Disc disease: Difference between revisions

Revision as of 07:10, 28 March 2011

Background

if no cauda equina or progressive neuro deficit- delay surg for a month
epidural steroids for temporary symptomatic relief
discetomy gives better pain control over 4 yrs but not past 10
microdiscectomy similar to standard discectomy but perscutaenour or laser disctmy less effective than standard surg

SPINAL STENOSIS

avoid alcohol and strengthen legs to prevent falls
exercise bike or walking recommened with rest when pain comes
decompressive laminectomy for severe persistent pain
adding spinal fusion to decompression improves outcome
even with surg, sxs may reoccur in a few years

CHRONIC LBP

neural remodeling and neurplasticity may explain chronic pain in absence of ongoing tissue injury- alters perception of pain
intensive exercise helps
antidepressants especiallly tricyclics (better than SSRI), also helpful
no long term opioids
goals may need to be refocused
multiple surgical precedures no helpful

PREVENTION

corsets and education not helpful
wt loss, excersice, stop smoking helpful

Source

7/2/09 PANI

Authors:

@@ Line 1: / Line 1: @@
-- if no cauda equina or  progressive neuro deficit- delay surg for a month
+==Background==
+# if no cauda equina or  progressive neuro deficit- delay surg for a month
+# epidural steroids for temporary symptomatic relief
+# discetomy gives better pain control over 4 yrs but not past 10
+# microdiscectomy similar to standard discectomy but perscutaenour or laser disctmy less effective than standard  surg
-- epidural steroids for temporary symptomatic relief
+==SPINAL STENOSIS==
+# avoid alcohol and strengthen legs to prevent falls
+# exercise bike or walking recommened with rest when pain comes
+# decompressive laminectomy for severe persistent pain
+# adding spinal fusion to decompression improves outcome
+# even with surg, sxs may reoccur in a few years
-- discetomy gives better pain control over 4 yrs but not past 10
+==CHRONIC LBP==
+# neural remodeling and neurplasticity may explain chronic pain in absence of ongoing tissue injury- alters perception of pain
+# intensive exercise helps
+# antidepressants especiallly tricyclics (better than SSRI), also helpful
+# no  long term opioids
+# goals may need to be refocused
+# multiple surgical precedures no helpful
-- microdiscectomy similar to standard discectomy but perscutaenour or laser disctmy less effective than standard  surg
+==PREVENTION==
+# corsets and education not helpful
+# wt loss, excersice, stop smoking helpful
-SPINAL STENOSIS
-- avoid alcohol and strengthen legs to prevent falls
-- exercise bike or walking recommened with rest when pain comes
-- decompressive laminectomy for severe persistent pain
-- adding spinal fusion to decompression improves outcome
-- even with surg, sxs may reoccur in a few years
-CHRONIC LBP
-- neural remodeling and neurplasticity may explain chronic pain in absence of ongoing tissue injury- alters perception of pain
-- intensive exercise helps
-- antidepressants especiallly tricyclics (better than SSRI), also helpful
-- no  long term opioids
-- goals may need to be refocused
-- multiple surgical precedures no helpful
-PREVENTION
-- corsets and education not helpful
-- wt loss, excersice, stop smoking helpful
+==Source==
 /2/09 PANI
 [[Category:Neuro]]
+[[Category:Ortho]]