This document discusses maintaining proper posture to prevent back pain and injury. It recommends sitting with neutral spine alignment, either by sitting forward on the chair without back support or leaning back with back support. Certain postures can increase back injury risk factors. The document also mentions biopsy procedures for cancer diagnosis and treatment options for back pain including physical therapy, injections, and surgery, noting minimally invasive surgeries have benefits like better patient outcomes, lower costs, shorter hospital stays and recovery times, and less invasiveness especially for the elderly.

1. BACK PAIN
Dr Fong Shee Yan
MBBS, FRCS, FAMS
Singapore SPORTS
And Orthopaedic
Clinic

2. Maintaining a neutral spinal
posture is important when seated
as well as during lifting tasks.
If sitting without back support,
rotate the hips forward until a
neutral posture is achieved.
If using the backrest, sit back in
the chair to allow the backrest to
help maintain a neutral posture
and reduce muscle loading.
“Flat” Neutral
Back Injury Risk Factors

3. “Red Flags” !

6. BIOPSY FOR CANCER
• Remove the Stylet from the Osteo
Introducer (or Advanced System)
• The cannula should be 2-3mm in
front of the posterior wall of the v.b.
• For a biopsy, use a Bone Biopsy
Device (BBD) Advance manually to
the anterior third of the v.b. Retract
the device, and eject the biopsy
using the BBD stylet

11. Nachemson

12. MRI
Pfirrmann’s
…naturally

13. MRI
Pfirrmann’s
…naturally

14. MRI
Pfirrmann’s
…!!!!!!!!!!!!!!

15. Better ?

16. Better ?
Physical Therapy 50-70%
Intradiscal Injection 70%

17. Repeat MRI ?
Physical Therapy 50-70%
Intradiscal Injection 70%

18. Repeat MRI
Surgery 90%

21. Minimal

25. MRI
Pfirrmann’s
…!!!!!!!!!!!!!!

26. MRI
Pfirrmann’s

29. Why Minimally Invasive ?
• Patient Outcomes
• Costs
•Length of Stay
•Length of Recovery
• Less Invasive for the elderly
治疗效果肯定，可达到切开手术的效果，
且有创伤小、病人痛苦少、易接受。
住院时间短，术后早期恢复活动及工作。

30. Thank You
Dr Fong Shee Yan