Living with a problem back or neck can be frustrating. Pain may keep you from doing what you like or need to do. You may have tried other treatments, including surgery, which didn’t relieve your pain. Now, you and your doctor have decided that spinal fusion may be the best way to control your pain. Spinal fusion permanently connects two or more bones in your spine. This booklet lets you know what to expect before, during, and after your surgery.
Back or neck problems can have many causes. They include:
No matter what the cause, the weakness, numbness, or pain that you feel is disrupting your life. You may find it hard to do your job, excercise, or keep up with your daily errands. And your family and social life may be strained as a result. But relief may be within your reach.
During spinal fusion, your surgeon locks together, or fuses, some of the bones in your spine. This limits the movement of these bones, which may help relieve your pain. Your back or neck won’t be quite as flexible. Even so, you may feel more flexible after a fusion because you can move with less pain.
Which section of the spine is fused depends on where your pain is. Sections of the spine that may be fused include:
Your surgeon will decide which is best for you.
A stiff, painful shoulder can keep you from doing even simple things, like dressing yourself or carrying groceries. But there’s good news. A worn-out shoulder can be replaced, just as a bad hip or knee can be. Shoulder replacement is safe and reliable. Surgery relieves the pain and may let you return to many of your normal activities.
If you do heavy work or play active sports, your shoulder may have become worn and arthritic from overuse or torn from an injury. Or you may have a chronic disease, such as rheumatoid arthritis, that has destroyed the joint. If you’ve had a bad fall, you may have broken your shoulder. Whatever the cause, your shoulder is stiff and painful. You may not be able to use your arm to reach behind your back or over your head. Your pain may be worse at night, when you’re active, or when it’s cold and damp. If heat, rest, exercise, and medication haven’t relieved your pain, your doctor may be recommending replacement surgery.
Shoulder replacement surgery almost always relieves pain and may give you more strength and movement in your shoulder. During surgery, an orthopaedic surgeon (a doctor who specializes in treating bone and joint diseases) replaces all or part of your problem shoulder with an artificial joint, called a prosthesis. The prosthesis replaces the rough, worn parts of your shoulder with smooth metal and plastic parts.
The knee is a hinge joint, formed where the thigh bone and shinbone meet. When the knee is healthy, the joint moves freely. This is because the joint is covered with slippery tissue and powered by large muscles.
When one or more parts of the knee are damaged, joint movement suffers. Over time, cartilage starts to crack or wear away. Because cartilage cannot fully repair itself, the damage may keep increasing. At first, your knee may just be a little stiff. But as the bones of the joint begin rubbing together, you’re likely to feel pain.
Years of normal use can cause cartilage to crack and wear away (osteoarthritis). As exposed bones rub together, they become rough and pitted. The joint grinds. Being overweight or having an alignment problem, such as knocked or bowed knees, puts extra force on the joint. This may speed up the damage.
A chronic disease, such as rheumatoid arthritis or gout, can cause swelling and heat (inflammation) in the joint lining. As the disease progresses, cartilage may be worn away and the joint may stiffen.
A bad fall or blow to the knee can injure the joint. If the injury does not heal properly, extra force may be placed on the joint. Over time, this can cause the cartilage to wear away (traumatic arthritis).
Persistent pain in your low back or leg caused by spinal disc problems can be frustrating because it limits your ability to move and do the things you enjoy. Your disc problem may be corrected by a discectomy, the surgical removal of the portion of the disc that’s putting pressure on a nerve, causing pain. in your back or leg. Your surgeon may recommend a “classic” discectomy, a micros discectomy, or a percutaneous discectomy. The basic differences among these disc surgeries are the size of the incision, how your surgeon reaches your disc, and how much of the disc is removed. The “classic” discectomy and microdiscectomy require a hospital stay of a few days. Percutaneous discectomy is usually an out-patient surgery.
To remove the disc material that is causing the pain, your surgeon first makes an incision in the midline of your back (over the bump you feel when you run your hand over your lower spine). Then, to see and reach the damaged disc, your surgeon removes some or all of the lamina. Next your surgeon removes the disc material that is pressing on a nerve.
The incision is 2-3 inches long.
Your surgeon may recommend a microdiscectomy to treat your disc problem. This surgery is much like the “classic” discectomy, except that your surgeon uses an operating microscope to magnify, highlight, and see the disc. A magnified view means that the incision, located in the midline of your back, is smaller than that of a “classic” discectomy, with less damage to surrounding tissue.
The incision is about an inch long.
Is an outpatient procedure that uses x-ray pictures and a video screen as a guide for your surgeon to reach and fix the damaged disc. The incision, made in the small of your back, is about the size of a puncture wound. Because your surgeon can see the damaged disc on a video screen, it’s not necessary to remove bone to view and reach the disc. After surgery, a small bandage is placed over the incision.
The incision is about 1/4 inch long, large enough to insert a small instrument.
You use your knee every time you take a step. Because of this, living with a worn or injured knee joint can be painful and frustrating. Even simple things, such as squatting to pick up the morning paper, may cause pain. But you don’t have to live this way. In many cases, an orthopaedic surgeon (a doctor who treats bone and joint problems) can replace the damaged knee joint. The surgery is safe and effective. For many people, having a total knee replacement means a return to pain-free movement. This booklet will help you learn what knee replacement means for you. It can also help answer many of your questions.
No matter what your age, a problem with the knee joint may keep you from activities you enjoy. Pain and stiffness may even limit the daily tasks you can do. Problems with the knee joint tend to build up over time. Your knee pain may be caused by any of the following:
You may not have to live with knee pain for the rest of your life. Total knee replacement surgery almost always reduces joint pain. During this surgery, your damaged knee joint is replaced with an artificial joint (called a prosthesis). Surgery can’t make you young again, but it can bring real benefits.
After a total knee replacement, you can look forward to moving more easily. Most people gain all of the benefits listed below. Knee replacement surgery almost always:
The arthroscope is an instrument used to look directly into joints. This makes it useful for both diagnosis and treatment. The arthroscope contains magnifying lenses and coated glass fibers that beam an intense, cool light into the joint. A camera attached to the arthroscope allows your surgeon to see a clear image of most areas of your knee joint on a monitor. This procedure allows doctors to view the knee joint without making a large incision (cut) through the skin and other soft tissues. Arthroscopy is used to diagnose and treat a wide range of knee problems.
Your surgeon must evaluate your knee to diagnose your problem. An evaluation may include a medical history, physical exam, and one or more diagnostic tests. To confirm the diagnosis, arthroscopy is often done. The arthroscopic procedure is usually an outpatient procedure, meaning patients don’t need to stay hospitalized overnight. At the beginning of the procedure, you will receive an anesthetic. It could be general anesthesia which will make you sleep or spinal anesthesia which will numb you from the waist down or just local anesthesia which will numb your knee.
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Sterile fluid is inserted through one portal to expand your knee joint. This makes it easier to see and work inside your joint. After inserting the arthroscope through another portal, your surgeon confirms the type and degree of knee damage. Whenever possible, your surgeon treats your knee during arthroscopy, using surgical instruments such as shavers or laser. This procedure results in less pain for patients, less joint stiffness, and often shortens the time it takes to recover and return to favorite activities.
As with similar surgeries, arthroscopy carries the risk of bleeding, infection, and stiffness, as well as recurring knee problems.
The rotator cuff is a powerful team of muscles and connecting tendons. These muscles and tendons attach your upper arm to your shoulder blade. Your rotator cuff helps you perform the following physical activities: reach, throw, push, pull and lift.
Your shoulder might hurt because your rotator cuff tendons are swollen or damaged.
This could be caused by many things which might include:
The older you get, the weaker your muscles and tendons become which means they are more easily injured. A rotator cuff injury can make everyday activities painful. What can you and your doctor do to stop the pain and get your shoulder back in shape? First your condition is evaluated. You and your doctor will then plan the best way to reduce your pain and heal your rotator cuff. Depending on your injury, your treatment may involve non-surgical care, surgical care, or both.
Care for your injury will most likely begin with non-surgical treatment ranging from simple rest to pain soothing injections your doctor will tell you how often you may need this treatments if the treatments relieve your pain you will be given an exercise program to restore your shoulders power if your pain just won’t quit you and your doctor may decide you need surgery.