Health

Torsion and herniated disc cause severe spinal deformity – VnExpress


An elderly male patient was confined to a wheelchair due to scoliosis, severe herniated disc compressing nerve roots, walking normally after 3 days of surgery.

Mr. Cao Nguyen, 73 years old, from Quang Ngai province, discovered back pain about 10 years ago. Thinking that the cause of the pain was the hard work of farming, he only took painkillers by himself, but the condition did not improve for many years. Three months ago, he felt more pain in his back, accompanied by numbness in his left leg. Recently, he not only had a lot of back pain, but began to show signs of not being able to walk, taking a few steps and his legs fell, and had to have someone to help him.

When he went to Tam Anh General Hospital for examination, specialist doctor I Le Thanh Vuong, Department of Chiropractic, Orthopedic Trauma Center said that Mr. Nguyen had very serious scoliosis L2-L3 and L3-L4. . Magnetic resonance imaging (MRI) results showed that the L5-S1 vertebrae were slipped, and the L5 isthmus was missing. The patient also has a long herniated disc from L1 to S1, narrowing of the left root canal at L3-L4, L4-L5. The results of the electromyography showed severe damage to the left L4, L5, S1 nerve roots, consistent with the symptoms and images on MRI.

X-ray images of the patient’s spine before and after screwing surgery, correcting scoliosis. Image: Tam Anh General Hospital

The solution for this case is surgery to slide and correct the spinal axis. Doctor Thanh Vuong said that because the patient’s spine structure was severely deformed, he had to open surgery to reveal the surgical field more clearly. Dr. Vuong approached the patient’s spine with an incision about 20 cm long and observed the position of collapsed floors causing narrowing of the side niches. The doctor carefully rooted the nerve, cut the facet joint, probed each leg to check, to avoid damage to the patient’s nerves. When determined it is safe, the doctor uses an ultrasound knife to cut the bone. Thanks to the use of ultrasonic vibration, the knife has the ability to stop bone bleeding, not injure soft tissues or ligaments, and limit damage to nerve roots. The doctor screwed the arch peduncle into the bone, placed a vertical bar to straighten the spine and fixed the screw to widen the left clutch hole, completely releasing the nerve roots at the L4, L5, S1 roots. The patient also had 2 discs replaced L4-L5 and L5-S1 to create space for nerve roots. The surgery was completed in 2 hours and 45 minutes, earlier than expected.

On the first day after surgery, the doctor instructs the patient to move and turn in bed. On the second day, the patient was trained to sit and walk around the bed under the guidance of rehabilitation technicians. During the day, the sick person can take care of some personal needs with the help of loved ones. Starting from the third day, the patient put on the belt by himself, got out of bed, took the first steps and on the 5th day walked well, was allowed to leave the hospital.

Doctor Thanh Vuong advised Mr. Nguyen before being discharged from the hospital.  Photo: Han Thai

Doctor Thanh Vuong advised Mr. Nguyen before being discharged from the hospital. Image: Han Thai

“As soon as I regained consciousness, my left leg was completely numb, my legs moved well. I felt healthy and comfortable. The incision was still slightly painful, but I was very happy to get out of the wheelchair,” patient Nguyen said. To share.

Doctor Thanh Vuong said that spondylolisthesis is common in the elderly due to age factors, living habits, and injuries during work. Age affects the bone structure, joint surface, weak ligaments deform the spine, making the situation of nerve root compression worsen day by day.

“Compression due to scoliosis and spondylolisthesis in the elderly should be operated as soon as possible to restore nerve function and avoid the risk of disability,” noted Dr. Thanh Vuong.

Han Thai

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