Causes of low back pain:
Posture disorders
Soft tissue strain
Herniated disc
Calcifications
Lumbar shifts
Tumors
Inflammatory and microbial diseases
Bone diseases
Fractures
Diagnosis:
The patient who applied with the complaint of low back pain should firstly undergo a clinical examination. Complaints of leg pain in addition to low back pain, sensory defect, loss of strength, and thinning of the muscles require investigation.
The most common and reliable examination method used in spine and nervous system diseases is MR imaging. In addition to MRI, Computed Tomography, EMG (measures the electrical activity of nerve and muscle tissues) can be performed.
Treatment: Treatment is planned according to the diagnosis made as a result of the examinations.
Mechanical Low Back Pain: Low back pain due to improper use of the waist. Appropriate medications, 1-2 days of rest and exercise are the appropriate treatment methods. If mechanical low back pain is chronic, physical therapy is appropriate.
Spinal Fracture: Depending on the degree of the fracture, medication rest, corset application, kyphoplasty (bone cement injection into the fractured spine), stabilization (fixation of the spine with screws) can be performed.
Lumbar Slip: Treatment is planned according to the degree of slippage. If drug therapy, exercise, physical therapy and corset applications are not sufficient, stabilization treatment can be performed.
Inflammatory Diseases: Treatment is planned according to the microorganism causing the inflammation.
Spinal tumor: Treatment is planned according to the characteristics of the tumor. Removal of the tumor, radiotherapy and chemotherapy are added if necessary.
Lumbar Hernia: It is the compression of the spinal cord and/or the nerve roots coming out of the spinal cord by overflowing the cartilage tissue between the two vertebrae. In the disposition of lumbar hernia, the methods used in the treatment of mechanical low back pain are applied at the beginning.
Conditions requiring surgical treatment:
-Unbearable back and leg pain,
-Thinning of the muscle,
-Loss of strength
– Urinary incontinence (requires emergency surgery)
– Cases with long-term treatment and no response.
Treatment Methods Applied in Lumbar Hernia:
Simple Discectomy: Under general anesthesia, the surgeon reaches the spine with a 5-6 cm skin incision in the middle of the waist. It opens a window on the bone and removes the jelly-like cartilage tissue from the damaged disc from the side of the nerve tissue.
Ejecting 30% of the disk is sufficient. There is no need to replace the ejected disc. The chance of disc reoccurrence is 3-5%. Risks caused by anesthesia, nerve rupture, infection, blood collection, adhesion formation in the late period and fear of being disabled are the most important problems of herniated disc surgery. The incidence of all these complications is less than 2%.
Microdiscectomy: A 2 cm incision is made under general anesthesia. With the same method, cartilage tissue is removed with the help of a microscope. The recurrence rate is less than simple discectomy. Since less tissue is affected during the intervention, recovery is faster. The hospital stay is one day or less.
Endoscopic Microdiscectomy: In this procedure, the incision is the same as in microdiscectomy. The surgeon tries to remove the damaged disc with the help of a guide sent through the skin under the guidance of X-ray. This method also shortens the hospital stay. The recurrence is slightly higher.
Laser Nucleoplasty: It is used during the removal of the disc by burning and vaporizing the laser. Nerve tissue can also be damaged during this burning. It is not applied to every lumbar hernia case. The patient is operated under local anesthesia. After 1 hour of rest, they are discharged on the same day. It should be applied in limited cases and in good hands.
MANAGEMENT OF WAIST PAIN
Causes of low back pain:
Posture disorders
Soft tissue strain
Low back hernia
Calcifications
Lumbar shifts
Tumors
Inflammatory and microbial diseases
Bone diseases
Fractures
Diagnosis:
The patient who applied with the complaint of low back pain should firstly undergo a clinical examination. Complaints of leg pain in addition to low back pain, sensory defect, loss of strength, and thinning of the muscles require investigation.
The most common and reliable examination method used in spine and nervous system diseases is MR imaging. In addition to MRI, Computed Tomography, EMG (measures the electrical activity of nerve and muscle tissues) can be performed.
Treatment: Treatment is planned according to the diagnosis made as a result of the examinations.
Mechanical Low Back Pain: Low back pain due to improper use of the waist. Appropriate medications, 1-2 days of rest and exercise are the appropriate treatment methods. If mechanical low back pain is chronic, physical therapy is appropriate.
Spinal Fracture: Depending on the degree of the fracture, medication rest, corset application, kyphoplasty (bone cement injection into the fractured spine), stabilization (fixation of the spine with screws) can be performed.
Lumbar Slip: Treatment is planned according to the degree of slippage. If drug therapy, exercise, physical therapy and corset applications are not sufficient, stabilization treatment can be performed.
Inflammatory Diseases: Treatment is planned according to the microorganism causing the inflammation.
Spinal tumor: Treatment is planned according to the characteristics of the tumor. Removal of the tumor, radiotherapy and chemotherapy are added if necessary.
Lumbar Hernia: It is the compression of the spinal cord and/or the nerve roots coming out of the spinal cord by overflowing the cartilage tissue between the two vertebrae. In the disposition of lumbar hernia, the methods used in the treatment of mechanical low back pain are applied at the beginning.
Conditions requiring surgical treatment:
-Unbearable back and leg pain,
-Thinning of the muscle,
-Loss of strength
– Urinary incontinence (requires emergency surgery)
– Cases with long-term treatment and no response.
Treatment Methods Applied in Lumbar Hernia:
Simple Discectomy: Under general anesthesia, the surgeon reaches the spine with a 5-6 cm skin incision in the middle of the waist. It opens a window on the bone and removes the jelly-like cartilage tissue from the damaged disc from the side of the nerve tissue.
Ejecting 30% of the disk is sufficient. There is no need to replace the ejected disc. The chance of disc reoccurrence is 3-5%. Risks caused by anesthesia, nerve rupture, infection, blood collection, adhesion formation in the late period and fear of being disabled are the most important problems of herniated disc surgery. The incidence of all these complications is less than 2%.
Microdiscectomy: A 2 cm incision is made under general anesthesia. With the same method, cartilage tissue is removed with the help of a microscope. The recurrence rate is less than simple discectomy. Since less tissue is affected during the intervention, recovery is faster. The hospital stay is one day or less.
Endoscopic Microdiscectomy: In this procedure, the incision is the same as in microdiscectomy. The surgeon tries to remove the damaged disc with the help of a guide sent through the skin under the guidance of X-ray. This method also shortens the hospital stay. The recurrence is slightly higher.
Laser Nucleoplasty: It is used during the removal of the disc by burning and vaporizing the laser. Nerve tissue can also be damaged during this burning. It is not applied to every lumbar hernia case. The patient is operated under local anesthesia. After 1 hour of rest, they are discharged on the same day. It should be applied in limited cases and in good hands.
