Slipped Disc

[Green Lantern]

Hello Air Ween,

anything new on this?

I have some patients who have had success with Titanium replacements albeit only as a last recourse.

[hint-of-lime]

Hello Air Ween,

anything new on this?

I have some patients who have had success with Titanium replacements albeit only as a last recourse.

 

By titanium replacements do you mean a disc replacement (which is essentially a piece of plastic sandwiched between 2 metal pieces simulating a mobile disc - very much like your joint replacements for the hip and knee) or interbody fusion using a titanium cage-like device filled with bone graft and sandwiched between the endplates? The latter is a variation of the spinal fusion surgery commonly done using mere bone grafts in the not so distant past and the former is a newly emerging technology which reportedly preserves spinal motion after excision of the erring disc. Unfortunately, disc arthroplasty/replacement has very limited applications. Fusion surgery, on the other hand, has much more to offer - though at the sacrifice of joint motion and some future complications of a fused spine. I think it all boils down to knowing the indications for each procedure and their limitations. A knowledgeable spine surgeon should be able to explain them to you. Most spine surgeons should be able to perform a fusion surgery but there are only 5 qualified disc replacement surgeons in the country - 1 in St. Lukes, 3 in Asian Hospital, I'm not sure where the other guy is based, though.

[Green Lantern]

Very informative hint-of-lime.

The patients that I have handled (for non orthopedic reasons) only related their disk replacement experience and outcome.

They were very happy with the disk arthroplasty because it preserved their full range of motion.

Edited November 20, 2006 by Green Lantern

[Piedro08]

Very informative hint-of-lime.

The patients that I have handled (for non orthopedic reasons) only related their disk replacement experience and outcome.

They were very happy with the disk arthroplasty because it preserved their full range of motion.

 

 

i agree with the preservation of full range of motion, but i think there are still questions like on the viability and long term outcome on disc replacements, however, if you have some additional information on these please pm me. thanks

[hint-of-lime]

i agree with the preservation of full range of motion, but i think there are still questions like on the viability and long term outcome on disc replacements, however, if you have some additional information on these please pm me. thanks

 

You're right - the long term outcome studies haven't come out yet (though the DePuy Charite Lumbar Artificial Disc has a 20 year outcome report - though I don't think that this reflects the true results of the current incarnation of its artificial disc design called the Charite III - a 3rd generation model which has been in existence for much less than that amount of time). The medium term outcomes, though, report almost equal results with a fusion procedure in terms of pain relief and patient satisfaction. Now, why would one do a disc arthroplasty if the outcome is equal to a fusion? Why not fuse outright? The current thinking among spine arthroplasty surgeons is that the goal is to delay a fusion for as long as possible to avoid adjacent segment degeneration ( which is accelerated degeneration of the discs superior and inferior to a fused spinal segment which eventually become pathologic and may require surgery at these areas in the future due to pain) which has been well documented in recent years. I just feel that at this point in time, the indications are limited to young patients with pristine facet joints (some studies report limited applications with mild facet arthrosis, though) because of the reported effect of the disc on loading of the posterior facets. In other words, proper patient selection is the key to success with the current technology. And to be blunt about it - the patient's financial capability because the implants themselves already cost a small fortune.

[Air Ween]

been quite awhile..after my 8 sessions of physical therapy and 4 months working out, my condition improved. up to this time, all the pains disappeared..i just hope this would be permanent..or else ill just have to resort another way, that i hope you guys wud provide me..thanks alot.

 

i just cant imagine myself undergoing such surgeries..makes me tremble..

[HaxxxoR]

hi guys, I would like to know more about slipped disc, anong klaseng sakit po ba to? eto ba yung dahil sa sobrang weak ng mga muscles mo hirap kang tumayo or gumalaw (leads to muscle pains)?

[FastAndTheCurious]

I got a slip disk when I was young. I fell from the roof. With the lack of money before, I tried to punish myself not talking to my Mom about it to seek medical help. I cannot bend down or run but still I can walk, my back really hurts. For three or four months i dealt with the pain and without noticing it, it just went away.

 

Any effects that would comeout when I grew old?

[hint-of-lime]

HaxxxoR Posted Feb 1 2007, 02:37 PM

hi guys, I would like to know more about slipped disc, anong klaseng sakit po ba to? eto ba yung dahil sa sobrang weak ng mga muscles mo hirap kang tumayo or gumalaw (leads to muscle pains)?

 

The vertebral bodies in your spinal column (back bone) have a soft intervertebral disk sandwiched between them. This disk acts like a joint where the bones can move and also as a sort of cushion for shock absorption. Sometimes because of wear and tear or trauma, the disk can burst at its weakest area at the back where it is adjacent to the spinal nerve roots. At this initial phase, the symptoms will be that of severe back pain. Eventually, the gel-like substance that the disk contains may protrude out of the disk and impinge (iipitin) the nerve root. The nerve roots supply sensation to the skin and strength to the muscles. When the impingement occurs, the symptoms will be that of a sharp pain radiating from the lower back or buttocks to the area the impinged nerve supplies thus manifesting more like leg pain rather than back pain. In addition, if the impingement is severe enough, there may be some weakness of the muscles that the affected nerve root supplies and some decrease in sensation on that patch of skin that the affected nerve root supplies - though this does not always happen. Left to itself, after a certain period of time ranging from several weeks to several months and even several years, the disk gel (or nucleus pulposus) will be absorbed by the body and the radiating pain may disappear and convert back to back pain. This pain may even disappear during the course of several years if the patient can tolerate the initial symptoms.

 

In answer to your question, the pain is not because the muscles are weak - it is because naiiipit yung nerve and because naiiipit yung nerve, the muscles may also exhitbit some degree of weakness.

 

 

I got a slip disk when I was young. I fell from the roof. With the lack of money before, I tried to punish myself not talking to my Mom about it to seek medical help. I cannot bend down or run but still I can walk, my back really hurts. For three or four months i dealt with the pain and without noticing it, it just went away.

 

Any effects that would comeout when I grew old?

 

It is part of the natural history of back pain that the pain will eventually disappear kung matiis mo yung sakit. There may or may not be any effect on you when you grow up. IT really depends on what exactly the pathology was that you had. If it is really just the slipped disk, then there may not be any consequences. However if there was some amount of instability to the spine caused by the fall, then there may be some long term consequences. Either way, if you are asymptomatic - wala ka namang nararamdaman - at the moment with regards to your back, then probably nothing needs to be done anytime soon. You can probably have an orthopedic surgeon have a look at you if you develop some back pain in the future so he can assess your spine - given your history of previous trauma. Of course if you want a more accurate answer soon for your peace of mind, the only way would be to have x-rays taken of your spine and, if you have any of the work-ups previously done when you fell - bring those with you and have yourself and the x-ray assessed by an orthopedic surgeon particularly one sho specializes in spine.

[Air Ween]

npansin ko lang, whenever i gain weight mdyo may nraramdaman akong "ngawit" sa lumbar area ko whenever i bent down and then raise up..does this have anything to do with my previous condition?

[d33th]

Hi, bear in mind that the regular xray of the lumbar spine only shows the visualized osseous structures, meaning the bony structures, so this is only helpful if you have an obvious displacement of your vertebral body, as in a spondylolisthesis, but if your concern is the intervertebral disk, if your thinking of a disk herniation, you should strongly consider having an MRI done, this would show the degree of the disk herniation, at the same time it can show you any narrowing of your spinal canal or vertebral foraminae.

[boner51873]

npansin ko lang, whenever i gain weight mdyo may nraramdaman akong "ngawit" sa lumbar area ko whenever i bent down and then raise up..does this have anything to do with my previous condition?

 

 

Hi there!

 

I've been reading all the posts here and i can't help but put my 2 cents worth into this.

 

First of all, we should first establish the cause of your back pain...

there are several major cause of back pains ranging from musculo-skeletal spasms, to herniated discs, to narrowing of the spinal canal and foraminae, to tumors and infections, and a myriad of other causes. this can be diagnosed with a thorough history and physical examination...from there, a trial of rehabilitation and physical therapy coupled with a regimen of muscle relaxants and analgesics could be done. About 80% of back pains would resolve especially if this is due to a musculo-skeltal strain of the back muscles. The rest should be worked-up and investigated on more with other imaging modalities such as appropriate xrays and/or an MRI of the spine.

 

MRIs of the spine are an important part of the management of back pains although it is not supposed to be requested left and right owing to its cost. Usually, we orthopedic surgeons order an MRI if we are contemplating on a possible surgery or if history and physical examination points to a pathology in which surgery might be indicated. Examples of which are spinal cord compression secondary to a herniated disc, an abscess (Potts disease being the most common in the Philippines -- TB of the spine), a narrowing of the canal (Spinal Stenosis) or of the foramen (where the spinal nerve exits), of a possible tumor.

 

I agree with some of the orthopedic/spine surgeons the others have enumerated...i even know some of them personally...these are orthopedic surgeons who are known not only in our country but also have made there mark internationally.

 

But, after reading your account on your back pain (but without the benefit of seeing you and examining you in person), i think that your back problem is something which is amenable to conservative treatment. Meaning, prevention would be better than cure. Indeed, gaining weight (especially in the wrong places) would certainly aggravate your back pain. Remember that your spine bears your weight too, like your foot, ankles, knees and hips especially when at an upright position. Back hygiene is essential to be able to prevent your back muscles from straining, becoming spastic and therefore, becoming painful. Proper posture at work, at home and when sleeping should always be on your mind. There are a lot of literature available for this.

 

I hope i was able to help you regarding your problem.

[dimmiket]

best cure for back pain that is not caused by trauma, herniation or tumors: more sex! do the cat and camel while doing the deed. takes a longer time to come while doing lumbar exercises

[arnoldtan]

sa akin ito eh....sumasakit ang paa ko, sa may puwitan hanggan legs, pero sa right side lang, masakit siya kapag matagal akong nakaupo, pero kapag bago akong gising sa umaga ok naman siya, kapag masakit hindi ako makatayo nang diretso...

[john27007]

sa akin ito eh....sumasakit ang paa ko, sa may puwitan hanggan legs, pero sa right side lang, masakit siya kapag matagal akong nakaupo, pero kapag bago akong gising sa umaga ok naman siya, kapag masakit hindi ako makatayo nang diretso...

 

 

hi, mukhang meron kang radiating pain from your buttocks to your legs. tinatawag etong sciatica. naiipit ang nerve mo kapag matagal kang nakaupo. try to stand or walk and avoid sitting for prolonged periods of time. you can also take out your wallet because thick wallet can impinge on your sciatic nerve. you could put warm compress, take some anti-inflammatory medications like ibuprofen or naproxen (flanax) just as long as you have no allergies, kidney, heart problem, liver problem, stomach acidity nor pregnant. after 5 days you will feel a decrease in pain. but be sure to be checked by a doctor because it is hard to prescribe medications without asking histories and do physical examinations on you.