With the economic and social development, lifestyle changes, people’s bones are becoming more and more “fragile”, early “aging” phenomenon is common. Reporters from the recently held in Guangzhou, the first national spine, artificial joint new technology advanced seminar was informed that China’s cervical lumbar spine lesions, osteoarthritis, scoliosis incidence is increasing year by year, but in the treatment of medical amplification, over treatment and other issues.
At the same time, the general lack of public awareness of spinal health care, there are many misconceptions about how to avoid cervical lumbar spine disease, for example, now popular in the “geeks”, “geeks” a bed computer desk and adult “back belt “, in fact, does not guarantee that 100% of the spine does not have problems.
Problem one
Scoliosis treatment should not be expanded
Guangdong Provincial People’s Hospital orthopedic spine surgery deputy chief physician Dr. Chang Weinbing pointed out that there are many unreasonable spinal diseases in China, especially in the field of scoliosis treatment, mainly the scale of surgery is too loose control, fusion is unreasonable, the indications proliferation, “some hospitals less than 40 years old originally can do conservative treatment of patients, but also surgery. ” Chang Weibing pointed out that this medical expansion and overtreatment is not good for patients. Usually, patients with mild scoliosis of less than 20° on the X-ray photos can perform physical exercises under the guidance of a doctor to correct the posture and reduce the deformity, and generally do not need to do surgery. In the case of scoliosis, the angle of curvature is around 20°~30°, unless the scoliosis is basically fixed in older patients who can have surgery first, it is usually advisable to do conservative treatment with brace orthopedics and regular follow-up observation, and to consider surgery only if the scoliosis angle progresses faster.
Question 2
Internal fixation of the spine is not recommended for young patients
Zheng Qiujian, director of orthopedics at Guangdong Provincial People’s Hospital, pointed out that the most cutting-edge treatment hotspots in the field of orthopedics are the correction of severe scoliosis deformity, cervical artificial disc replacement technology, spinal non-fusion technology and minimally invasive hip and knee joint replacement, arthroscopic technology and other new technologies, including spinal disease surgery to reduce the direction of trauma, becoming a new trend in treatment.
Zheng Qiujian introduced, previously, the disc protrusion from the open incision treatment more than 10 centimeters, the patient has to lie two or three months after surgery. Nowadays, with the continuous progress of treatment technology, many hospitals have adopted minimally invasive surgery, the incision is only a few centimeters, the patient only needs to rest for about a week after surgery. Some patients can also be treated by the puncture method, which does not require an incision. However, he stressed that the puncture method has clear indications, and not all patients are suitable. “The puncture method can be considered for relatively simple conditions, mild lesions, and patients who are young and do not have combined spinal stenosis.”
For younger patients, today’s orthopedic community advocates a nonfusion technique, in which the vertebral segment is surgically fixed with special instrumentation. “The previous emphasis on surgery took the form of internal fixation of the spine, but this surgery can lead to problems with the adjacent vertebral segments, which can have a significant impact on young people.” Zheng Qiujian said the advantage of non-fusion technology is the ability to stop adjacent vertebral segments from fusing.
It is understood that the non-fusion technology has been carried out in Europe and the United States for more than a decade, the domestic has just been introduced, these years Beijing, Guangzhou and Shanghai three large hospitals have been carried out. At present, the provincial hospital has adopted non-fusion technology to carry out a wide range of artificial disc replacement and other types of surgery, especially for the cervical and lumbar spine fixed the most obvious effect.
Early stage osteoarthritis patients
Chondrocyte “self-repair” is available
Patients with advanced osteoarthritis need artificial joint replacement, but after the artificial joint is installed, it is not a permanent solution. “Usually, traditional artificial joints need to be rebuilt after 10 years of implantation.” The materials and joint types of artificial joint prostheses have also improved in recent years, from metal-to-polyethylene in the past to the latest metal and ceramic joints that are better suited to the needs of younger patients with severe disease, Cheng said.
He pointed out that young patients and patients with early arthritis do not necessarily need artificial joints at present, but can also try to use cartilage cells to self-repair defects. Currently, Guangdong Provincial People’s Hospital is working with foreign research institutions to jointly conduct research on the clinical application of tissue-engineered cartilage to repair cartilage defects.
According to the report, when using this technology, doctors need to use an arthroscope to remove a number of cartilage cells from the patient’s body and culture them in vitro for three weeks. Depending on the extent and location of the patient’s defect, a certain number of cartilage cells are cultured and then transplanted back into the patient’s damaged area, thus achieving automatic cartilage cell repair and healing.
Problem 3
“Computer dependence” makes the neck “age” decades earlier
“In the past, cervical spondylosis was regarded as a common disease of people in their fifties and sixties, unless it is an acute injury, and generally rarely see patients with cervical spondylosis in their twenties and thirties, but in the past five years, I can receive several young patients almost every time I go to the clinic.” Wang Yisheng, chief physician of the orthopedic department of Guangdong Provincial People’s Hospital, said the rapid rejuvenation of cervical spondylosis is related to the bad work habits of young people, especially “computer dependence” is not a small danger. Buried head looking at the display screen is not in line with the physiological structure of the cervical spine. The physiological structure of the cervical spine protrudes, the most suitable physiological position is the head in a neutral position and slightly posterior, otherwise it is easy to cause cervical ligament strain, leading to cervical spondylosis.
Computer monitor should be placed in front of the body
On the other hand, many offices, home computer placement is incorrect, becoming a major cause of cervical spondylosis and even lumbar spondylosis.
Guangzhou, many units, the company’s desk is L-shaped, the computer is mostly placed on the side of the body on the table, some worse, simply squeeze the computer to the right end of the desk. Commuters work a busy, in a hurry to turn the chair to the computer’s position, often twisting the body or turn your head to see the computer. “This is not only easy to cervical problems, lumbar muscles will also be damaged.” Wang Yisheng said, the office is another common misconception is that “people high desk short”, when working always need to bend over and head down. In addition, the mouse is placed too far away from the body, the operator often need to stretch the arm to hold the mouse, also inappropriate.
He pointed out that the correct approach should be lowered to the chair, the monitor is elevated, placed in front of the body, the line of sight is horizontal, preferably in the middle of the screen. Some occupations often need to lower their heads, should be in between the work stitches, let the neck relax.
Today, the bed computer desk has become the “geeks”, “geeks” new favorite. Users lying flat on the bed or leaning on the pillow, by adjusting the tilt angle of the desktop, the line of sight is almost vertical and computer screen, closer to the state of sitting watching the computer, is believed to protect the cervical and lumbar spine. With a bed computer desk, someone simply lying is a whole day not to “move the nest”.
In this regard, Zheng Qiujian said, this bed computer desk can only be considered better than nothing, but still can not be used for a long time, “the muscles and ligaments are still under tension, every half hour it is best to get up and move, or change the posture, or the spine will still be a problem.”
Adult spinal disease should not be corrected with a back brace
How can adults with spinal disease be corrected? Long-term correction with a back brace like children? Or by carrying a cross or sleeping on a board bed like flag guardsmen do?
“These are passive intensive training, ordinary people should not take these approaches.” Wang Yisheng said, back for a long time, the ligaments are compressed, and blood flow is not good. The back strap is a short-term behavior, belong to the hard argument over, the cure is not the root cause. Without strong muscle and ligament support, after release, the spine will gradually return to the abnormal position. He said that patients should consult their doctors for advice on the cause and choose the appropriate treatment, unless there is severe nerve compression, generally do not need open surgery.
If the spine has issued an “alarm”, exercise therapy should be taken to prevent the situation from worsening: one is to do the “swallow balance”. The upper body is bent forward to the horizontal, while one leg is raised as high as possible to the horizontal, both arms are raised backwards, and the head is tilted up. Adjust your breathing, maintain this state as much as possible, and then change legs to carry out; Second, often practice push-ups, swimming, playing badminton and lifting dumbbells to do chest expansion, the elderly can walk backwards or fly a kite; Third, you can often do neck health exercises. Maintain a sitting posture, hands crossed behind the head, the head in the middle position, lean back at the same time, the hands force forward wrench. You can also do head turning exercise; fourth is to take the recumbent posture exercise. Leaning on the back of a high sofa or lying in bed, the back of the head pressure backrest or pillow.