General Questions

What is lumbago and what sciatica? What is their etiology?

Using the term “lumbago” we mean back pain, whereas “sciatica” means pain in the lower limb, due to pressure to sciatic nerve. Intervertebral disc hernia constitutes the most frequent cause of lumbago and sciatica in young and middle-aged people.

 

What does vertebral instability mean?

Vertebral instability is the lack of stability and the abnormal movement between two vertebrae. It constitutes a frequent cause of chronic lumbago, leading to gradual destruction of intervertebral joints.

 

What is spondyloarthritis?

Spondyloarthritis is the destruction of joints of two adjacent vertebrae. It is frequent in older patients, constituting a frequent cause of chronic lumbago and as well as of vertebral stenosis.

 

What is vertebral stenosis?

Vertebral stenosis is the stenosis of spinal canal. This canal is formed by the vertebrae, serving the passing of the nerves that provide sensation and motion to our arms and legs. Stenosis may be found in the neck, thorax or in our waist, leading to numbness and weakness to our upper or/and lower limbs, depending on its localization.

 

I have osteoporotic fractures in spinal column. What is this?

Osteoporotic fractures are defined as the sedimentation of vertebral bodies which occurs with minimum or not at all force (namely without a hit) due to severe osteoporosis. They result in pain and kyphosis, which means patient’s arching. The way of dealing includes the use of splint or the waxwork with vertebral restoration and cement injection.

 

I suffer from acute lumbago-sciatica. Am I in danger to become paralyzed?

In extreme cases, which are not nevertheless unlikely, the sciatica due to a large intervertebral disc hernia may can combined with severe nerve pressure, leading to temporary or, if it is not treated on time, to permanent paralysis of specific muscles. Such muscles are, except for leg muscles, the muscles which control the anus or the urinary bladder. The result is urinary and faecal incontinence. Elements that must worry us are the intense numbness or decreased strength of one muscle and numbness in genitals and anus.

 

What is cauda equina sundrome?

The appearance of urine disorders or the urine or faecal incontinence is called cauda equina syndrome and constitutes a bell for emergency treatment.

 

I suffer from acute lumbago-sciatica. Is there drug therapy?

The administered drug therapy aims to soothe nerve irritation which causes the pain. However, it cannot treat the problem etiology, which usually is intervertebral disc hernia. You may overcome but not treat the substantial nerve pressure. This is the reason why the same clinical picture often returns in another time.

 

When is surgically intervertebral disc hernia treated?

An intervertebral disc hernia is surgically treated if the pain remains for a long period of time despite the drug therapy or if it presses the nerves, leading to decreased neural function.

 

What is the difference between endoscopic discectomy and microscopic discectomy?

Despite the limited incision and accuracy that microscope provides, microscopic discectomy remains still an open intervention. It demands general anesthesia, injuring parallely back muscles and bones. Endoscopic method is in contrast conducted under local anesthesia, causing almost not at all tissue injuring so that it does not require hospitalization. It is characterized by much shorter hospital stay and direct mobilization. We substantially enter from a far lateral skin incision of 8 mm. Patient is in the same time mobilized since it is conducted under local anesthesia, being able to leave hospital the same day.

 

What is kyphoplasty?

Except for spinal fusion, there are also other types of surgery which can be conducted with fine tubes, such as kyphoplasty. It constitutes a modern method of vertebral osteoporotic fractures treatment. The operation is conducted with two small incisions of one cm for every vertebra. A special balloon is through the tubes in vertebra inserted, correcting while swelling the shape of the broken vertebra. The created after balloon deflation space is filled with acrylic cement and the vertebral body is thus strengthened and stabilized. Patient usually remains in the hospital for one day. The return in daily activities is direct and pain relief is spectacular.

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CONTACT

Dr. Stylianos N. Kapetanakis

Orthopedic and Spine Surgeon MD, FRCS, PhD
Priv. Consultant Spine Surgeon
Ass. Professor at Medical School of Democritus University of Thrace

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