Spinal Health - Herniated Or Ruptured Disk

spinal stenosis

Discs are positioned between each vertebra bone in your spine. A disc is made up of two parts: the outer ring is called the annulus; the inner part is called the nucleus. The annulus is hard and fibrous, while the inner nucleus is made up of soft gelatinous material. These discs allow for easy mobility of the backbone as we move and bend, and act as cushions between the vertebral column.

The effects of frequent excessive pressure on your back can cause the discs in your spinal column to rupture or be herniated. Ordinary aging will decrease the height and the softness of the disc, so they will become less effective as shock absorbers. A ruptured or herniated disc happens when pressure causes the nucleus to push against the annulus to the degree that the annulus rips. The majority of herniated discs will rupture toward the spine, causing pain, pressure and irritation on the nerves.

If the rupture is bad enough to cause irritation, you will often times have pain shooting down the leg, following the course of the nerve. You may also experience numbness, weakness or tingling in the leg. More severe cases can involve pain in both legs and loss of bladder or bowel control. If those symptoms occur, a doctor should treat the problem immediately.

Most of the time, a ruptured or herniated disc can get better without surgery. Over-the-counter anti-inflammatory drugs (also known as NSAIDS) such as Advil or Aleve can relieve the pressure and alleviate the pain after a few days. If, after a few days, the NSAID is not mitigating the pain, the next step may be prescription medicine such as higher strength NSAIDS, pain medication, steroids or muscle relaxers.

If the stronger medication is also not effective, you'll need further testing in the form of a MRI or CT scan. The results of these tests can establish if you will need an epidural injection of Cortisone. The injection is into your back, around the root of the nerve being pinched.

If none of these treatments help, a microdiscectomy may be needed. A microdiscectomy is a surgical procedure that is done trough a small incision. Using magnification and special instruments, the surgeon can remove the portion of the disc that is ruptured and causing discomfort. A microdiscectomy is less invasive than a traditional lumbar laminectomy, usually being performed with epidural anesthesia so the patient can stay awake during the procedure. The likelihood of vomiting or nausea after a microdiscectomy is decreased, and patients can usually go home a few hours after surgery.

After your symptoms subside, start an exercise or walking program to rehabilitate and strengthen your back to significantly reduce the chances of a slipped disc or pinched nerve from happening again. If you are overweight, losing the extra pounds can remove the excess pressure on your back. Practice safe lifting techniques with proper back mechanics when moving heavy objects.

Spinal Stenosis - Finally a Non-Surgical Solution

spinal stenosis

What is Stenosis?

Spinal Stenosis is a medical condition in which the spinal canal narrows and compresses the spinal cord and/or exiting nerve roots. Stenosis is from the Greek word meaning "a narrowing". Central canal stenosis is a narrowing of the channel in the center of each vertebra through which passes the spinal cord on its way down the spine. Foraminal stenosis is a narrowing of the channel on either side of the vertebra where the spinal nerve roots exit on their way to various parts of the body such as down the arms or legs. The vertebral foramen is a small opening or hole for the exiting spinal nerve root that is formed where the downward notch in the bone of a vertebra meets the upward notch of the vertebra below it. Spinal stenosis may affect the cervical, thoracic or lumbar spine. Lumbar spinal stenosis results in low back pain and can radiate down the nerves into the buttocks, hips, thighs, legs, or feet. Cervical spinal stenosis results in neck pain and can radiate down the nerves into the shoulders, arms, wrists, and hands.

What Causes it?

Although it is true that some individuals congenitally have larger or smaller canals than do others, the cause of the narrowing is usually a combination of 3 different degenerative factors present in varying degrees in different patients. First, when a disc herniates the bulge takes up space narrowing the nerve channel. Second, as the involved disc dries out and loses height (a process known as desiccation) it causes the vertebra to become closer together further narrowing the nerve channel. Third, as the stress on the joint compounds and osteoarthritis begins to result, bone spurs (osteophytes) form and ligaments thicken (hypertrophy) gradually narrowing the channel even further. These 3 factors in various combinations and degrees of severity compromise the space in the channel and conspire to compress (pinch) the spinal cord or nerve root. These 3 factors may also be referred to as Degenerative Disc Disease, the most common cause of spinal stenosis.

Spondylolisthesis and scar tissue formation as a result of prior surgical fusion are other factors that can contribute to spinal stenosis. Spondylolisthesis describes the anterior displacement of a vertebra or the vertebral column in relation to the vertebra below. Also, rarely, various bone diseases such as Paget's Disease or tumors in the spine are responsible for the narrowing. An MRI can rule in or rule out a wide range of possibilities rare though they may be.

A Non-surgical Solution

Spinal Decompression Therapy, first approved by the FDA in 2001, has since evolved into a cost-effective treatment for herniated and degenerative spinal discs, and the resultant spinal stenosis; one of the major causes of back pain and neck pain. It works on the affected spinal segment by significantly reducing intradiscal pressures. The vacuum thus created retracts the extruded disc material allowing more room for the pinched nerve, and will many times additionally increase the spacing between the vertebra as the involved discs are rehydrated, allowing even more room for the nerve. Furthermore, as the disc rehydrates its shock absorbing capabilities are restored reducing mechanical stress on the related structures (facet joints and supporting ligamentous tissues) slowing or halting the osteoarthritc damage. This is a non-surgical conservative procedure for patients suffering with bulging or herniated discs, degenerative disc disease, posterior facet syndrome, sciatica, failed back surgery syndrome, and non-specified mechanical low back or neck pain resulting in spinal stenosis.

The Causes of Back and Neck Pain

spinal stenosis

When dealing with back and neck pain, it is important to have your pain
evaluated by a professional. Simply dismissing back or neck pain as
typical and unimportant can be a very harmful mistake.

Overuse or under use of the back muscles is by far the most common
cause of back pain that manifests as tightening or spasm of the muscles
that connect to the spine. Inflammation and swelling often occur in the
joints and ligaments, especially in the cervical and lumbar regions, as
people age.

Many conditions can cause back and neck pain, ranging from injury to
infection to simply twisting the wrong way. Traumatic injuries such as
those sustained in an automobile accident or other type of accidents can damage muscles, joints, ligaments, and
vertebrae.

A herniated disc occurs when the nuclear pulposus, the inner material
of the disc, pushes through a tear in the annulus fibrosis, the outer
material of the disc causing nerve root compression. The cervical and
lumbar regions of the spine have the most mobility and the discs there
are more likely to wear down or be injured. Ninety percent of disc
herniations occur in the lower two lumbar vertebrae.

Spinal stenosis, the narrowing of the spinal canal, can cause spinal
cord irritation and injury. Conditions that cause spinal stenosis include
infection, tumors, trauma, herniated disc, arthritis, thickening of
ligaments, growth of bone spurs, and disc degeneration. Spinal stenosis
most commonly occurs in older individuals as a result of vertebral
degeneration.

A pinched
nerve, or radiculopathy, occurs when something rubs or presses against a
nerve, creating irritation or inflammation. Radiculopathy can result
from a herniated disc, bone spur, tumor growing into the nerves, and
vertebral fracture, and many other conditions.

Sciatica is a certain type of radiculopathy that involves inflammation
of the sciatic nerve. Pain is experienced along the large sciatic
nerve, from the lower back down through the buttocks and along the back of
the leg.

A spinal tumor that originates in the spine (primary tumor) or spreads
to the spine from another part of the body (metastatic tumor) can
compress the spine or nerve roots and cause significant pain.

Infections of the vertebrae (e.g., vertebral osteomyelitis), the discs,
the meninges (e.g., spinal meningitis), or the cerebrospinal fluid can
compress the spinal cord and result in serious neurological
deterioration, if it is not diagnosed and treated immediately.

Facet joints allow movement of the spine. The facet joints are formed
by two adjacent vertebra and direct or guide movement of the spine.
As facet joints degenerate, they may not align correctly, and the
cartilage and fluid that lubricates the joints may deteriorate. Bone then
rubs against bone, which can be very painful.

These are just a few of the conditions that can be responsible for back
and neck pain. Thankfully, most cases of back and neck pains are
related to mechanical causes and can be readily addressed by a trained
chiropractor. The point is, however, pain is a warning signal that should
not be ignored. The best place to have your back and neck pain
evaluated is with a chiropractor.

My chiropractic office in San Diego California is like many across the
United States. While chiropractic care helps many different
conditions, it is often viewed as treatment for back pain and neck pain.

Stop Arthritis Joint Pain Now! CMO to the Rescue!

spinal stenosis

According to many, cetylmyristoleate, as an anti-inflammatory and pain reliever, has no equal. That same crowd will also say that CMO or (CM8-as it is sometimes called) sits atop the throne as king of the joint pain relievers and as an immune system modulator.

Why, you may ask? is it so well received amongst the medical community and the thousands of users who swear by it? Well, one reason is its origin- it is an all-natural highly pure waxy type of ester that is modified to be taken orally. It has no harsh chemicals or any type of drugs that can cause you harm. CMO is basically a fatty acid.

The best part about cetylmyristoleate is.... it attacks the source of your pain and inflammation and goes right to the joint. Because the ester substance is of a waxy form (fatty acid), it is able to "ooze" into joints and "lubricate"the region enough to allow for joint movement (range of motion) and most importantly --the reduction or even elimination of the awful pain.

Although Glucosamine and Chondroitin receive most of the fanfare these days, their "luster" has begun to tarnish as of late with poor testimonials; poor clinical studies and more and more talk about the dangers of taking Chondroitin. In the meantime, cetylmyristoleate has moved into the preferred position as "the" joint pain reliever.( refer to:cetylmyristoleate/ Wikipedia)

CMO began its historical rise to take the preferred position as "the" joint pain reliever back in the early1960's by Harry Diehl who was a research chemist working out of the National Institutes of Arthritis in Bethesda, Md. (National Institutes Of Health) While studying the immunity of mice to arthritis, he discovered cetylmyristoleate. Through his research and development his findings were first published in the 1994 issue of the American Journal of Pharmaceutical Sciences.

With the double studies that followed, it was concluded,indeed, that CMO is effective in the treatment of many forms of arthritis and joint pain. The admirable combination of effectiveness and safety (over 10,000 people die yearly from NSAIDS) sets CMO up as the "go-to" joint pain supplement for the coming years.

Cetylmyrisitoleate is so non-discriminating with its lubrication of the joint region that it is equally effective on Degenerative Osteoarthritis; Rheumatoid Arthritis; Gout; Bursitis; Spinal Stenosis; sports related injuries; and even Fibromyalgia pain. Although CMO is not a cure for any of these ailments; it will lubricate the joint region and decrease the inflammation to a point where it could potentially add to ones positive quality of life.

Remember that not all pain relief systems help all people-- and this one is no different. Research shows that cetylmyristoleate works on about 80% of those who use it, typically within 3or4 weeks. Since its premise is joint lubrication from the ester (fatty acids) it is presumed that there is a good chance that it will be effective.

Although Glucosamine and Chondroitin together are the popular 'In Vogue Duo" joint pain relief system today-their effect on many people is inconclusive at best.

My take on all this? Test any quality cetylmyristoleate product for yourself. Give it enough time for you to get a good meter of its effectiveness, (maybe 2-4 weeks) and see how you feel then. One thing is for sure---there won't be any questions; you'll have peace of mind; and who knows? You may even feel pain free!

Anterior Cervical Corpectomy Spine Surgery in India - Benefits, Costs and Risks

spinal stenosis

What is cervical corpectomy spine surgery?

Like anterior cervical discectomy and fusion (ACDF), cervical corpectomy is performed through the front of the neck. Corpectomy means removal of the vertebral body, the major part of the cervical vertebra which looks like a building block. It is basically a long ACDF. Corpectomy is performed when two or more cervical discs need to be removed. For certain patients it is easier to remove two or more discs plus the intervening body or bodies. This is particularly true when there are osteophytes (bony spurs) behind the body and/or the disc space is narrow. By removing a cervical body there is a large area of exposure which is easier to work through rather than working down a narrow disc space.Corpectomy is done for much the same reasons as an ACDF but usually when there are two or more disc levels associated with bony spurs pressing on the spinal cord or, less often, for tumours of the cervical spine.

Benefits of Anterior cervical corpectomy spine surgery

Anaesthesia - General Anaesthetic is avoided.
Patient Feed back - Local anaesthetic protected patient feedback allows more accurate diagnosis and better targeted precise surgery.
Encouraging Clinical Outcomes - Clinical results indicate encouraging outcomes in at least 80% of patients sustained when examined 2 - 4 years later.
Blood loss - At least 10 times less than conventional surgery.
Nerve Damage - Patient feedback avoids nerve damage which is more likely with the patient in the unconscious state.
Complications - 7 times less than fusion and an order less severe.

How Much Does an Anterior cervical corpectomy spine surgery Cost?

The cost of an anterior cervical corpectomy spine surgery will vary based on the extent of the surgery. Spine surgery prices are also dependent on the surgeon you choose, your location, and other factors. Spine surgery can be affordable and there are several spine surgery financing options available to cover the cost of the procedure.

The cost usually involves three fees, including:
o Surgical fee
o Anesthesia fee
o Facility fee

Each of these fees is dependent on the extent of the surgery. Ultimately, the cost of the rhinoplasty procedure will depend on your individual needs and goals. In the initial consultation with a plastic surgeon, you can determine the surgical procedure that's right for you and discuss cost and financing options. Though nose job/rhinoplasty prices may be intimidating, the result can be well worth the money, especially if rhinoplasty is something you have

Risks of spine surgery

Infection
This may simply be an infection of the wound which requires some dressings, removal of a stitch and/or antibiotics. Deeper infection may require a return to theatre to drain the collection of pus. Infection may also affect the CSF (cerebrospinal fluid) around the nerve roots and spinal cord, which is called meningitis and requires hospitalisation and intravenous antibiotics, but is virtually always curable. Infection of an operated disc space or of bone often requires initial hospitalisation and intravenous antibiotics, and then several weeks or months of oral antibiotics, often supervised by an infectious diseases doctor.

Paralysis
Prior to surgery, there may already be some nerve or spinal cord damage causing muscle weakness. A nerve or the spinal cord may be already squashed and at increased risk of being injured because of the manipulation needed to try to free the nerve or spinal cord. Nerve or spinal cord damage may also affect control of the bladder and bowel.

Death
Death on the operating table is very rare. Death can occur with any surgery and usually occurs after the operation. The most common reasons are myocardial infarct (heart attack) due to the stress of the surgery, a rare reaction to a drug (anaphylaxis) or pulmonary embolus. I mention the risk of death or paralysis (stroke) to any patient having an operation, no matter how minor the procedure.

Anterior cervical corpectomy spine surgery in India

Price advantage is a major selling point. The slogan, thus is, "First World treatment' at Third World prices". The cost differential across the board is huge: only a tenth and sometimes even a sixteenth of the cost in the West. Dental, eye and cosmetic surgeries in Western countries cost three to four times as much as in India.

For long promoted for its cultural and scenic beauty, India is now being put up on international map as a heaven for those seeking quality and affordable healthcare. As Indian corporate hospitals are on par, if not better than the best hospitals in world and the country is becoming a preferred medical destination. In addition to the increasingly top class medical care, a big draw for foreign patients is also the very minimal or hardly any wait list as is common in European or American hospitals.

Problems in Proper Ergonomics - Slouching At Your Desk

spinal stenosis

According to recent research, almost one-third of the population spends more than 10 hours a day sitting. That is a lot of time to spend in a chair. Especially when research has also shown that sitting all day can be detrimental to your health - in particular your lower back. In fact, the majority of lower back pain is most likely due to improper sitting positions.

It's no surprise that more than 1-in-3 people suffer from lower back pain. When sitting at a desk, hunched over the computer, or even playing video games, there is a tendency to lean forward and slouch. This can also cause neck and shoulder pain. Our bodies were just not designed for long periods of sedentary activity. Unfortunately, most of us have no choice about the amount of time spent sitting at the desk. The best we can do is sit in the proper ergonomic position.

What is the best way to sit?

It turns out that sitting upright at a ninety degree angle may not be best either. Research by the Radiological Society of North America studied the effects of three different sitting positions on spinal compression and alignment: slouching; sitting at a 90 degree angle; and sitting in a open, relaxed, slightly leaning back position. After measuring spinal movement across all three positions, it turned out that sitting upright placed the most strain on the spine, resulting in disk compression. Slouching is not so great either, however. Sitting in a slouch also caused strain on the spine, especially the lower spinal area, and caused a reduction in spinal disk height. So what is the best sitting position? In fact, sitting in an open-angled (125- to 135-degree) posture was found to place the least amount of strain on the lower back.

An open posture leads to less back pain

So, the best thing to do to avoid back problems is not to slouch in your desk chair. However, don't sit up straight like your mother told you, either. Instead, adopt an open sitting posture where the angle between your thighs and body is greater than 90 degrees. There are many types of chair options for doing this including saddle-style chairs, such as the Hag Capisco, or seats which allow for dynamic movement in all directions, such as the Swopper Chair. Finally, the best thing you could do for your back is get up out of your seat often and move around - standing is the best sitting position of all.

Laminectomy-Discectomy to Remove Herniated Discs

spinal stenosis

One of the causes for back pain is a herniated disc where a fragment of the disc gets dislodged and presses against the spinal cord or nerves surrounding the spinal cord. Relief from this type of back pain is possible through discectomy.

This is a spinal surgical procedure used to remove the herniated disc from the spinal canal. It is performed with the surgeon making an incision to look at the herniated disc and then remove it for relief from back pain.

The procedure

The surgery takes about an hour, based on the extent of disc herniation, the patient's size and other factors. It is done with the patient lying face down, under general anesthesia wherein a 3 centimeter incision is made on the center of the back.

The surgeon then dissects the muscles away from the spinal bone and using the help of special instruments, removes some bone and ligament from the back of the spine. This part of the procedure is also referred to as laminotomy.

With the removal of bone and ligament, your surgeon can find and remove the herniated disc. Based on the condition and appearance of the remaining disc, your surgeon may remove more of the disc to prevent future disc herniation. When the surgeon is sure the disc has been completely removed, the incision is closed and a bandage applied.
Recovery

Your body requires several weeks for the symptoms of the surgery to dissipate. Any pain you experience around the incision can be controlled using oral pain medications. You only have to spend a day at the hospital after which you may be asked to wear a lumbar corset.

You will be encouraged to do gentle activities after surgery, and to avoid lifting heavy objects, bending and excessive back twisting. Till your doctor advises it, refrain from doing any form of strenuous exercise or activity.

Possible complications and risks

There is always a chance of another disc herniating and giving similar symptoms. And as the success rate of a discectomy is 85-90%, there is always a chance of the remaining 10% of patients suffering from persistent symptoms. It is usually patients who have suffered from its symptoms for long, and have neurological deficiency who are at a risk of complete recovery.

The other surgical risks include bleeding, infection and spinal fluid leaks. Though all this can be treated, it entails a longer hospital stay and perhaps, additional surgery.