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Preserving Motion Before and After Spine Surgery

Authored by Lindsay Orosz, PA-C, MPAS. March 29, 2021

“An inch of movement will bring you closer to your goals than a mile of intention.”

This quote by American writer, Steve Maraboli, highlights the importance of movement and motion.  Motion is defined as the action or process of moving, which occurs automatically throughout our day.  The spine is the central support structure for our bodies, and helps us bend, twist, walk, sit, and stand.  It’s no surprise that the term ‘backbone’ can mean both the spinal column and the chief support of an organization, right?  

Motion is Seamless Without Pain

So our neck and back support the majority of the movements we make, which is often done without even thinking about it.  But what about pain?  Pain can be mild, moderate, or severe but in all forms, can inhibit motion or cause improper motion.  Chronic pain in the neck or back can also lead to a lack of exercise, thereby weakening the muscles surrounding the spine, leaving the spine unsupported and more vulnerable to injury.  Plato said, “Lack of activity destroys the good condition of every human being, while movement and methodical physical exercise save it and preserve it.”  A quality fitness routine is not just for those that participate in sports, but is fundamental for keeping us moving throughout our everyday lives.

Neck Motion

If we focus on the neck (cervical spine), think about how many times a day you look up, down, left, right, or some combination.  It’s just too many to count!  In the past few minutes alone, I’ve looked up at my computer screen, down at my phone, left to look out the window as the mailman arrived, and then way down to the floor when I dropped my pen.  

Now that working from home is commonplace, the term ‘tech neck’ has become very real for many of us that were used to an ergonomic office setup, but do not have the same luxuries at home now.  Makeshift home offices and sharing workspaces with homeschooled children can be hard on the neck.  I would venture to say that as you are reading this, you are giving your neck a good stretch and adjusting your posture, knowing that your neck needs to move.  

Outside of the home or office, think about clearing your blind spot while driving, stargazing at night, looking upward to give your order to the server at a restaurant, or looking to the side as you receive your coffee at the drive up window.  Motion is so important, and these examples only scratch the surface.

Low Back Motion

If we shift the focus to the low back (lumbar spine), the amount of weight this portion of the spine carries is much greater than the neck.  Therefore the motions get bigger and more obvious, and the forces are greater.  Think about how many times you adjust from standing to sitting, then back again on any given day.  

There is also quite a variety in how we bend.  A slight forward bend can be reaching into the refrigerator.  A deeper bend is when you put something in or take out of the oven.  Depending on each person’s flexibility, an even deeper bend may be touching the toes for a good morning stretch, or bending over to tie your shoes.  

Then the back is also designed to support a bend and lift combination, such as picking up a child, grocery bags, and even those heavy bags of mulch or dog food.  We can’t leave out twisting, which is that rotational movement of the spine.  Like when we are laying in bed and twist over to turn off the alarm or looking backward when someone comes up from behind us.  Once you start to think about it, the list goes on and on.

But What if I Need a Spine Surgery?

When the structures in the neck or low back wear out to the point of needing spine surgery, motion is not something that gets thrown out the window.  In fact, your spine surgeon will likely measure what type of motion you have before surgery, and discuss your desired activities after surgery and then contemplate what type of motion is needed for those activities.  That information is vital in surgical planning.  There are often multiple surgical options available, and tailoring the right surgery to the right patient can be challenging, but is critical for success.  It is important to have an open conversation with your spine team as you move through the surgical planning process.  

If you are recommended for a fusion, find out if you are a candidate for a motion-preserving option, such as a disc replacement surgery.  This is also known as arthroplasty, which can be done in the neck, low back, and either alone or combined with a fusion if surgical correction is planned at more than one level (or spine segment).  A disc replacement implant is designed to maintain the motion of a spine segment, whereas a fusion eliminates the motion of a spine segment.  There are times when limiting motion through a fusion is the only way to relieve pain, which becomes a worthwhile trade off.  The only way to understand your options is to be vocal and ask your surgeon.  

Advice for now

In the meantime, keep moving and try not to take your current state of motion for granted.  I leave you with a final quote by Irish playwright George Bernard Shaw that rings true: “We don’t stop playing because we grow old; we grow old because we stop playing.”

About The Author

Lindsay Orosz, PA-C, MPAS, Physician Assistant

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