When first examining methods for surgical intervention let's have a look at traditional open back surgery to correct herniated disc problems.
Spinal Discectomy: The goal of a discectomy is the removal of the problematic herniated disc or disc material from the spinal canal. When a disc herniated occurs a fragment of the normal disc is dislodged. Symptoms of a herniated disc are most often caused by this fragment pressing up against and applying pressure to either the nerves that surround your spinal cord or the spinal cord itself.
This open discectomy surgery is performed under general anesthesia and depending on the severity of the herniation will take about an hour to complete. The patient will lay face down with the back pointing upwards during the discectomy.
An incision about 3 cm long will be made over the center of your back and through this incision the surgeon will remove the fragment of herniated disc. Carefully dissecting the muscles away from the bone of your spine, the surgeon will then proceed to remove a small amount of the bone and ligament from the back of your spine. This part of the surgical procedure is referred to as a laminotomy. When the surgeon is confident that there are no more disc fragments and there is nothing left to be “cleaned up" the incision is closed and a bandage is applied.
It is not unusual for the patients' symptoms to take several weeks to dissipate but often when patients awake after surgery their leg pain is gone. After the surgery most patients will spend the night in the hospital and be discharged the following day. The pain around the incision is controlled with oral medication. Although not needed in all situations, to help control some of the pain a lumbar corset brace is often worn.
The success rate of an open discectomy is about 85-90%. Risks of this surgery include spinal fluid leaks, bleeding and infection. Usually these will require a longer hospitalization but they are all treatable.
Now that we have looked at what is involved with a traditional open spinal discectomy, let's explore a different avenue and become informed on minimally invasive surgery.
Percutaneous arthroscopic laser discectomy: This surgical process is preformed to remove herniated disc or bulging disc material that is applying pressure to a nerve root or to the spinal cord.
When the patients history, physical examination and imaging, such as a CT scan or MRI indicate that a disc is herniated or there are signs of a bulging disc and the material inside the disc has not ruptured into the spinal canal a percutaneous arthroscopic laser discectomy can be performed.
If the patient has significant bony anomalies or is suffering from foraminal stenosis they are not a good candidate for a percutaneous arthroscopic discectomy. This patient would benefit from a foraminotomy procedure.
During a traditional percutaneous arthroscopic laser discectomy the surgeon will be guided using x-ray monitoring and fiber optics. The results of these two factors are displayed on a monitor that is similar to a TV screen. Through the use of this screen the surgeon can see what is compressing the nerve during the procedure and then remove is with the laser. This ensures a much high success rate.
Once a local anesthetic is administered, a small incision will be made where a round depuy tube is inserted into this incision. The goal of this tube is to allow for the percutaneous arthroscopic discectomy with minimal damage to surrounding muscles by pushing them out of the way and not cutting or tearing them.
Inserted into this working tube is the laser, camera, suction, irrigation and other surgical instruments and once everything is in place, the surgeon will use a laser to vaporize the disc material. Once the material is vaporized the pressure that was being put on the spinal cord or nerve will no longer be present. Patients will often feel immediate relief during the percutaneous arthroscopic laser discectomy procedure as the pressure is minimized. The tube is slowly removed after the completion of the procedure allowing the muscles to move back into place.
A percutaneous arthroscopic laser discectomy procedure take half an hour to forty five minutes and the patient is released after 1-2 hours of monitoring. Patients are encouraged to take a long walk that afternoon or evening. The patient will return to their surgeon the following day for a post-op visit to get clearance to go home.
Author : Robert Langard
http://www.articleclick.com/Article/Surgical-Treatments-for-Herniated-Discs/961261
Tuesday, February 24, 2009
Laminotomy - The Detailed Information You Need to Know
The term laminotomy is derived from the Latin words lamina - Bony plate that covers the vertebras posterior arch and otomy - Cutting or incision.
When a laminotomy is performed it is done to gain access to the spinal canal. A laminotomy uses an endoscopic approach to this for the surgeon to free any compressed or “tethered" nerves in the area. Because of the minimally invasive nature to this procedure, it can be performed in a surgical outpatient setting without the need for general anesthesia or lengthy hospital stays.
A laminotomy is performed when there is evidence of nerve compression due to bone spurs, disc problems such as a herniated or bulging disc, scar tissue formation from failed back surgery and other natural phenomena and arthritis in the spine.
A laminotomy works by increasing the amount of room available for surrounding nerves and the spinal cord.
Differences between a traditional laminectomy and minimally invasive laminotomy:
Laminotomy - Procedure performed to remove the ligamentum flavum which spinal stenosis is attributed to. The ligamentum flavum can naturally thicken over times, constricting the spinal canal and causing nerve root compression. When a laminotomy is performed to remove the ligament, the surrounding nerves and spinal cord will no longer suffer from constriction due to a lack of space.
Laminectomy - This is conventional open back surgery that requires general anesthesia and (often) a lengthy hospital stay combined with long recovery time. A laminectomy is performed to remove the lamina to increase the amount of space for surrounding neural tissues.
The Laminotomy procedure in detail:
The patient is first given a local anesthetic and a small incision is made. A round Depuy tube is then inserted into the incision with the tube being gradually increased in size by sliding new tubes over the previous one. The final working tube is about 18 millimeters in diameter which the surgeon will use to gain access to the patients back for the medical instruments. These instruments include the laser, camera, suction, irrigation and a few others. When a working tube is used in minimally invasive procedures, it helps to maintain minimal damage by pushing the surrounding muscles out of the way instead of cutting or tearing them.
Once the working tube has been secured the surgeon can then begin the process of removing the material causing the pain. During the procedure and once the surgeon has released trapped nerves many patients will comment on immediate relief of pain. The symptoms of back and leg pain are caused by entrapped nerves and corrected by decompressing the spinal canal.
It is important to realize a laminotomy is not an arthroscopic procedure performed inside the joint. A laminotomy is an endoscopic procedure performed with the same tube as other arthroscopic surgeries, without breaching the joint.
Recovery for a laminotomy:
Once the procedure is complete the patient will receive one or two stitches (sometimes none!) and be moved to a recovery room where they are monitored for the next few hours. After this time the patient is then allowed to leave as long as they are accompanied by a companion. It is recommended that the patient takes a long walk that afternoon or night. The following day the patient returns to get full clearance from the doctor to head home.
Author : Brenda Miller
http://www.articleclick.com/Article/Laminotomy-The-Detailed-Information-You-Need-to-Know/1042259
When a laminotomy is performed it is done to gain access to the spinal canal. A laminotomy uses an endoscopic approach to this for the surgeon to free any compressed or “tethered" nerves in the area. Because of the minimally invasive nature to this procedure, it can be performed in a surgical outpatient setting without the need for general anesthesia or lengthy hospital stays.
A laminotomy is performed when there is evidence of nerve compression due to bone spurs, disc problems such as a herniated or bulging disc, scar tissue formation from failed back surgery and other natural phenomena and arthritis in the spine.
A laminotomy works by increasing the amount of room available for surrounding nerves and the spinal cord.
Differences between a traditional laminectomy and minimally invasive laminotomy:
Laminotomy - Procedure performed to remove the ligamentum flavum which spinal stenosis is attributed to. The ligamentum flavum can naturally thicken over times, constricting the spinal canal and causing nerve root compression. When a laminotomy is performed to remove the ligament, the surrounding nerves and spinal cord will no longer suffer from constriction due to a lack of space.
Laminectomy - This is conventional open back surgery that requires general anesthesia and (often) a lengthy hospital stay combined with long recovery time. A laminectomy is performed to remove the lamina to increase the amount of space for surrounding neural tissues.
The Laminotomy procedure in detail:
The patient is first given a local anesthetic and a small incision is made. A round Depuy tube is then inserted into the incision with the tube being gradually increased in size by sliding new tubes over the previous one. The final working tube is about 18 millimeters in diameter which the surgeon will use to gain access to the patients back for the medical instruments. These instruments include the laser, camera, suction, irrigation and a few others. When a working tube is used in minimally invasive procedures, it helps to maintain minimal damage by pushing the surrounding muscles out of the way instead of cutting or tearing them.
Once the working tube has been secured the surgeon can then begin the process of removing the material causing the pain. During the procedure and once the surgeon has released trapped nerves many patients will comment on immediate relief of pain. The symptoms of back and leg pain are caused by entrapped nerves and corrected by decompressing the spinal canal.
It is important to realize a laminotomy is not an arthroscopic procedure performed inside the joint. A laminotomy is an endoscopic procedure performed with the same tube as other arthroscopic surgeries, without breaching the joint.
Recovery for a laminotomy:
Once the procedure is complete the patient will receive one or two stitches (sometimes none!) and be moved to a recovery room where they are monitored for the next few hours. After this time the patient is then allowed to leave as long as they are accompanied by a companion. It is recommended that the patient takes a long walk that afternoon or night. The following day the patient returns to get full clearance from the doctor to head home.
Author : Brenda Miller
http://www.articleclick.com/Article/Laminotomy-The-Detailed-Information-You-Need-to-Know/1042259
The Differences Between Spinal Stenosis and Foraminal Stenosis.
When the spinal nerves in the lumbar area of the back are being compressed, it can be a result of lumbar spinal stenosis. Do to alterations in the blood vessels that drain blood from the area the cauda equina between the stenosis levels become congested. By preventing the nerve roots from conducting effectively, this congestion will affect people more while walking. There can be a great deal of pain in the buttocks, thighs and legs when this happens. Numbness or weakness may accompany this pain.
Quite often a patient's ability to walk will be severely limited and rarely become debilitating to the point that the patient will stop walking. After a five to ten minute period of rest this discomfort will usually subside. Pain can also be alleviated by lying down with the legs flexed, sitting or squatting. These activities help to increase the area of the spinal canal that is congested. Often beginning in the lower legs these symptoms may progress into the buttocks although it may happen in the reverse order starting in the buttocks and working is way down the legs which is referred to as “sensory march". Along with this “sensory march" low back pain is also a common complaint of patients suffering from foraminal stenosis. Often beginning on one side of the body these symptoms may progress and affect both sides. This may be referred to by your doctor as neurogenic claudication.
Men tend to be affected more often by neurogenic claudication then women and this is usually more prevalent after the age of fifty. A comfort zone is usually achieved as people decrease their walking distance which typically will be at least one hundred meters. It is unfortunate that this condition is lifelong and often progressive. Sometimes non-surgical methods can be explored and provide adequate relief from the pain of foraminal stenosis such as pain management, physical therapy and other methods. There are surgeries that can be preformed to widen the spinal canal and this may become a viable option if your symptoms continue to worsen and the pain and lifestyle reduction become too painful.
There is a difference between neurogenic claudication from decreased blood flow to the lower extremities and calcified blood vessels (peripheral vascular disease) and it is important that your doctor is able to differentiate this. This can be easy to miss as the condition affects older people and has similar symptoms. One of the differences in peripheral vascular disease is that these symptoms are typically not relieved by a person's change in their posture. Peripheral vascular disease will not show any signs of sensory march symptoms either.
Pain extending down the leg area that corresponds to an affected nerve can be caused by lumbar spinal stenosis as the foramina becomes narrow and more pressure is placed on the affected nerve root. Because of this foraminal stenosis is classed as a form of lumbar spinal stenosis which can exist along with cervical stenosis and classic claudication symptoms. Although it usually takes about six to twelve months for recovery, foraminal stenosis may respond to conservative treatment methods. If conservative treatment methods fail and there is severe pain or lifestyle activity reduction, surgical options to widen the foraminal area may become more desirable.
Author : Markus Sturgeon
http://www.articleclick.com/Article/The-Differences-Between-Spinal-Stenosis-and-Foraminal-Stenosis./969960
Quite often a patient's ability to walk will be severely limited and rarely become debilitating to the point that the patient will stop walking. After a five to ten minute period of rest this discomfort will usually subside. Pain can also be alleviated by lying down with the legs flexed, sitting or squatting. These activities help to increase the area of the spinal canal that is congested. Often beginning in the lower legs these symptoms may progress into the buttocks although it may happen in the reverse order starting in the buttocks and working is way down the legs which is referred to as “sensory march". Along with this “sensory march" low back pain is also a common complaint of patients suffering from foraminal stenosis. Often beginning on one side of the body these symptoms may progress and affect both sides. This may be referred to by your doctor as neurogenic claudication.
Men tend to be affected more often by neurogenic claudication then women and this is usually more prevalent after the age of fifty. A comfort zone is usually achieved as people decrease their walking distance which typically will be at least one hundred meters. It is unfortunate that this condition is lifelong and often progressive. Sometimes non-surgical methods can be explored and provide adequate relief from the pain of foraminal stenosis such as pain management, physical therapy and other methods. There are surgeries that can be preformed to widen the spinal canal and this may become a viable option if your symptoms continue to worsen and the pain and lifestyle reduction become too painful.
There is a difference between neurogenic claudication from decreased blood flow to the lower extremities and calcified blood vessels (peripheral vascular disease) and it is important that your doctor is able to differentiate this. This can be easy to miss as the condition affects older people and has similar symptoms. One of the differences in peripheral vascular disease is that these symptoms are typically not relieved by a person's change in their posture. Peripheral vascular disease will not show any signs of sensory march symptoms either.
Pain extending down the leg area that corresponds to an affected nerve can be caused by lumbar spinal stenosis as the foramina becomes narrow and more pressure is placed on the affected nerve root. Because of this foraminal stenosis is classed as a form of lumbar spinal stenosis which can exist along with cervical stenosis and classic claudication symptoms. Although it usually takes about six to twelve months for recovery, foraminal stenosis may respond to conservative treatment methods. If conservative treatment methods fail and there is severe pain or lifestyle activity reduction, surgical options to widen the foraminal area may become more desirable.
Author : Markus Sturgeon
http://www.articleclick.com/Article/The-Differences-Between-Spinal-Stenosis-and-Foraminal-Stenosis./969960
Back, Sciatica, Muscle and Joint Pain relief with Acupressure Mat
There is a natural source of healing power in everyone. When this healing power is activated, it triggers a series of complicated internal processes producing a Healing Response. Pain or injury act to alert the body that damage control is needed, at which point the Healing Response begins and endorphins are generated to repair the affected area. This increases the heart rate and alters the blood pressure to speed up the elimination of toxins from the damaged area.
This therapy is considered to be the 'mother of acupuncture', in that it was used as a means to stimulate the body's energy flow long before needles were used for that purpose.
Acupressure is also known to aid your health in a number of other positive ways - including reducing stress and tension; increasing blood circulation; aiding in the removal of toxic wastes; providing relief from head, neck and shoulder aches; promoting healing; increasing energy levels; and increasing feelings of well-being.
This natural pain relief technique requires a special simple but extremely effective device - Acupressure Mat and can be learned by anyone through the easiest steps of instructed Applications. It has provided effective relief in thousands of clinical cases and the success rate is 80%. Further, it doesn't seem to matter how severe the pain is or how long you have had it.
Unlike most drugs, relief is usually immediate.
Over 70 million of people have successfully regained their healthy and pain free lives with the Tibetan (Kuznetsov) Applicator!
The Tibetan Applicator is an effective and easy to use acupressure pain relief device. It is made from non-allergenic materials and consists of high density plastic spines which are precisely arranged to best stimulate the body's internal abilities to heal itself.
The Applicator provides particularly effective treatment for: arthritic pain, lower and upper back pain, sciatica, knee pain, muscle and joint pain, insomnia, headache, fat and cellulite.
The Applicator works by applying NON penetrative acupressure on numerous points over an area of the body.
The pressure spines stimulate blood flow and lymph circulation locally. Endorphins (“hormones of happiness" or "natural pain killers") are released. These are effective in blocking pain and producing analgesia and a sense of well-being.
The Applicator has been successfully used by millions of people for many years all over the world. It eliminates muscle pain, increases the flexibility of joints and increases resistance to muscle fatigue. The Tibetan applicator produces exceptional results in the treatment of sciatica pain, lower back pain, numbness or tingling in legs, pinched nerves, upper back pain, chronic pain in cervical spine, joint pains and spasms.
Scientific research has also shown phenomenal results for sufferers of low or high blood pressure, insomnia and chronic fatigue.
The Applicator has an immediate effect on pain caused by hard physical work, over exertion in sport or other physical stress related activities.
Use of the Acupressure Mat results in complete relaxation free from pain or stiffness.
Author : Care
http://www.articleclick.com/Article/Back-Sciatica-Muscle-and-Joint-Pain-relief-with-Acupressure-Mat/977339
This therapy is considered to be the 'mother of acupuncture', in that it was used as a means to stimulate the body's energy flow long before needles were used for that purpose.
Acupressure is also known to aid your health in a number of other positive ways - including reducing stress and tension; increasing blood circulation; aiding in the removal of toxic wastes; providing relief from head, neck and shoulder aches; promoting healing; increasing energy levels; and increasing feelings of well-being.
This natural pain relief technique requires a special simple but extremely effective device - Acupressure Mat and can be learned by anyone through the easiest steps of instructed Applications. It has provided effective relief in thousands of clinical cases and the success rate is 80%. Further, it doesn't seem to matter how severe the pain is or how long you have had it.
Unlike most drugs, relief is usually immediate.
The Tibetan Applicator is an effective and easy to use acupressure pain relief device. It is made from non-allergenic materials and consists of high density plastic spines which are precisely arranged to best stimulate the body's internal abilities to heal itself.
The Applicator provides particularly effective treatment for: arthritic pain, lower and upper back pain, sciatica, knee pain, muscle and joint pain, insomnia, headache, fat and cellulite.
The Applicator works by applying NON penetrative acupressure on numerous points over an area of the body.
The pressure spines stimulate blood flow and lymph circulation locally. Endorphins (“hormones of happiness" or "natural pain killers") are released. These are effective in blocking pain and producing analgesia and a sense of well-being.
The Applicator has been successfully used by millions of people for many years all over the world. It eliminates muscle pain, increases the flexibility of joints and increases resistance to muscle fatigue. The Tibetan applicator produces exceptional results in the treatment of sciatica pain, lower back pain, numbness or tingling in legs, pinched nerves, upper back pain, chronic pain in cervical spine, joint pains and spasms.
Scientific research has also shown phenomenal results for sufferers of low or high blood pressure, insomnia and chronic fatigue.
The Applicator has an immediate effect on pain caused by hard physical work, over exertion in sport or other physical stress related activities.
Use of the Acupressure Mat results in complete relaxation free from pain or stiffness.
Author : Care
http://www.articleclick.com/Article/Back-Sciatica-Muscle-and-Joint-Pain-relief-with-Acupressure-Mat/977339
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