2013年1月22日星期二

Spine Navigation Surgery (1)


Spine Navigation Surgery - minimally invasive and computer assisted surgery

Spine Navigation Surgery was introduced since year 2000 and adapted in Hong Kong for more than 5 years. Similar technology was widely used in daily activities like driving, computer games (like Wii),etc.. The image-based technology used in spinal surgery utilizes scans of the patient's bony anatomy and instruments that are tracked by the Navigation System's camera. Navigation can help orthopaedic surgeons to guide their instruments for precise screw placement and reduce X-ray exposure.





Spine navigation surgery - Applications

Orthopaedic doctors will undergo proper diagnosis and evaluation before recommendation of surgery. Generally, spine navigation surgery is applicable for common spinal disorders requiring screw placement and especially for areas requiring high surgical precision. For example,

  1. Revision spine surgery.
  2. Patients with osteoporotic bones.
  3. High risk areas like the cervical spine or areas with severe deformities.









Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.

2013年1月21日星期一

Degenerative scoliosis (2)


Treatment

In some cases, the symptoms can be relieved and activities of daily living can be maintained by appropriate pharmacologic treatment. For patients with their daily function severely affected despite of non-surgical treatment, surgical decompression and reconstruction can be considered after taking into the accounts the pros and cons in particular patient’s medical co-morbidities.





Surgery

The purpose of the surgery is to reduce pressure on the nerve, stabilize and improve the spine alignment by instrumentation and fusion. 3D computer navigation helps to reduce the difficulty and improve the precision of screw insertion in the deformed areas.












Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.


2013年1月18日星期五

Degenerative scoliosis (1)




Symptoms

Scoliosis means abnormal lateral curvature in the spine. There are different kinds of scoliosis. While the others kinds presents mainly in childhood and adolescent with purely deformity, the degenerative scoliosis mainly affects the elderly population by not only deformity but also neurological symptoms. It is regarded as the most severe stage of spine degeneration.




Clinical signs

Detailed clinical consultation, examination would identify the functional impairment and neurological deficit. Standing and dynamic x-ray examination measures the deformity and instability. MRI scan helps to precisely locate the area of nerve compression. Other examinations like CT scan and nerve root block may be necessary in some cases.




Exercise

Physiotherapy is an effective way to strengthen your muscles. The strong muscles can help to maintain a correct position of the spine. Low-impact activities can increase overall fitness without straining the back.











Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.

2013年1月14日星期一

Sciatica




Prolapsed intervertebral disc causing sciatica

Sciatica is a pain symptom radiating from the low back to the calf and foot. It is usually caused by prolapsed intervertebral disc most commonly occurred at 30-50 years old. At these age, our intervertebral discs, especially the lower lumbar, started to have tears of different extent, followed by dehydration and collapse. The may cause low back pain and it was reported that up to 80% of the population may have a least one episode of major low back pain during their working age. These tears cause pain but most of these are only transient. The pain may improve with time and the most important factor to improve the symptoms and prevent it from becoming chronic pain is to stay active, sometimes with the aid of appropriate pain medications and physiotherapy. In some of the individuals, the disc may protrude through the tear and cause compression on the lumbar nerve. This causes radiation pain down the leg, i.e. sciatica.


Physiotherapy

There are various modalities of physiotherapy help to relief pain and prevent prolonged bed rest which is found to be detrimental to functional recovery. More importantly, the physiotherapists help the patient to maintain proper posture and perform appropriate exercise to strengthening the back muscles. The strong muscles can help to maintain a correct position of the spine. Low-impact activities can increase overall fitness without straining the back.


Pharmacologic and surgical treatment

According to research and clinical experience, many patients can relieve their pain by maintaining regular and appropriate physical activities in several weeks. Six weeks of physiotherapy / pharmacologic treatments would be advised for general case. Orthopaedic doctors may employ nerve blockers for some serious cases. Generally, more then 80% of the patients would have their symptoms improved with these non-surgical treatments in a few weeks’ time. Surgical treatment is indicated for
Cauda equina syndrome-the lumbar and sacral nerve roots are severely compressed by the propapsed intervertebral disc. Apart from lower limb pain, the patient also has pain and numbness in in the buttocks and peranal area and bowel and uninary incontinence or retention. This condition needs emergent surgical treatment.
The disabling pain persist after 6 weeks of physiotherapy / pharmacologic treatments
Progressively worsening neurological deficit.
Orthopaedic doctors will undergo proper diagnosis and evaluation before recommendation for surgery. The main purpose of the surgery is to reduce pressure on the nerves.


















Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.

2013年1月10日星期四

Fracture


Bone fracture and healing

In the past, fracture reduction and fixation required absolute anatomical reduction and stability. This often led to fracture non-union due to excessive vascular and soft tissue damage during surgery. Nowadays, absolute anatomical reduction is found to be un-necessary except fractures into joints. The reduction and fixation should minimize the trauma to the surrounding blood vessels and soft tissues. The fixation stability should be relative to stimulate bone formation during fracture healing. Modern minimally invasive fracture and reduction techniques help to achieve these goals on one hand, and to facilitate rehabilitation and functional recovery on the other.






Reference information: www.ispine.com.hk

It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your personal physician.

2013年1月4日星期五

如何診斷骨質疏鬆症?



 


骨質疏鬆症通常由你的詳細病史、身體檢查、骨骼 X光、骨質密度儀及一些特殊化驗測試診斷出來的。如果你的醫生發現你有過低的骨質,他可能需要進行其他的測試來排除可能引起骨質流失的其他疾病,如軟骨病(維生素D 缺乏症)或副甲狀腺功能亢進。

骨質密度儀是一種安全無痛的X光檢查。它會拿你的骨質密度與你相同性別和種族的人,在其大約 20 25 歲時的骨質密度(即人生中最高的骨質密度)作比較。

這種檢查通常用於更年期的女性身上。現今有多種骨質密度儀用來檢查身體不同地方的骨質密度。雙能量 X射線骨質密度測量儀(DEXA)是最準確的方法之一,但是其他的技術也能作出診斷,包括單光子吸收測量(SPA),定量計算機斷層掃描(QCT),放射線骨質密度儀和超聲波。你的醫生會決定那一種方法比較適合你。

骨質疏鬆症會導致脊椎骨質變弱而部分倒塌,身高因而變矮及產生駝背。










參考資料: www.ispine.com.hk

以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的骨科醫生查詢,而不應單倚賴以上提供的資料。



2013年1月2日星期三

甚麼是骨質疏鬆?



在我們的一生中,骨質都在不斷地生長及分解。若這兩者之間能取得平衡,骨骼便得以保持強健。然而,在大約30歲後,骨骼的分解便開始超越生長的速度,令骨骼變得脆弱和多孔。當骨質密度減低至一定程度,便屬於骨質疏鬆。

骨質疏鬆的情況十分普遍。在香港,約有一半更年期後的婦女患有骨質疏鬆。




骨質疏鬆 後果可大可小
由於早期症狀不明顯,骨折或許是骨質疏鬆最先出現的症狀,它可出現在身體的任何部位,包括脊椎、股骨。


如不及早預防和治療骨質疏鬆,可能會引致以下嚴重後果:
骨折
活動能力下降
失去自我照顧的能力
生活質素下降
永久殘障
死亡




骨質疏鬆的預防
不少簡單的生活習慣,都可補充骨質及預防骨折,並有助減低患上骨質疏鬆的機會。這些包括:
多吸收鈣質
多接觸陽光有助吸收維他命D
適量的負重運動(建議與專業人士商討)
減少或避免吸煙及酗酒










參考資料: www.ispine.com.hk

以上所提供的資訊僅作為教育及參考用途,如果你有任何醫療問題,
應向自己的骨科醫生查詢,而不應單倚賴以上提供的資料。