sharp pain in lower spine – Scoliosis 50 questions (very complete question summary) – scoliosis expert wang yu popular science series

What is neuromuscular scoliosis?

A: neuromuscular scoliosis refers to because of nerve and muscle disease causes the muscle strength of imbalance, especially around the spine muscle asymmetry caused by the lateral bending, the most common causes include small ル paralysis after of spastic paralysis, brain, progressive muscle ling shrinkage, etc. Because the muscle strength of paraspinous muscles is weakened or disappeared in these patients, patients often cannot sit independently, and often need both hands to support the chair to sit.

What are the hazards of scoliosis?

A: mild to moderate scoliosis does not affect visceral or other bodily functions. Only serious lateral, generally at least more than 60 degrees オ will cause chest and abdominal cavity space is significantly reduced, causing heart and lung and stomach bowel, compression and the corresponding function. Cardiopulmonary function in tolerance is reduced, refers to the activities such as as far as you can't walk breath and heartbeat to accelerate, or two or three floors on the walk to have a rest オ can continue to climb stairs. Reduced abdominal space can lead to reduced appetite and, in severe cases, pregnancy.

Does scoliosis develop in adulthood?

A: after adulthood, the side turn over 40 degrees will also develop slowly, with an average annual speed of 1 degree. And in two ages will significantly increase: one is the birth: 1 to 2 years after scoliosis generally does not affect the pregnancy and birth, but pregnancy and birth will aggravate the lateral bending, because during pregnancy can appear toughening 帯 relaxation, moreover after birth, often holding the baby in spinal load increase, the two factors are often result in a lateral curvature of apparent progress; Second, after the age of 60, osteoporosis can weaken the strength of the spine. Under the influence of gravity, the original lateral curvature will become more and more curved. Therefore, patients with lateral curvature of the column should take conscious measures in these two stages, that is, try to hold the child as little as possible after birth, start to supplement calcium after the age of 50, and actively supplement calcium after the age of 60.

How is the degree of scoliosis measured?

Answer: the degree of scoliosis is need to take an X-ray オ energy out. X-rays are usually taken of the full length of the spine and in a standing position. Take a reading on the film after taking the film. The degree that thoracic vertebra bends and waist bend wants to measure separately, get two degrees finally, one is bosom bends, another is waist bends, take the severest degree that the biggest degree represents illness commonly degree. Scoliosis is particularly common in girls with complex risk factors.

Why do you get scoliosis?

Answer: there are many reasons for scoliosis, generally divided into congenital and acquired. Congenital is to point to the abnormal development of the spine in the fetal stage. The critical stages of the embryonic development of spinal cord are the 5th and 6th weeks of gestation, when the spine is segmented. If the fetus in this period by drugs, viruses, physical and chemical factors, easy to appear spinal development. Later natural scoliosis often occurs in adolescence, more than the onset of 10 years old, the cause of the onset of scoliosis in adolescents is still unclear, but generally speaking, it does not simply appear because of the wrong way to sit and sleep or carry a bag. But there are more intrinsic causes, related to developmental abnormalities, neuromuscular imbalances, hormonal disturbances, or impaired balance regulation. There is no way to predict who will have adolescent scoliosis and who won't.

Is scoliosis hereditary?

Whipping: although some patients have a family history of scoliosis, most do not pass scoliosis on to the next generation

sharp pain in lower spine

Is the incidence of scoliosis high?

A: the incidence of scoliosis is not very low, about 3 percent, or 3 in 100 people. What is this concept? So if you go out and you see two hundred people, six of those two hundred people have scoliosis; Or maybe you have 300 kids in your grade, and if you screen them, you can find about 10 scoliosis. But why do we think it's so rare to see someone with a bent spine? This is because although the incidence of scoliosis is not low, as high as 3%, the vast majority are mild. Scoliosis can only be seen in tights when it is more than 30 degrees, and in clothes that are not too tight when it is more than 40 degrees. The incidence of scoliosis above 40 degrees is much lower, about 3 in 1,000.

Is there a difference in incidence of scoliosis between men and women?

Answer: congenital side is curved boy more see, the ratio of male and female is about 4:1. And then natural scoliosis, that is, adolescent idiopathic scoliosis, in which girls are significantly more than boys, especially in patients whose curvature exceeds 40 degrees, girls account for more than 90%.

Why is it so much more common in girls?

A: it's not particularly clear what causes it, and it's still being studied, but it does have a high incidence in girls, which suggests that genes play a role in idiopathic scoliosis.

Discover child vertebra is not straight, how should the parent do?

A: parents should be aware of the possibility of scoliosis if they see a child with shoulder or lower back asymmetry. Take your child to the hospital for an X-ray of the spine to determine whether there is scoliosis. If there is lateral bending, ask your doctor to measure the Angle. Surgical treatment is not considered if the curvature of the spine is less than 40 degrees

If it is scoliosis, how should be treated?

A: generally speaking, a side bend of less than 20 degrees requires only exercise and regular X-ray viewing. 20- to 40-degree bends require exercise and braces. If the temperature is above 40 degrees, surgical correction should be considered.

Hear some hospitals do massage traction wait for conservative treatment, is curative effect reliable?

A: it is not recommended to try yoga, massage, traction or traditional Chinese medicine for scoliosis correction. None of this has any scientific basis. Methods of treating scoliosis, such as traction beds and orthotics, were first seen in Greek medical books a few dry years ago, but after thousands of years of testing, these simple treatment ideas have proved ineffective and have been eliminated. In recent years, a large number of patients have tried and proved to be ineffective. At present, all public third-class a hospitals in China do not do this kind of treatment, which is the reason. Only some small and medium-sized private hospitals still do these treatments, but often only for commercial purposes and the final effect of treatment is very limited. Some small hospitals in Beijing do conservative treatment of scoliosis, which turns out to be deceptive. Some hospitals claim to have more than 20 patents, which are also false propaganda. Even on the Internet to show foreign patients come to see a doctor, in fact, are looking for a few foreigners posed. Hope that patients and parents who have the ability to distinguish will not be fooled again

Don't you need braces under 20 degrees?

Answer: the corrective effect of the brace is proportional to the degree of scoliosis, the greater the degree of the brace, the greater the corrective space. If the degree of degree is less than 20 degrees, the orthodontic effect of the brace is limited, which may limit the child's thoracic development, so it is better to consider the brace treatment after the degree of degree is more than 20 degrees.

If you shoot regularly without braces, how often?

A: if a child is between 10 and 13 years old, it should be taken every 3 months, and every 6 months after the age of 13.

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If the degree is between 20 and 40 degrees, what is the brace treatment?

Answer: support provides cure to must be made to order by professional technician, do not buy a back to carry on the back simply beautiful, carry on the back beautiful it is to correct habitual hump back, to true spinal column side bends is useless. Braces must be worn for 20-22 hours a day, including when sleeping, and only when bathing or exercising. As the child grows taller, the braces need to be replaced annually. Girls should wear it at least 2 years after menstruation.

What are the attention points of brace therapy?

Answer: after the brace is finished, take a film to see the effect of the brace correction, and wear 1 hour after the film, at this time the effect is the effect of the brace correction, at the same time you can feel whether the brace is appropriate, if you feel uncomfortable, you can ask the technician to adjust. Before some patients reported in other hospitals to do a brace on the wear, also did not take a picture to see the effect. This is a bad situation. If the brace doesn't work well or doesn't work at all, the child will suffer a lot instead of wearing it for a year.

If the film is re-examined every other year, the brace should be removed 4 hours in advance, so as to truly reflect the current degree. Because the degree of rebound will occur after taking off the brace, but the degree of rebound varies from person to person. What we need to review the film is the true degree of rebound.

What does exercise therapy include if it's 20-40 degrees?

A: exercises include bending sideways, flying swallows and swimming. Side bent, suitable for "c" (single bend) side

Curved, if it is the "s" shape is not recommended to do (" s "shape refers to the chest bending and waist bending at the same time). Bend over in the opposite direction of the curvature of the spine to counter scoliosis. Every day 50-100, in 2-3 groups to complete swallow fly, can exercise back muscles, increase soft tissue balance, 50-100 a day, in 2-3 groups to complete. As for swimming, both freestyle and breaststroke are ok, 600-1000 meters per day. Some people also recommend the monkey bars, but it is difficult to stick to them. Girls are not strong enough to do several sets every day, so the effect is hard to be guaranteed.

What types of corrective surgery are there for scoliosis?

A: what we call orthodontic surgery is orthodontic fusion surgery, where you put a metal peg in the body that straightens and maintains the curvature of the spine, which is like a metal brace in the body. Stents alone are not enough. They are inserted with bone grafts, where you place granular bones on the dorsal side of the spine, and these granular bones paratinate and hold the spine in place, just like an electric welding. Therefore, in fact, about half a year after the operation of the metal stent to support the role of the spine, when the maintenance of spine curvature mainly rely on the fusion of granular bone. In addition to corrective and fusion surgery, there are some special types of lateral curvature surgery, including hemivertebra resection, growth rod and navigation minimally invasive surgery.

What is the meaning of hemivertebra excision?

Answer: half vertebra is half vertebra meaning. It is the most common congenital scoliosis. The normal vertebra is symmetrical, while the half vertebra has only the right or left side, and the other side does not grow. Our spine consists of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae, one on one. If one of these segments is not symmetrical to the right or the left then it can affect the whole hemibotomy where you remove this abnormal vertebra, you fix it with a nail rod, you take the nail rod out after 2 to 3 years and you're done.

What does a growth stick mean?

A: growth rods are used for early scoliosis, which is pronounced before age 10. The children before the age of 10 should not correct fusion surgery, because once had corrective fusion surgery, the child's body length is fixed, and the age of the child's body until 18 years of age and growth potential, premature convergence to lose the child's height and due to the lower limbs are still in the growth, adult body and the proportion of lower limb disorders. To solve this problem, doctors developed growth rods. By means of the operation, through 3 three small cut ロ into metal stents, the metal stents can correct the lateral bending, and allow each year to do a small operation to extend it. This buys precious time for the child to receive the final corrective fusion surgery after the age of 12, greatly improving the outcome.

Navigation minimally invasive surgery?

Answer: navigation minimally invasive is to achieve a breakthrough progress in recent years, which is based on the latest navigation equipment, combined with technical innovation, operation only three 5 cm incision can be completed before to 40 cm ロ can オ 売 into operation, suitable for 90 degrees within the acquired scoliosis. Scoliosis was previously considered to be a very invasive and risky procedure. The advent of navigation devices has dramatically changed that. First of all, the big trauma, the big trauma of traditional surgery is that you have to make the spine very blue before you can put a screw in, because traditional surgery relies on anatomical markers and the surgeon's experience. Navigation does not. Navigation screws rely on an intraoperative ct scan, which does not require looking directly at the anatomy of the spine, greatly reducing the incision and injury to the back muscles. And then there's the risk. It used to be thought that spinal surgery was risky because of the concentration of nerves and blood vessels around the spine. The advent of navigation devices has greatly increased the safety of surgery, because the navigation device's screen clearly shows which vessels are which nerves, greatly reducing the risk of damage to vessels and nerves. Therefore, the application of navigation makes scoliosis surgery less harmful and safer. Besides, minimally invasive navigation can also correct cervical scoliosis. Because navigation can place cervical pedicle screws, which was difficult to do before the absence of navigation, cervical scoliosis can also be corrected.

How much correction can scoliosis get through surgery?

A: the degree of correction of scoliosis depends on the flexibility of the scoliosis itself. The more flexible the lateral bend, the greater the degree of correction. Usually the younger the age, the more flexible the better the correction, so the optimal age for scoliosis surgery is 13-15 years old. This age group spine flexibility is good, the correction effect is good, and the body is also close to mature, comprehensive consideration is the most suitable for publicity this age group correction. Young mild to moderate bending 80-90% is not a problem, severe bending, very stiff bending is more difficult, but 50% correction should not be a problem.

What is the optimal age of scoliosis operation?

A: half vertebral body is the best age of 3 to 5 years old, in other words, if the age of three lateral bending is obviously more than 40 degrees can surgery, if at the age of 3 degree is not large, such as オ 10 to 20 degrees, then you can wait a few years, surgery again at 5-6 years of age. After the age of three, you can have surgery. The best age for adolescent idiopathic scoliosis is 13-16 years old, when the bones are nearly mature and soft, which is the best age for correction

What do you need to prepare before scoliosis surgery?

A: current surgical techniques do not require special preparation before surgery. Of course, if you take nutrition supplements and do physical exercise, such as swimming, running or climbing stairs, for a period of time before surgery, it will be beneficial for faster recovery after surgery. Patients with severe scoliosis require spirometry training under the guidance of a physician

When do I need preoperative traction?

Answer: generally more severe side bend need traction, the severe refers to more than 100 degrees, and in addition to the side bend and kyphosis, and very stiff, the doctor party get a correction risk large effect is difficult to guarantee can be traction first. Traction is generally the first basin ring traction. The disadvantages of traction are that it is time consuming, often requires months of traction, and patients suffer. But the advantage is that it's safe and it works.

What is neuromonitoring?

A: neuromonitoring can monitor nerve signals in real time. If there is a trend of nerve damage, it can be detected at the first time, and surgical strategies can be changed as early as possible to avoid permanent nerve damage.

Does corrective fusion require blood transfusion?

Answer: at present, many hospitals have blood transfusion technology and team, unless it is on the baidu side curved orthopedics, otherwise it is not necessary to transfusion other people's blood.

Import spinal column is fixed inside material and homebred material, which is better?

Answer: this problem is not too important, the domestic weigao is very suitable for side bending orthopedics, tools are perfect, accessories are complete, on the contrary, many imported brand screws do not have this advantage

How should treat ache after the operation?

A: currently, the department of anesthesiology has advanced pca technology (patient self-controlled analgesia), which allows patients to control the use of painkillers according to the situation of pain. Under the effect of this technology, patients usually return to normal soon after surgery, greatly reducing the pain feeling after lateral curvature surgery.

How long can you drink water and take food after the operation?

Whipping: scoliosis usually has no effect on diet. Generally 6 after complete anesthesiaYou can eat when you're young.

How long can I get up and walk after the operation?

Answer: generally, you can walk under the support protection for 3-5 days after the operation. You can leave the hospital for 7-10 days after the operation. When you leave the hospital, you can basically take care of yourself.

When can you take a bath after the operation?

A: after the wound heals, you can take a bath, usually about 10 days after the operation. The proposal chooses the means of shower, want to have the protection of the family at the same time, lest fall.

How long can I go to school or work after surgery

Answer: one month after the scoliosis surgery, the left stone, after full recovery of physical strength, under the protection of the brace, can go to work and go to school.

How long can acuteness motion be after spinal column turns an operation?

Answer: half an year can be strenuous exercise after general operation. Because by this time the granulae have healed and the spine has hardened, strenuous exercise will not matter.

Can you bend over after scoliosis operation?

A: it depends on the scope of the operation. If the operation only involves the thoracic vertebra, it has little impact on the bending. Because the normal thoracic vertebra also has no range of motion due to rib fixation, and the thoracic vertebra also has no range of motion after scoliosis surgery, just like normal people. If the operation involves the lumbar spine, it will have a certain impact on bending, but there will be no bending. Because the person bends mainly by the hip joint, only a few rely on the lumbar spine, so even if all five lumbar spine fixed, is still able to bend.

sharp pain in lower spine

If do operation of spinal column scoliosis still can be pregnant?

A: spinal orthopedics generally does not affect pregnancy. On the contrary, scoliosis surgery can also improve trunk field depression, increase pelvic volume, is beneficial to pregnancy, so it is best to do scoliosis surgery before pregnancy.

When does the wound fold?

Answer: at present, many hospitals use absorbable intradermal suture. The covering line is not visible on the wound surface, and the stitches do not need to be removed.

How long should I wear the brace?

Answer: generally speaking, if there is no abnormality after 3 months of postoperative wear of the brace, you can not wear it.

Does the metal stent that the operation places need to be taken out later?

A: because the stent is titanium alloy and doesn't interact with its own tissues, it doesn't cause any adverse reactions in the body, so it can be removed for life. Even if the stent is removed for some reason, the corrected ridge will not be bent by the removal of the stent, because the fused granular bone maintains the spine

How long does it take to return to the hospital?

Answer: general 3 months after the operation, 1 year, 2 years each take a film to let the doctor see. If it is inconvenient for patients in other provinces, they can send the film after shooting locally, or send it with WeChat or qq.

Expert introduction

sharp pain in lower spine

Wang yuDoctor of orthopedics, Peking University (2008). Doctor of spinal surgery, Aarhus university, Denmark (2012). 200cases of spinal deformity such as scoliosis, especially good at navigation minimally invasive orthopedics. As the first author, 18 sci papers have been published in international journals, 8 of which have been published in authoritative journals in the field, including spine and spine j

Good at: minimally invasive surgery for scoliosis with osteotomy for kyphosis

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