If the patient does not have a decrease in sensitivity and strength in the lower limbs and feet, conservative therapies are limited. There is also the technique of oxygen-ozone therapy with Tac guide
How is low back pain treated? The first step is the diagnosis: once the triggering cause has been identified, the therapeutic path is decided. The options are numerous: from anti-inflammatory drugs to pain therapy and surgery in the most severe cases. Also there rehabilitation it is part of the treatment path. There are also non-pharmacological treatments, such as for example l’ozonotherapy. If the patient does not have sensitivity and strength disorders in the lower limbs, it is limited to a conservative therapy with epidural interventions – explains Maurizio Fornari, Head of Neurosurgery at the Humanitas Clinical Institute in Milan -. If, on the other hand, despite the treatment, the pain remains very strong, so much so that the patient has problems with claudication (difficulty in walking, ed), surgery is considered. Observation times, to evaluate any improvements, are standard: for a herniated disc, 2-3 months are allowed to pass before resorting to a scalpel, if symptoms permit. A stricture takes 3-6 months, the amount of time needed to understand if the therapies lead to substantial improvements.
Very precise surgery
Unlike the case of spondylolisthesisSince this is a mechanical alteration, this is the rarest spontaneous solution, but in patients with symptoms of recent onset it is worth trying a period of conservative treatment before considering surgery. In Italy 3 and a half million people suffer from so-called isthmic spondylolisthesis, a form for which surgery is not indicated (5% of cases). The degenerative form, on the other hand, often requires intervention – continues Fornari -: it has a very high incidence over the age of 60 (30%), especially among women. Hormonal problems and osteoporosis can play a role in the onset of the disease. Vertebral surgery today is very precise, thanks to intraoperative imaging techniques. All the steps are computerized and robotic. Current interventions are rapid, minimally invasive and involve minimal blood loss. The patient can, and must, walk almost immediately and then do targeted exercises for a month – he stresses Maurizio Fornari -. Furthermore, compared to a few decades ago, the need for a subsequent intervention has almost disappeared. Goal of the surgery restore the altered components (disc, joints) and widen the size of the canal to free the nerve roots.
Healthy lifestyle
People with back problems are often understandably afraid of going under the knife and perhaps avoid being seen by an orthopedist or neurosurgeon. Nothing could be more wrong, because spinal disorders can worsen and become chronic. In some cases, surgery can prevent serious complications – he says Pedro Berjano, head of the GSpine4 operating unit of the Galeazzi Orthopedic Institute in Milan -. In the case of a herniated disc, surgery has a very high success rate, but when it comes too late the sciatic nerve may have incomplete recovery. Relatively simple endoscopic surgery, with a 5 mm wound that avoids muscle injury. The patient’s recovery can be rapid, but it requires exercise, muscle strengthening and an improvement in the general lifestyle. Unhealthy habits after surgery (smoking, overweight, poor physical activity, incorrect postures) are associated with less brilliant results. Then there are gods genetic factors which can influence the appearance of a herniated disc. An important aspect is the quality of collagen, genetically determined, but also the physical structure plays a role: in a tall and heavier person, the mechanical stress exerted on the spine is stronger. Finally, jobs that involve physical effort can in the long run encourage the development of back problems, concludes Berjano.
Tac guided ozone therapy
Ozone is a powerful anti-inflammatory and acts quickly on pain. effective on disc herniation and other disorders of the posterior compartment of the spine which may involve facet joints, muscles or ligaments. Matteo Bonetti one of the leading experts in ozone therapy in Italy, head of the Neuroradiology service at the Istituto Clinico Citt of Brescia, president of the Fio (Italian Federation of ozone therapy) and secretary of the World federation of ozonetherapy. Therefore, in addition to drugs and a scalpel, there is the option of for some back problems minimally invasive non-surgical therapies. In 1996 we began to use the oxygen-ozone therapy technique with Tac guide – Bonetti affirms -: it has the advantage of reaching the target directly with a 9 cm long needle and thanks to the images provided in real time by the Tac. In the case of a herniated disc ozone only accelerates the natural healing mechanism, leading to dehydration of the spilled material. The therapy is performed in specialized centers and not all regions reimburse it. Ozone (O3) tends to transform itself back into oxygen and therefore its concentration in the mixture must be monitored by means of a photometric reader – continues the expert -. essential to administer a precise amount, because in too high doses it can have a toxic effect. If performed correctly, the oxygen-ozone therapy technique with Tac guide it can replace, in some cases, cortisone cycles often prescribed to patients with herniated discs. And ozone doesn’t have the typical steroid side effects.
January 1, 2022 (change January 1, 2022 | 13:18)
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