- Mahesh Pandya, Consultant Orthopedic Surgeon, Baba Advanced Orthopedic Hospital, Vadodara, Gujarat, India
The reader clinicians use this strategy described for the management of syndrome of common backache with or without sciatica and have their own judgment. The author treated more than 5,000 patients with lumbar spine distraction. This book provides chain of events in degenerative lumbar spine disorder and their relevant anatomy, physiology, biomechanics, clinical examination, diagnosis, conservative treatment, recent advances to support triangular and lumbar spine distraction. Degeneration is a natural process and body definitely adapts to the slow, natural degeneration positively and effectively. Certain factors like muscle weakness, stiffness, change of curvature in spine, postures, work pattern, etc. speed up the degenerative disorder. In final stage of degeneration, virtually conservative treatment is aimed at controlling pain with medicines and modification of activities. So far, no single measure has been helpful in controlling this progression. Surgical correction is helpful in two situations: instability and neurological compression. Looking at some helpless situations of failed back, it is generally accepted that surgical option should be kept as a final resort in a degenerative lumbar spine disorder. In spite of extensive scientific research, better understanding of biomechanics, the problem of degenerative lumbar spine disorder is on rise with number of common backache patients increasing more than ever. Early treatment being provided as of now relies on ‘spontaneous’ relief in pain over a period of time. The first ever low back pain heralds the beginning of degenerative process in lumbar spine. The symptom of pain may be self limiting but it should not be ignored once pain subsides because in 60 percent of patients there is a recurrence within two years. There have been many ‘answers’ to this common problem of mankind by many systems of medicine but none has proven convincing so far. Controlling pain for some time has become possible because of advent of good and relatively safer pain killers. But it is not possible, predictably, to reduce the frequency of recurrence of pain and that way slow the progression of degenerative structural changes in lumbar spine.