2. BACKPAIN
4/5 ADULTS HAVE BACKPAIN ATLEAST
ONCE IN LIFETIME
PREVANTION IS SIMPLE
MOSTLY REQUIRES HOME /SIMPLE
TREATMENT
RARELY REQUIRES SURGERY
10. OTHER CAUSES
SPACE OCCUPYING
LESIONS – TUMORS
INFECTION OF SPINE-
T.B., DISCITIS
SPINAL INJURY
REFERRED PAIN FROM
PELVIC INFLAMATORY
DISEASE
DEPRESSION
11. WHEN TO CONTACT A DOCTOR
CONSTANT-INTENSE PAIN PRESENT DURING
LYING DOWN OR AT NIGHT
PAIN RADIATING TO LEG.
WEAKNESS, NUMBNESS OR TINGLING IN
LEGS.
BLADDER/ BOWEL INVOLVEMENT.
FOLLOWING A FALL/INJURY
FEVER/ WEIGHT LOSS
NEW PAIN AFTER AGE OF
50.(CANCER/OSTEOPOROSIS)
13. PLAIN X-RAYS
MORE IMPORTANT IS LAT. VIEW.
ALIGNMENT-SPONDYLOLISTHESIS.
SPINAL CANAL DIAMETER-SPINAL CANAL
STENOSIS.
DISC SPACE NARROWING.
(MISINTERPRETATION COMMON )
LOSS OF LUMBER LORDOSIS (MUSCLE
SPASM).
DEGENERATION OF SPINE (SPONDYLOSIS).
FRACTURES.
TUBERCULOSIS/ NEOPLASMS
16. NCV/BONESCAN
EMG-NCV STUDY: TO CHECK
ELECTRIC IMPULSE PRODUCED BY
NERVE, TO RULEOUT MUSCULAR
PATHOLOGY.
BONESCAN
CLINICO-PATHOLOGICAL
CORELATION IS MUST
17. TREATMENT OF ACUTE NONSPECIFIC
PAIN
PHYSICAL THERAPY-APPLICATION
OF ICE/ HEAT.
ULTRASOUND/IFT/SWD/IR
ELECTRIC STIMULATION(TENS)
SHORT TERM BED REST.
DRUGS: NSAID,MUSCLE
RELAXANTS.
SPINAL CORTISOL INJECTIONS.
PREVENSION PROGRAMS.
18. CHRONIC BACK PAIN
LOW DOSE ANTIDEPRESANT.
NSAIDs –SHORT COURSE.
PHYSIOTHERAPY TRAINING FOR
POSTURE & FLEXIBILITY.
MUSCLE STRENTHENING
EXERSICES.
ACCUPUNCTURE/ACCUPRESSURE.
19. SURGICAL TREATMENT
RARELY NEEDED.
RESERVED FOR PATIENTS HAVING
IDENTIFIABLE CAUSES OF NERVE
COMPRESSION OR INSTABILITY ON MRI.
SURGERY IS ESSENTIALY HAVING TWO
OBJECTIVES
1) DECOMPRESS NEURAL ELEMENT –
LAMINECTOMY,DISCECTOMY,FORAMINOTOMY,LAT
ERAL CANAL DECOMPRESSION,FENESTRASION
2) STABILIZASION & ALIGNMENT OF SPINE- BONY
FUSION,LAMINOPLASTY,IMPLANTS(SCREWS &
PLATES.
22. WHY SURGICAL RESULTS
DEFER?
UNDERSTANDING OF NEUROLOGY & BASIC
ANATOMY.
CLINICO-PATHO-RADIOLOGICAL
CORRELATION.
USE OF MICROSCOPE – MINIMAL
DISTURBANCE TO NORMAL ANATOMY-
BETTER DECOMPRESION. MINIMAL
SURGICAL TRAUMA TO ALREADY
COMPROMISED NEURAL TISSUE, LESS
INSTABILITY DUE TO MINIMUM INVASION &
LOSS OF BONE.
23. SURGICAL RESULTS
HIGH SPEED MICRO DRILL- AVOIDS FURTHER
INSULT TO COMPROMISED NEURAL TISSUE DUE TO
NIBBLERS, REMOVES BONE PIECES WHERE NO
OTHER INSTRUMENT CAN WORK.
MICROBIPOLAR CAUTERY- AVOIDS THERMAL
INJURY TO ROOTS,AVOIDS VASCULAR INSULT TO
ROOTS.
IITV- IMP. TO CHECK CORRECT LEVEL & DIRECT
APPROACH & FOR FIXASION WITH IMPLANTS.
MOST IMPORTANT IS SURGICAL EXPERTISE &
TISSUE RESPECT(GENTLENESS).
24. PREVENTION
DAILY EXERSICE.
BUILD MUSLE STRENGTH & FLEXIBILITY.
OMIT SMOKING.
MAINTAIN BODY WEIGHT.
CORRECT POSTURE & GAIT
- STAND SMART
- SIT SMART
- SLEEP SMART.
- LIFT SMART– LET LEGS DO THE WORK
INSTEAD OF BACK.
