Did you know that back pain is the leading cause of disability in Americans under 45 years old? Not to mention that an estimated 26 million citizens ages 20-64 report frequent back pain. This number includes politicians, celebrities and even world-class athletes.
Tiger Woods, a professional golf player and 14-time major championship winner, is no exception. Over the past 3 years, chronic back pain required that the golfing-legend put his career on hold and undergo 3 separate microdiscectomy surgeries between April 2014 and October 2015.
A microdiscectomy, also known as a microdecompression, is a fairly common minimally invasive spine procedure that is meant to relieve pressure being put on the spinal nerve - often by a herniated disc. During the operation, the surgeon will make a small incision over the affected area in a person’s spine and insert a tubular retractor (a tool that creates a small tunnel down to the spinal column through which the surgeon can operate). At this point, the surgeon is able to remove the herniated disc material pressing on the nerve and, ideally, relieve pain.
“[A microdiscectomy] is different from any of the other surgeries and procedures that I've had in the past, where, okay, you blow out your ACL, which I did and I had ACL reconstruction and you're back in nine months. That's the timetable. For nerves, there are really no timetables, and therein lies the tricky part because you can come back earlier or you can come back later. It just depends on how the nerve heals and how it settles.”
While most microdiscectomy surgeries are typically successful (90-95%) there is a slight chance (5-10%) that the patient will develop a recurrent disc herniation at some point in the future. Occasionally, a microdiscectomy can be successful at relieving pressure on the spinal nerve for a short time but the pain can return due to continued degeneration of the disc. Not to mention the fact that professional golfers put quite a bit of strain on their lower back, some estimate up to 10 G-forces, which can cause problems over time. Whatever the reason, Tiger’s disc herniation recurred and required that he undergo additional surgeries in order to address his pain and get him back on the course.
Though Tiger is still recovering from his most recent surgery (October, 2015) and there is no clear timetable for his return to golf, both he and his fans are optimistic.
“I'm absolutely making progress, and I'm really happy with how far I've come.”
Peyton Manning, a two time Super Bowl champion and soon-to-be Hall of Fame quarterback, also struggled with a herniated disc that nearly ended his 13 year career prematurely and forced him to sit out the entire 2011 season.
Herniated discs can occur in athletes who engage in contact sports, like football, where repetitive stress is put onto the discs in the spine. It can be helpful to imagine that the discs providing shock absorption and cushioning between the vertebrae in your spine are designed a lot like jelly donuts — a strong outer ring of fiber with a softer, more gelatinous substance in the center. When exposed to repeated stress and duress, it’s possible for the outer shell (or annulus) of a disc to weaken and rupture. This, in turn, allows the soft, inner material to leak out of the disc and put pressure on the nerves surrounding it. The now herniated, or slipped disc, disc can cause excruciating pain as well as numbness and tingling in various parts of the body.
Peyton Manning specifically suffered from herniated cervical discs, which occur in the seven vertebrae located directly below the skull. In order to address the issue, he had 2 posterior neck surgeries and finally 1 anterior neck surgery over the course of 18 months. The first three surgeries were posterior decompression which means that the surgeon approached the spine from the back. However, in the third and final operation, the surgeon approached the spine from the front which is known as anterior surgery.
In an anterior operation, the surgeon make an incision in the front of the neck and removes the herniated disc material putting pressure on the nerves surrounding the spine. The reason surgeons choose to enter the spine from the front is because the nerves face forward and are easier to access that way. After performing the microdiscectomy, they next create a “tunnel” so the nerve can run out of the spine and use a bone graft to hold it in place. Finally, the doctor will often put a small metal plate across the “tunnel” to give patient mobility and allow them to return back to their normal activities as soon as possible; this is known as a fusion.
Manning’s surgery was successful and, after taking a season off to recover, he was able to fight through some nerve damage and return to the NFL, eventually, winning the Super Bowl in 2016.
Tiger Woods and Peyton Manning are world-class athletes and, yet, were among the thousands of Americans who consider undergoing spine surgeries every year.
What about you?
Are you one of the 31 million Americans who suffer from back pain? Is your condition keeping you from enjoying your life, having a career or performing simple tasks? Then it’s time to talk to a spinal specialist about your options.
Surgery of any kind should be a last resort and, in most cases, an effective solution can be found for your pain that never involves throwing you onto the operating table. Nevertheless, if your condition does require surgery, rest assured that advances in minimally invasive spine surgery have changed the game in terms of procedure, recovery times and overall effectiveness.
Whether you’re a world-famous athlete or just an average Joe, you don’t have to struggle with back pain. Talk to your doctor and discover how you can find lasting relief.