Ozone local anaesthesia with strict real time radiological control, which ensures the proper placement of Ozone in the center of the disc making it shrink.
Low Sciatica and PIVD
Among working-age people, as many as 20 percent experience back symptoms at least every year. facet arthropathy, sciatica, muscle strain, sacroilitis, bulging or herniated discs and degenerative disc disease. Prolapsed intervertebral discs (PIVD) are the most common cause of low back pain associated with a defined structural Abnormality.
Patients who are not helped by weeks of conservative therapy are often referred for pain that has persisted beyond a four-week period should be referred to a multidisciplinary pain center.
Different Non Surgical Interventions Employed Successfully:
Epidural Steroid Inj.
Epidurogram & Epidurolysis.
Nerve root sleeve/ transforaminal Inj.
Intra-discal steroid inj.
Nucleoplasty- Thermal & Mechanical
Conventional treatment methods for back pain comprise lamminectomy/ discectomy microsurgery, endoscopic disectomy and percutaneous arthoscopic disectomy, among others. These are invasive methods and their goal is to remove or contain the protruding disc. However, these methods have occasionally demonstrated a discrete incidence of failure and/or recurrence. Outcome studies of lumber disc surgeries ranging from 4% to 15%, have been noted. "In case of surgery, the chance of recurrence of pain is nearly 15 percent as against less than three percent in Ozone treatment.</p> <p><strong>Reasons for the failures</strong> of conventional surgeries are:</p> <ol> <li> <p>Dural fibrosis</p> </li> <li> <p>Arachnoidal adhesions</p> </li> <li> <p>Muscels and fascial fibrosis</p> </li> <li> <p>Mechanical instability resulting from the partial removal of boney & ligamentous structures required for surgical exposure & decompression</p> </li> <li> <p>Presence of Neuropathy.</p> </li> <li> <p>Multifactorial etiologies of back & <a href=">leg pain, some left unaddressed surgically.
Understanding the need for Nano-Technology
The use of ozone revolution for treating disc diseases
Muto suggested an intradiscal injection of Ozone for a disc Ozone injection into the intervertebral disc. After that successful outcome has been reported from various European centers. It is very important to note from those reports that complications are remarkably few. Not a serious single life-threatening complication was found even after 120,000 cases of Ozone nucleolysis, which stresses the safety of these procedures.
The most critical portion of performing any of the minimally invasive procedures is the accuracy and safe positioning of the needle (or terminal device) in the centre of the disc space. The risk in ozonucleolysis is particularly minimised, with the use of a very thin 22/25-gauge needle. It may take anywhere from 5 to 30 minutes to position a needle in the centre of the disc space under radiological guidance. Once the needle is safely placed in position, ozonucleolysis is completed in only another 2 to 3 minutes.
How does water contained within the domain of proteoglycans. The water binding capacity of the proteoglycan molecule is partially a property of its size and physical shape, but the main force that holds water to the molecule stems from the ionic, carboxyl (COOH) and sulphate (SO4) radicals of the glycosaminoglycan chains. The ozone can have a direct effect on these carboxyl and sulphate groups, breaking down some of these glycosaminoglycan chains which make up the proteoglycans. The destruction of these cross-linked structures reduces their ability to hold water therefore diminishing the size of the herniation by collagen fibers and signs of regression (vacuole formation and fragmentation)- a sort of disk “<strong>mummification</strong>.”</p> soluble receptors able to neutralize proinflammatory cytokines like interleukin (IL)-1, IL-2, IL-8, IL-12, IL-15, <a href=">interferon, and tumor necrosis factor. Therefore, by reducing the inflammatory components there is a corresponding reduction in pain.
By stimulating fibroblasts & immunosuppressor cytokines
In fact, over 120,000 patients have been treated successfully worldwide using the injection of medical ozone with a success rate of 80-90% and with a near nil rate of procedure-related complications. “The procedure is a safe and effective alternative to open surgical procedure. Patients get the advantage of going home after a short recovery on the same day. They generally go to work within a week and are spared prolonged absence from work and disability,” The treatment relieves pain substantially and, after two sittings, people "can go back to work under medical guidance".
Comparison: 1. More hospital stay One day/day care 2. Complications of prolonged surgery& spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a daycare setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. The total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular in European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no post-operative discomfort or morbidity and low cost.
We all know that spine is one of the crucial parts of our body. The spine forming bones or vertebrae are protected by spongy and small discs. In healthy condition, these discs play the roles of shock absorbers for our spine and help to retain its flexibility. However, while a disc gets damaged, it might break open or bulge. This particular condition is known as ‘herniated disc’. This condition is also called ruptured or slipped disc. An individual can be suffering from the issue of the herniated disc in any of the part of his/her spine. However, most of the herniated discs influence the lumbar spine or lower back. Sometimes, it happens in cervical spine or neck and rarely this condition is seen in the thoracic spine or upper back.
A herniated disc might be sourced from the disc erosion. With age, the discs start drying out and they become unable to retain their flexibility. Another reason for which this problem can generate is spine injury. It might result in minute cracks or tears in the disc’s hard outer coating. While it occurs, the thick gel (from the internal part of the disc) might be forced out via the cracks or tears in the disc’s outer layer. As a result, the disc can become break open or bulge.
Whenever a herniated disc starts pressing the nerve roots, the affected person can feel pain, weakness, and numbness in the nerve traveling area of his/her body. When the herniated disc issue affects one’s lower back portion, it can generate numbness and pain in his/her buttock, as well as, down his/her leg and this condition is known as sciatica. It is the most prominent sign regarding a low back herniated disc. If a herniated disc does not provide pressure to the nerve, then the affected person might be suffering from a backache. Sometimes, there is no pain absolutely. Generally, a herniated disc heals automatically with the passage of time. The affected person should take patience and strictly follow the treatment plan provided by the doctor. In case, there is no change in the symptoms within the pre-specified period, then that person should consult the doctor about the appropriate surgery.
Endoscopic techniques for the purpose of diagnosis have been started since the late 1970s. Experts initiated the utilization of the popular techniques of endoscopic surgery in the 1990s, however, the particular technique is now used for the spine conditions’ treatment. In this procedure, pain and spine specialist make use of specialized instrumentation, as well as, video cameras and perform it through minute incisions. For alleviating interruption to one’s tissue and muscles, the surgeon receives access to the respective vertebrae through the placement of collections of tubes in the endoscopic spine surgery. The Endoscopic spine processes are usually executed in either 23-hour stay or an outpatient setting. The particular minimally invasive spine surgery is utilized for relieving pain sourced from pressing of herniated discs on nerve roots. In case you have a concern or query you can always consult an expert & get answers to your questions!
Also called as slipdisc pain or sciatica may affect your lumbar or cervical or throracic spine. But most common is l4 5and l5-s1 level or c5-6 level.
Most of painful condition of pertaining to your spine due to bulge, prolapse (protrusion), extrusion, sequestration. In with all condition nucleus pulposus come out from it originally site. Causing pressure over traversing or exiting nerve roots. Most of time patient getting treatment for of slipdisc or sciatica etc without any radiological evidence.
What causes pivd?
*unwanted prolonged exposure to sitting posture
*acute forward flexion
*unwanted weight lifting
*trauma or accident
*keep on exercise for chronic pain condition
What is symptoms?
Paresthesia, numbness, tingling sensation, burning sensation, spasms in thigh's and calf muscles, radiating pain upto knee or foot. Unable to sitting or standing for long hours, bowl or bladder incontinence, motor power affected
What are basic investigation?
X-rays only show alignment and fracture and displacement of vertebrae,
Mri scan shows all soft and hard structure of spine-all disc, nerve, ligaments, joint, vessel and muscles etc can be seen in perfect way
Emg, ncv, neurometry etc
There's two types of options for your spine pain, one is conservative treatment with bed rest, exercises and medicine. But upto certain duration 6week to 6month you can try with. If no red flag sign like loss of motor power. Or bowl bladder involvement should take opinion from surgeon.
Post procedure- follow up-
Regular physiotherapy and rehabilitation services is mandatory for strengthening of your spine.
Prognosis-success of procedure is 95%with all precautions and safety measures.
Spondylolisthesis refers to the condition which affects your spinal bones or lower vertebrae. Due to this condition one of the lower vertebrae overlaps the bone directly beneath it. Although a painful condition, it can certainly be treated with both surgical and therapeutic methods.
People with spondylolisthesis often find it difficult to perform routine activities. They usually encounter symptoms such as- persistent pain in the pelvic region, lower back; stiffness in the legs, hamstrings and hip muscles.
What causes spondylolisthesis?
The causes of spondylolisthesis can vary with lifestyle, heredity and age. Children may develop this condition due to an injury or birth defect. Nevertheless, people belonging to all age groups are susceptible to spondylolisthesis if the condition is genetic.
Over exercise or strenuous physical activities can cause spondylolisthesis because over stretching and carrying heavy weight or strain puts too much stress on the lower back.
Participating in sports like football, gymnastics, weightlifting are likely to trigger spondylolisthesis.
Spondylolisthesis can also be triggered due to sondylolysis. The vertebrae safeguard the spinal cord and work with tendons, ligaments, joints and muscles to provide flexibility, structure and support to the neck. Any sort of damage or wear and tear in the protective cartilage and bones in the neck can lead to cervical spondylosis, which in turn leads to spondylolisthesis.
What is the treatment for spondylolisthesis?
Treatment of spondylolisthesis depends on the severity of the pain. While non-surgical methods help ease the pain, a surgery is recommended when the bone has slipped to such an extent that your spine doesn’t respond to medications.
Non-surgical treatment includes the following-
Medical attention is crucial for countering symptoms of spondylolisthesis. Although this condition may not seem life-threatening, if left untreated, it can lead to chronic, persistent pain and permanent nerve damage.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Spinal surgery becomes inevitable when back pain cannot be managed with medications and/or exercise. This is a major decision and requires planning for many things before, during, and after the surgery.
Before a spinal surgery- This preparation will help in smooth recovery, especially if you do not have a full-time caretaker.
Discontinue pain killers: Discontinue pain killers at least 10 to 14 days before surgery. These are blood thinners and can prolong bleeding during the surgery.
Prepare for blood loss: Most people experience some blood loss, but not excessive.
Use a toilet seat raiser: Sitting and getting up from the toilet seat may be difficult. The seat raiser is used to increase the height, making this movement easy.
Enable easy access to common items: Before heading for the surgery, keep things which are commonly used within easy reach. This will help reduce movement and avoid searching (especially if someone else is going to be doing it).
Stock it up: Cooking may not be feasible during the initial postop period, and so it is advisable to stock up food items (ready to eats, fruits, soups, etc.) which will come in handy.
Slip-ons: Bending down and tying shoes may not be easy, so slip-ons can be used.
Caregiving: It is always advisable to have someone stay over with you during the initial postop days. They could help with regular household chores, cooking, etc.
Lifestyle changes: Ensure you eat well in the days before surgery, quit smoking, quit/use moderate amounts of alcohol, and exercise as advised by your surgeon.
After Surgery- Post surgery, there will be some pain and limitation of movement. It is important to understand that adherence to post-op instructions will improve the success rate of the surgery. Also, recovery time for spine surgery is slightly longer and affects overall quality of life, so psychological preparation is required.
Postoperative medications: These will be given to control infection and pain in the immediate postop period, and should be taken without fail
Rehab: The surgeon will recommend physical therapy and rehab exercises which need to be followed. Complete recovery may take anywhere between 3 to 12 months. During this time, care should be taken to avoid repeat injury.
Support: Adequate back support should be provided using lumbar support and ergonomic chairs, and the right posture should be maintained. Ensure there is no undue strain on the back muscles.
Weight management: With excess weight, there is too much strain on the lower disks. Therefore, weight should be managed to reduce this strain.
Smoking and alcohol should be completely stopped, as healing can be hampered.
With some preparation, spinal surgery can be sailed through smoothly. Consult an Expert & get answers to your questions!
Arachnoiditis of the spinal cord is a non specific inflammatory disease of the arachonoid membrane which is characterized pathologically by thickening of the arachnoid membrane with adhesion or adherence to the dura matter and manifested clinically through roots or radiclar signs and symptoms.
Arachnoiditis is usually seen in 40 to 60 years of age but rarely below 20years.
Paresthesia: this also takes place due to irritation of the sensory nerve roots.
Sensory loss: this occurs when the sensory nerve roots get completely blocked.
Muscle weakness with atrophy: although the anatomy of the motor nerve roots make them less prone to get compressed, it can happen in the later stage which will then give rise to weakness and wasting of the corresponding muscles.
The medical management usually consists of corticosteroids in acute stage of inflammation. NSAID for pain relief and inflammation.
Surgical management consists of Rhizotomy in cases of unbearable pain.Surgical decompression for removal of cyst.
PHYSIOTHERAPY MANAGEMENT comprises of
Moist heat mainly for reducing the muscle spasm.
SSF also relieves pain by reducing spasm and by increasing the blood supply to the area. In case of radiating pain due to involvement of nerve roots the patient may be treated with TENS. Even in cases of paresthesia TENS is usually used.
Laser has been found to reduce the inflammation and also break the adhesion in the deep seated structures which helps in setting free the irritation on the nerve roots thereby relieving the discomforts of the patient.
Active exercises like static exercises for the abdominus, back extensor, gluteus and quadriceps helps in reducing pain in the initial stages and also maintains the tone in the muscles.
Dynamic exercises may be started once the pain level comes within the patient’s tolerance level. These exercises may be continued by the patient throughout the life for preventing any chances of recurrence.
SLR: Active and passive SLR is given to lengthen the neural structures and relieve the tension in them. This is a type of neural mobilization that helps in relieving the signs of radiculopathy.
Gait training in cases of muscular weakness.
The spinal cord is like a cable consisting of millions of nerves that transmit messages in the form of electrochemical signals from the brain to the rest of the body, and also sensations from the body back to the brain. We are able to perceive pain and move our limbs because of messages sent through the spinal cord.
The spinal cord is soft and vulnerable to injury. It is protected by the bony structure of the vertebral column. A spinal cord injury can happen if there is a fracture of the spine. Sometimes, even if the vertebral column is intact, violent shaking can cause cord contusions. It’s an extremely serious type of injury that is likely to have a lasting and significant impact on most aspects of daily life.
If the spinal cord sustains an injury, some or all of these impulses may get blocked. The result is a loss of sensation and mobility below the level of injury. A spinal cord injury closer to the neck will typically cause paralysis throughout the body, while one in the lower back may affect the legs but spare the hands.
A spinal cord injury is often the result of violent trauma. Events like spontaneous hemorrhage, infection, tumors or autoimmune diseases can also cause spinal cord damage. Some causes of traumatic injury to the spinal cord are :
Some symptoms of a spinal cord injury include:
If there is the slightest suspicion that someone has a back or neck injury:
Because spinal cord injuries are often due to unpredictable events, the best you can do is reduce your risk. Some risk-reducing measures include:
Seek the opinion of a Neurosurgeon or an Orthopedic spine surgeon as soon as possible. X-rays, CT scan or MRI scans may be advised for assessing bony or soft tissue injuries of spine. Minor injuries require only immobilization and rest. Severe injuries, however, may require steroid injections and surgical intervention. Time is of essence, and an early surgery in certain situations may save a limb that would otherwise be paralyzed for life.
The medical term ‘spina bifida’ or spinal bifida refers to a congenital defect in the spine. In simpler terms, spina bifida is a defect in the neural tube. Based on the severity of this disease, spina bifida can be divided into three different types:
The symptoms of spina bifida vary depending on each of these three types. Let's take a closer look at its symptoms here:
Myelomeningocele is the most severe form of spina bifida. In this type of neural defect, spinal canal of the baby remains open in the middle or lower back along a few vertebrae. Due to this opening, a sac is formed at the back of the baby at birth, which exposes the baby to several life-threatening infections.
Some of the common symptoms of this type of spina bifida are:
Physical deformities from moderate to severe levels are also very common in this type of spina bifida.
Meningocele is a ratherrare form of spinal bifida in which a sack of fluid stays in open at the back of the baby. Here the protective membranes that usually stay around the spinal cord push out through the vertebrae’s opening. Though this sack contains no part of the spinal cord, it may cause minor disabilities.
Some common symptoms of this kind of spina bifida are:
Spina bifida occulta is the mildest form of spina bifida, which, in majority of the cases, often stays hidden as its symptoms are rarely visible. As it doesn’t even cause any form of disabilities, it generally goes unnoticed. It doesn’t cause any damages to the nerves or the spinal cord.
Some common symptoms of occulta are:
In this kind of spina bifida, neither any sack of fluid is formed, nor are there any visible opening in the back. Sometimes, people who have spina bifida are not aware of it due to its minimal symptoms.
Spina bifida usually affects a child before birth, when the brain or the cord or the protective covering over them fails to develop completely. Knowing about the symptoms can be one of the best ways to identify and diagnose this disease and opt for proper treatment solutions. If you wish to discuss about any specific problem, you can consult a Neurosurgeon.
What is Spinal Stenosis: The narrowing of the gaps in the spine or the backbone is called as Spinal stenosis. This leads to pressure on the nerves and the spinal cord. 5% of cases of spinal stenosis are seen in the low back of the lumbar spine. In some cases the narrowing of the spine leads to the compressing of the nerve root, which leads to pain in the leg.
Causes of spinal stenosis: It can be caused by aging, arthritis, trauma to the spine, spondylolisthesis and tumor of the spine
Symptoms of spinal stenosis: There is constant pain in the back and legs as stenosis pinches the nerve responsible for sensation and muscle power. Other symptoms are numbness and tingling in the legs, frequent falling and pain while walking.
Treatment of spinal stenosis:
- A routine program with exercises and physical therapy are the best treatment for spinal stenosis. The exercises are not a complete cure but they are beneficial in keeping the patient active. A physical therapy can be supervised and once the period of the same is over people easily transition to the exercise program. The key for exercise is starting slowly in order to build strength.
- Generally, the patients are counseled not to perform strenuous activities as that might worsen the symptoms of spinal stenosis. In case of lumbar stenosis, patients find it comfortable when they are flexed forward. The doctor might recommend walking while being bent over and leaning when using a walker if not walking upright; sitting in recliners is also recommended instead of straight back chairs.
- Injections of cortisone are usually given in the epidural space. This is believed to relieve the symptoms of spinal stenosis temporarily. Though there have been studies which question the use of these injections as they lead to the risk of osteoporosis related fractures. This is still being pondered over by the doctors as a suitable treatment option as it has its own benefits and risks.
- Medications such as the antiinflammatory medicines like ibuprofen or aspirin are helpful in controlling the symptoms of spinal stenosis. Narcotic drugs might also prove to be helpful if used with care and for a short while. This is helpful for severe pain related to the nerves. Muscle relaxants like gabapentins might also be recommended. In some case anti depressants might also be given to provide relief from pain.
Though side effects are a concern when using these medications and the patient should let the doctor knows about their allergies.
In case you have a concern or query you can always consult an expert & get answers to your questions!