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Lordosis

MARK ANTHONY O.BERNABE

The Human Spine


Spine

made up of 33 vertebrae
Five regions:

Cervical Vertebrae
Thoracic Vertebrae
Lumbar Vertebrae
Sacrum
Coccyx

Intervertebral

Disc

Spongy, cartilaginous
Natural

curve in the
spine helps distribute
stress

Pathophysiology of
Lordosis
Background

Inward curvature of the lumbar and cervical vertebrae


(swayback appearance)
Anterior pelvic tilt, when the pelvis tips forward when resting
on top of the femurs
Can cause herniated disc

Symptoms

Severe lower back pain


Exaggerated Posture
Diagnosis

Physical Examination
MRI/CT Scan
Who

is at risk?

Discitis
Spondylolisthesis
Kyphosis
Osteoporosis
Obesity

Treatment Methods
Drugs

Nonsteroidal antiinflammatory drugs


Prevent discomfort and swelling
Physical

Therapy

Strengthening of muscles
Improving posture
Reducing body weight
Brace

Lordactiv lumbar belt


Surgery

Depuy Bengal Stackable Cage System

Product
Used

to treat vertebrae T1-L5


Materials
Carbon Fiber Reinforced Polymer (CFRP)
Titanium Rods
Tantalum Beads
Versatile

Adjustable height and angles options


Stackable

Cage System

Replace excised vertebral tissue


Used singularly or stacked
Similar in dimension to normal vertebrae

Advantages over other


Methods
Structure

supports loads with


modulus of elasticity close to that
of cortical bone
Ridges and teeth resist rotation
and migration
Cavities accept bone graft
Radiolucent so healing can be
assessed by normal radiographic
methods

Costs
Cost

is dependent on size

~$1800 for 18mm


$6190 for 66mm
Disectomy

costs can vary from $15,000

to $75,000
Corpectomy can range between $25,000
and $40,000
Hospitals sometimes have contract rates
Insurance coverage is dependent
on individual insurance companies

Surgical Protocol
Disectomy

Removes the herniated or affected disc


Incision down the center of the back, muscles and
nerves moved aside and problematic disc is removed
and device is implanted
Suture or metal staples are used to close up
Corpectomy

Removes multiple vertebrae, more invasive


Device implanted in the removed area
Suture or metal staples are used to close up
Caliper

to determine defect height


Fluorscopy to determine lordotic
angle

Recovery After Surgery


Most

patients go home 1-2 days


(disectomy) or 4-5 days (corpectomy)
later
1-4 weeks recovery time.
8-12 weeks recovery needed for more labor
intensive jobs
Surgical tape to affix suture, keep wound dry and
clean
Narcotic medication may be taken for pain for 2-4
weeks (not more because addictive)
Physical therapy recommended
Do not sit for long periods of time or drive for the
first 2-4 weeks

Possible Complications
Potential

Complications of Surgery

Haematoma
Skin necrosis outside operation region
Deep infection around implantation
Thrombosis

Osteoporosis

patients may
encounter problems with device
fixation
Obesity (too much stress)

Improvements after Procedure


80-90%

of patients show good

results
Better sitting posture
Improved sagittal balance
Reduced pain
Optimized fusion environment