UNDER THE KNIFE OF SPONDYLOLISTHESIS
Imagine you are sitting in a doctor’s office waiting for a report on your condition. Your symptoms are pain that spreads across your lower back that doesn’t go away, spasms that stiffen the back and tighten the hamstrings, and numbness in the lower extremities. Upon examination and after x-rays, the doctor sits down in the room and tells you of a condition you have called spondylolisthesis. Spondylolisthesis.....??? What is that.....??? Spondylolisthesis is the forward slippage of one vertebra on the vertebrae beneath it. This forward slippage can be the result of many causes and is classified based on the reason for the slip (American Academy for Orthopaedic Surgeons, p 1). Most cases of the disease occur in the low lumbar spine with the most common spinal levels being either L5-S1 or L4-L5. Depending on the cause of the disease, it can be classified as one of six different types. The types are congenital, isthmic, degenerative, traumatic, pathological, and post-surgical. When faced with spondylolisthesis the question of how to deal with the condition arises. The options to treat the condition are small in number. One can either choose conservative treatment or a more radical decision of surgery. Here our controversy arises: to have surgery or to choose another route. This is a much more difficult decision than it may seem due to the fact that most of the routes come to a dead end. Conservative treatments only alleviate the symptoms; they do not correct the slippage. We should now go on to the different types of spondylolisthesis, their symptoms, and their treatments.
CONGENITAL
This form of spondylolisthesis is caused by an abnormality of the bones of the spine. An individual is born with an abnormality of the arch in back of the spine. This abnormality most commonly occurs at the L5-S1 levels of the spine and usually includes the joints that connect one vertebra to another at the back of the spine. These joints are called facet joints (Ullrich, p 1). Due to the nature of the bones, the normal ability of the spine to keep proper alignment is lost as vertebral body of L5 slips forward on S1. As diagnostic technology has improved (MRI’s and CT Scans) this once thought rare occurrence is becoming identified more and more with each new advancement in the field. Two orthopedic authorities, Winter & Moe, quote a percentage of 14-21% of all cases of spondylolisthesis are caused by an abnormal bone formation known as dysplasia.
Imagine living in a world where everything is super-sized. Imagine having to step on a stool to crawl into bed, or having to climb onto a shelf to be able to reach a light switch. Most of all, imagine having to look up to your much taller younger sister when she speaks to you. Situations like these are what Ivy Broadhead, a teenager with achondroplasia, have to go through everyday.
What is scoliosis? Scoliosis is a musculoskeletal disorder that causes the back to curve sideways like and “S” or a “C” and cause the body to lean to one side. Scoliosis can eventually if not looked into and not treated colid with your bodily organs like your heart, lungs, and kidneys. This can cause you to slump down into a hump and cause it hard to breath and do physical activity.
OA is a musculoskeletal disease that causes chronic joint pain and reduced physical functioning (Laba, brien, Fransen, & jan, 2013). Osteoarthritis (OA) is a non-inflammatory disorder of synovial joints that results in loss of hyaline cartilage and remodeling of surrounding bone. OA is the single most common joint disease, with an estimated prevalence of 60% in men and 70% in women later in life after the age of 65 years, affecting an estimated 40 million people in the United States (Goodman & Fuller, 2009). Women are more commonly affected after the age of 55, almost everyone has some symptoms by the age of 70 (Tan, Zahara, Colburn & Hawkins, 2013, p.78). Osteoarthritis can be described radiological, clinical, or subjective. It commonly affects hands, hips, knees, shoulders, and the spine (Walker, 2011, p. 14). Osteoarthritis is an intrinsic defect in the joint cartilage. Caused by slowly progressive deterioration of articular cartilage that is accompanied by degenerative bony changes, including thickening of the subchondral bone cyst, and formation of large bony protrusions (osteophytes) at the joint margins. Osteoarthritis usually occurs in the large weight bearing joints such as the knees and hips, as well as some of the smaller joints in the hands and feet (Ciccone, 2007,p. 229). ). It is predicted by 2020 to become the fourth leading cause of disability globally (Laba et al., 2013, p.2). According to Juby and Davis (2011), these changing demographics with the aging of the “baby boomer” generation will likely result in an increase in the prevalence of both degenerative and inflammatory arthritis, and timely access to appropriate care and maximization of therapeutic interventions will be vital to maintain indepe...
Osteoporosis, and osteoarthritis are completely different conditions, they are frequently mixed up for the other, in particular osteoporosis and osteoarthritis, because both names start with “osteo. This report will discuss the similarities and differences between the both diseases.
Osteoporosis is a disease of the bone. The bones become weak and brittle and are prone to fractures. A person with osteoporosis can fracture a bone just by hitting a table or turning while in bed. Most people with osteoporosis keep on getting fractures because the weight of the body cannot be supported by the bone and normal body movements, including walking, will strain the bone. This condition arises when the rate of bone growth cannot keep pace with bone loss. Osteoporosis can affect any bone including the hip, wrist or spine.
Osteoporosis is a silent, complex, multifactorial, chronic disease characterized by the progressive loss of bone density, which leads to the risk of imminent fractures (1). Osteoporosis "Osteo" is Latin for bone. "Pores" means "full of pores or holes." Thus, osteoporosis means "bones that are full of holes"(1). The bone mass reflects the balance between formation by osteoblasts and resorption by osteoclasts. Around the third decade of life the peak bone mass is reached, and then begins a slow process more continuous bone loss progresses with age(1). Osteoporosis is a metabolic bone disease characterized by low bone mineral density (BMD), the deterioration of the microarchitecture of cancellous or trabecular bone, and changes in the physical
Osteoporosis is a bone disease of that causes a decrease in bone mass. In osteoporosis the bones become weak and fragile. Since the bone mass is decreased, the bones have more of chance of fractures. The bone is continuously breaking down by cells which is known as osteoclasts and rebuilding by other cells known as osteoblasts. Osteoporosis happens once the reabsorption causes the bones to reach a fracture threshold. Any fall or lifting action that would not ordinarily bruise or strain the common person would break one or additional bones in somebody with severe osteoporosis. “Women of fair, freckled complexion with blonde or reddish hair, and women from northwest European background have a higher incidence of osteoporosis than the general population” (Rosdahl, 2012, p.1248). Osteoporosis most commonly happens in postmenopausal women. Some risk factors include age, menstrual status, smoking, sedentary lifestyle caffeine use, and alcohol consumption.
The syndrome is caused because of Genetic mutation that replaces connective tissues (muscles) with bones when someone gets injured instead of getting cured. This results in a new skeletal structure. Unfortunately this syndrome does not have any cure and the patients are advised to always be careful and not to fall or have any kind of traumas. They can’t engage in any sports in order to prevent any injuries. Surgery for removal of extra bones is not an option because removal of bones will lead to ingrowth of more bones. From previous cases it is seen that most of the patients suffering from this condition do not live more than 40 years and they die of respiratory
Spinal fusion stabilizes the spinal vertebra by fusing the disk spaces between the vertebra. The purpose of Lumbar fusion surgery is designed to help create solid bone between the adjoining vertebra. Classically Autograft bone has been used for fusion. This case study demonstrates the successful use of a synthetic bone graft called Signafuse. Signafuse is a moldable bone graft comprising a proprietary combination of patented bioactive glass particles and biphasic mineral granules suspended in a patented resorbable polymer carrier.
Tests after tests including MRI’s, X-rays, and experimental procedures were performed to show I had five ruptured disks in the lower lumbar section of my back. Tedious Examination done by a group of doctors concluded I had a crippling disease of the spinal column called spinal stenosis. Spinal stenosis is a narrowing of the spinal canal that causes compression of the spinal cord. (Lohr,1) If this disease was ignored any longer, it would lead to many other problems affecting other areas of my back to help support this weakness. It was an extremely rare case for an athlete my age.
The big picture. Where the two schools of medicine differ is in philosophy. Doctors of osteopathy "treat people, not just symptoms," says Karen Nichols, dean of the Chicago College of Osteopathic Medicine. "The course list looks exactly the same, but the M.D.'s focus is on discrete organs. The osteopathic focus is that all of those pieces are interrelated. You can't affect one with out affecting another." That means paying more than simple lip service to the idea of the "whole" patient: It means that diagnosis and treatment rely on an examination of a person's environment and family and general situation as well as his or her body. Not surprisingly, about 65 percent of the nation's 52,000 licensed osteopaths (by comparison, the country boasts at least 900,000 M.D.'s) are primary-care physicians. The American Association of Colleges of Osteopathic Medicine has a description of osteopathic training, as well as short profiles of 20 schools, at www.aacom.org. The D.O. programs and their contact information are listed in the directory section of this book.
Scoliosis is a disease that attacks the muscles and ligaments of the spinal column, causing a sideways twisting and rotation of the spine, ribs, and pelvis. Its is a C-shaped or S-shaped curvature of the spine. An S-shaped curve is created when a secondary curve counterbalances primary abnormal curve. It severely impairs the bodies neurological, hormonal, and nutritional systems.
Scoliosis is a deformation of the spinal column. The classification for Scoliosis is when the spinal column is curved sideways. Usually in the shape of the letter c or s. Unlike Lordosis, which is an extreme inward curve of the spine; or Kyphosis, a forward curve of the spine. Scoliosis's exaggeration lies in the how it's slanted.
Orthopedic is a very complex area of surgery and it requires experienced and dedicated surgeons who know what to do in their specific area. Orthopedic surgery is basically concerned with injuries and conditions that affect the musculoskeletal system. So whether you have problems with joints, bones, ligaments, tendons, nerves or muscles, this is where you need to start off.