Stating that muscles are the most important elements holding the system in the spine system, Prof. Dr. Kaya Aksoy said, "Decreased muscle strength is the biggest handicap in terms of spine health. Human being is a being built on movement, inactivity and muscle weakness jeopardize the health of the spine."
Underlining that there is no single correct treatment especially in waist and back surgeries, Prof. Dr. Aksoy emphasized the importance of personalized treatment.
NPISTANBUL Hospital Brain, Nerve and Spinal Cord Surgeon Prof. Dr. Kaya Aksoy attended the 'Spine Health Symposium' organized by Üsküdar University Faculty of Health Sciences Physiotherapy Rehabilitation Department.
Speaking at the symposium titled "Approach to Lumbopelvic Rhythm Pathologies" held at Üsküdar University Altunizade Campus Nermin Tarhan Conference Hall, Prof. Dr. Aksoy talked about spine health, waist and hip problems and gave information about individualized treatment methods in treatment.
Prof. Dr. Kaya Aksoy noted that the spine is a whole with the bones of the neck, back, waist and hip, and that our shoulder blades are also included in this whole, and said, "The smallest functional unit is the two vertebrae without muscle tissue, the disc tissue between them and the structures we call facets that articulate the vertebrae to each other and the ligaments between the vertebral bone protrusions (Ligament). The vertebra has six degrees of freedom of movement in three axes. During these movements in the form of bending forward, backward, sideways and rotation, a load is placed on the spine."
80% of the load on the spine passes through the disc tissue
Stating that 80% of the load on the spine passes through the cushion (disc tissue) between the vertebrae, Prof. Dr. Kaya Aksoy said, "The sheath (annulus) surrounding the disc tissue is subjected to tension. The load that cannot be lifted, wrong position causes a tear both in the disc and in the annulus. Thus, the disc cushion between the two vertebrae can pop out. After the intervertebral cushion degenerates, degenerative changes in the bone also begin. In addition, reaction in the fluid in the joints that connect the vertebrae, cartilage damage, loosening of the capsule, joint slippage, and calcification in the joints can also occur."
Prof. Dr. Aksoy noted that the main structure that provides the integrity of the spine and is responsible for elasticity is the thick ligaments called "ligaments" that provide connections between the vertebral protrusions from the neck to the coccyx, both from the front, through the vertebrae and between the vertebral protrusions, and said, "Decrease in elasticity here is among the causes of deformations. Muscles are the most important elements holding the system. Decreased muscle strength is the biggest handicap in terms of spine health. Man is a being built on movement, inactivity and muscle weakness jeopardize the health of the spine."
"Narrow canal" emerges in old age
Pointing out that in old age, the cushion between the two vertebrae gradually decreases in absorbing the load from above, Prof. Dr. Kaya Aksoy said, "The decrease in the height of the cushion (disc distance) between the two vertebrae, the presence of calcifications at the ends of the vertebrae, the loss of elasticity of the ligaments and the increase in their volume create narrow canal disease and cause difficulty in walking. If a person (without vascular problems) walks 50 meters - 100 meters, rests and then starts walking again, it means that he/she has a narrow canal. In addition to the narrowness of the canal, all the vertebrae should be evaluated to see if there is a slippage in the vertebrae, if there is a slope to the right or left. Even if there is a problem in the lower back, all vertebrae of the person should be evaluated."
Beware of postpartum hunchback!
Stating that there is an inverted (C) shaped posture in the back and waist after birth, Prof. Dr. Kaya Aksoy said, "Later on, the waist gradually bends inwards, the back is slightly hunched outwards, and the neck also has an inward slope like the waist. These curves are very important in keeping the spine and hips upright against gravity when standing."
Individualized treatment is required for low back problems
Prof. Dr. Kaya Aksoy said, "It is an imbalance when the plumb line extended down the neck comes in front of or behind the coccyx."
"Differences in the balance angles that enable standing, especially between the hip and waist, cause back and hip problems, and in order to compensate for these, new positions are formed by walking by leaning forward, backward movement of the hip and bending of the knees in the legs (walking with two bends). The same surgery is not performed for everyone for the problem in the lower back. Individual solutions are required."
There is no single treatment scheme
Prof. Dr. Kaya Aksoy underlined that there is no single correct treatment scheme, especially in lumbar surgeries, back surgeries, when the spine enters abnormal conditions for various reasons from the normal position, and said, "There is no single treatment scheme. It is necessary to check the individual angles for everyone, to give the correct position in surgery and to restore the patient's balance. The plumb line, which provides the patient's upright and balanced posture from top to bottom, is very important for the surgery to be performed by calculating the angles in the hip and waist joints and evaluating them individually, and the angles and directions to be adjusted are very important if a screw rod is to be placed."
The entire spine should be evaluated
Prof. Dr. Kaya Aksoy emphasized that the entire spine should be evaluated, not just the pathology at the site where it is seen, and said, "Even in a simple herniated disc surgery, the neck and back should be evaluated. In low back, back, hip, leg, coccyx pain, reflected pain of organs such as the urinary bladder, female and male genital organs, large intestine, and reflected pain due to diseases of organs located in the abdomen should be differentiated. Both neurological and systemic diseases as well as tumors, osteoporosis, bone pathologies should be sought and ruled out."