Lumbar Spine and Sciatica

Healthy Lumbar For Life

Healthy Discs = Movement, Alignment and Canal

Disc Injuries :Slipped BulgingHerniated

Nervous system

Front view

Back View

Piriformis Muscle and

Sciatic Nerve

Cauda Equina

Postural Muscles = Proprioception

1. Dorsal columns2. Cerebellum3. Vestibular ocular

syst.

Psoas muscle

99% of the time Muscles are

NOT the Problem

Rounding of the ShouldersHyper-kyphosis Toxic vs Disease

Start 1st Year 2nd Year Discs can Regenerate

Upright positional MRI of the lumbar spineLondon Upright MRI Centre, London, UK, andDepartment of Radiology, The Royal National Orthopaedic

Supine magnetic resonance imaging (MRI) is routinely used in the assessment of low back pain and radiculopathy.

However, imaging findings often correlate poorly with clinical findings.

Clinical Radiology (2008)63, 1035e1048

MRI SupineMRI weight bearing

Weight Bearing stress X-rays after Surgery

Failed Back Surgery Syndrome98%,80%,40%,29%,15%

incidence of FBSS depends on how you measure

•spine surgeons often quote a 98% success rate for fusion surgery. (This percentage however refers to the success of the fusion process, not the reduction of pain.)•pain reduction for single level fusions 40-80%•Pain reduction with three levels15%

Microdiscectomy quoted by neurosurgeons a 95-98% success rate

•however when success is defined is returning to their previous occupations without pain medications, the overall success rate drops to 74%

•For workmans compensation patients, the success rate is 29% (Surg Neurol 1998 Mar;49(3):263-7; discussion 267-8).

•Post-operative plain radiographs showed a correct position of the implants in all patients. •The post-operative percentage of spondylolisthesis, measured on plain radiographs post-operatively and at final follow-up, remained unchanged in all patients.•8 out of 12 patient reported a significant improvement of pain, neurogenic claudication, and radiculopathy.• However, four patients did not experience any relief of symptoms following surgery and no improvement at follow-up.•12 weeks, two patients, that initially had experienced a relief of symptoms suffered from a recurrence of pain, neurogenic claudication, and radiculopathy.•a third patient experienced a recurrence of symptoms at 24 months follow-up.

Eur Spine J. Feb 2008; 17(2): 188–192. High failure rate of the interspinous distraction device

(X-Stop) for the treatment of lumbar spinal stenosis caused by degenerative spondylolisthesis

In conclusion, the X-Stop interspinous distraction device showed an extremely high failure rate, …

We do not recommend the X-Stop for the treatment of lumbar spinal stenosis with degenerative spondylolisthesis…

Infections contracted in hospitals are the fourth largest killer in the United States causing as many deaths as AIDS, breast cancer and auto accidents combined.

— One out of every 20 hospital patients gets an infection.

103,000 of die each year

Epidural Injections

Knee Pain from the LumbarMarge 47 yo woman

Lumbar Surgeries

Increasing

Spinal Decompression

7 Surgeries Still in Pain 6 degree reduced to less than 1 degree

Never lay on your Back with Both Knees Bent

Turn Sitting into Therapy•Bottom of the elbow is the bottom of the towel•Base of the rib cage•20 min on •10 min off

Ball Chair stabilizes pelvisOnly time for No Towel

Move Twist Bounce

•Moves Lymph•Stimulates Bone Growth•Charges up the Brain•Decreases Fatigue

Stabilizing the Pelvis• Approximate hips

•Unstable pelvis from long term LBP, scoliosis, sedentary lifestyle

•“the adjustment feels good but the pain comes back in a hour”

•Takes about 3 weeks to stabilize

•Trochanter support Vital to check for knee rehab

Approximate hips

Sit Like a cowgirl/cowboyStable sitting position

Or Ball Chair

Pain Medications Cause Hyper-sensitization

Decrease cartilage production Inhibits proteoglycan production

(the building blocks of cartilage) Causes accelerated bone

destruction

American Journal of Medicine, 1999, Dec.

Tylenol and NSAID’s Cause Arthritis

Sweet Potato

BroccoliCruciferous Veggies

BlueberryBerries

PapayaPineapple

Green Veggie Juice

Anti-inflammitoriesTurmeric

Suzy 44yo womanBowel dysfunction Back PainFibromyalgiadepression

Nerve pressure from abnormal Biomechanics

Proper nerve supply – Get Checked for Subluxation

Regular Exercise

Proper Nutrition

Sufficient Rest

Prayer and Meditation

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The The ChiropractiChiropracti

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