Thursday, March 4, 2010

Disc Decompression therpay

Between the bones of the spine (vertebrae) there is soft tissue which acts like a shock absorber. Through injury or other causes, some patients have had this material compressed, distorting the shape of the disc and causing the material to create pressure on surrounding nerves (neural impingement). Several conditions may cause such neural impingement, including spinal stenosis, disc herniation, or, rarely, tumors.

Disc decompression is a surgical procedure performed to alleviate pain caused by pinched nerves. In this procedure, a small portion of the bone over the nerve root and/or disc material from under the nerve root is removed. This gives the nerve root more space and provide a better healing environment.

There are two common types of decompression procedures:

  • Microdiscectomy (or micro-decompression)
  • Laminectomy (or open decompression)

With modern spine surgery techniques, both procedures can usually be done with reduced post-operative discomfort and a high degree of success in alleviating low back pain and/or leg pain.

The microdiscectomy procedure

A small portion of the bone over the nerve and/or disc material from under the nerve root is removed to relieve neural impingement and provide room for the nerve to heal. A microdiscectomy is typically performed for lumbar herniated disc.

A microdiscectomy surgery is more effective for treating leg pain than for lower back pain. The impingement on the nerve root can cause substantial leg pain, and while it may take weeks or months for the nerve root to fully heal and numbness or weakness get better, patients normally feel relief from leg pain almost immediately after a microdiscectomy surgery. Microdiscectomy surgery is typically recommended for patients who have experienced leg pain for at least six weeks and have not found sufficient pain relief with conservative treatment such as oral steroids, NSAID's, and physical therapy.

Importantly, since almost all of the joints, ligaments and muscles are left intact, a microdiscectomy does not change the mechanical structure of the patient's lower spine (lumbar spine).

Usually, a microdiscectomy procedure is performed on an outpatient basis or with one overnight stay in the hospital. Post-operatively, patients may return to a normal level of daily activity quickly.

The laminectomy procedure

A lumbar laminectomy is a surgical procedure that is performed to alleviate pain caused by neural impingement. The laminectomy surgery is designed to remove a small portion of the bone over the nerve root and/or disc material from under the nerve root to give the nerve root more space and a better healing environment.

A laminectomy is effective in decreasing pain and improve functions for patients with lumbar spinal stenosis, a condition that primarily afflicts elderly patients and is caused by degenerative changes that result in enlargement of the facet joints. The enlarged joints then place pressure on the nerves.

The surgical results for a laminectomy are much better for relief of leg pain caused by spinal stenosis, and not nearly as reliable for relief of lower back pain. Although removing the lamina and part of the facet joint can create more room for the nerve roots it does not eliminate the arthritis. Unfortunately, symptoms may recur after several years as the degenerative process that originally produced the spinal stenosis continues.


LASE stands for "Laser Discectomy", a procedure where laser light is used to correct problems with discs in the spine. The procedure is common and less invasive than other alternatives.

After sedation, a miniature endoscope with a laser fiber is carefully inserted into the disc while remaining outside the spinal canal. A laser is used to remove disc tissue near the herniated site in order to decompress the disc. The procedure takes approximately one hour. Success rates are seen in about 66 - 75% of all patients who have this procedure.

The incision through the skin is less than 1/4 inch. The LASE endoscope allows your doctor to see the bulging disc tissue and remove it with the laser fiber. By removing some of the nucleus from the disc, the pressure on the nerve is reduced or eliminated along with the pain.

LASE -bridges the gap between conservative therapy and surgery for the treatment of contained herniated discs. The LASE procedure is a cost-effective, minimally-invasive treatment for those patients who prefer to avoid conventional back surgery. LASE often provides relief from the pain and a fast return to routine activities. Because it is minimally-invasive, it is appropriate for many patients whose health or age may exclude them from more aggressive surgical intervention.

Want stand tall? Then sit straight!

Fixing one's posture requires discipline and persistence. Mind Your Body lists some tips to help you along:

1: Reverse your routine
If you slouch all the time, try sitting or standing up straight as long as you can and then slouch for short intervals to relax.

The more you practice, the easier it will be to maintain proper posture for longer periods, said physiotherapist Farzad Hafezi of Documentation Based Care Singapore.

2: Work smart:

Occupational therapist Chen Hui Wen from Changi General Hospital shares this advice:

Adjust the height of the chair you use in the office so your table is at elbow level. This will help you avoid hunching at work.

Keep your chair close to your desk to avoid having to lean over.

Make sure your feet stay flat on the ground while you are seated. Use a foot rest for support if necessary.

Place a cushion in the small of your back if your chair does not have back support.

Take frequent short breaks. No matter how ergonomically correct your work station is, the human body is not meant to stay in one position for too long.

3: Set yourself visual reminders:

Use small coloured stickers as visual reminders to sit or stand up straight.

You can stick these on places like the corner of your laptop screen, on your watch or your mirrors at home, said Mr Farzad.

4: Stretch

Rounded, or forward slouching, shoulders can result when one's tight chest muscles pull the weaker upper back muscles forward, said Mr Farzad.

Stretch these muscles by pulling your shoulder blades back and holding them there for a few seconds. Repeat sets of this process throughout the day. More simple posture exercises can also be found at:

5: Tape your back

Get into a proper posture position and stick an 'X' across your upper back using medical tape.

This way, when you start to slouch or when your shoulders drop, the tug felt can serve as a reminder to straighten your back again, said Mr Farzad.

Sitting straight boosts your confidence!

Sitting up straight isn’t just good for your posture - it also gives you more confidence in your own thoughts, says a new study.

Researchers found that people who were told to sit up straight were more likely to believe thoughts they wrote down in that posture, regarding their fitness for a job.

On the other hand, those who were slumped over their desks were less likely to accept these written-down feelings about their own qualifications.

The results, based on a study of 71 students at Ohio State University (OSU), show how our body posture can affect not only what others think about us, but also how we think about ourselves, said Richard Petty, study co-author and OSU psychology professor.

“Most of us were taught that sitting up straight gives a good impression to other people,” Petty said.

“But it turns out that our posture can also affect how we think about ourselves. If you sit up straight, you end up convincing yourself by the posture you’re in,” Petty added.

The research was published in the October issue of the European Journal of Social Psychology.

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