OUCH , MY BACK HURTS !
Dr Sureisen Mariapan
“ Cause for the pain will be identified with further imaging modalities like X-rays and Magnetic Resonance Imaging . Currently , a lot of minimally invasive options are available to treat this conditions . Back pain can be treated with radiofrequency ablation of facet joints , intradiscal therapy like laser with epidural steroid injections . Radiculopathy ( pain radiating to leg ) responds well to transforaminal epidural steroid injection , pulsed radiofrequency of dorsal root ganglion and endoscopic decompression surgery .
“ For more advanced disc disease , fusion surgery would be advised ,” he said .
RADIOFREQUENCY PROCEDURES He said that if the back pain is due to degenerative facet joints , radiofrequency procedure is a good option of treatment .
“ This procedure is done by inserting needles to numb the sensory nerves that supplies the affected facet joints at your back , thus reducing the pain sensation transmitted to the brain . This can be done as day care procedure ” he said .
ENDOSCOPIC SPINE SURGERY Spinal stenosis and intervertebral disc problem can be addressed effectively with endoscopic decompressive or discectomy surgery . This surgery is performed using spinal endoscope via 1cm wound .
“ Using spinal endoscope , the image of the spinal structures are magnified 10x . We are able to remove the bone or ligament that is squeezing the nerve safely and effectively . Blood loss , wound infection and pain after surgery can be reduced significantly . Patient able to return to work and resume their activities faster . I believe this makes surgery in elderly patients feasible and safe ,” he said .
S
ITTING too long and concentrating on working using a computer with incorrect posture can cause back pain . Two common condition seen in office workers are spinal disc syndrome and spinal stenosis .
SPINAL DISC SYNDROME AND SPINAL CANAL STENOSIS
Spinal disc disease ranges from disc tear , slip disc to aging disc ( degeneration ). With progression , pain and numbness will radiate to the hips , knees and foot , a condition known as sciatica . Further progression of this disease can lead to urinary and defecation difficulties .
Pantai Hospital Kuala Lumpur Orthopedic Consultant and Spine Surgeon , Dr Sureisen Mariapan , said back pain with radiation to hip and leg could occur because of torn disc due to the injury , with resultant disc herniation compressing the nerves .
Dr Sureisen said the cause of the pain can also be attributed to spinal stenosis where nerves are squeezed together in a narrowed spinal canal .
“ This is associated with reproducible leg pain with walking and other activities . Typically , pain subsides with cessation of activity and rest ,” he said . Spinal stenosis predominantly seen in those aged 40 years and above . However due to ‘ office syndrome ’ contributed to prolonged sitting , it is commonly seen in individuals in the mid-30s .
EARLY MEDICAL ATTENTION “ Those with back pain due to aging spine would be advised for short course of anti-inflammatory medications and physiotherapy up to six weeks to recuperate .”
FUSION SPINE SURGERY In advanced disc disease , fusion surgery is advised . The disc has degenerated and incompetent to absorb the pressure loaded on the spine . Painful movement together with severe leg pain necessities fusion surgery to replace the painful , compressive disc and stabilize using titanium pedicle screws .
“ Minimally invasive spinal fusion is effective and safe . Newer technologies like navigation and robotic assisted surgery able to increase the accuracy and safety of the procedure .”
RECOVERY PERIOD Dr Sureisen said the period for a patient to fully recover depends on the surgery and severity of the disease . Usually , patient can be discharged in 2-3 days after surgery . Patient able to perform mild physical activities 2 weeks after discharge . Rigorous physical activities and driving is advised to be avoided during the first 4-6 weeks after surgery .
He advised individuals who have symptoms of back pain or radiating pain to leg , to consult spine surgeon early .
Contact us : Pantai Hospital Kuala Lumpur 8 , Jalan Bukit Pantai 59100 Kuala Lumpur , Malaysia Tel : + 603 2296 0888 ( General Line ) Tel : + 603 2296 0706 ( International Patient Centre ) Website : www . pantai . com . my / kuala-lumpur Email : my . phkl . ipc @ parkwaypantai . com / my . phkl @ parkwaypantai . com
GlobalHealthAsiaPacific . com OCTOBER 2021
31