Vertebral Gliding The spine loses its shape

Flexible spine stabilization gives back support

05/14/2014

Congenital malformation, age-related wear, weak trunk muscles, overuse, injuries - various causes can be considered for vertebral gliding. While the movement of two superimposed vertebrae initially shows no symptoms, it is later due to the associated instability of the spinal column for the constriction of nerves and the so-called spinal stenosis. Those affected complain mainly of pain that radiate in the buttocks and legs and increase under stress: every movement is associated with unbearable pain and a path of 100 meters without a break can no longer cope. When conservative treatment is needed to relieve or require stiffening surgery or motion-preserving procedures such as flexible spine stabilization, Mathias Pippan, Spine Surgeon and Specialist in Orthopedics at the Spine Institute in Mainz Orthopedic Center (OZM).

In old age, sliding vertebrae are mainly caused by signs of wear and tear on the spine. Thus, vertebral bodies, intervertebral discs, joints, ligaments and muscles can no longer withstand constant strain and age and give way. „Especially due to loosening in the joints and the ligaments important for the stability of the spinal column, vertebrae move easily“, explains Dr. Pippan. „Afflicted discs and a weak back muscles increase the risk of vertebral sliding. The body tries to compensate for this instability by building up bone mass on vertebral bodies and joints, which in addition leads to spinal canal angina and pain radiating down to the legs.“

The first step in therapy is usually the treatment of acute pain. Thus, a combination of painkillers and targeted exercise therapy in the form of physiotherapy and back exercises to strengthen the back and abdominal muscles often brings relief. „In the case of protection, an aggravation of the symptoms is imminent, since muscles lose their strength due to insufficient movement and this reduces their stability“, noticed Dr. Pippan. „Otherwise, muscles support the spine like an endogenous corset and prevent the gliding of the spine already in the neck. Special exercises for strengthening restore mobility and stability in the back.“ Heat treatments, electrotherapy and other physical applications, as well as acupuncture and neurostimulation, are sometimes complementary. Combined sensibly, these measures create additional relief. For symptoms of nerve root involvement, physicians may recommend treatment with root-injected, analgesic, and decongestants. In special cases, local anesthetics are injected into the facet joints.

However, conservative treatment sometimes reaches its limits. „Especially when it comes to strong numbness, nerves take damage and sliding spurs and bone spurs narrow the spinal canal, doctors recommend surgery“, knows Dr. Pippan from practice. As part of the procedure, surgeons expand the spinal canal and remove interfering tissue structures that lead to constriction. Sometimes this is followed by a stabilization operation. Here, the method of choice is a stiffening operation under which, however, when multiple vertebral segments are stiffened together, the mobility may suffer. For several years, medical specialists have been increasingly turning their attention to movement-preserving surgical procedures. One promising method is flexible spine stabilization, also known as the TOPS system. „As a dynamic implant, it ensures that the patient remains mobile and permanently painless in all directions after surgery“, describes Dr. Pippan the procedure. (Pm)