Increasing incidence of Lumbar Spondylitis

Lumbar spondylitis is one of the most common backbone and lifestyle diseases. Spondylitis or osteoarthritis of spine is a continuous process of wear and tear of our backbone, which in part is due to age-related degeneration of the intervertebral disc, the bones and joints of our backbone, and the supporting ligaments and muscles. The other major role is played by the physical and mental pressures of modern life; and also by bending forward and lifting heavy things; physical and dietary stress of pregnancy and lactation; hormonal imbalance during menopause; uncontrolled diabetes, thyroid disorders; increased uric acid; smoking and alcoholism and so on.

These changes in backbone can make it sore, stiff and deformed. They also lead to compression of our spinal cord and sciatic nerves in our backbone, resulting in severe sciatic pain, cramps in thigh and calf, tingling, numbness in feet, loss of balance and coordination that can incapacitate a person from walking and performing day-to-day activities. Lumbar spondylitis can also be a major cause of disability in relatively younger and middle-aged population.

Prevention is the best cure because the changes of lumbar spondylitis are reversible only in early stages. The disc becomes dehydrated with loss of its turgor pressure and elasticity, and as a result it becomes more stiff losing its springiness and cushion-like effect. Calcification of disc leads to hardening, a result of deposition of bone-like material that gets converted into discophyte. Due to loss of elasticity of the disc, there is more pressure on the joints of the spine and these facet joints have to compensate for loss of disc function by taking more load. Over time, these joints start developing abnormal gaps or breaks in them called spondylolysis. At times, the gaps increase to an extent that they are no longer able to hold vertebral bones together, leading to spondylolisthesis-slipping of one vertebral bone over the other.

Abnormal loading also leads to formation of extra bone spikes called osteophytes, which compress the spinal cord and sciatic nerves. Since supporting ligaments act as shock absorbers, they become thick and enlarge in size, filling the central lumbar canal-the spinal cord and sciatic nerves pass through it-thereby narrowing the space, called lumbar canal stenosis. The supporting muscles also become weak and flabby, and lose their tone, which further increases the load on the disc, joints and ligaments. Since all these structures are closely related, wear and tear in any of these structures has a cascading effect that leads to rapid degeneration of other dependent structures. Except in the early stages, slowly these changes become irreversible.

In Save Your Back campaign, people are taught to de-stress both at work and at home. Meditation, yoga and reiki go a long way in de-stressing along with acupressure and acupuncture. Brisk walking, swimming, jogging, sports and exercising are our backbone saviours. Training of proper postures as per our jobs, called occupational therapy or back school training, and ergonomic designing of work stations should become a priority. Emphasis should be on balanced diet and healthy eating, or the backbone will start depleting at a very young age.

A culture of antepartum and postpartum exercises along with healthier nutrition has to be inculcated during and after pregnancy. Hormone replacement therapy needs to be made more popular among menopausal women. Diabetic and thyroid patients and those with high uric acid levels need to be more regular with their treatment. Avoiding smoking and alcoholism will be a right step towards a healthier backbone.

Also, recent revolutionary changes in the management of lumbar spondylitis have made a remarkable impact on the life of the patients. These procedures are safe, risk-free and have no side-effects, even in elderly spondylitic patients. Nucleoplasty, annuloplasty, radiofrequency disc ablation and ultrasonic disc ablation are some of the non-surgical procedures done to make the hard, calcified, stiff disc of lumbar spondylitis soft and springy. While radiofrequency and ultrasonic facet joint ablation are used to treat osteophytes, selective nerve root injections are used to treat sciatic pain. These procedures are usually combined to give a lasting cure.

Minimally invasive surgery, using endoscopes, microscopes, lasers and robotics, offer a safe and effective way without any risk to the nerves and without creating any weakness in the backbone. There is rapid recovery with no bed rest and early return to work. Success rates of such surgeries are as high as 95 per cent. So get back to your back now before lumbar spondylitis does.