Spondylodesis (splinting, tension) refers to a partial stiffening of the lumbar spine (lumbar spine) artificially induced by surgery. Such stiffening can be considered a last resort in cases of extremely persistent and unbearable back pain. This can be the case with injuries to the lumbar spine, but also with inflammation or deformation of the spine (scoliosis).
It is hoped that motion-dependent pain will disappear due to the stiffening. The procedure has a permanent effect. Spondylodesis of the lumbar spine is a complex and risky operation! Therefore, a long and detailed consultation as well as a thorough and lasting examination before the procedure is indispensable.
General information
The (lumbar) spinal column belonging to the lumbar region usually consists of 5 free lumbar vertebrae (L1-L5), which are connected to each other via cartilaginous intervertebral discs, the so-called intervertebral discs. Each vertebral body also has 4 small joint surfaces which, together with the upper and lower lumbar vertebral bodies, form individual joints which are responsible for the mobility of the lumbar spine as a whole. The vertebral arch forms the posterior (dorsal) part of the vertebra, and together with the vertebral body forms the vertebral hole.
All vertebral holes together form the spinal canal through which the spinal cord passes. In the lateral area, the lumbar spine contains the rib processes, while the vertebral arches contain spinous processes that are directed backwards. A mobile segment is now understood to be 2 adjacent vertebral bodies, which are connected to each other by the intervertebral disc between them and the vertebral joints.
The lumbar spine bears the main load of the body and is statically and mechanically the most stressed. This section of the spine is particularly susceptible to injuries and signs of wear and tear! It is therefore not surprising that the movement segments L4-L5 and L5-S1 are stiffened most frequently!
In some diseases, stiffening of the lumbar spine by spondylodesis may be suitable to eliminate instabilities that have arisen. A lack of stability in the mobile segments can have various causes, the most common of which are: 1) Wear-related disc diseases (osteochondrosis) Age-related and also load-related, the ability of the disc to act as a buffer or shock absorber decreases. As a result, the load on the vertebral bodies increases and instabilities develop.
2) Spondylolisthesis In this clinical picture, the spinal column slides forward (ventrally) in relation to the vertebral body beneath it. This phenomenon is often found in younger people and is accompanied by a considerable pain load, since the sliding vertebral body can irritate emerging nerves. 3) Spinal canal stenosis of the lumbar spine Lumbar spinal canal stenosis refers to a change or narrowing of the spinal canal, so that the nerves passing through it can be irritated or damaged.
The disease can be acquired or congenital. 4) Vertebral body fracture (fracture) Complicated fractures involving the spinal canal can indicate spondylodesis. If there is a risk that the spinal cord will be injured or squeezed, stiffening is the method of choice.
5) Spondylitis (infection of the vertebral bodies) In many cases, an inflammation of the vertebral bodies can be treated with a suitable antibiotic. However, if there is a risk that the infection will spread to the central nervous system, a blockage of the affected lumbar vertebral bodies may be the last resort. 6) Vertebral body tumors, whether benign or malignant, can greatly reduce bone strength. This causes instabilities that can be eliminated by spondylodesis. 7) Scoliosis Deformity of the lumbar spine