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Lumbar Dorsal Fixation Tips

Lumbar Microdiscectomy

Dr. Pramod Saini 88% (10 ratings)
MBBS, MS - Orthopaedics, FNB Spine surgery, Fellowship In Spine Surgery (AO Spine)
Orthopedist, Noida
Lumbar Microdiscectomy

 A lumbar microdiscectomy is performed to relieve pressure on nerve roots caused by a severe herniated disc in the lumbar spine that causes sciatica like pain. The lumbar spine is the lower area consisting of the bottom five vertebrae. A herniated disc may cause lower back pain and pain or numbness in the legs and feet. Surgery may be needed if symptoms include severe leg pain, weakness or numbness in the extremities and impaired bowel or bladder function. A lumbar microdiscectomy is a minimally invasive procedure. A microscope is used to view the area through a small incision aroud 2 c.m long in the lower back to view the pinched nerve. Surgical instruments are then inserted through the incision to remove only the portion of the disc that is applying pressure on it, as well as any disc fragments that may have broken off. Patient is made to sit stand and walk from very next day and is discharged Next day. Stiches, in selected cases, can be can be self dissolving subcuticular which does not require removal. Patient can join back their desk job in 2 weeks.

7 people found this helpful

Know Your Back or Lumbar Spine

Dr. Vishwas Virmani 91% (22895 ratings)
MPT, BPT
Physiotherapist, Noida
Know Your Back or Lumbar Spine

If we look at the human backbone or spine , we can see that the  vertebrae rest upon one another similarly to a stack of cotton spools .

The spine is divided into regions. There are seven vertebrae in the cervical region (neck), twelve vertebrae in the thoracic region (upper back), and five vertebrae in the lumbar region (lower back) ..

Beneath the lumbar vertebrae are found the sacrum and the coccyx. It is the lower back or lumbar and sacral regions that concern us most.

Each vertebra has a solid part in front, the vertebral body, and a hole in the back .When lined up as in the spinal column, these holes form the spinal canal. This canal serves as a protected passageway for the bundle of nerves which extends from head to pelvis-the spinal .Special cartilages, called the discs, separate the vertebrae. The discs are located between the vertebral bodies just in front of the spinal cord . Each disc consists of a soft semi-fluid centre part, the nucleus, which is surrounded and held together by a cartilage ring, the annulus or annular ligament.  The discs are similar to rubber washers and act as shock absorbers.  

The are able to alter their shape, thus allowing movement of one vertebra on another and of the back as a whole.The vertebrae and discs are linked by a series of joints to form the lumbar spine or low back. Each joint is held together by its surrounding soft tissues-that is, a capsule reinforced by ligaments. Ligaments can be likened to the stays that hold a mast in place on a sailing ship. If a stay were to give way, the mast will likely fall when subjected to extra strains.

Muscles lie over one or more joints of the low back and may extend upward to the trunk and downward to the pelvis. At both ends each muscle changes into a tendon by which it attaches itself to different bones. 

When a muscle contracts, it causes movement in one or more joints.Between each two vertebrae there is a small opening on either side through which a nerve leaves the spinal canal, the right and left spinal nerve . Amongst other tasks, the spinal nerves supply our muscles with power and our skin with sensation. In other words, it is through the nerves that we can move ourselves and feel temperature, pressure and pain. The nerves are really part of our alarm system: pain is the warning that some structure is about to be damaged or has already sustained some damage.In the lower part of the spine some of these nerves combine on each side to form the right and left sciatic nerves. The sciatic nerves service our legs, and when compressed or irritated, they may cause pain in the leg which often extends below the knee. This is then called sciatica.

Functions of the lumbar spine:

In animals that walk on all fours, the weight of their body is distributed evenly by DISC their four legs. Most of the time the spine is held in aIl more or less horizontal position and the compressive forces that exist in upright man do not occur.

In human beings, the spine is held in a more or vertical position, at least during waking and working hours. When we are upright, , lumbar spine bears the compressive weight of the body above it transmits this weight to the pelvis when sitting and to the feet when  standing, walking and running. Thus the lumbar spine, providing  flexible connection between the upper and lower half of the body protects the spinal cord and also has a greater function in weight  bearing. In the evolution of the horizontal-spine posture of animals to the vertical-spine posture of man, the discs between the vertebrae have adapted to support heavier weights. In addition, the  spinal column has developed a series of curves that ingeniously allow for better shock absorption and flexibility.

3 people found this helpful

How To Treat Sciatica And Lumbar Pain?

Dr. Punnam Gupta 88% (174 ratings)
BPTh/BPT; certificate in sports medicine, PGCR, Diploma in Sports Medicine
Physiotherapist, Delhi
How To Treat Sciatica And Lumbar Pain?

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1 person found this helpful

Know Your Back or Lumbar Spine

Dr. Vishwas Virmani 91% (22895 ratings)
MPT, BPT
Physiotherapist, Noida
Know Your Back or Lumbar Spine

If we look at the human backbone or spine , we can see that the  vertebrae rest upon one another similarly to a stack of cotton spools .

 The spine is divided into regions. There are seven vertebrae in the cervical region (neck), twelve vertebrae in the thoracic region (upper back), and five vertebrae in the lumbar region (lower back) ..

Beneath the lumbar vertebrae are found the sacrum and the coccyx. It is the lower back or lumbar and sacral regions that concern us most.

Each vertebra has a solid part in front, the vertebral body, and a hole in the back .When lined up as in the spinal column, these holes form the spinal canal. This canal serves as a protected passageway for the bundle of nerves which extends from head to pelvis-the spinal .Special cartilages, called the discs, separate the vertebrae. The discs are located between the vertebral bodies just in front of the spinal cord . Each disc consists of a soft semi-fluid centre part, the nucleus, which is surrounded and held together by a cartilage ring, the annulus or annular ligament.  The discs are similar to rubber washers and act as shock absorbers.  

The are able to alter their shape, thus allowing movement of one vertebra on another and of the back as a whole.The vertebrae and discs are linked by a series of joints to form the lumbar spine or low back. Each joint is held together by its surrounding soft tissues-that is, a capsule reinforced by ligaments.Ligaments can be likened to the stays that hold a mast in place on a sailing ship. If a stay were to give way, the mast will likely fall when subjected to extra strains.

Muscles lie over one or more joints of the low back and may extend upward to the trunk and downward to the pelvis. At both ends each muscle changes into a tendon by which it attaches itself to different bones. 

When a muscle contracts, it causes movement in one or more joints.Between each two vertebrae there is a small opening on either side through which a nerve leaves the spinal canal, the right and left spinal nerve . Amongst other tasks, the spinal nerves supply our muscles with power and our skin with sensation. In other words, it is through the nerves that we can move ourselves and feel temperature, pressure and pain. The nerves are really part of our alarm system: pain is the warning that some structure is about to be damaged or has already sustained some damage.In the lower part of the spine some of these nerves combine on each side to form the right and left sciatic nerves. The sciatic nerves service our legs, and when compressed or irritated, they may cause pain in the leg which often extends below the knee. This is then called sciatica.

FUNCTIONS OF THE LUMBAR SPINE

In animals that walk on all fours, the weight of their body is distributed evenly by DISC their four legs. Most of the time the spine is held in aIl more or less horizontal position and the compressive forces that exist in upright man do not occur.

In human beings, the spine is held in a more or vertical position, at least during waking and working hours. When we are upright, , lumbar spine bears the compressive weight of the body above it transmits this weight to the pelvis when sitting and to the feet when  standing, walking and running. Thus the lumbar spine, providing  flexible connection between the upper and lower half of the body protects the spinal cord and also has a greater function in weight  bearing. In the evolution of the horizontal-spine posture of animals to the vertical-spine posture of man, the discs between the vertebrae have adapted to support heavier weights. In addition, the  spinal column has developed a series of curves that ingeniously allow for better shock absorption and flexibility.

1 person found this helpful

Reasons Behind The Lumbar Disk Pain

Dr. Shyam Bhairi 90% (61 ratings)
MBBS Bachelor of Medicine and Bachelor of Surgery
Orthopedist, Hubli-Dharwad
Reasons Behind The Lumbar Disk Pain

There are many structures in the lumbar spine that can cause pain. Any kind of trouble to the nerves and veins that goes through the spine, joint issues, the disks themselves, the bones and the muscles - would all be able to act as a cause behind the pain.

Numerous lumbar spine conditions are interrelated. For instance, an unstable joint can lead to disk degeneration, which can put weight on the nerve roots and cause the disk to collapse at times. The following are the main reasons behind the lumbar disk pain:

  1. Problems in the muscles: The biggest reason behind lumbar disk pain is muscle strain or other muscle issues. Strain because of truly difficult work, twisting, or different activities that can put pressure on your spine like heavy lifting, cause the disk to rupture or slip at times.
  2. Disk degeneration: Intervertebral disks are pads that are spongy and act as shock absorbers. This can cause pain in your disk. This condition can be referred to with many names, however, is famously known as degenerative disk disease.
  3. Lumbar Disk Herniation: Herniated disks are most common reasons behind the lumbar disk pain. A herniated disk may be caused all of a sudden because of damage to the spine or truly difficult work or happen gradually as a form of general wear and tear in the spine. Leg pain (sciatica) is the most widely recognized symptom of a herniated disk.
  4. Sacroiliac Joint Dysfunction: The sacroiliac joint, which attaches to the base of the lumbar spine and the tip of the tailbone, can cause lumbar disk pain or even sciatic pain if there is any kind of fracture in the joint that allows for movement or rather, limits any particular movement.
  5. Spondylolisthesis: Spondylolisthesis happens when one vertebra slips behind the other or underneath it. The slip most normally happens in the lower lumbar vertebrae (e.g. L4 –L5 or L5 – S1). In case that the slipped vertebra presses the nerve root at that point, it can bring about shooting leg pain and gradually foot pain as well.

There are certain ways in which this problem can be treated to a certain extent. These methods are as follows:

  1. Common medications: Muscle relaxants. This solution works as an anti-depressant of the nervous system and expands as well as relaxes the tense muscles, easing pain from muscle stiffness or fits
  2. Back supports: A few patients find that a back support can be used to bring comfort and gradually diminish the pain. There is some proof that using a brace every day, can speed up the healing process and lessen the pain. A back support may likewise be useful after back surgery.
  3. Back Braces: Epidural steroid infusion. This infusion includes a steroid inserted specifically into the external piece of the dural sac, which surrounds the spinal chord. An x-ray, called fluoroscopy, is utilized to control the needle in the right area. The objective of the infusion is to soothe the pain by decreasing irritation around a compressed nerve root.

All About Lumbar Disc Pain!

Dr. Himanshu Gupta 89% (54 ratings)
Fellow Adult Knee Reconstruction and Sports Injuries, Fellowship in Interventional Pain Practice, MS - Orthopaedics, MBBS
Orthopedist, Gurgaon
All About Lumbar Disc Pain!

There are many structures in the lumbar spine that can cause pain. Any kind of trouble to the nerves and veins that goes through the spine, joint issues, the disks themselves, the bones and the muscles - would all be able to act as a cause behind the pain.

Numerous lumbar spine conditions are interrelated. For instance, an unstable joint can lead to disk degeneration, which can put weight on the nerve roots and cause the disk to collapse at times. The following are the main reasons behind the lumbar disk pain:

  1. Problems in the muscles: The biggest reason behind lumbar disk pain is muscle strain or other muscle issues. Strain because of truly difficult work, twisting, or different activities that can put pressure on your spine like heavy lifting, cause the disk to rupture or slip at times.
  2. Disk degeneration: Intervertebral disks are pads that are spongy and act as shock absorbers. This can cause pain in your disk. This condition can be referred to with many names, however, is famously known as degenerative disk disease.
  3. Lumbar Disk Herniation: Herniated disks are most common reasons behind the lumbar disk pain. A herniated disk may be caused all of a sudden because of damage to the spine or truly difficult work or happen gradually as a form of general wear and tear in the spine. Leg pain (sciatica) is the most widely recognized symptom of a herniated disk.
  4. Sacroiliac Joint Dysfunction: The sacroiliac joint, which attaches to the base of the lumbar spine and the tip of the tailbone, can cause lumbar disk pain or even sciatic pain if there is any kind of fracture in the joint that allows for movement or rather, limits any particular movement.
  5. Spondylolisthesis: Spondylolisthesis happens when one vertebra slips behind the other or underneath it. The slip most normally happens in the lower lumbar vertebrae (e.g. L4 –L5 or L5 – S1). In case that the slipped vertebra presses the nerve root at that point, it can bring about shooting leg pain and gradually foot pain as well.

There are certain ways in which this problem can be treated to a certain extent. These methods are as follows:

  1. Common medications: Muscle relaxants. This solution works as an anti-depressant of the nervous system and expands as well as relaxes the tense muscles, easing pain from muscle stiffness or fits
  2. Back supports: A few patients find that a back support can be used to bring comfort and gradually diminish the pain. There is some proof that using a brace every day, can speed up the healing process and lessen the pain. A back support may likewise be useful after back surgery.
  3. Back Braces: Epidural steroid infusion. This infusion includes a steroid inserted specifically into the external piece of the dural sac, which surrounds the spinal chord. An x-ray, called fluoroscopy, is utilized to control the needle in the right area. The objective of the infusion is to soothe the pain by decreasing irritation around a compressed nerve root.
2402 people found this helpful

6 Causes Of Lumbar Disc Pain!

Dr. Rahul Nerlikar 85% (10 ratings)
MS - Orthopaedics, M.Ch - Orthopaedics, FRCS, MBBS
Orthopedist, Pune
6 Causes Of Lumbar Disc Pain!

There are many structures in the lumbar spine that can cause pain. Any kind of trouble to the nerves and veins that goes through the spine, joint issues, the disks themselves, the bones and the muscles - would all be able to act as a cause behind the pain.

Numerous lumbar spine conditions are interrelated. For instance, an unstable joint can lead to disk degeneration, which can put weight on the nerve roots and cause the disk to collapse at times. The following are the main reasons behind the lumbar disk pain:

  1. Problems in the muscles: The biggest reason behind lumbar disk pain is muscle strain or other muscle issues. Strain because of truly difficult work, twisting, or different activities that can put pressure on your spine like heavy lifting, cause the disk to rupture or slip at times.
  2. Disk degeneration: Intervertebral disks are pads that are spongy and act as shock absorbers. This can cause pain in your disk. This condition can be referred to with many names, however, is famously known as degenerative disk disease.
  3. Lumbar Disk Herniation: Herniated disks are most common reasons behind the lumbar disk pain. A herniated disk may be caused all of a sudden because of damage to the spine or truly difficult work or happen gradually as a form of general wear and tear in the spine. Leg pain (sciatica) is the most widely recognized symptom of a herniated disk.
  4. Sacroiliac Joint Dysfunction: The sacroiliac joint, which attaches to the base of the lumbar spine and the tip of the tailbone, can cause lumbar disk pain or even sciatic pain if there is any kind of fracture in the joint that allows for movement or rather, limits any particular movement.
  5. Spondylolisthesis: Spondylolisthesis happens when one vertebra slips behind the other or underneath it. The slip most normally happens in the lower lumbar vertebrae (e.g. L4 –L5 or L5 – S1). In case that the slipped vertebra presses the nerve root at that point, it can bring about shooting leg pain and gradually foot pain as well.

There are certain ways in which this problem can be treated to a certain extent. These methods are as follows:

  1. Common medications: Muscle relaxants. This solution works as an anti-depressant of the nervous system and expands as well as relaxes the tense muscles, easing pain from muscle stiffness or fits
  2. Back supports: A few patients find that a back support can be used to bring comfort and gradually diminish the pain. There is some proof that using a brace every day, can speed up the healing process and lessen the pain. A back support may likewise be useful after back surgery.
  3. Back Braces: Epidural steroid infusion. This infusion includes a steroid inserted specifically into the external piece of the dural sac, which surrounds the spinal chord. An x-ray, called fluoroscopy, is utilized to control the needle in the right area. The objective of the infusion is to soothe the pain by decreasing irritation around a compressed nerve root.
2521 people found this helpful

The Lumbar Roll: Remedy for Back Pain

Dr. Vishwas Virmani 91% (22895 ratings)
MPT, BPT
Physiotherapist, Noida
The Lumbar Roll: Remedy for Back Pain

The Lumbar Roll

  • As few seats of chairs provide adequate support for the lower back, a portable lumbar roll is essential equipment for people with ongoing back problems. When sitting on a seat with a backrest(supported sitting), a lumbar roll will facilitate the maintenance of a correct lordosis and posture.A lumbar roll is a support specially designed for the low back.
  • Without this support,the low back will slouch when ever you are distracted or cease to concentrate on anything other than holding the lordosis actively with your own muscles-for example, when talking, reading, writing, watching television or driving your car. To counteract this slouching you must place a lumbar roll in the small of your back at the level of your belt line whenever you sit in an easy chair ,car or office chair.
  • The lumbar roll should be no more than 4 to 5 inches in diameter before being compressed and should be moderately filled with foam so that under compression its diameter reduces to about 1.5 inches. A cushion does not serve the same purpose as it has the wrong shape and does not provide adequate pressure at the precise level of the low back. A regular cushion should not be relied upon for long-term... use but may be of some assistance in an emergency.
  • The aim is  first to restore the correct posture and then to maintain it. It may take up to a week of practice to master this fully. As a rule, pain of postural origin will decrease as your sitting posture improves, and you will have no pain once you maintain the correct posture. The pain will readily recur in the first few weeks should you allow yourself to slouch while sitting. 
  • Eventually you will remain completely pain free even when you forget your posture; however, never again should you allow yourself to sit slouched for long periods.When first starting these procedures to correct your sitting posture, you will experience some new pains. These are different from your original pain and may be felt in other places. 
  • New pains are the result of performing new exercises and maintaining new positions; they should be expected and will wear off in a few days,provided postural correction is continued on a regular basis. Once you have become used to sitting correctly you will enjoy it and will soon notice the reduction or absence of pain and the improved comfort. From then on you will automatically choose chairs that allow you to sit correctly.
  • Regular Interruption of Prolonged Sitting

Travelling for long distances by bus, car or airplane, especially when sitting in a cramped seat and without regular breaks which permit you to restore the lordosis, may cause a gradual and progressive attack of low back pain or may aggravate existing problems. Nearly everyone will be aware of some stiffness or discomfort in the low back after an uninterrupted car ride of a few hours. If you already have back problems, such a journey may be a risk situation for you. If you are the driver yourself, the risk is even greater.In order to minimise the risks of prolonged sitting, it is necessary that you interrupt sitting at regular intervals and before pain starts.For example, when undertaking long car journeys, you should stop the car every hour, get out and bend backward five or six times and walk about for a few minutes. This will reduce the pressure within the discs and relieve the stresses on the surrounding tissues. As airlines continue to provide seating calculated to damage the human spine, you should, when flying long distances, regularly stand and walk up and down the aisle of the plane. This is not only important for the sake of your back but is also necessary to assist in the stimulation of the circulation in the legs. These are simple measures you can take that will significantly reduce the risk of another episode of back pain.

Maintaining a Safe Lumbar Arch in Back Pain!

Dr. Vishwas Virmani 91% (22895 ratings)
MPT, BPT
Physiotherapist, Noida
Maintaining a Safe Lumbar Arch in Back Pain!

Maintaining a Safe Lumbar Arch

  • When swabbing, hold the mop close to your body, and avoid bending at the waist. Stiffen your core and move your pelvis and ribs together. Do not rotate by twisting the spine.
  • Using props, armrests, and desks for reading can help to minimize bending while sitting.
  • Sitting in a flexed posture places increased pressure on the lumbar disc..Chiropractic Management

Balancing Loads-

  • Minimize and balance your loads. Even if you maintain an ideal posture and lift correctly, the weight you lift may contribute to the pressure within the disc and cause further herniation of a disc. If you do not need to lift during the healing period of your disc injury, do not lift.
  • How to stand up from sitting position-
  • When rising from a seated position, avoid curling your spine forward. Rising in this manner can cause continual re-injury to the discs throughout the day.
  • The preferred way to rise is to maintain a normal curve in your lower back, keep your chest out, and brace your abdominal muscles. Scoot to the edge of the chair so that your legs are under you and do most of the lifting. This one ADL (Activity of Daily Living) modification has been accountable for the reduction of symptoms in many chronic disc herniations.
2 people found this helpful

Microdiscectomy For Lumbar Disc Disease And Sciatica

Dr. Namit Singhal 90% (26 ratings)
MCH Neuro Surgery, MBBS Bachelor of Medicine and Bachelor of Surgery, MS - General Surgery
Neurosurgeon, Agra
Microdiscectomy For Lumbar Disc Disease And Sciatica

Microdiscectomy for symptomatic lumbar disc in young patients who have failed nonoperative treatment has a high success rate based on outcome measures, patient satisfaction, and return to active duty. Patients with sequestered or extruded lumbar disc herniations had significantly better outcomes than did those contained herniations. Patients with contained disc herniations and smoking have less satisfaction rates.

1 person found this helpful
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