Since its inception, back surgery has been considered a very risky, very invasive surgical procedure. This is due to the fact that the spinal column is filled with so many critical nerves, muscles and bones that one false move can leave a patient paralyzed. Unfortunately, even if a patient made it through surgery without anything going wrong, many who underwent the open back procedure realized that their back pain was even worse after surgery than it was before. Because of this, Dr. Rezaian of the California Orthopedic Clinic in Beverly Hills pioneered a new technique known as minimally invasive back surgery. Unlike open back surgery, minimally invasive back surgery is laser guided and does not require cutting the patient’s back wide open to fix the issue. In fact, Dr. Rezaian’s minimally invasive back surgery is so gentle that patients do not need to undergo general anesthesia and have little to no scarring after the procedure.
The beauty of his minimally invasive back surgery is the technology used to perform it: Dr. Rezaian incorporated the principals used in endoscopic surgery and laser surgery into a whole new approach for back surgery. Instead of weeks of agonizing recovery time, patients who undergo the minimally invasive back surgery are back on their feet the same day. The difference is so dramatic that some patients who were brought in barely able to stand have been able to walk out of the office after undergoing Dr. Rezaian’s minimally invasive back surgery. Most importantly, the minimally invasive back surgery yields much better results for patients than traditional surgery. When you look at the facts, it is easy to see why Dr. Rezaian’s experienced hand and cutting edge surgical techniques make him the go-to orthopedic surgeon for minimally invasive back surgery.
Based on a review of these 600 patients with back problems, we have created a new practical classification for the diagnosis of back pain. According to this classification, there are only two types of back pain in medicine: the constant or malignant pain., and the intermittent or benign pain.
Constant low back pain occurs day and night, at work and at rest, when the patient is happy, and when angry or depressed. We call this type of pain malignant pain.
Intermittent low back pain is relieved for some period of time within a 24-hour period. We call this type benign pain, and it comprises nearly 95% of all low back pain.
Subclassifications of Intermittent Low Back Pain. There are five subclassifications of intermittent low back pain:
2. Low back pain that is aggravated suddenly and is accompanied by weakness of the muscles, urinary problems, or both, caused by cauda equina syndrome. Look for acute or subacute midline rupture of disc L3-L4 and more rarely L4-L5. This may be seen in all ages and comprises 1-2% of all back pain.
3. Low back pain that gets worse at rest and gets better with exercise and activities, accompanied by joint stiffness, should lead one to consider inflammatory disease, particularly ankylosing spondylitis. This type is commonly seen in middle-aged persons.
4. Low back pain that gets worse with straightening the back is reported by patients who state they cannot lie flat with the lower limbs straight. They normally feel more pain with walking and then differentiate claudication from endarteritis. This type is seen in the age group over 60 years with history of degenerative discopathy of the lumbar spine. This is mostly due to spinal stenosis.
5. Low back pain that is accompanied by a skin lesion (systemic lupus erythematosus or cafe-au-lait), or multiple joint involvement that changes with cold and hot weather speaks for the correct diagnosis of systemic lupus erythematosus and rheumatoid arthritis.
Using the above classification system, we have been able to diagnose every patient with low back pain in this sample of 600 patients,. We have confirmed our diagnosis with objective tests and have rendered correct treatment on over 99% of the patients to the degree that they have returned to work even after being on disability for up to 8 years.
It was surprising correctly a large number of patients who had been referred for psychiatric therapy which of course did not relieve their back pain. Their pain fit well in our classification, and they were successfully treated.
Laboratory Studies Indicated for Investigation and Evaluation of Back Pain.
1. X-rays including flexion and extension views are required to have a general evaluation of bone structure and to have a baseline for further development. Many authors do not recommend X-rays for back pain for back pain of less than 6 weeks' duration. We disagree since the first X-ray immediately after injury may be normal, but 6-8 weeks later may show degenerative change, and one may then relate these changes to the injury.
2. complete blood cell count (CBC), urine analysis, erythrocyte sedimentation rate (ESR), and blood chemistries including alkaline phosphatase and acid phosphatase are indicated in the management of malignant back pain.
3. Magnetic resonance imagine (MRI) is indicated for any patient who demonstrates neurological deficit, e.g., numbness on nerve distribution, deep tendon reflex changes, or weakness of special groups of muscles.
4. A computerized axial tomography (CAT) scan is helpful to demonstrate bony changes, e.g., osteophytes, old fractures, bony destruction, spinal stenosis.
5. Myelography and CAT scan are helpful in evaluation of complicated cases. e.g., patient with failed back surgery.
6. bone scan is necessary to rule out bony lesions due to infection or malignancy.
Back pain can be very debilitating for those who suffer from it. Not only is it a mental drain to be constantly in pain, but back pain can end up limiting a person’s daily activity and enjoyment of life. For California residents suffering from severe, persistent back pain, we invite you to visit us at the California Orthopaedic Medical Clinic for the latest back pain laser treatment. Unlike old fashioned spinal surgery, laser treatment for back pain is quick, easy, and only requires local anesthesia. With traditional back pain surgery, patients experienced excruciating pain, long recovery time and less than stellar results. Patients who have undergone the back pain laser treatment at the California Orthopaedic Medical Clinic have experienced astounding results - a full 98% of all patients who receive laser treatment for their back pain report an excellent or good outcome.
Dr. Seyed Rezaian, Medical Director and lead surgeon at the California Orthopaedic Medical Clinic, is a world-renowned expert in back pain and laser treatments. Dr. Rezaian has performed the laser treatment for back pain on over 2,000 patients, many who had previously undergone traditional surgery with poor results. Back pain laser treatments are available for people ages 13 and above, and since the laser treatments do not require risky general anesthesia, they can be performed on senior citizens who would not even be eligible for traditional open back pain surgery. Laser surgery for back pain involves a small incision and is performed laparoscopically, so the procedure is as minimally invasive as possible while yielding maximum results and freedom from back pain.
It can be a struggle to deal with back pain. Even mild back pain can make everyday activities difficult. Short term remedies aren’t always enough, and some medications cause troublesome side effects. Fortunately, more and more patients are putting their hopes in back pain laser treatment. With advanced endoscopic techniques, back pain laser treatment can be very safe and effective. Patients who cringe at the thought of complicated surgery can see if they qualify for back pain laser treatment. Studies have been done by the Laser Spine Institute to prove the effectiveness of such minimally invasive procedures. Most patients are back on their feet in no time after receiving such treatment. The incisions are very small during back pain laser treatment, which minimizes the risk of surrounding tissue being damaged. This means increased safety and faster recovery time.
Traditional back surgery requires anesthesia, large incisions, and a long recovery time. Indeed, it could take months to recover from traditional, complicated procedures. Now, with advanced technology, back pain laser treatments can be performed in an outpatient clinic with local anesthesia. This can be done with minimal or no scarring. However, despite this type of treatment being less complicated than traditional treatment, it still requires an excellent surgeon. Like all medical procedures, it’s important to choose a good physician. Patients need to search for qualified surgeons who have experience with back pain laser treatment, like Dr. Rezaian. Dr. Rezaian is a pioneer in the back pain laser treatment techniques, and has been helping patients cure their back pain without open back surgery for nearly twenty years.