(Health Korea News / Doo-yong Choi) The spine supports the main skeleton from the neck, back, waist, hips, and tail, maintains balance, and protects the spinal cord. However, as time goes by, the spine accumulates fatigue and naturally begins to wear out and creak. It’s the same way that things break down if you use them for a long time. It is no exaggeration to say that spinal disease is a chronic disease of modern people. Statistics show that more than 80% of the total population in Korea suffers from back pain at least once in their life.
Spinal disease is accompanied by tremendous pain in a wide range from the waist to the hips and legs, causing great inconvenience in daily life. You can strengthen the muscles around spinal joints and prevent spinal diseases with just proper lifestyle habits and simple stretching.
Every year, October 16th is World Spine Day. It was designated by the World Health Organization (WHO) to raise awareness of spinal diseases and provide appropriate prevention and treatment. Let’s learn about the causes, symptoms, and treatment methods of spinal diseases that threaten a healthy daily life.
◇Last year, about 9.6 million people had spinal diseases… People in their 20s to 40s account for 22%
The number of patients with spinal diseases in Korea is steadily increasing. According to the Health Insurance Review and Assessment Service, the number of patients with spinal disease last year (2023) was 9,596,890, an increase of 14.3% or 1.2 million over the past 7 years compared to 8,397,832 in 2016. If we include the 2,641,777 patients with cervical spine disease last year, the number of patients increases to about 12.24 million. One in four people in Korea has visited the hospital due to spinal disease.
The problem is that spinal diseases are easily observed even in young people these days. Looking at the actual distribution of patients with spinal diseases by age, the proportion of young spinal diseases in their 20s to 40s accounts for about 22% as of 2023. Recently, the number of young spinal patients in their 20s to 40s has been increasing significantly due to various reasons such as excessive use of smartphones and tablet PCs, incorrect lifestyle habits, sitting for long periods of time, increasing stress, and lack of exercise due to busy work or study.
◇herniated discmany symptoms improve with conservative treatment
Spinal disease herniated disc, spinal stenosis, SpondylolisthesisThis is a representative example. Intervertebral disc herniation is a disease well known as ‘disc’. Back pain and radiating pain along the nerves are characteristic due to physical stimulation due to a herniated intervertebral disc and chemical stimulation due to inflammation around the nerves. Radiating pain is mainly found in the arms and hands in the cervical spine, and in the legs and feet in the lumbar spine. In rare cases, it can put pressure on the central nerve itself, causing serious symptoms such as paralysis of the limbs or bowel and urinary disorders.
In most cases of herniated discs that do not have severe symptoms, symptoms often improve on their own without surgical treatment. It can be cured naturally simply by resting, and in many cases, symptoms are improved with so-called conservative treatments such as medication, physical therapy, and exercise therapy. However, if these treatments do not provide satisfactory results or the pain is severe enough to interfere with daily life, injection treatments such as epidural injections or nerve root blockade can be attempted.
Surgical treatment is considered when pain does not improve or worsens despite conservative treatment or injection therapy, or when not only pain but also limb strength is weakened. In the case of the lumbar spine, surgery is generally performed to remove only the herniated intervertebral disc using a microsurgical microscope or endoscope. For the cervical spine, it is common to perform spinal fusion surgery, which removes the entire intervertebral disc of the relevant segment and fuse the two vertebrae into one, but many surgical procedures are also performed to preserve spinal movement using artificial discs. Additionally, minimally invasive surgery using an endoscope or microscope is sometimes performed.
◇spinal stenosisIf it occurs in the lumbar spine, conservative treatment… Cervical spine surgery
When the spine or surrounding ligaments undergo abnormally severe degenerative changes, part of the bone grows and the ligaments become thicker. As a result, the spinal canal through which the spinal nerves pass narrows and puts pressure on the nerves within it, which is called spinal stenosis.
Spinal stenosis that occurs in the lower back usually occurs between the 4th and 5th lumbar vertebrae. Fortunately, there is no central nerve, the spinal cord, in this area and only peripheral nerve bundles exist, so patients often do not feel any symptoms even if the degree of pressure is severe.
A typical symptom of spinal stenosis is leg pain that worsens when walking. Walking becomes difficult due to pain, numbness, and muscle weakness in the lower extremities below the hip where the nerves compressed in the stenosis area pass. At this time, bending or sitting will relieve the pain.
First try conservative treatment through injection treatments such as medication or nerve blocks, and then consider surgical treatment if there is no effect in reducing pain or if paralysis of the lower extremities or walking difficulties occur. On the other hand, spinal stenosis (cervical spondylotic myelopathy) that occurs in the cervical spine is difficult to prevent worsening of the disease with conservative treatment, and once the nerves are damaged, there is no recovery. Surgical treatment is required.
Because the spinal cord, which is the central nerve, occupies most of the space within the spinal canal, the cervical spine often puts direct pressure on the spinal cord. In severe cases, pressure or damage to the spinal nerves weakens the strength of the hands and arms, makes delicate finger movements difficult, and balance in the lower extremities. Many cases are accompanied by paralysis symptoms such as loss of sensation and difficulty walking.
◇SpondylolisthesisTreatment methods vary depending on the degree of bone slippage.
Spondylolisthesis refers to a disease in which the alignment of adjacent vertebral bodies is misaligned, causing one vertebral body to be displaced forward (anterior displacement) or behind (posterior displacement) the adjacent vertebral body. It is also called ‘spinal slippage’ or ‘spondylolisthesis’ because the spine is pushed out. It occurs when the joint processes are congenitally damaged, trauma, or spinal degeneration weakens the connection between the upper and lower spine. Aging is the biggest cause, and it occurs frequently in the elderly and women in their 50s and 60s, but recently it has also frequently occurred in office workers who sit for long periods of time.
Spondylolisthesis can occur in any part of the spine, but it most often occurs in the lumbar spine. Typically, people complain of back pain and numbness in their legs, and in severe cases, it can cause paralysis of the hips or lower extremities. Diagnosis is mainly made by examining how much the bone has slipped using X-rays.
Through a method called ‘Mayerding’s Grade’, the upper surface of the vertebra below the pushed out vertebra is divided into four grades and the degree to which each grade has been pushed out is evaluated. Conservative treatment is preferred up to stage 2, which is less than 50%, but in cases where there is severe nerve compression or joint instability, surgery may be considered depending on the symptoms.
◇Proper posture is a preventive measure… The habit of crossing your legs is the worst enemy of your back health.
The first step in prevention is to maintain a good posture. First, sit deep into the chair with your buttocks pressed against the backrest, straighten your back, and keep your knees bent at a 90° angle. The habit of crossing your legs when sitting is the worst enemy for your back. The habit of crossing your legs for long periods of time can cause pain around the lower back and pelvis and even lead to spinal deformation.
Sleeping posture is also important. Use firm bedding that allows your hips to sink about 1 to 2 cm, and choose a low, soft pillow that is about the height of your neck above your shoulders when lying down. One that can support your head and shoulders will reduce the burden on your neck and lower back. Above all, it is good to move your body frequently and increase walking time. To help strengthen the spine and lower back, walking exercise is recommended at least three times a week, walking slightly briskly for 40 to 50 minutes. (Written by Professor Choi Doo-yong, Neurosurgery, Incheon St. Mary’s Hospital Brain Hospital, Catholic University)
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Source: www.hkn24.com
