Vertebral Compression Fracture and Kyphoplasty
Why suffer from chronic back pain caused by back injuries, trauma and osteoporosis when you can reverse it without an open surgery?
The Kyphon Kyphoplasty Technique
Around the world, there are 100 million people who are at risk of having thin bones, with a staggering 44 million cases found in the USA alone. The most at risk are women who account for 4 times the amount of cases with more than half of are aged over 55 years old. The medical treatment expense for this issue is 20 million dollars per year, which is an amount that even exceeds the costs involved for the treatment of heart diseases (treatment expenses are made up of the hospital expenses added to the financial loss caused by being unable to attend work whilst recovering).
Thin bones can result in broken bones in more than 1.5 million Americans every year. Among this amount, 700,000 patients are found to have a broken vertebral bone (data from National Osteoporosis Foundation). When the broken back bone is at the upper chest area, the spine will be severely compressed; resulting in the lung volume becoming depressed by 9%. Subsequently, lungs may not function properly and breathing can be seriously affected, especially in the elderly.
For patients with thin bones, seemingly harmless incidents, such as a small fall on the buttock, riding in the car on a bumpy road or making a wrong body turn, can cause a crushed backbone (compression fracture of the spine bone). Alarmingly, the symptoms might not be felt right away and it could take up to 2-3 days or even several weeks for pain to be felt. Furthermore, if left untreated, or the wrong treatment is administered, the pain will gradually increase over time.
Symptoms of a Broken Vertebral Bone
Usually, the symptoms start with a backache and minor pain at the waist. The backbone is formed; (i.e., the bone collapses in height) and the spine angles forward. At this point, it is difficult to live a normal life, with even the simplest tasks, such as getting out of bed, becoming a burden. There are also a number of other difficulties that a patient will encounter, such as pain when bending or twisting, and an inability to walk for long distances. Due to the fact that their quality of life is hindered, people affected are less inclined to use their body unless absolutely necessary. Unfortunately, this only exasperates the problem as the density and the strength of the bone is reduced due to the reduction of its use. The consequence of this is that the remaining vertebrae will crumble down, causing multiple fractures.
There is also a possibility of a more serious condition developing, such as lung disease, due to the reduction of the lung functioning. Subsequently, the death rate is increased by 23-43%.
Note: A vertebral compression fracture is also called VCF. It is usually caused from a collapse or breakdown in one or more bones of your vertebrae. Vertebrae are round, strong bones that are stacked up on top of each other. Your spine is made up of thirty-three vertebrae. The bones stack up in a line that goes down the middle of your back.
Compression fractures of the spine occur when there is too much pressure on the vertebra. The vertebra collapses, and becomes wedge-shaped, instead of round. The bone tissue on the inside of the vertebra may also get crushed and squeezed. Fractures may be mild or severe. They happen most often in the thoracic (middle) and lumbar (lower) parts of the spine.
Treatment Options for a Vertebral Compression Fracture
Most compression fractures heal with simple remedies of medicine, rest, avoiding activities that exert added strain on the back and by using a special back brace. Usually patients are also given medication to control the pain. However, although medications can help ease pain, they are not designed to heal the fracture. It is important to note that the crushed spine or the angled forward bone will not return to its original condition. Therefore, a patient may have to live with a humped back resulting to reduction in body height. Another drawback of this method is that the healing of the bone can take up to 3-4 months. During this time, a patient’s quality of life can suffer. Furthermore, there is a risk that the other bones will be crushed and will start to cave in. Put in simple terms, this process is like stacks of the stories of a high building – once one is crushed and tilted, the weight will be loaded on one side and can lead to the rest of the stories crumbling down.
Open surgery returns bones to the right place by putting them together using wires, pins, plates, or screws. This method helps raise the crushed bone back to its normal height and can also help lift the humped back. This has been the most common way to address the problem over the last few decades. The advantage of this method is that the crushed bone is ‘lifted up’ so that it does not compress the nerve. Therefore the nerve is not destroyed and can return to its previous state. The drawback is that the patient will lose a small amount of blood, and will encounter pain around the wound, at the skin and around their muscles. Unfortunately, the result on the patient with thin bones is not as effective. Also, this method cannot be performed on a patient with a separate ongoing disease as it is considered too invasive and there is a poor outcome in the osteoporotic bone
Vertebroplasty is the procedure for stabilizing compression fractures in the spine. Bone cement is injected into back bones (vertebrae) that have cracked or broken, often because of osteoporosis. The cement hardens, stabilizing the fractures to support your spine. To perform vertebroplasty, the surgeon inserts a needle into the damaged vertebra. Once the surgeon is sure the needle is in the right place, bone cement is injected through the needle into the fractured bone. A reaction in the cement then causes it to harden. This fixes the bone in place so that it does not collapse any further, as it heals. This procedure is most helpful for reducing pain. It also strengthens the fractured bone, which enables patients to rehabilitate faster. The drawback is that the cement might leak out and therefore might not be able to support the crushed bone back in its place.
Note: The cement is not a common constructive cement. Known as polymethylmethacrylate (PMMA), it is a special kind of cement that starts as liquid and hardens over time.
Kyphoplasty is when a balloon is placed in the fractured vertebrae. During this process, bone cement is put inside the space made by the balloon. Two long needles are then inserted through the sides of the spinal column into the fractured vertebra body. These needles guide the surgeon while they carefully drill two holes into the vertebral body. There is a large element of skill involved in this process as the needles and drill holes need to be placed in the correct area. The surgeon then slides a hollow tube with a deflated balloon on the end through each drill hole. Inflating the balloons restores the height of the vertebral body and corrects the kyphosis deformity. Before the procedure is complete, the surgeon injects bone cement through a small hole in the skin (percutaneously) into the hollow space formed by the balloon. This fixes the bone in its corrected size and position.
Again, there are advantages and disadvantages of this procedure. One benefit is that no further surgery is required. The procedure also eradicates any severe pain and in fact strengthens the fractured bone. It also gives the advantage of improving some or all of the lost height in the vertebral body. Additionally, the patient will usually recover very quickly; in some cases patients have been known to get up to perform routine activities only a day after the surgery. Furthermore, patients will not need to stay in bed, even during cases, as mentioned previously, when they constantly have to lie down due to the amount of pain caused by body movements. Other advantages are that there will not be a large surgery wound, as well as minimal blood loss for the patient.
The drawback, however, is that it is an expensive procedure. The equipment and the balloon can only be used once and the surgeon needs to be a skilled specialized doctor who is trained to carry out this type of procedure. In addition to this, the surgeon uses a fluoroscope to guide a needle into the fractured vertebra body. A fluoroscope is a special X-ray television that allows the surgeon to see a patient’s spine and the needle as it moves. As the fluoroscope is not available in every hospital, this can also be costly for the patient.
A New Technique in Kyphon Kyophoplasty
From my own observation and experience, in order to make this technique successful within crushed backbone fracture treatment, the following compositions are required:
1.It is essential to use 2 F-x-ray machines in order to see the picture clearly and quickly – this is much more effective than the old technique that uses only 1 machine.
2.Modern, more advanced, pressure measurement equipment is required as it allows for digital measurements and can make finer and more precise calculations, which prevents putting too much pressure in the balloon.
3.The flattened balloon should also be designed for the surgeon to see the point and area to be incised that will ensure greater precision when putting pressure on the area.
4.When using the new cement injector, it is imperative to make the cement volume and the injection pressure known while the injection is being administered, in order for the injection to be controlled.
Even with these positive recommendations and findings that these techniques are all relatively safe, in reality, there is no single or individual method that is a perfect fit for every patient. The first step should always be to consult your doctor but if possible, it is, of course, much better to keep your bones strong and healthy.
Healthy body and joints to you
The following story is from a previous patient who had recurring backache caused by a herniated disc for almost 20 years.
The bones (vertebrae) that form the spine in your back are cushioned by small spongy discs. When these discs are healthy, they act as shock absorbers for the spine and keep it flexible. But when a disc is damaged, it may bulge or break open. This is called a herniated disc. It may also be called a slipped or ruptured disc.
I had been through a back surgery twice. I waited for three days for the third surgery at a hospital in Silom area, and the doctors told me I did not need any more surgery since the symptom was not too serious and that I could still live a normal life. I accepted the experienced doctors’ advice then but I was still left with this on-and-off pain that could not be cured for quite a long time.
Fast forward to this day, I can now say that I am in a better condition, and I want to share my experience so that it may be of good benefit to some of you.
The symptom first started with my inappropriate lifting posture. There was a streaking pain at my waist area and I could not move my legs. After five minutes, the pain ceased. I slowly dragged myself and limped my way to the car and drove to see the doctor. The doctor at the clinic said that it was a muscle inflammation and gave me the medicine for pain and inflammation. I stayed at home for three days. I could not go to work because I hard such difficulty walking.
From then on, such streaking pain would occur each year for at least two to three times that lasted for many years. Every time the pain occurred I had to stay home for three to four days to recuperate since it was so painful to stand up and walk. I went to see a popular Orthopedic doctor in the province, and I was on treatment for many years, from taking pills to getting injections and undergoing computerized x-rays. The doctor then sent me to do an MRI scan in a very expensive hospital in Bangkok (the only hospital that had the facilities at the time). The films showed that the intervertebral disc was out of place, and it was pressing the spinal cord and nerve that caused numbness down to the back of my feet. The doctor decided to perform an operation. He made an incision of about five inches and scraped out the broken invertebral disc and cut out part of my pelvic bone to replace it. The pelvic bone on the upper part will gradually weld to the lower part to become one piece. But then my vertebrate lost its elasticity. It took me almost a month to recover.
After the operation, I had to see the doctor periodically for a follow-up check. This went on for weeks to months and years. The symptom was a lot better than before but it was still there. The doctor then decided to do another operation. This time, the cut was made from the back. He put the instrumentation to connect the upper and lower vertebrate to strengthen and prevent it from pressing on the nerve. It took me three weeks to recover. For years, the numbness on the back of the feet remained and from time to time the pain was severe. I gave up and accepted it that way.
In 2001, the pain became more frequent to the extent that I had to stay in bed. I went again to see the doctor at another hospital. I had been through x-ray many times: both the standard and computerized x-ray. The x-ray picture did not come out good so the doctor put me through MRI again. The reflection of the instrumentation inside my body made the picture blurry. Finally, the dye was injected into my spine and the picture of the standard x-ray was used for diagnosis. The picture showed that there were more herniated discs: the upper and lower part of the former problematic one. It was because of that bone (which was operated on years ago) has lost its elasticity, thus putting more burden to the upper and lower invertebral disc. Boy! I did not know whether it was because of my bad deeds when I was a child (hit a few snakes and broke their back to death) had come back to get me!
I waited at the hospital for another three days before the doctors finally decided not to proceed with the operation. The reason, according to them, was that it was not worth to take the risk with this repeat operation on the same spot for many times. So, I had to live with the severe pain for several times again each year. In 2003, I went to work in China for three years. I was lucky enough that during that time there, the severe pain rarely occurred. Most of the times when I started to feel a little bit of pain, I immediately took painkillers. I took extra caution with the way I move but every time I came back home I needed to see the doctor and asked for more prescriptions to help me cope with my pain to last my stay in China. The medicine, each time, cost me almost 10,000 baht. I became desperate to see every doctor that was known for the treatment of the pain. Most of them are widely known nationwide. I went to see and consulted every Orthopedic doctor I could find just to make sure I would not get so sick to the extent of interrupting my job contract in China.
There was a doctor at another hospital in Thailand who told me directly that the symptom would never go away. If the pain is too frequent and the numbness of the feet is increased to a great extent, the only way out is to undergo an operation; the more areas with pain, the more operation should be performed. To prevent and decrease the chances of experiencing pain, I was told I needed to exercise my back muscle to make it strong enough to securely connect and support the vertebrate. I agreed with that opinion but there were just too many exercises to be done and it was so time consuming. The exercise plan would not suit a person like me, who is not so eager to push oneself to exercise. I did it for only a few days and gave up. The exercises were too complicated so I will not talk about it here but I just want to mention that the heart of the problem is the back muscle.
Finally, I came back from China when the pain recurred. I met an Orthopaedic Surgeon named Doctor Somsak Laowattana at another hospital in Thailand and it changed my life! And when he learned about my past treatments, he told me that if it was he, who performed the previous surgeries, he would have forced me to follow the back muscle exercise plan right after my wound had recovered. I would not have to do frequent visits to the doctor from then on. The exercise will strengthen the back muscle and prevent the problem from recurring, and it is imperative to be done daily. When he explained the exercise to me, I found out it was very easy and not time consuming. I followed the exercise routine continuously for the next three months, and I can now feel that my back is stronger and my abdomen is firmer. The most important thing is that I am no longer feeling streaking pains up to now. The pain is gone for good! The exercise, for me, is the real treatment. Now… it’s time for you to learn the exercise.
Every morning when you get up…
- Lie on your back, stretch your feet and keep them close together
- Lift your feet about one foot above the floor (not to lift higher)
- Keep your feet in that lifted position for 10 seconds
- Lower your feet and rest for five seconds… this is one set
- Continue with the exercise for 10 sets; that means it will only take 150 seconds of your time per day
Can you see that? It’s so easy just like a piece of cake!
- Each week, increase 500 gram of the sandbag weight around your feet
- The increased weight will strengthen the back muscle and solve the problem
- How much weight should you carry? The doctor says gradually increase it until you can not lift it anymore
- The minimum weight for each person to carry can be calculated as follows:
Minimum weight to carry = (body weight – weight of both legs)/10
In general, both legs weigh about 10 kilograms. If you are overweight or underweight you can adjust accordingly (don’t tell me your leg weighs 50 kilogram each!)
I hope that this 150-second exercise will be of help to the ones who suffer from back pain. And I wish that this good deed of informing everyone with this message will help me live a normal life away from back pain forever.
Dr. Somsak’s Patient
7 August 2007
Minimally Invasive Open Surgery for Discectomy is a surgical treatment of the prolapsed (herniated) spinal disc by using a small incision technique without using an endoscope or camera. The pressure on the tissue, muscle and bone around the affected area is going to be minimal. The orthopedic surgeon must be a specialist on spine anatomy who will put the incision on the skin in a correct starting point to precisely get to the vertebrate with just a small wound size – only 1–2 cm per bone pillow or vertebrate. This procedure gently pushes through the tissue into the innermost layer of the bone disc to ensure that the tissue is only bruised to the minimum.
The operation uses a modern technology instrument called Flu X-ray (the real time x-ray), a fiber optic headlight (high powered lamp) and a very small surgical knife. The instrument helps reduce the incision size as well as the duration of the surgical procedure.
The benefits of MIS are:
- Less pain
- Less blood loss
- Shorter recovery time & hospital stay
This MIS technique may not be possible if the patient is overweight, or with thick or crooked waistline and backbone.
“Backache” Operation is our last choice Part 1
There are 12 methods to prevent the backache so that the patients do not have to have the back operation.
From a medical statistic, it shows that within one’s lifetime, there is at least one chance we will get a severe backache. If we ignore a simple back pain from the very beginning, there is a lot of chance that it becomes chronic pain that might no longer be curable by medications but through a back operation.
When the severe backache specific symptom occurs, the body becomes stiff; the back is so stiff that we cannot walk or stand up for a long time. As you turn your body or bend your back, you feel a streaking or a severe pain. The way you walk also appears to be stiff like a robot. Some might feel a darting pain down to the legs as if the muscle is being torn apart, followed by numbness at the thigh and calf.
Our backbone is like a sailboat. The strong muscles supporting the back are comparable to the strings on both sides of the sailboat’s pole. The cause of the backache generally is from the severe inflammation of these muscles. The muscles are called Paraspinal Muscles. They are the inner back muscles, supporting the backbone. They prevent the thrusting force done to the backbone disc. Some people neglect to take good care of this muscle that they become weak. When there is a force done at the back or some non-rhythmic movements like bending to lift a heavy object, hard coughing or sneezing, sudden jerking or turning of the body, there is a high chance of damaging and inflaming the muscle. Some incidents might be so severe that the backbone disc slips forward and out of place leading it to press on the nearby nerve. There is also a backache that is combined with nerve inflammation.
The backache, which is caused by the backbone nerve that comes down to the leg, is different from the muscle inflammation. The pain is not only at the back but is spread to the buttock, thigh or calf. The pain is only felt on one side and not on both sides. There also are two (2) kinds of numbness; one is the Hypersensitive Feeling similar to the numbness we get when we sit overlying the leg or the feeling of being pierced by the needle or the feeling of ants crawling on your skin. As time passes by, the pain appears to change and becomes a Hyposensitive Feeling – a low or abnormally decreased sensitivity to motion and sense of touch.
The sensation slowly gives a feeling that is likened to the thickening of the skin; an example of this is the absence of pain even when a needled is pierced onto the skin. The numbness of the skin will, however, be limited to some areas and not the whole leg; the numbness of the thigh might be just as the size of a lime at first then increases later on.
The weakness of the leg muscle will result in limping as you walk or the sagging of the knee or foot that causes you to trip on your foot tip and fall down. If you take a good look, you might see that the muscle is emaciated on one side (one side shrinks or gets smaller). When you get to this stage, it just means that the patient has had neglected the condition for a long time, making it chronic and with the pain spreading out.
The nerve cell had been damaged that the nerve impulse that helps stimulate or inhibit the action of the leg becomes less. The muscle could not squeeze, contract or move for quite some time, and the number of muscle fiber also decreases.
The final symptom is the loss of control of the automatic nerve system of the back i.e. could no longer withhold urination or defecation, and there is less sweating. At this stage, the chance to get back to normal is minimal which leave the patient with no other option but have an operation.
There are 12 methods and or 12 guidelines of practices to prevent backache from spreading out and damaging the back nerve. These 12 methods are collected from the data of patients who had chronic backache and were unable to do something about it. In my succeeding articles, I will tackle more about these methods, one by one, in order to make sure that operation comes as a last resort.
When Surgery is the Last Choice for Backache
According to medical findings, when patients first feel a splitting pain from their back, down to their leg it is due to their bone disc becoming dislocating and exerting added pressure on the nerve. Fortunately, it is possible to recover from this high level of discomfort by simply relaxing and lying down for 10-14 days. This pain usually comes about due to the increased amount of pressure that is exerted on the spinal nerve, as it is pressed by the bone disk or bone ‘spur’. For some patients, the only way to recover from this is by undergoing back surgery. This highlights the importance of following the advice of the doctor and addressing any particular issues early.
How Patients can avoid Back Surgery
There are several preemptive measures that a patient can take that can save them from requiring surgery. These can be equally as effective for a patient who is suffering moderate pain, to a patient who has numbness or muscle weakness, or even for a patient suffering from quite severe pain who is unable to walk. The basis of these finding is formed from the collation of data of previous observations, taken from patients with back pain who finally end up requiring back surgery. These findings showed that because of a patient’s own repeated incorrect behaviors, the pain was being stimulated and their symptoms were actually becoming more aggravated.
The Importance of Following Medical Advice
If a doctor’s advice is to, ‘stay put’, then it is recommended that you really should follow this guidance and do not do any kind of activity that can exert any pressure on the affected area. Nevertheless, young people today are prepared to work hard and perhaps, if they feel some discomfort, they may just continue working and refuse to stay home to recuperate, being more concerned with the standard of the job they are doing. However, in cases of severe backache, this historical way of thinking is dangerous and can result in huge consequences for an individual’s health.
As mentioned earlier, when patients first develop the injury where the bone disc is dislocated and presses on the nerve, they can relive themselves of most of the pain from the back down by relaxing and lying down for 5 to 14 days. They should also try not to move around as much. This will enhance the recovery process and ensure that the swollen spinal disc will subdue. If the symptoms do not increase then the chance to recover without the need for surgery is as high as 95%. However, if a patient does not follow professional advice, and the required time for rest and recuperation is not adhered to, then the dislocated disc will slip out further and further and the pain will intensify. Furthermore, the further the disc slips out, the less chance there is for a patient to recover without surgery. It is considered that there is approximately a 60% chance that an individual could have severe backache and not require surgery.
Some would argue that, unfortunately, people are overly concerned about their work and colleagues or are perhaps fearful that their employer will not take kindly to them requiring an absence, when really their only concern should be their own health and wellbeing and taking the correct precautions with their body.
Lying down to rest for the first 5 – 14 days after the injury can help save the patient from needing surgery up to 95% of the time. Therefore, these first few weeks should certainly not be thought of as ‘lost time’ as they will help prevent the need for surgery in the future. During this time, activities that will put added pressure on the spine such as sitting, standing and walking, should be avoided. On the contrary, if a patient does require surgery, the time required for recovery is usually at least one month, and can often be even longer. This highlights the importance of resting during the initial stages of the injury as, when compared to lying down, the continuous press of such activities on the slipped disc will result in there being less chance for it to recover back into place. Other effects could be that the pain does not subside satisfactorily and the area could become inflamed and swollen.
When surgery is required
After two weeks, the area around the dislocated disc could become swollen and further inflamed, leading to a more permanent pressing on the spinal nerve. If this occurs, the more intense the pressure is, the longer amount of time it can take for the blood veins to transport the nutrients to that area. Consequently, an ever-increasing amount of nerve cells will die and a patient’s symptoms will intensify. Such symptoms are: the enlargement of the area that is numb, weak legs, and an inability to lift their feet past a stair edge. In these cases, the doctor will have no choice other than to recommend curing the problem by administering surgery to take out the slipped disc.
Unfortunately, if the issue is not addressed at this point, then the prospect of a full recovery and for the nerve cell to fully recuperate is drastically reduced. Another point to mention is that this particular operation does also not guarantee that the nerve will come back to its previous fully functioning state. Therefore, to reiterate the point, if a doctor’s advice to a patient is to stay put, then they should stay put
Backache: When Surgery is the Last Choice
After a patient receives an x-ray, it is commonly discovered that their spine doesn’t look normal. Also, its appearance can appear to be crooked or slightly curved. A common concern is that this irregular spine is caused as a result of the long lasting backache they have had to endure over a prolonged period of time. As result of this, people will often seek the help of either a registered or unregistered chiropractor to receive chiropractic treatment. This usually involves the creation of traction in the back or the method of ‘back pulling’, believing that this is the best way to restore the back to its previous straight position. What many people perhaps don’t realise is that this treatment can cause many further issues during the recovery period and is not an effective way to treat a crooked spine.
It should not be assumed that backache is caused as a result of a crooked or out of shape spine. Many patients will visit a doctor due to their chronic back pain and, when taking the x-ray of the back, it might show that the spine is not normal or straight. The first point to be taken into consideration is that not all individuals have a perfectly straight spines. Normal variation dictates that, in fact, lots of people in all walks of life have a crooked spine but do not suffer from any symptoms of backache. The difference in some organs are not always due to a disease. For example, many people have uneven arms and legs, and it is very common not to have the same nose ridge height. Therefore, if it is not considered a disease then there is no need to waste time or money on the practice of back traction or back pulling. This is simply not the correct method to cure backache and it will not lead to recovery.
Secondly, some conditions can cause a temporary crooked spine, such as the inflammation of the waist muscle or inadequate rest. Another cause could be that the muscles of the two sides of the back are not of equal strength. If the treatment applied is accurate for the root cause these conditions can be corrected and the spine will return to be straight. The concept of traction and the pulling of the back is not an appropriate technique to restore the spine to a correct state. On the contrary, the pulling and traction of the spine will create a harmful harsh vibration on the spine and spinal disc and could lead to further problems.
If someone does suffer from a severe backache and is not aware whether it is because of a slipped spinal disc or another issue, they can observe the results of an x-ray. Often, after observing the results, they can become anxious and panic, believing that they have a crooked spine. Following this self-diagnosis they will often seek out chiropractic treatment, perhaps having seen it in a fashion magazine or general health book. Unfortunately, the consequences from this can be disastrous as the spinal disc can dislocated further or even be broken. If the disc is broken then the patient will feel an unbearable sharp pain from their back down to their legs. Surgery will be the only option and the patient will be in a very high level of discomfort.
From a medical point of view, back traction or pulling is considered an extreme and rather aggressive treatment. Therefore, if after an examination the cause of the backhache or leg pain cannot be confirmed then the supervising doctor will not give permission for such treatments. This is because there is high potential that the treatment will cause more damage, rather then alleviate the pain. It would be unhelpful to let the x-ray film showing a crooked back determine that a visit to the chiropractor is required to eliminate the pain. In fact it could just be that rest is required. In which case, the recommended 5-7 days’ rest will restore the patient’s back to its original straightness.
There is also another form of crooked spine, which requires a more advanced treatment. In this case, if the spine is not treated, it will become more and more crooked along with the growth. The issue here is that the points of spinal growth on both sides are not functioning equally, as sections of the spinal bone are not of equal length. Consequently, the spine tilts out from the perpendicular point of the body. This occurs most commonly during the rapid growth of teenagers, where the back is evidently crooked, along with them having contracted muscles. An x-ray taken of the side of the body will also show a crooked spine coupled with a prominent uneven curve scapula bone of the back. If a physician or doctor were to examine this by laying their hands on the back then the unevenness of the curved scapula would clearly be felt.
In order to observe whether a child’s back is permanently crooked, parents would need to examine the child from their back down to their feet. If the scapula bone curve can easily be recognised, then further investigation is necessary as it could represent symptoms of a permanent crooked back. In these cases then it is recommended to take the child to see the doctor as soon as possible in order to address the problem as if it is left until the time the child stops growing, unfortunately it could be too late.
Moreover, there is actually strong evidence, backed up by studies and research, to suggest that chiropractic treatment techniques are not the correct way to cure a permanently crooked back. However, surprisingly, many people still turn to this form of treatment. In addition to this, the advice often given to wear a back support is also ineffective when attempting to straighten the back. Therefore, it would appear to be an additional expense that is simply not necessary. Furthermore, it could also cause added anxiety for the child due to the fact they would have to wear a plastic brace to school each day.
Another important point to consider is that, according to medical research, a permanently crooked back is not the cause of a severe backache, it only gives a disproportional appearance and a shorter body. Those that have a crooked back and feel that their parents are responsible should reassess their thinking, as research shows that this is highly unlikely. It is much more advisable to find out the true cause of the problem and to correct it accordingly. When the right treatment is administered, in time the pain will disperse. As always, patients should not ignore the problem and allow it to develop as this could lead to increased complications and surgery would become unavoidable. It should be reiterated again – surgery is the last choice.
The Percutaneous Epidural Neuroplasty (PEN)
1. The newly designed tool is called PCM (Pain Control Manipulator). The handle is connected to a very small tube of 2 mm diameter and 30 cm lengths at the end of the tube embedding an even smaller tube used for injection. This small tube is gradually inserted into the space at the back of the lumbar on top of the coccyx, and then slides up into the connected epidural space of the spine at the waist up to the area where the scar tissue is.
The structure of our backs is very similar to that of a sailboat sailing across the sea with its sails fully extended. As we stand we are fighting the natural force of gravity.. We are able to stand due the vertebrae (spine) and strong muscles in our back in the same way that a sailboat can stand thanks to the strong supporting ropes on both sides.
For the majority of cases, a patient needs to undergo an x-ray in order to determine if they have suffered slipped vertebrae. So, logically, the prevention of slippage of the vertebrate is not easy unless we routinely x-ray all people. The issue needs to be further considered and explored.
You should seek the help and support of a doctor about your back if you have persistent back pain for more than 2 weeks or if you are suffering from leg or calf pain on the same side or same area. If you suffer from these or similar symptoms, you should seek the advice of a specialist doctor for diagnosis immediately.
The pictures show the patient before and after the back operation
Scoliosis is the bending of the spine or the spine is distorted to the side which can occur with all ages. Most often it happens to children Especially in children aged 10-15 years. In general, if the symptoms are mild, usually do not need treatment. If the spine is very crooked May cause back pain, waist, chronic neck pain Should consult a doctor or specialist for treatment or correcting the crooked spine properly.