16-year old Lingamurty [name changed] had a progressive spinal deformity since early childhood. He had undergone foramen magnum decompression for Chiari malformation, in early childhood. This is a surgery done at the junction of head and neck so as to restore circulation of fluid in the brain and spine. Despite this, his deformity had progressively increased.
Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.Fernandez M, Ferreira ML,Refshauge KM, Hartvigsen J, Silva IR, Maher CG, Koes BW, Ferreira PH. Eur Spine J. 2016 Nov;25(11):3495-3512. Epub 2015 Jul 26.
PURPOSE: Previous reviews have compared surgical to non-surgical management of sciatica, but have overlooked the specific comparison between surgery and physical activity-based interventions.
METHODS: Systematic review using MEDLINE, CINAHL, Embase and PEDro databases was conducted. Randomised controlled trials comparing surgery to physical activity, where patients were experiencing the three most common causes of sciatica-disc herniation, spondylolisthesis and spinal stenosis. Two independent reviewers extracted pain and disability data (converted to a common 0-100 scale) and assessed methodological quality using the PEDro scale. The size of the effects was estimated for each outcome at three different time points, with a random effects model adopted and the GRADE approach used in summary conclusions.
RESULTS: Twelve trials were included. In the short term, surgery provided better outcomes than physical activity for disc herniation: disability [WMD -9.00 (95 % CI -13.73, -4.27)], leg pain [WMD -16.01 (95 % CI – 23.00, -9.02)] and back pain [WMD -12.44 (95 % CI -17.76, -7.09)]; for spondylolisthesis: disability [WMD -14.60 (95 % CI -17.12, -12.08)], leg pain [WMD -35.00 (95 % CI -39.66, -30.34)] and back pain [WMD -20.00 (95 % CI -24.66, -15.34)] and spinal stenosis: disability [WMD -11.39 (95 % CI -17.31, -5.46)], leg pain [WMD, -27.17 (95 % CI -35.87, -18.46)] and back pain [WMD -20.80 (95 % CI -25.15, -16.44)]. Long-term and greater than 2-year post-randomisation results favoured surgery for spondylolisthesis and stenosis, although the size of the effects reduced with time. For disc herniation, no significant effect was shown for leg and back pain comparing surgery to physical activity.
CONCLUSION: There are indications that surgery is superior to physical activity-based interventions in reducing pain and disability for disc herniation at short-term follow-up only; but high-quality evidence in this field is lacking (GRADE). For spondylolisthesis and spinal stenosis, surgery is superior to physical activity up to greater than 2 years follow-up. Results should guide clinicians and patients when facing the difficult decision of having surgery or engaging in active care interventions.
DOI: 10.1007/s00586-015-4148-y PMID: 26210309
Spinal problems could be a major worry, if left untreated or unnoticed. Scoliosis is one of major risk to the spine as it completely deforms the structure of backbone. The deformation leads to further issues in the body and as such one issue develops several problems to the body. Here, in this I will let you know about scoliosis like spinal problem-
There are some disorders in the body which can never be replaced, only be treated if you consult a doctor on time. Scoliosis is a medical condition in which spinal structure gets deforms and incapable a person to move. The irregular spinal structures bring others problems as well to the person traumatised by the condition.
Spine is the structure which gives support to the body and enables the body to stand. But, sometimes these backbones get affected with severe diseases and thus rupture the whole construction.
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