Requirements
Stiffening only has a chance of success if the cause of pain can be limited with absolute certainty to one or more vertebral bodies. In this way, the affected sections of the spine can be stiffened in a targeted manner.
Diagnostics
There are different methods to precisely localize the cause of pain. The X-ray image is the starting point for the examination. Here, for example, signs of wear and shifts of the vertebrae relative to each other can be easily detected.
Further methods are used for more precise analysis. These include computed tomography (CT), which provides additional cross-sectional images of the soft tissues of the lumbar spine (lumbar spine). For example, a spinal canal that is too narrow can be detected as a cause of pain.With the help of magnetic resonance imaging of the lumbar spine (MRI of the lumbar spine), it is possible to assess soft tissue changes (inflammation, herniated disc of the lumbar spine, etc.)
in longitudinal section without radiation exposure. Under certain circumstances a myelography can be used. In this imaging procedure, a contrast medium is injected into the spinal cord tube (subarachnoid space), which makes it possible to better assess the width of the spinal canal and the nerve roots that are leaving it.
In addition to the imaging procedures, there is also the possibility of fixing the affected sections of the spinal column on a trial basis, so to speak. For this purpose, either a plaster cast or an external support frame can be used: Under anesthesia, four screws are drilled through the skin into two adjacent vertebral bodies and then fixed together with an external frame. If the stiffening created on a trial basis eliminates the pain, it can be assumed that stiffening by spondylodesis will also be successful.
A good result can only be expected if the psyche of the back pain patient is assessed in addition to the physical diagnosis. For this purpose, it is necessary to work out the motivation, resilience, pain processing and the will to recover in detailed discussions. Because after a consequential intervention such as spondylodesis of the lumbar spine, the patient will have to undergo extensive follow-up treatment (rehabilitation clinic, physiotherapy, etc. ), the course of which is central to the outcome of the operation.
