Spine-Pain

Postprocedural discitis is an infection in the vertebral disc space that may occur following any invasive procedure of the spine, especially those in the low back, and can be difficult to diagnose.

The incidence of postprocedural discitis is rare, with an overall occurrence rate of between 0.2% to 4% of all spine procedures. However, as the number of spine procedures performed each year increases, so does the incidence of postprocedural discitis

http://www.spine.org/articles/postprocedural_discitis.cfm

Iatros means physician in Greek, and -genic, meaning induced by, is derived from the International Scientific Vocabulary. Combined, of course, they become iatrogenic, meaning physician-induced. Iatrogenic disease is obviously, then, disease which is caused by a physician.

In common usage, then, iatrogenic disease is now applied to any adverse effect associated with any medical practitioner or treatment. The practitioner need not be a physician, he might be a nurse or a radiology technician, or any one of the scores of differentiated healthcare workers encountered in hospitals, clinics, nursing homes, or offices, or for that matter in the ambulance on the way to one of those places. For those who advance the language to the frontier, iatrogenic disease can be caused by practitioners whose association with medicine is negligible or antithetical, such as homeopaths, chiropractors, and psychologists (especially now that they are lobbying for the authority to write drug prescriptions).

http://www.iatrogenic.org/define.html

Question: Since a spinal fusion surgery eight years ago, all activities and exercise create sciatica pain. The leg numbness and tingling and aching from the sciatica are so bad they sometimes wake me at night. My surgeon has just suggested a discogram and CT scan. I’m avoiding a myelogram because it caused a severe headache the last time I had one performed. Will the information from the discogram and CT scan be as good as that derived from a myelogram? Which is the most effective test for my situation?

Doctor’s response: A CT scan, discogram and myelogram are completely different tests providing different information. The myelogram is better for identifying a pinched nerve that may be causing the sciatica. This is important if the pain is primarily in the legs or if there is any leg weakness with the leg numbness and tingling. A discogram is a provocative test that is designed to tell if the front of the disc space is still a cause of pain.

Having a headache after one myelogram does not necessarily mean that you will have one again. However, both the tests will have to go through the thecal sac, which is what usually gives you the myelogram headache. Usually the discogram can be done from the side, but after a spinal fusion, often the only way to get in the disc space is through the thecal sac. Therefore, either test may give you a spinal headache, so choosing a discogram to avoid a spinal headache is not reasonable.

http://www.spine-health.com/backtalk/exquestions/sciatica01.html

Spine fusion indications

Diagnostic studies

There are a number of diagnostic studies that are available to investigate the etiology (medical cause) of the pain. The most common study is an x-ray of the low back, which can show if there is some boney instability or deformity to the spine.

For a small percentage of people an MRI scan cannot be safely performed, e.g., if the patient has a pacemaker. In these cases a CT scan with myelogram may be done. The anatomic information from a CT scan with myelogram is very similar to that of an MRI scan. A CT myelogram is also sometimes ordered as an adjunctive study to a MRI scan as it can show very subtle nerve root compression and also images out in the foramen better.

http://www.spine-health.com/topics/surg/mlsf/mlsf02.html

Neuromuscular Therapy

Description

Neuromuscular therapy (NMT) is a form of massage. It is supposedly distinguished from other types of massage in that a quasi-static pressure is applied to the skin with the aim of stimulating specific areas of skeletal muscle. Often these areas of muscle are myofascial trigger points.

The application of NMT is dependent on several key factors:

The location of myofascial trigger points
Force has to be applied perpendicular to the skin surface if muscle is to be stimulated).

http://www.answers.com/topic/neuromuscular-therapy

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http://en.wikipedia.org/wiki/Neuromuscular_therapy