Spine Diseases
Lumbar Hernia
A herniated disc is a displacement of the cartilaginous cushions (discs) between the lumbar vertebrae into the spinal canal.
The herniated structure may extend into the spinal canal and compress the spinal cord and/or nerves to the legs. This can lead to back and leg pain, numbness, chills and tingling sensation in the leg, difficulty in walking and loss of workforce, and in advanced cases, incontinence and weakness in the leg. Delay in treatment may cause the problem to worsen or become permanent. Your physician will inform you if surgery is necessary. Nowadays, microsurgical and endoscopic methods (also known as closed surgery) have made herniated disc surgeries very safe and practical. Patients get rid of their pain immediately after surgery and can walk the same day. Hospitalization period is reduced to 1 day. After a few weeks of protection and rest, they can easily return to their old lives.
Neck Hernia
Similar mechanisms and problems in lumbar herniated discs also apply in the neck. Wear and tear in the discs between the cervical vertebrae can lead to herniation into the spinal canal over time, causing severe compression of the spinal cord and the nerves going from the neck to the arms. This can lead to pain in the neck, frequent stiffness, dizziness and short episodes of blackouts, arm pain, numbness, tingling, loss of strength and clumsiness in the hands. Since the spinal cord passing through the neck region is a control line to the whole body, spinal cord compression can also lead to more advanced problems such as loss of strength in the arms and legs, balance disorders, difficulty walking, and incontinence.
In cases that do not require surgery, medication, prevention, weight control, neck exercises, cervical collars and physical therapy programs have an important place, while in cases that are advanced enough to require surgery, microsurgery and techniques are nowadays easily and safely applied and patients benefit permanently. Likewise, patients are ambulated on the day of surgery and discharged the following day. After three weeks of rest and protection, they can return to their old lives.
To summarize,
Modern treatment methods have made lumbar and cervical herniated discs less feared. On the contrary, in appropriate cases, modern endoscopic discectomy or microsurgery methods have brought patient comfort to a satisfactory level.
LUMBAR SPINAL STENOSIS (LUMBAR NARROW CANAL)
Secondary narrowing of the lumbar spinal canal due to congenital or facet joint hypertrophy. In neurogenic claudication, symptoms and signs such as pain along the nerve trace, loss of sensation and muscle weakness occur after the patient has been walking or standing for some time. Symptoms are relieved by sitting or lying down and arterial pulses are normal. In contrast to disc herniation, sciatic nerve stretch tests are negative.
SPONDYLOLISTHESIS
Spondylolisthesis is when the corpus of a vertebra (usually L4 or L5) slips forward over the vertebra below. The slippage is caused by joint failure (congenital or degenerative) or a fracture of the lamina. It is usually asymptomatic. However, in advanced cases of listhesis, narrowing of the spinal canal may cause symptoms and signs of root compression.
SPINAL TRAUMA
Each year, approximately 2/100 000 of the population is admitted to hospital for spinal trauma. Fractures or slips resulting from upper cervical (C1-4) trauma are incompatible with life due to sudden respiratory arrest due to diaphragmatic and intercostal muscle paralysis if they cause a complete spinal cord incision. Spastic quadriparesis occurs in incomplete medulla spinalis lesions in this region. Lower cervical (C4-T1) lesions occur as a result of vertebral fractures and slipped vertebrae. Lesions in this region cause spastic quadriplegia/paresis without respiratory paralysis. In spinal cord lesions above the C7 segment, the patient is often dependent on the care of others. In cases where the C7 segment is preserved, the patient is independent to some extent since wrist movements can be performed.
In collapse fractures of the thoracolumbar region, the result of spinal cord damage is paraplegia (paralysis of the legs). These patients can lead a significantly independent life with rehabilitation when upper limb strength is normal. In lesions at the T12-L1 vertebral level, the conus medullaris and cauda equina may be damaged together. A distal paraparesis/plegia with first and second motor neuron signs develops. In lesions below the level of L1 vertebra, typical cauda equina syndrome is seen. In these traumas, the prognosis is slightly more promising because the lumbosacral roots are more resistant to injury. Complete loss of motor and sensory functions below the level of the lesion occurs after complete spinal lesions at any level.