth defects that impact other parts of the body such as the heart and kidneys.

Clinical photo and MRI of a child with congenital kyphosis

(Left) Clinical photo of a child with congenital kyphosis in his thoracic spine. (Right) An MRI of his spine shows spinal cord compression. This can lead to neurological symptoms like weakness and numbness in the legs. Courtesy of Texas Scottish Rite Hospital for Children

Symptoms

The signs and symptoms of kyphosis vary, depending upon the cause and severity of the curve. These may include:

  • Rounded shoulders
  • A visible hump on the back
  • Mild back pain
  • Fatigue
  • Spine stiffness
  • Tight hamstrings (the muscles in the back of the thigh)

Rarely, over time, progressive curves may lead to:

  • Weakness, numbness, or tingling in the legs
  • Loss of sensation
  • Shortness of breath or other breathing difficulties

Doctor Examination

Mild kyphosis often goes unnoticed until a scoliosis screening at school—and this prompts a visit to the doctor. If changes to the patient’s back are noticeable, however, it is usually quite troubling for both the parents and the child. Concern about the cosmetic appearance of the child’s back is often what leads the family to seek medical help.

Physical Examination

Your doctor will begin by taking a medical history and asking about your child’s general health and symptoms. He or she will then examine your child’s back, pressing on the spine to determine if there are any areas of tenderness.

In more severe cases of kyphosis, the rounding of the upper back or a hump may be clearly visible. In milder cases, however, the condition may be harder to diagnose.

During the exam, your doctor will ask your child to bend forward with both feet together, knees straight, and arms hanging free. This test, which is called the “Adam’s forward bend test,” enables your doctor to better see the slope of the spine and observe any spinal deformity.

Clinical photo of Adam's forward bend test

To assess for a curve, your doctor will ask your child to bend forward at the waist.
Reproduced from JF Sarwark, ed: Essentials of Musculoskeletal Care, ed 4. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2010

Your doctor may also ask your child to lay down to see if this straightens the curve—a sign that the curve is flexible and may be representative of postural kyphosis.

Tests

X-rays. These studies provide images of dense structures, such as bone. Your doctor may order x-rays from different angles to determine if there are changes in the vertebrae or any other bony abnormalities.

X-rays will also help measure the degree of the kyphotic curve. A curve that is greater than 50 degrees is considered abnormal.

Pulmonary function tests. If the curve is severe, your doctor may order pulmonary function tests. These tests will help determine if your child’s breathing is restricted because of diminished chest space.

Other tests. In patients with congenital kyphosis, progressive curves may lead to symptoms of spinal cord compression, including pain, tingling, numbness, or weakness in the lower body. If your child is experiencing any of these symptoms, your doctor may order neurologic tests or a magnetic resonance imaging (MRI) scan.

Treatment

The goal of treatment is to stop progression of the curve and prevent deformity. Your doctor will consider several things when determining treatment for kyphosis, including:

  • Your child’s age and overall health
  • The number of remaining growing years
  • The type of kyphosis
  • The severity of the curve

Nonsurgical Treatment

Nonsurgical treatment is recommended for patients with postural kyphosis. It is also recommended for patients with Scheuermann’s kyphosis who have curves of less than 75 degrees.

Nonsurgical treatment may include:

Observation. Your doctor may recommend simply monitoring the curve to make sure it does not get worse. Your child may be asked to return for periodic visits and x-rays until he or she is fully grown.

Unless the curve gets worse or becomes painful, no other treatment may be needed.

Physical therapy. Specific exercises can help relieve back pain and improve posture by strengthening muscles in the abdomen and back. Certain exercises can also help stretch tight hamstrings and strengthen areas of the body that may be impacted by misalignment of the spine.

Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs, including aspirin, ibuprofen and naproxen, can help relieve back pain.

Bracing. Bracing may be recommended for patients with Scheuermann’s kyphosis who are still growing. The specific type of brace and the number of hours per day it should be worn will depend upon the severity of the curve. Your doctor will adjust the brace regularly as the curve improves. Typically, the brace is worn until the child reaches skeletal maturity and growing is complete.

X-rays of a kyphotic spinal curve before and after bracing

(Left) This patient has a 65° curve in the thoracic spine. (Right) Although it cannot be seen on x-ray, the patient is now wearing a back brace that has helped to reduce the excessive curve.
Reproduced from Pizzutillo PD: Nonsurgical treatment of kyphosis. Instructional Course Lectures, Pediatrics. Rosemont IL, American Academy of Orthopaedic Surgeons, 2006, pp. 181-187.

Surgical Treatment

Surgery is often recommended for patients with congenital kyphosis.

Surgery may also be recommended for:

  • Patients with Scheuermann’s kyphosis who have curves greater than 75 degrees
  • Patients with severe back pain that does not improve with nonsurgical treatment

Spinal fusion is the surgical procedure most commonly used to treat kyphosis.

The goals of spinal fusion are to:

  • Reduce the degree of the curve
  • Prevent any further progression
  • Maintain the improvement over time
  • Alleviate significant back pain, if it is present

Surgical Procedure

Spinal fusion is essentially a “welding” process. The basic idea is to fuse together the affected vertebrae so that they heal into a single, solid bone. Fusing the vertebrae will reduce the degree of the curve and, because it eliminates motion between the affected vertebrae, may also help alleviate back pain.

During the procedure, the vertebrae that make up the curve are first realigned to reduce the rounding of the spine. Small pieces of bone—called bone graft—are then placed into the spaces between the vertebrae to be fused. Over time, the bones grow together—similar to how a broken bone heals.

Before the bone graft is placed, your doctor will typically use metal screws, plates and rods to increase the rate of fusion and further stabilize the spine.

Exactly how much of the spine is fused depends upon the size of your child’s curve. Only the curved vertebrae are fused together. The other bones in the spine can still move and assist with bending, straightening, and rotation.

X-rays of a kyphotic curve before and after spinal fusion

(Left) Preoperative x-ray of a 17-year-old boy with a painful 80° curve caused by Scheuermann’s kyphosis. (Right) After spinal fusion and stabilization with plates and screws, the curve has been reduced to 38°.
Reproduced from Wood KB, Melikian R, Villamil F: Adult Scheuermann kyphosis: valuation, management, and new developments. J Am Acad Orthop Surg 2012; 20:113-121

Long-Term Outcomes

If kyphosis is diagnosed early, the majority of patients can be treated successfully without surgery and go on to lead active, healthy lives. If left untreated, however, curve progression could potentially lead to problems during adulthood. For patients with kyphosis, regular check-ups are necessary to monitor the condition and check progression of the curve.

Cervical Spondylotic Myelopathy (Spinal Cord Compression)

Cervical Spondylotic Myelopathy (Spinal Cord Compression)

Article Featured on AAOS

Cervical spondylotic myelopathy (CSM) is a neck condition that arises when the spinal cord becomes compressed—or squeezed—due to the wear-and-tear changes that occur in the spine as we age. The condition commonly occurs in patients over the age of 50.

Because the spinal cord carries nerve impulses to many regions in the body, patients with CSM can experience a wide variety of symptoms. Weakness and numbness in the hands and arms, loss of balance and coordination, and neck pain can all result when the normal flow of nerve impulses through the spinal cord is interrupted.

Anatomy

Your spine is made up of 24 bones, called vertebrae, that are stacked on top of one another. The seven small vertebrae that begin at the base of the skull and form the neck comprise the cervical spine.

The areas of the spine

Cervical spondylotic myelopathy occurs in the cervical spine—the seven small vertebrae that form the neck

Other parts of your spine include:

Spinal cord and nerves. The spinal cord extends from the skull to your lower back and travels through the middle part of each stacked vertebra, called the central canal. Nerves branch out from the spinal cord through openings in the vertebrae (foramen) and carry messages between the brain and muscles.

Spinal nerve root

Spinal nerve root.

Intervertebral disks. In between your vertebrae are flexible intervertebral disks. They act as shock absorbers when you walk or run.

Intervertebral disks are flat and round and about a half inch thick. They are made up of two components:

  • Annulus fibrosus. This is the tough, flexible outer ring of the disk.
  • Nucleus pulposus. This is the soft, jelly-like center of the disk.

Cause

Cervical spondylotic myelopathy (CSM) arises from degenerative changes that occur in the spine as we age. These degenerative changes in the disks are often called arthritis or spondylosis.

Cervical Disk Degeneration

Bone spurs. As the disks in the spine age, they lose height and begin to bulge. They also lose water content, begin to dry out, and become stiffer. This problem causes settling, or collapse, of the disk spaces and loss of disk space height.

As the disks lose height, the vertebrae move closer together. The body responds to the collapsed disk by forming more bone—called bone spurs—around the disk to strengthen it. These bone spurs contribute to the stiffening of the spine. They may also make the spinal canal narrow—compressing or squeezing the spinal cord.

Illustrations of a healthy cervical vertebra and disk and a disk that has collapsed

(Left) Side view of a healthy cervical vertebra and disk. (Right) A disk that has degenerated and collapsed.

Herniated disk. A disk herniates when its jelly-like center (nucleus pulposus) pushes against its outer ring (annulus fibrosus). If the disk is very worn or injured, the nucleus may squeeze all the way through. When a herniated disk bulges out toward the spinal canal, it can put pressure on the spinal cord or nerve roots.

As disks deteriorate with age, they become more prone to herniation. A herniated disk often occurs with lifting, pulling, bending, or twisting movements.

Cross-section and side views of a herniated disk

Herniated disk (cross-section and side views)

Other Causes of Myelopathy

Myelopathy can arise from other conditions that cause spinal cord compression, as well. Although these conditions are not related to disk degeneration, they may result in the same symptoms as CSM.

Rheumatoid arthritis. Rheumatoid arthritis is an autoimmune disease. This means that the immune system attacks its own tissues. In rheumatoid arthritis, immune cells attack the synovium, the thin membrane that lines the joints.

As the synovium swells, it may lead to pain and stiffness and, in severe cases, destruction of the facet joints in the cervical spine. When this occurs, the upper vertebra may slide forward on top of the lower vertebra, reducing the amount of space available for the spinal cord.

Injury. An injury to the neck—such as from a car accident, sports, or a fall—may also lead to myelopathy.

For example, a “rear end” car collision may result in hyperextension, a backward motion of the neck beyond its normal limits, or hyperflexion, a forward motion of the neck beyond its normal limits. Because these types of injuries often affect the muscles and ligaments that support the vertebrae, they may lead to spinal cord compression.

Symptoms

Typically, the symptoms of CSM develop slowly and progress steadily over several years. In some patients, however, the condition may worsen more rapidly.

Patients with CSM may experience a combination of the following symptoms:

  • Tingling or numbness in the arms, fingers, or hands
  • Weakness in the muscles of the arms, shoulders, or hands. You may have trouble grasping and holding on to items.
  • Imbalance and other coordination problems. You may have trouble walking or you may fall down. With myelopathy, there is no sensation of spinning, or “vertigo.” Rather, your head and eyes feel steady, but your body feels unable to follow through with what you are trying to do.
  • Loss of fine motor skills. You may have difficulty with handwriting, buttoning your clothes, picking up coins, or feeding yourself.
  • Pain or stiffness in the neck

Doctor Examination

Physical Examination

After discussing your medical history and general health, your doctor will ask you about your symptoms. He or she will conduct a thorough examination of your neck, shoulders, arms, hands, and legs, looking for:

  • Changes in reflexes—including the presence of hyper-reflexia, a condition in which reflexes are exaggerated or overactive
  • Numbness and weakness in the arms, hands, and fingers
  • Trouble walking, loss of balance, or weakness in the legs
  • Atrophy—a condition in which muscles deteriorate and shrink in size

Tests

X-rays. These provide images of dense structures, such as bone. An x-ray will show the alignment of the vertebrae in your neck.

Magnetic resonance imaging (MRI) scans. These studies create better images of the body’s soft tissues. An MRI can show spinal cord compression and help determine whether your symptoms are caused by damage to soft tissues—such as a bulging or herniated disk.

MRI scan of a herniated disk pressing on spinal cord

This MRI image shows herniated disks pressing on the spinal cord (red arrows). Reproduced from Boyce R, Wang J: Evaluation of neck pain, radiculopathy and myelopathy: imaging, conservative treatment, and surgical indications. Instructional Course Lectures 52. Rosemont, IL, American Academy of Orthopaedic Surgeons, 2003, pp.489-495.

Computed tomography (CT) scans. More detailed that a plain x-ray, a CT scan can show narrowing of the spinal canal and can help your doctor determine whether you have developed bone spurs in your cervical spine.

CT scan showing narrowing of the spinal canal due to bone spurs

This CT scan shows bone spurs that have led to narrowing of the spinal canal (arrows).

Myelogram. This is a special type of CT scan. In this procedure, a contrast dye is injected into the spinal column to make the spinal cord and nerve roots show up more clearly.

Treatment

Nonsurgical Treatment

In milder cases, initial treatment for CSM may be nonsurgical. The goal of nonsurgical treatment is to decrease pain and improve the patient’s ability to perform daily activities. Nonsurgical treatment options include:

Soft cervical collar. This is a padded ring that wraps around the neck and is held in place with velcro. Your doctor may advise you to wear a soft cervical collar to allow the muscles of the neck to rest and limit neck motion. A soft collar should only be worn for a short period of time since long-term wear may decrease the strength of the muscles in your neck.

Physical therapy. Specific exercises can help relieve pain, strengthen neck muscles, and increase flexibility. Physical therapy can also help you maintain strength and endurance so that you are better able to perform your daily activities. In some cases, traction can be used to gently stretch the joints and muscles of the neck.

Medications. In some cases, medications can help improve your symptoms.

  • Nonsteroidal anti-inflammatory medications (NSAIDs). Drugs like aspirin, ibuprofen, and naproxen can help relieve pain from reduce inflammation.
  • Oral corticosteroids. A short course of oral corticosteroids may help relieve pain by reducing inflammation.
  • Epidural steroid injection. Although not often used to treat CSM, in this procedure, steroids are injected into the space next to the covering of the spinal cord (the “epidural” space) to help reduce local inflammation. Although a steroid injection may temporarily help relieve pain and swelling, it will not relieve pressure on the spinal cord.
  • Narcotics. These medications are reserve for patients with severe pain that is not relieved by other options. Narcotics are usually prescribed for a limited time only.

Although people sometimes turn to chiropractic manipulation for neck and back pain, manipulation should never be used for spinal cord compression.

Surgical Treatment

If nonsurgical treatment does not relieve your symptoms, your doctor will talk with you about whether you would benefit from surgery. The majority of patients with symptoms and tests consistent with CSM are recommended to have surgery.

There are several procedures that can be performed to help relieve pressure on the spinal cord. The procedure your doctor recommends will depend on many factors, including what symptoms you are experiencing and the levels of the spinal cord that are involved.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

An Experts Guide to Avoiding Back Pain

Deciding whether to have spine surgery

By Alan S. Hilibrand, MD | Featured on AAOS

Orthopaedic surgeons encourage “shared decision-making” when it comes to treating patients, because the doctor and patient each provide information needed to make a decision about surgery.

Read more

Physical Therapy For Lower Back Pain - 10 Best Exercises For Relief

Physical Therapy For Lower Back Pain – 10 Best Exercises For Relief

When you have a sedentary lifestyle, there are several problems that you might suffer. One of the most common issues is a problem with the lower back, which can be excruciatingly painful. Thankfully, a few easy exercises can offer relief. When you do them consistently, these exercises can give you long-term relief from chronic lower back pain. Here are ten exercises your physical therapist might suggest you use. Make sure you follow their instructions – these are just summaries.

Read more

The Best Exercises for Spinal Cord Injury Survivors

The Best Exercises for Spinal Cord Injury Survivors

By Erin Jones | Article Featured on US News

AFTER A SPINAL CORD injury, it’s no surprise that life changes. Even daily tasks, like getting dressed in the morning, may become more difficult. Depending on a patient’s injury, however, certain exercises can help those with spinal cord injuries improve function and adapt to using a wheelchair.

Read more

How Does a Surgeon Fix Scoliosis?

How Does a Surgeon Fix Scoliosis?

Most scoliosis surgeons agree that children who have very severe curves (45-50° and higher) will need surgery to lessen the curve and prevent it from getting worse.

The operation for scoliosis is a spinal fusion. The basic idea is to realign and fuse together the curved vertebrae so that they heal into a single, solid bone.

With the tools and technology available today, scoliosis surgeons are able to improve curves significantly.

Surgical Treatment for Scoliosis

General Questions About Surgery for Scoliosis

Do I need surgery?

If your curve is greater than 45-50°, it will very likely get worse, even after you are fully grown. This may increase the cosmetic deformity in your back, as well as affect your lung function. Surgery is recommended.

Curves between 40° and 50° in a growing child fall into a grey area — several factors may influence whether surgery is recommended. These should be discussed with your surgeon.

How successful is surgery for scoliosis?

Spinal fusion is very successful in stopping the curve from growing. Today, doctors are also able to straighten the curve significantly, which improves the patient’s appearance.

How straight will my spine be after surgery?

Because your spinal bones protect your spinal cord, your surgeon will straighten the bones only as far as is safe.

The degree of correction from surgery depends on how flexible your scoliosis is before your operation. In general, the more flexible your curve is, the better the correction from surgery. Your doctor can measure your flexibility before surgery with special x-rays called bending or traction films.

Most patients recover from surgery with curves that have been straightened to less than 25°. In many cases, these small curves are hardly noticeable.

I have back pain associated with my scoliosis. Will the surgery relieve it?

Immediately after surgery, there will be more pain than before, but this usually resolves over a period of a few weeks to a few months. Most patients report that their back pain is better at 1 year from surgery than it was beforehand.

Everyone — whether there is scoliosis or not — has some back discomfort from time to time. Expecting to never have any future back pain would be unrealistic.

General Questions About Surgery for Scoliosis

Do I need surgery?

If your curve is greater than 45-50°, it will very likely get worse, even after you are fully grown. This may increase the cosmetic deformity in your back, as well as affect your lung function. Surgery is recommended.

Curves between 40° and 50° in a growing child fall into a grey area — several factors may influence whether surgery is recommended. These should be discussed with your surgeon.

How successful is surgery for scoliosis?

Spinal fusion is very successful in stopping the curve from growing. Today, doctors are also able to straighten the curve significantly, which improves the patient’s appearance.

How straight will my spine be after surgery?

Because your spinal bones protect your spinal cord, your surgeon will straighten the bones only as far as is safe.

The degree of correction from surgery depends on how flexible your scoliosis is before your operation. In general, the more flexible your curve is, the better the correction from surgery. Your doctor can measure your flexibility before surgery with special x-rays called bending or traction films.

Most patients recover from surgery with curves that have been straightened to less than 25°. In many cases, these small curves are hardly noticeable.

I have back pain associated with my scoliosis. Will the surgery relieve it?

Immediately after surgery, there will be more pain than before, but this usually resolves over a period of a few weeks to a few months. Most patients report that their back pain is better at 1 year from surgery than it was beforehand.

Everyone — whether there is scoliosis or not — has some back discomfort from time to time. Expecting to never have any future back pain would be unrealistic.

Common Questions About Spinal Fusion for Scoliosis

What is involved with a spinal fusion surgery?

In a spinal fusion, the curved vertebrae are fused together so that they heal into a single, solid bone. This will stop growth completely in the abnormal segment of the spine and prevent the curve from getting worse.

All spinal fusions use some type of bone material, called a bone graft, to help promote the fusion. Generally, small pieces of bone are placed into the spaces between the vertebrae to be fused. The bone grows together — similar to when a broken bone heals.

Metal rods are typically used to hold the spine in place until fusion happens. The rods are attached to the spine by screws, hooks, and/or wires.

Exactly how much of the spine is fused depends upon your curve(s).

What is a bone graft?

A bone graft is primarily used to stimulate bone healing. It increases bone production and helps the vertebrae heal together into a solid bone.

In the past, a bone graft harvested from the patient’s hip was the only option for fusing the vertebrae. This type of graft is called an autograft. Harvesting a bone graft may require an additional incision during the operation. It increases the length of surgery and can cause increased pain after the operation because of an additional region of the pelvis being included in the procedure.

One alternative to harvesting a bone graft is an allograft, which is cadaver bone. An allograft is typically acquired through a bone bank.

Today, several artificial bone graft materials have also been developed.

How long does the surgery take?

Most fusions last from 4 to 8 hours, depending on the size of the patient’s curve and how much of the spine needs to be fused.

How much pain will I be in after surgery?

The amount of pain people report after surgery varies a great deal from patient to patient. The surgery is a major procedure that involves moving muscles and realigning the skeleton.

The first few days are usually quite uncomfortable, but most people improve rapidly by the third or fourth day, and they can walk around, and get in and out of bed well enough to go home. The pain continues to improve gradually and most teenagers can return to school by 2 to 4 weeks after surgery.

Mild pain may persist, but by 3 to 6 weeks after surgery, pain medicine should no longer be necessary.

What type of pain control will there be after the operation?

Pain control varies between different doctors and hospitals. In many cases, a PCA (patient controlled anesthesia machine) is used, which injects a small dose of pain medicine intravenously when you push a button. Some surgeons use an intravenous catheter (small plastic tube placed in a vein) to provide the medication in larger but less frequent doses. The pain relief system that your doctor is accustomed to using is probably the safest and most reliable for you after surgery.

On the second or third day after surgery, your doctor will most likely change your medication to pills or liquid pain relievers taken by mouth. These medicines are an opiate (morphine-like medicine.) Because these medications are known to be addictive if taken for a long time, you will be encouraged to switch to acetaminaphen as soon as possible after you go home.

Do the rods and other implants stay in my spine even after it has fused?

If rods are used in a fusion, they usually do not need to be removed. Very few people require rod removal, and this may be for a variety of reasons such as infection or broken rod.

Will fusion make my back stiff and unable to move?

The fused portion of your back will be permanently stiff. Most people have enough motion in the unfused portion of their backs to perform all activities of daily living and most sports. If you participate in activities that require a tremendous amount of flexibility, it may take awhile to adapt. Most people find that within a year or so their backs begin to feel “normal” when participating in those activities.

Can I have my scoliosis corrected without a fusion?

We wish that we had a method and materials that would straighten the spine and also allow normal motion between all the bones. Unfortunately, we do not have this capability. Anything we put in to hold the spine straight, also makes the spine stiff in the area of surgery.

Common Questions About Surgical Recovery

Most patients are in the hospital for 4 to 7 days, out of school for 2 to 4 weeks, and back into activities in 2 to 6 months.

How long do patients need pain medication after being discharged home?

Most surgeons prescribe strong pain medicines to patients after scoliosis surgery. Patients who have not used opiate pain killers before usually stop needing them within 2 to 4 weeks after surgery. If the patient has used these medicines frequently before surgery, it may take longer to stop needing them.

It is best to stop taking these strong medicines as soon as possible because they can be addictive if taken for long periods of time.

What limitations will I have right after surgery?

Your surgeon will detail any limitations you have after surgery. Most patients will be asked to avoid heavy lifting and to minimize the amount of bending forward for the first 6 to 12 weeks.

Does surgery lead to permanent restrictions on activities?

No, most patients are able to return to all their favorite activities and sports.Most patients return to non-contact sporting activities (running, weightlifting, exercises) approximately 4 to 6 months after surgery.

Before returning to all activities, including contact sports, the spine must be fully healed. It typically takes 6 to 12 months after surgery to obtain a solid fusion of the spine and get back to all activities.

Will I be able to walk after surgery?

Yes. Some patients may need physical therapy after surgery, but they are able to walk when they are discharged from the hospital.

When can I go back to school after the operation?

Most children miss between 2 to 4 weeks of school after surgery. It typically takes about 4 weeks before the spine is healed enough for carrying a backpack.

When will I be allowed to drive a car?

You will not be able to drive a car until you have healed well enough from surgery. In addition to being off of your narcotic pain medicines, you need to be moving around well enough to be safe. This typically takes 6 or more weeks.

When can I start hanging out with my friends again?

Your friends can visit you after surgery in the hospital and at home. Going out with your friends — like to school functions or the movies — can occur after you are off all pain medications and are feeling back to normal (this usually happens about 4 weeks after surgery).


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

Scoliosis Treatment, Causes, Symptoms & Surgery

Scoliosis Treatment, Causes, Symptoms & Surgery

Medical Author: Charles Patrick Davis, MD, PhD | Medical Editor: Melissa Conrad Stöppler, MD | Article Featured on MedicineNet

What is scoliosis?

Scoliosis is a disorder that causes an abnormal curve of the spine, or backbone. The spine has normal curves when looking from the side, but it should appear straight when looking from the front. Kyphosis is a curve in the spine seen from the side in which the spine is bent forward. There is a normal kyphosis in the middle (thoracic) spine. Lordosis is a curve seen from the side in which the spine is bent backward. There is a normal lordosis in the upper (cervical) spine and the lower (lumbar) spine. People with scoliosis develop additional curves to either side of the body, and the bones of the spine twist on each other, forming a “C” or an “S” shape in the spine.

Scoliosis is about two times more common in girls than boys. It can be seen at any age, but it is most common in those over about 10 years of age. Scoliosis is hereditary in that people with scoliosis are more likely to have children with scoliosis; however, there is no correlation between the severity of the curves from one generation to the next.

What causes scoliosis?

Scoliosis affects about 2% of females and 0.5% of males. In most cases, the cause of scoliosis is unknown (known as idiopathic). This type of scoliosis is described based on the age when scoliosis develops, as are other some other types of scoliosis.

  • If the person is less than 3 years old, it is called infantile idiopathic scoliosis.
  • Scoliosis that develops between 3-10 years of age is called juvenile idiopathic scoliosis.
  • People who are over 10 years old (10-18 years old) have adolescent idiopathic scoliosis.

More than 80% of people with scoliosis have idiopathic scoliosis, and the majority of those are adolescent girls; the most common location for scoliosis is in the thoracic spine.

Medical literature often has more specific names or terms for scoliosis:

  • Kyphoscoliosis: a combination of outward and lateral spine curvature
  • Dextroscoliosis: curvature of the spine to the right
  • Rotoscoliosis (rotatory): curvature of the vertebral column turned on its axis
  • Levoconvex: curvature of the spine to the left
  • Thoracolumbar: curvature related to both the thoracic and lumbar regions of the spine

What are the causes of other types of scoliosis?

As stated above, idiopathic scoliosis and its subtypes comprise over 80% of all scoliosis patients. However, there are three other main types of scoliosis:

  • Functional: In this type of scoliosis, the spine is normal, but an abnormal curve develops because of a problem somewhere else in the body. This could be caused by one leg being shorter than the other or by muscle spasms in the back.
  • Neuromuscular: In this type of scoliosis, there is a problem when the bones of the spine are formed. Either the bones of the spine fail to form completely or they fail to separate from each other during fetal development. This type of congenital scoliosis develops in people with other disorders, including birth defects, muscular dystrophy, cerebral palsy, or Marfan syndrome (an inherited connective tissue disease). People with these conditions often develop a long C-shaped curve and have weak muscles that are unable to hold them up straight. If the curve is present at birth, it is called congenital. This type of scoliosis is often much more severe and needs more aggressive treatment than other forms of scoliosis.
  • Degenerative: Unlike the other forms of scoliosis that are found in children and teens, degenerative scoliosis occurs in older adults. It is caused by changes in the spine due to arthritis known as spondylosis. Weakening of the normal ligaments and other soft tissues of the spine combined with abnormal bone spurs can lead to an abnormal curvature of the spine. The spine can also be affected by osteoporosis, vertebral compression fractures, and disc degeneration.

There are other potential causes of scoliosis, including spine tumors such as osteoid osteoma. This is a benign tumor that can occur in the spine and cause pain. The pain causes people to lean to the opposite side to reduce the amount of pressure applied to the tumor. This can lead to a spinal deformity. In addition, researchers suggest that genetics (hereditary), muscle disorders, and/or abnormal fibrillin metabolism may play a role in causing or contributing to scoliosis development.

What are risk factors for scoliosis?

Age is a risk factor as the symptoms often begin between 9-15 years of age. Being a female increases the risk of scoliosis, and females have a higher risk of worsening spine curvature than males. Although many individuals who develop the problem do not have family members with scoliosis, a family history of scoliosis increases the risk of the disease.

What are scoliosis symptoms and signs?

The most common symptom of scoliosis is an abnormal curve of the spine. Often this is a mild change and may be first noticed by a friend or family member or physician doing routine screening of children for school or sports. The change in the curve of the spine typically occurs very slowly so it is easy to miss until it becomes a more severe physical deformity. It can also be found on a routine school screening examination for scoliosis. Those affected may notice that their clothes do not fit as they did previously, they may notice an uneven waist, or that pant legs are longer on one side than the other.

Scoliosis may cause the head to appear off center, leaning to one side or notice one hip or shoulder to be higher than the opposite side. Someone may have a more obvious curve on one side of the rib cage on their back from twisting of the vertebrae and ribs. If the scoliosis is more severe, it can make it more difficult for the heart and lungs to work properly. This can cause shortness of breath and chest pain.

In most cases, scoliosis is not painful, but there are certain types of scoliosis than can cause back pain, rib pain, neck pain, muscle spasms, and abdominal pain. Additionally, there are other causes of these nonspecific pains, which a doctor will want to look for as well to rule out other diseases.

What tests to health care professionals use to diagnose scoliosis?

If someone thinks he or she has scoliosis, see a doctor for an examination. The doctor will ask questions, including if there is any family history of scoliosis, or if there has been any pain, weakness, or other medical problems.

The physical examination involves looking at the curve of the spine from the sides, front, and back. The person will be asked to undress from the waist up to better see any abnormal curves, physical deformities, or uneven waist. The person will then bend over trying to touch their toes. This position can make the curve more obvious. The doctor will also look at the symmetry of the body to see if the hips and shoulders are at the same height, leaning to one side, or if there is sideways curvature. Any skin changes will also be identified that can suggest scoliosis due to a birth defect. A doctor may check your range of motion, muscle strength, and reflexes.

The more growth that a person has remaining increases the chances of scoliosis getting worse. As a result, the doctor may measure the person’s height and weight for comparison with future visits. Other clues to the amount of growth remaining are signs of puberty such as the presence of breasts or pubic hair and whether menstrual periods have begun in girls.

If the doctor believes a patient has scoliosis, the patient could either be asked to return for an additional examination in several months to see if there is any change or the doctor may obtain X-rays of the back. If X-rays are obtained, the doctor can make measurements from them to determine how large of a curve is present. This can help decide what treatment, if any, is necessary. Measurements from future visits can be compared to see if the curve is getting worse.

It is important that the doctor knows how much further growth the patient has left. Additional X-rays of the hand, wrist, or pelvis can help determine how much more the patient will grow. If a doctor finds any changes in the function of the nerves, he or she may order other imaging tests of your spine, including an MRI or CT scan to look more closely at the bones and nerves of the spine.

What types of specialists treat scoliosis?

Usually, a person’s primary care or pediatric physician notices the problem and consults an orthopedic surgeon or neurosurgeon who specializes in spine surgery. In addition, a rehabilitation specialist and/or a physical therapist may be consulted. Some patients may need a neurologist or an occupational therapist as part of the treatment team.

What is the treatment for scoliosis?

Treatment of scoliosis is based on the severity of the curve and the chances of the curve getting worse. Certain types of scoliosis have a greater chance of getting worse, so the type of scoliosis also helps to determine the proper treatment. There are three main categories of treatment: observation, bracing, and surgery. Consequently, there are treatments available that do not involve surgery, but in some individuals, surgery may be their best option.

Functional scoliosis is caused by an abnormality elsewhere in the body. This type of scoliosis is treated by treating that abnormality, such as a difference in leg length. A small wedge can be placed in the shoe to help even out the leg length and prevent the spine from curving. There is no direct treatment of the spine because the spine is normal in these people.

Neuromuscular scoliosis is caused by an abnormal development of the bones of the spine. These types of scoliosis have the greatest chance for getting worse. Observation and bracing do not normally work well for these people. The majority of these people will eventually need surgery to stop the curve from getting worse.

Treatment of idiopathic scoliosis usually is based on the age when it develops.

In many cases, infantile idiopathic scoliosis will improve without any treatment. X-rays can be obtained and measurements compared on future visits to determine if the curve is getting worse. Bracing is not normally effective in these people.

Juvenile idiopathic scoliosis has the highest risk for getting worse of all of the idiopathic types of scoliosis. Bracing can be tried early if the curve is not very severe. The goal is to prevent the curve from getting worse until the person stops growing. Since the curve starts early in these people, and they have a lot of time left to grow, there is a higher chance for needing more aggressive treatment or surgery.

Adolescent idiopathic scoliosis is the most common form of scoliosis. If the curve is small when first diagnosed, it can be observed and followed with routine X-rays and measurements. If the curve or Cobb angle stays below about 20-25 degrees (Cobb method or angle, is a measurement of the degree of curvature), no other treatment is needed. The patient may return to see the doctor every three to four months to check for any worsening of the curve. Additional X-rays may be repeated each year to obtain new measurements and check for progression of the curve. If the curve is between 25-40 degrees and the patient is still growing, a brace may be recommended. Bracing is not recommended for people who have finished growing. If the curve is greater than 40 degrees, then surgery may be recommended.

As explained above, scoliosis is not typically associated with back pain. However, in some patients with back pain, the symptoms can be lessened with physical therapy, massage, stretches, and exercises, including yoga (but refraining from twisting pressures on the spine). These activities can help to strengthen the muscles of the back. Medical treatment is mainly limited to pain relievers such as nonsteroidal anti-inflammatory medications (NSAIDs) and anti-inflammatory injections. These treatments are not, however, a cure for scoliosis and will not be able to correct the abnormal curve.

What is the treatment for scoliosis? (Continued)

There are several different types of braces available for scoliosis. Some need to be worn nearly 24 hours a day and are removed only for showering. Others can be worn only at night. The ability of a brace to work depends on the person following the instructions from the doctor and wearing the brace as directed. Braces are not designed to correct the curve. They are used to help slow or stop the curve from getting worse with good back brace management treatment. Intermittent or chronic discomfort may be a side effect of any treatments used to slow or correct the spinal curvature.

If the curve stays below 40 degrees until the person is finished growing, it is not likely to get worse later in life. However, if the curve is greater than 40 degrees, it is likely to continue to get worse by 1-2 degrees each year for the rest of the person’s life, a long-term effect of the disease. If this is not prevented, the person could eventually be at risk for heart or lung problems. The goals of surgery for scoliosis are as follows: correcting and stabilizing the curve, reducing pain, and restoring a more normal curve and appearance to the spinal column.

Surgery involves correcting the curve back to as close to normal as possible and performing a spinal fusion to hold it in place. This is done with a combination of screws, hooks, and rods that are attached to the bones of the spine to hold them in place. The surgeon places bone graft around the bones to be fused (spinal fusion) to get them to grow together and become solid. This prevents any further curvature in that portion of the spine. In most cases, the screws and rods will remain in the spine and not need to be removed. There are many different ways for a surgeon to perform the fusion surgery. It may be all performed from a single incision on the back of the spine or combined with another incision along your front or side. This decision is based on the location and severity of the curve.

Surgery recovery and scar formation varies some from person to person. A doctor will use medications to control the patient’s pain initially after surgery. A patient will likely be up out of bed to a chair the first day after surgery and will work with a physical therapist who will assist him or her in walking after the surgery. As the patient continues to recover, it is important to improve muscle strength. The physical therapist can help the patient with exercises for the muscles that will also help with the pain. Typically, a young person will miss about six weeks of school and may take about six months to return to their normal activities, although recovery time varies between individuals.

As with any surgery, there are risks of surgery for scoliosis. The amount of risk depends partially on the patient’s age, the degree of curve, the cause of the curve, and the amount of correction attempted. In most cases, the surgeon will use a technique called neuromonitoring during surgery. This allows the surgeon to monitor the function of the spinal cord and nerves during surgery. If they are being placed at increased risk of damage, the surgeon is alerted and can adjust the procedure to reduce those risks. There is a small risk of infection with any surgery. This risk is decreased with the use of antibiotics, but it can still occur in some cases. Other potential risks include injury to nerves or blood vessels, bleeding, continued curve progression after surgery, broken rods or screws, and the need for further surgery. Each of these is rare.

If a tumor such as osteoid osteoma is the cause of the scoliosis, surgery to remove the tumor is generally able to correct the curve.

People with degenerative scoliosis will often have more complaints of back pain and leg pain. This is related to the arthritis in the back and possible compression of the nerve roots that lead to the legs. Nonoperative treatment including physical therapy, exercises, and gentle chiropractic can help relieve these symptoms in some cases. People who fail to improve with these treatments may benefit from surgery. X-rays and possible MRIs will be obtained to plan for surgery. The surgery could include only a decompression or removal of bone spurs that are compressing the nerves. In some cases, a fusion will be necessary to stabilize the spine and possibly correct the abnormal curve. The cost of scoliosis surgery can be high; according to the Spinal Cord Society of surgeons, an average cost per operation (rod implants to straighten the spine) is $150,000 and may be higher or lower depending on the individual procedure.

Are there home remedies for scoliosis?

There are many home remedies that have been described for scoliosis; some involve herbal treatments, diet therapy, massage, physical therapy, stretches, certain exercises, and nutritional supplements like L-selenomethionine. A mattress that is composed of latex, memory foam, or cool gel (latex mattress infused with gel retains less heat than latex alone, also termed gel memory foam) and is adjustable (height of head and foot of bed can be adjusted) is recommended by some clinicians and patients. Patients are advised to discuss these treatments, especially exercises, with their doctor before starting any home remedies. Medical treatments are mainly over-the-counter pain medications when needed. Home remedies and medical treatments may reduce discomfort but do not provide a cure for scoliosis.

What is the prognosis for scoliosis?

School screening programs have helped to identify many cases of scoliosis early. This allows people to be treated with either observation or bracing and avoid the need for surgery in many cases. Most people with scoliosis can live full, productive, and normal lives with a relatively normal life expectancy. People with scoliosis are able to become pregnant and have children with no increased risk for complications. They may be at increased risk for additional low back pain during pregnancy. In general, as the degree of spine curvature increases, the prognosis worsens.

Newer advances in surgery have allowed for less invasive surgical methods that have less pain and shorter recovery periods. Surgery recovery time depends on the specific procedure that is performed; some may require an extended hospital stay with an in-patient stay at a rehabilitation facility (several weeks) while others may recover quickly and not require a rehabilitation facility. These techniques are still being developed, but the initial results are very promising.

Occasionally, untreated scoliosis can lead to deformity of the spine that is severe, painful, and result in the individual being unable to work or walk normally. Scoliosis may very rarely compromise breathing and cause death. Complications of pain and infections may rarely occur with treatments but may occur with surgery. Occasionally, patients are too optimistic about their treatments so patients are advised to discuss their expectations and follow up with their doctor to better understand the long-term prognosis and effects of their treatment.

The life expectancy has been reported to be reduced possibly by about 14 years in some individuals, especially those with more severe Cobb angle that is untreated but not all specialists agree with this controversial conclusion. Other clinicians either choose to avoid the controversy and say nothing while others suggest most people will have a near normal life span. Each individual with scoliosis should ask their treating physician about their life expectancy and potential for quality of life in the future with or without various treatment options.

Step-by-Step Exercises for a Stronger Back

Step-by-Step Exercises for a Stronger Back

By Len Canter | Article Featured on US News

Are you neglecting or even unaware of the muscles in your back? If so, you’re putting yourself at risk.

The trapezius is the diamond-shaped muscle that runs from neck to middle back and from shoulder to shoulder across the back. The latissimus dorsi — or “lats” — are the large back muscles that run from either side of the spine to your waist.

Here are two strength-training exercises that will help you develop these muscles for better upper body fitness.

Important: Start with a weight that allows you to complete at least eight reps with proper form, perhaps as low as 2-pound dumbbells. Build up to 10 to 15 reps for one complete set, and progress from one to three complete sets before increasing the weight. Never jerk the weights — controlled, steady movement is what brings results.

Standing dumbbell rows target the trapezius muscles as well as the upper arms and shoulders. Stand straight, feet shoulder-width apart, with a weight in each hand. Your elbows should be slightly bent, the dumbbells touching the fronts of your thighs, palms facing your body. As you exhale, use a slow, controlled movement to lift the weights straight up by bending the elbows up and out to bring the weights to shoulder level. Hold for a second, then inhale as you lower your arms to the starting position. Repeat.

Bent-over one-arm rows target the lats as well as the upper arms and shoulders. To work the right side first, stand to the right side of a bench. Place your left knee and left hand on it for support. Your back should be nearly parallel to the floor. Hold a dumbbell in your right hand, palm facing inward. Using only your upper arm, bend at the elbow to lift the dumbbell straight up to your waist as you exhale. Hold for a second and then lower it with control as you inhale. Complete reps, then switch sides and repeat.

You can also do bent-over rows using both arms at once. Stand with feet about shoulder-width apart. Hold a dumbbell in each hand and, bending from the waist, bring your back to nearly parallel with the floor. Keeping arms close to your sides, bend the elbows to lift the weights, bringing them up to waist level. Hold for a second and then lower the weights with control as you inhale. Repeat.

More information

The American Council on Exercise has more on exercises targeting the back muscles.

Back pain is extremely common, and surgery often fails to relieve it. Find out why your back hurts and whether surgery might help.

Back surgery: When is it a good idea?

Back pain is extremely common, and surgery often fails to relieve it. Find out why your back hurts and whether surgery might help.

Back surgery can help relieve some causes of back pain, but it’s rarely necessary. Most back pain resolves on its own within three months.

Low back pain is one of the most common ailments seen by family doctors. Back problems typically respond to nonsurgical treatments — such as anti-inflammatory medications, heat and physical therapy.

Back surgery might be an option if conservative treatments haven’t worked and your pain is persistent and disabling. Back surgery often more predictably relieves associated pain or numbness that goes down one or both arms or legs.

These symptoms often are caused by compressed nerves in your spine. Nerves may become compressed for a variety of reasons, including:

  • Disk problems. Bulging or ruptured (herniated) disks — the rubbery cushions separating the bones of your spine — can sometimes press too tightly against a spinal nerve and affect its function.
  • Overgrowth of bone. Osteoarthritis can result in bone spurs on your spine. This excess bone most commonly affects the hinge joints on the back part of the spinal column and can narrow the amount of space available for nerves to pass through openings in your spine.

It can be very difficult to pinpoint the exact cause of your back pain, even if your X-rays show that you have disk problems or bone spurs. X-rays taken for other reasons often reveal bulging or herniated disks that cause no symptoms and need no treatment.

Different types of back surgery include:

  • Diskectomy. This involves removal of the herniated portion of a disk to relieve irritation and inflammation of a nerve. Diskectomy typically involves full or partial removal of the back portion of a vertebra (lamina) to access the ruptured disk.
  • Laminectomy. This procedure involves the removal of the bone overlying the spinal canal. It enlarges the spinal canal and is performed to relieve nerve pressure caused by spinal stenosis.
  • Fusion. Spinal fusion permanently connects two or more bones in your spine. It can relieve pain by adding stability to a spinal fracture. It is occasionally used to eliminate painful motion between vertebrae that can result from a degenerated or injured disk.
  • Artificial disks. Implanted artificial disks are a treatment alternative to spinal fusion for painful movement between two vertebrae due to a degenerated or injured disk. But these relatively new devices aren’t an option for most people.

Before you agree to back surgery, consider getting a second opinion from a qualified spine specialist. Spine surgeons may hold different opinions about when to operate, what type of surgery to perform and whether — for some spine conditions — surgery is warranted at all. Back and leg pain can be a complex issue that may require a team of health professionals to diagnose and treat.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.

New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.

Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.

If you need orthopedic care in Albuquerque New Mexico contact New Mexico Orthopaedics at 505-724-4300.

An Experts Guide to Avoiding Back Pain

An Expert’s Guide to Avoiding Back Pain

Article BY ROBERT PREIDT | Featured on US News

Back pain is a common problem in the United States, but there are ways to protect yourself, an expert says.

Read more