Can lumbar instability be cured? Will there be sequelae?

Hello, will there be sequelae after lumbar fracture surgery for decades? Answer: Fang Zhan and Hello generally have no sequelae, mainly to protect the waist from fracture caused by external forces in the future. Can lumbar disc herniation that will not affect fertility be completely cured? Responder: Hello Wei Jianlin, ordinary surgery can be completely cured. I wish you a speedy recovery. Interviewee: zhuomuniao2008 suggested in 2008 to increase the epidural injection of equal amount of normal saline, increase intracranial pressure, and let patients lie on their backs to observe their condition, so as to facilitate brain surgery. Lumbar instability responder: Yao's lumbar instability can be caused, and it is necessary to rule out lumbar facet joint disorder or lumbar muscle strain. Acupuncture and massage physiotherapy, massage effect is very good. Fenbid can be taken orally to relieve pain. I wish you a happy mood. Respondent to the treatment of lumbar instability: Liu relieved the pain symptoms through acupuncture, massage and plaster. The second is to strengthen the functional exercise of the back muscles and increase the stability of the spine. Can you treat lumbar instability? Answer: Shuanke should not keep a posture for a long time, and the pain can be relieved by Fenbid. Vitamin B 1B 12, intramuscular injection of nutrient nerve, salt frying and hot compress of waist. You can also use the magic lamp to illuminate the local area. Generally, after a period of time, you can recover by yourself. Usually, your living habits are also very important. Avoid getting wet. If you wade in the water, get wet in the rain or sweat, you should change clothes and wipe immediately. What is the examination method of lower lumbar instability? How to check? Interviewee: qiyuk found some information about the examination of lower lumbar instability, as follows: X-ray examination is of great significance to the diagnosis of lumbar instability, especially dynamic photography, which can find vertebral instability earlier than MRI examination. Conventional photography also has certain reference significance. 1. Conventional lumbar X-ray plain film (1) generally shows that in the case of unstable lumbar spine, its main manifestations are asymmetric arrangement of facet joints and spinous processes, facet joint hyperplasia, hypertrophy, subluxation and other abnormal manifestations. (2) Traction spur: This spur is usually located in the front or side of the vertebral body, protruding horizontally, and its base is about 65438±0mm away from the outer edge of the intervertebral disc. This is due to the abnormal activity of adjacent vertebral bodies when the lumbar spine is unstable, which makes the outer fibers of the intervertebral disc annulus suffer from tensile strain. Its clinical significance is also different from the common claw bone spur. Small distraction osteogenesis indicates lumbar instability, while large distraction osteogenesis only indicates that this segment has been unstable. When the lumbar spine is stabilized, the distraction spurs can gradually disappear (Figure 2). (3) Intervertebral space stenosis: Intervertebral space stenosis is a common sign of lumbar diseases, and it is the indirect basis of dislocation and displacement of nucleus pulposus and degeneration of the whole intervertebral disc. The changes of facet joints often coexist with the stenosis of intervertebral space, because the stenosis of intervertebral space increases the pressure of facet joints, making them vulnerable to injury and pain. 2. Overview of dynamic X-ray film (1): Abnormal increase of relative displacement between adjacent vertebral bodies is one of the important manifestations of lumbar instability, and it is also the essence of lumbar instability. Clinically, for patients suspected of lumbar instability, doctors always hope to find reliable evidence of lumbar instability through X-ray examination. But in general, the X-ray plain film of lumbar spine is taken in an upright position when the patient is not doing flexion and extension activities. Due to the tension of sacrospinous muscle and static motion segment, it is difficult to show the change of posterior edge position between degenerative segments. At this time, it is necessary to observe the dynamics of lumbar flexion and extension. The continuous improvement of dynamic X-ray photography and measurement technology is helpful to the diagnosis of lumbar instability. (2) Photographic method: First, confirm the remains of Luscka joint on the X-ray film of lumbar spine (Figure 3). In the normal movement segment, the position of Luscka joint remains unchanged during the movement (Figure 4); When the motion segments are unstable, the relationship between them will change (Figure 5). Secondly, it is necessary to have an arch frame with suitable height and length, on which the patient lies prone or supine, and the lesion space is placed at the highest point, so that the lumbar muscles can fully flex and stretch under the condition of complete relaxation. When shooting dynamic photography of lumbar spine on the bow frame, it is necessary to control the shooting conditions because the ilium and sacrum overlap. Generally speaking, the center of the horizontal measuring tube is aimed at the highest point of the arch support and shoots at the center of the black box. The projection distance is 100cm, and the exposure condition is 95kV, 200 ms. (3) Measurement and calculation of displacement value: find out the segments with abnormal mutual position relationship between vertebral bodies on the X-ray film, make a connecting line A between the posterior upper edge and the posterior lower edge on the next vertebral body, and then make a parallel line C through the posterior upper edge of the previous vertebral body. Measure the vertical distance between straight lines A and C, with the backward movement indicated by RO and the forward movement indicated by AO, and measure the sagittal diameter W of the previous vertebral body. Shift value =RO (or AO)/W? 100%, when the supine position displacement value is 9%, or the prone position displacement value is 6%, it can assist the clinical diagnosis of degenerative lumbar instability (Figures 6 and 7). When the lumbar spine is completely flexed, if the Luscka joint breaks at the position of the diseased motion segment and the upper vertebral body slides forward, it generally means that the intervertebral disc has only mild degeneration; When the lumbar spine is fully extended, if the Luscka joint breaks at the position of the diseased motion segment and the upper vertebral body slides backwards, it generally indicates that the intervertebral disc has moderate or severe degeneration. Adams and others put forward the concept of "explicit damage". They believe that the tension of the interspinous ligament and supraspinous ligament is the highest when the lumbar spine is fully flexed, and the tension of the anterior longitudinal ligament is the highest when the lumbar spine is fully extended. Therefore, when the intervertebral disc degenerates moderately or above, the anterior longitudinal ligament is relaxed. If the lumbar spine is fully extended at this time, the relaxed anterior longitudinal ligament can not limit the posterior movement of the motion segment, that is, the dominant injury of the anterior limiting factor. The importance of 3.3. Overview of CT and MRI in diagnosis (1): Vertebral instability can lead to overactivity of facet joints, long-term facet joint wear and reactive bone hyperplasia, and finally osteoarthritis, which not only reduces the function of limiting vertebral flexion, but also aggravates vertebral instability. X-ray plain film can clearly show the degree of unstable segmental displacement, and can also show whether the facet joints in most cases are symmetrical, whether there is hyperplasia and hypertrophy, whether the gap is narrow, and whether there are bone spurs or osteophytes. However, due to the overlapping of bone structures, other pathological signs are often unclear on X-ray plain films, so CT and MR examination will play a role. (2) Diagnostic significance of CT examination: X-ray plain film can only reflect the two-dimensional structure of the examined part, while CT examination can show the degenerative signs seen in X-ray plain film in more detail, and can also clearly show some changes related to the compression of nerve roots and cauda equina, including calcification of joint capsule, hypertrophy of ligamentum flavum, stenosis of nerve root canal, lateral recess stenosis, deformation or stenosis of spinal canal, etc. These signs are helpful to explain the inconsistency between clinical symptoms and signs and X-ray signs. In the diagnosis of traumatic lumbar instability, CT examination can play a more superior role. Because, CT examination can not only show paraspinal hematoma, but also show the damage of posterior structure, and can also find the disorder of tiny bone structure and the interlocking of small joints. (3) The role of MRI: Clinical observation shows that MRI has the advantages of X-ray plain film and CT in analyzing the stability of spine, and can also find the changes of spinal cord intuitively. It is difficult for ct examination to show direct signs such as spinal angulation and spondylolisthesis, so sometimes CT examination is not reliable in diagnosing lumbar instability. The advantages of MRI in multi-directional imaging and direct display of spinal cord make it have special advantages in evaluating spinal instability, mainly in the following aspects: ① Diagnosis and grading of spondylolisthesis. ② To know whether the spinal canal is narrow and its degree. ③ To know whether the lumbar spine has scoliosis, angulation and its direction. ④ Display the degree and range of intervertebral disc and intervertebral joint degeneration. ⑤ Display whether the spinal cord is damaged and its nature and scope. ⑥ Soft tissues around the spine that affect the stability of the spine can be displayed, and dynamic imaging of the spine can be performed at the same time when necessary.