2017-07-26 / Health

Age and surgery

DEAR DR. ROACH: An MRI shows that I have spinal stenosis. I have not improved with chiropractic care, electrical stimulation, medication (including hydrocodone, tramadol and a pain patch), physical therapy or three spinal injections. After the third injection did not help, I told the surgeon I would need back surgery, but he said I am too old. I am 76. Am I too old? — H.S.

ANSWER: Spinal stenosis is a back condition in which the spinal cord or nerve roots are compressed due to bony abnormalities. The pressure on the nerves can cause pain, loss of reflexes and numbness. Spinal stenosis is most common in the lower back, but it can happen in the neck and mid-back as well. It is seen more often in people over 60 and is the most prevalent reason for back surgery in people over 65.

The MRI usually shows the compression on the spinal cord or nerve roots; however, the decision for treatment is made based on the symptoms, not necessarily how the back looks by MRI. You have had the recommended nonsurgical treatments, including several medications, physical therapy and injections. Consideration of surgical treatment is reasonable.

When considering any therapy, the physician must consider the potential benefits and risks. The benefit of surgery is that it is more likely to relieve pain and improve function. There is a small risk of a serious bad outcome (death, worsening of pain or weakness). In general, the older a person is, the more risky the procedure. However, there is no absolute age cutoff of who can and can’t get the surgery. The overall health of the person is more important than age. Younger people may be a bit more likely to see better improvements in walking after surgery.

Back surgery shouldn’t be undertaken lightly at any age. Get a surgical opinion — and probably a second opinion — before making a decision. Only the surgeon, with access to your MRI results and having completed a careful history and exam, can make an informed recommendation about your personal situation.

The booklet on back problems gives an outline of the causes of and treatments for the more-common back maladies. Readers can order a copy by writing: Dr. Roach — No. 303W, 628 Virginia Drive, Orlando, FL 32803.. Enclose a check or money order for $4.75 with the recipient’s printed name and address.

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DEAR DR. ROACH: Has the use of white powder, monatomic gold nutritional supplement been verified by the medical profession? Are the claims of mental clarity, long life span, disease cures, etc., accurate? — D.S.C.

ANSWER: I thought I knew supplements pretty well, but hadn’t heard of monatomic gold. Monatomic gold is supposed to be an “orbitally rearranged monoatomic element.” In fact, these don’t exist chemically, and anyone selling a product like this and claiming health benefits is deliberately scamming you or is confused. Metallic gold is inert and has no effect in the body, as opposed to gold salts, which are powerful and potentially dangerous medications, now seldom used for rheumatic diseases. Avoid “monatomic gold” supplements. ©2017 North America Synd.

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