Isthmic Spondylolisthesis: Treatment In Allen, TX

by Administrator 16. September 2017 12:10

Isthmic Spondylolisthesis is caused when one vertebra slips over the one below because of a fracture (Spondylolysis), elongation or other defect of a small bone (pars interarticularis – or isthmus) that connects the upper and lower facet joints. The isthmus has poor blood supply and is highly prone to stress fractures. The fracture may occur due to repeated, cumulative stress rather than trauma.

It usually involves the lowest level of the lumbar spine (L5-S1 segment). The condition does not usually cause any noticeable instability because of the large sacral ligament which connects L5 to the sacrum. Rare occurrences of the condition at the upper levels (L4-L5 or L3-L4) are known but trauma – rather than stress - is the more likely reason in such cases. If L5 slips off the sacrum down onto the pelvis, an extremely rare condition called “Spondyloptosis” occurs.

Though the isthmic fracture occurs in kids in the age group of 5-6 years, the symptoms manifest themselves only when the kids grow. It is not known to be a congenital condition. It also occurs in adolescents, athletes (like gymnasts), and the aged.  Isthmic Spondylolisthesis is a common cause of back pain in the adolescent group.

A huge majority of people – about 75 to 80% - usually do not show any symptoms (asymptomatic) and rarely require medical intervention. The condition may however, turn symptomatic in adults who are in their thirties or forties. The severity of the condition is usually graded on a scale of 1 – 4, in the order of increasing severity.

Causes:

  • Fracture, elongation or other defect of a small bone (‘pars interarticularis’ – or ‘isthmus’) that connects the upper and lower facet joints
  • Cumulative stress on the lumbar spine
  • Hyperextension of the lumbar spine as in athletic activities like gymnastics, weightlifting, playing football etc
  • Disc Degeneration in adults

Symptoms:

  • Low back pain often described as a ‘deep ache’
  • Radicular pain, i.e. pain that radiates into the buttocks and the back of thighs
  • Pain may radiate into the knees or feet
  • Pain which may aggravate while standing, walking, bending backwards, coughing, sneezing, etc.
  • Amelioration of pain when one is sitting or reclining back
  • Numbness, tingling sensation particularly after walking
  • Noticeable deformity of the lumbar back
  • Spinal Stenosis  or narrowing of the spinal canal
  • Progressive numbness/weakness of the legs
  • Urinary/fecal incontinence may also be noticed
  • Muscular spasm
  • A limp may develop and the gait may get altered

Diagnosis:

  • Medical history of the patient may be assessed
  • Physical examination to investigate and ascertain pain, balance while walking and other symptoms 
  • X-rays
  • MRI
  • CT Scan

Treatment:

  • Rest – particularly when the condition is caused due hectic athletic activity
  • Ice packs/Hot water bags
  • Medication with anti-inflammatory agents, Non-steroidal anti-inflammatory drugs may be prescribed
  • Simple stretching exercises may provide relief
  • Physiotherapy sessions may be recommended
  • Braces may be worn to support the spine
  • Surgical intervention by way of ‘spinal fusion’ may be a solution in rare cases

To know more about Isthmic Spondylolisthesis and other orthopedic conditions of the spine, visit the doctors at OrthoTexas. For an appointment, call us at (972) 727 – 9995 or visit 1125 Raintree Circle, Suites 100/100A, Allen, TX 75013.

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Orthopedic Treatment For Back Spasm

by Administrator 12. December 2016 07:32

Back spasm refers to the sudden, involuntary muscle contractions that lead to sharp pain in the lower back. A spasm is considered to be a natural mechanism through which the muscles protect themselves from the external or internal stress to any part of the body.

In the back, a spasm may be an indicator of either an underlying condition or injury to any of the spinal structures. It requires immediate medical attention and if left untreated, may result in permanent physical disability.

Causes

  • Anatomical conditions such as Herniated Disc, Spinal Stenosis, Osteoarthritis of the spine, Spondylolysis or Degenerative Disc Disease
  • Overuse injuries
  • Poor postural habits
  • Direct injury to the spine
  • Sports injuries
  • Vehicular accidents
  • Dehydration as well as deficiency of calcium and potassium
  • Lifting heavy weights
  • Spinal abnormalities, such as Kyphosis and Lordosis
  • Weak muscles along the spine and stomach

Symptoms

  • Sudden tightening of the back muscles
  • Dull or severe pain
  • Limited range of motion
  • Pain may be felt even while resting
  • Tingling sensation in the back, upper or lower extremities
  • Uncontrolled bladder and bowel movements
  • Numbness

Diagnosis

  • The patient may be questioned about the duration and onset of the pain, routine activities, occupation, past injuries, medications etc.
  • Palpation may be done to identify the exact location of the pain
  • The patient may be asked to perform some physical movements to identify the positions that increase pain
  • X-ray imaging may be done to analyze the bone structure
  • MRI and CT scan may help to diagnose problems in the soft tissue as well as vertebrae

Treatment

The aim of the treatment is to allow the affected muscles and soft tissues to heal naturally. For this, an orthopedic doctor may recommend the following treatment options:

  • Lie down on your back and keep the upper part of the body slightly elevated using pillows
  • Anti-inflammatory medicines and muscle relaxants may help to relieve pain
  • Applying ice packs at regular intervals to the affected part may help to reduce inflammation
  • Performing light exercises may help to improve blood circulation within the spine and promote healing
  • Using heat pads may provide immediate relief from muscle stress
  • Avoiding activities such as lifting weights, bending, twisting etc. may prevent aggravated pain and discomfort
  • Physical therapy may be required to promote muscle strength, flexibility as well as prevent recurring flare ups in the future

The spine specialists at OrthoTexas provide complete diagnosis and treatment for back spasm and other orthopedic conditions. To request an appointment with the surgeons in Allen, TX, feel free to call at (972) 727-9995.

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Lumbar Spinal Stenosis: Causes, Symptoms And Treatment

by Administrator 19. May 2016 10:06

The spinal column begins at the base of the head and extends to the lower back. It is made up of many small sized bones called vertebrae (stacked one above the other), nerves, intervertebral discs, ligaments and muscles. Lumbar Spinal Stenosis or LSS is a medical condition which arises as a consequence of the narrowing of the spinal column. It is termed as Lumbar Spinal Stenosis as it affects the lower back or the lumbar region of the spine. The symptoms of Spinal Stenosis develop over a period of time and occur periodically rather than being continuous. The condition can be of two types:

  • Central Stenosis- Narrowing of the central part of the spinal column
  • Foraminal Stenosis- Narrowing of the foramen or the part of the spinal column through which the nerve endings move out of the spinal column

Causes

  • Degeneration or general wear and tear of the spine
  • Congenital defects in the spine
  • Spinal Disc Herniation
  • Bone Tumor
  • Osteoporosis
  • Skeletal Dysplasias
  • Arthritis

Symptoms

  • Pain in the lower back which may radiate down to the buttocks, legs and feet
  • Tingling or pricking sensation in lower extremities
  • Loss of control over the bladder and bowel movement
  • Numbness and weakness in lower body parts
  • Claudication- pain is felt in the legs while walking
  • Difficulty in lying on the back, sitting or standing
  • Heaviness, fatigue, restricted motor function
  • Development of Postural Kyphosis over time

Diagnosis

  • MRI
  • CT scan may help to reveal bone development within the spine
  • Myelogram- injecting a dye in the spinal canal may provide a better view of the spinal structures
  • X-rays may help to diagnose abnormal bone spurs or shortening of disc height
  • Evaluation of the existing symptoms
  • Detailed analysis of the patient’s medical history

Treatment

  • Prescription of anti-inflammatory medicines and muscle relaxants to combat back ache and stiffness
  • Specific set of exercises may be recommended to keep the patient active and boost flexibility and strength
  • Lifestyle modifications need to be made and activities that exacerbate the pain should be avoided
  • Lumbar traction may be helpful in some cases
  • Injecting corticosteroids  into the epidural cavity may provide temporary relief
  • Laminectomy- surgical procedure which aims to remove any bone outgrowths or ligaments that compress the spinal nerves
  • Spinal fusion may be recommended in cases when the spine becomes unstable due to Arthritis. The vertebrae are fused together for added support
  • Surgical decompression may be done by making small incisions
  • Use of a removable back brace post surgery
  • Physical therapy may be required to regain mobility and flexibility

The spine doctors at OrthoTexas provide effective treatment for Lumbar Spinal Stenosis and other orthopedic conditions. To schedule an appointment with the doctors in Allen, TX, call at (972) 727 – 9995.

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Pilon Fractures: Orthopedic Allen, TX

by Administrator 19. August 2015 06:09

A Pilon Fracture, also known as Plafond Fracture, is a break or crack in the distal part of the tibia (shinbone) near the ankle. It is usually caused due to high impact injuries to the ankle, which cause the bones to crush into several pieces. In some cases, a Pilon Fracture may affect both the bones in the lower leg, tibia and fibula.  

Mainly, Pilon Fractures can be categorized as:

  • Type 1 Fracture: This is caused by low energy injuries in which the bone fragments are almost aligned and the joint surface is also appropriate.
  • Type 2 Fracture: This is a moderate energy injury in which the joint surface becomes incongruous.
  • Type 3 Fracture: This is a high impact injury in which the joint surface becomes inconsistent and the fracture extends up to the tibia.

Causes

  • Fall from a height
  • Motor vehicle injuries
  • Sports related injuries
  • Skiing accidents
  • Direct blow to the lower leg near the ankle

Symptoms

  • Severe pain
  • Swelling in the lower leg and around ankle joint
  • Bruising and discoloration near the ankle
  • Tenderness on touch
  • Formation of blisters
  • Inability to stand or walk
  • Visible deformity in the ankle joint

Treatment

Most Pilon Fractures require surgery to be treated completely. However, for patients with certain health problems or minimal physical activity, conservative treatment may be recommended.

Non-Surgical Treatment:

  • Immobilization: If the broken bone pieces are stable and not entirely misaligned, the orthopedic doctor may immobilize the ankle with the help of a cast or splint. Once the swelling subsides, the cast may be substituted with a brace that need to be worn for around 8 to 10 weeks.
  • Anti-Inflammatory Medications: The orthopedic doctor may prescribe certain anti-inflammatory medications to provide relief from pain and compress swelling.

Surgical Treatment:

  • External Fixation: It may be recommended in Pilon Fractures involving considerable damage to soft tissues. Certain external fixation devices, such as metal frames or screws, are used to stabilize the bones and allow the soft tissues to heal.
  • Internal Fixation: It may be suggested in type 2 or 3 fractures. Metal plates, screws or rods may be implanted to hold the tibia fragments in place till the time they heal.
  • Ankle Fusion: Surgery may be recommended in severe case of Pilon Fractures where the bone fragments are completely out of place. During the procedure, the orthopedic surgeon may reposition the fractured bone pieces into their original place.

The orthopedic surgeons at OrthoTexas, Allen provide complete diagnosis and treatment for Pilon Fracture. To schedule an appointment, you can call at (972) 727 – 9995 or visit 1125 Raintree Circle, Suites 100/100A, Allen, TX 75013.

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