What is Failed Low Back Surgery Syndrome? How Is It Treated?

Failed Low Back Surgery Syndrome is generally omitted or neglected foraminal strictures. Correct diagnosis, correct surgical indication, good surgical technique and equipment are very important in order to minimize the occurrence of this syndrome.

What is Failed Low Back Surgery Syndrome?

The fact that the back problem has not been resolved even though it has been treated with revision surgery at least once, the conservative treatments for at least 6 months are insufficient or the patient is not satisfied.

What are the Symptoms of Failed Low Back Surgery Syndrome?

The recurrence of the previous complaints of the patient, does not decrease or increase at all.

How Is It Diagnosed?

The diagnosis of Failed Low Back Surgery is a multidisciplinary decision. Evaluating all the pre-treatment examinations of the patient together with the physicians who treat other disciplines makes it easier to reach the correct diagnosis. Patient compliance is required. In order to find the source of pain, the target should be determined well with temporary injection treatments.

How Is It Treated?

If it is thought that the problem in the treatment is caused by the methods used in the old treatment, for example, if there is an infection and implant failure, this situation should be resolved first. It is possible to remove or renew the implant. It is appropriate to avoid a new open surgery in the minimally invasive approach. Often omitted or neglected foramen nerve compression is emphasized. After determining the target and level, the cause of pain is removed with foraminoscopy.

How Long Does Endoscopic Surgery Take?

Endoscopic surgery can take 1-2 hours. Although the optimal time is 30-45 minutes, it increases the time to differentiate the nerve tissues due to the intervention of the anatomy deformed tissues.

What is the Recovery Process After the Surgery?

In the procedures performed under local anesthesia, we confirm that the pain has passed on the operating table. The patient can get off the table without pain. However, under general anesthesia, we remove the patients after eating 4 hours after the effect of anesthesia is over. The painful process can mimic the old in the inflammatory phase after 72 hours. Similar pain occurs in the first ten days, but gradually decreases. When the exercises are started 3 weeks after the operation, new pain may develop.

Due to the pain, coping with neuropathic symptoms or even psychological support may be required. Mesotherapy-acupuncture helps the physical therapy process. Although this situation is not seen in some patients, both patient groups start to work to regain their belief in the treatment in a few months.

Patients should be returned to normal life within 6 months. The problem is completely resolved in the following months and 2 years.

How Much is the Surgery Fee?

It is determined according to the hospital and patient budget.

Diagnosis and Treatment of Articular Cartilage Lesions

Cartilage tissue is a metabolically active tissue. Healthy cartilage has an intercellular substance (matrix) rich in glucosaminoglycan glycoproteins, which hold a high amount of water in its hyaline cartilage structure. It is not a tissue that has the ability to repair itself, except for superficial losses. Since the cartilage cell is not capable of regeneration, the losses can be covered up to 1 mm by matrix production, without cellular migration, which is not the case for the cartilage cell. This type of healing is the healing of hyaline cartilage without scarring.

In superficial losses, if the injury does not reach the subchondral tissue, hyaline healing is achieved without the need for any cellular migration. In full-thickness injuries, we see that a non-cartilaginous tissue plays a role in the defect filled with fibrin and mesenchymal cells after cartilage repair and bleeding. In this case, the repair tissue is in the form of fibrocartilage scar tissue. Scar tissue is a rough, non-slippery tissue on the cartilage surface. It acts like a dead tissue with no active metabolism. The healing margin is uncertain and raised from the surface. The rough surface leads to a situation requiring intervention, which constantly wears and wears, resulting in a painful joint.

Hyaline cartilage provides a smooth and smooth surface as well as providing lubricity, which is one of the basic functions of cartilage. Fibrocartilage, on the other hand, serves as a filling function as a scar tissue and prepares the ground for the inflammatory response with PDGF and TGF-ß mediators released from mesenchymal cells, which have an important place in the physiopathology of arthritis.

Closure of the cartilage defect may be in the form of excessive scar tissue and this tissue may create a mechanical barrier. Osteophyte (bone protrusion-horn) formations are the hard osseous healing tissue of mesenchymal cells with stem cell characteristics, which are involved in the formation of fibrocartilage tissue. Therefore, in addition to the acute inflammatory response, the problems in the late period will be the healing tissue that disrupts the mechanical barrier. Unfortunately, this condition is painless following the recovery of the acute situation after trauma.

DIAGNOSIS

Whether the cartilage injury is traumatic, infection or aging, the diagnosis of the cartilage problem is very difficult after the acute condition (swelling, pain, feeling of being stuck) has disappeared. Examination and analysis of limitations in the patient’s daily life are of great importance in early diagnosis. Magnetic resonance imaging (MRI) is insufficient in the diagnosis of superficial lesions without contrast (arthrography). Findings found close to normal such as increased fluid in MRI reports; tripping, difficulty in climbing/descending stairs are sometimes very obvious, but they may not be innocent. In cases suggesting a mechanical problem, even if the history of the harvest and the findings of the examination do not support the findings of the MRI examination, “Diagnostic Arthroscopy” should not be avoided.

TREATMENT

Cartilage lesions that do not create mechanical barriers can be treated with recessive methods such as anti-inflammatory drugs, ice, and rest when it is sure that the body is within its healing capacity. Physical therapy is very effective in returning the patient to his normal life quickly. This should not exceed 3 weeks. Hyaluronic acid injection (viscosupplementation) and oral intake of glucosaminoglycan drugs (at least 6 months) during cartilage healing complete the treatment. Viscosupplementation has a mechanical and chemical contribution to the regulation of the metabolism of the cartilage matrix. In this respect, it is combined after arthroscopy treatment. If the complaints have not completely disappeared, arthroscopic surgery is the gold standard in cases that cause mechanical obstruction or cannot heal spontaneously.

Arthroscopic Surgical Treatment

It can be Diagnostic, Excisional or Reconstructive.

Diagnostic Arthroscopy is used in the early diagnosis of the cause of joint complaints despite radiological criteria. During arthroscopy, joint examination is performed; Meniscus tears, cartilage softening, cartilage tears, joint mouse (free parts) and ligament lesions are detected and promptly intervened. The intervention may include simple procedures such as removal of the lesion (excision-debridement) or complex applications in the form of repair (reconstructive).

Simple Arthroscopy (Excision-Debridement)

These are procedures such as meniscus tear, removal of cartilage pieces and plica cutting.

The healing potential of hyaline cartilage should be used in superficial cartilage lesions. The parts that are about to break off from the mechanical barrier surface should be taken out and the cartilage should be protected as much as possible.

When a cartilage lesion is detected, innocent folds that may be the cause are investigated and the cause is eliminated.

Arthroscopic Repair:

It covers meniscus repair, ligament repair and cartilage transplantation. If the cartilage loss involves a single surface and has not severely damaged the opposite surface, repair is required if it is a full-thickness injury. In this case, it can be done by providing autologous (own cartilage) from another donor (allograft, xenograft). In addition to arthroscopic applications such as mosaicplasty, there are cartilage transfer surgeries performed by opening the joint.

Considering the advantages of hyaline cartilage healing, similar mechanical problems may be encountered if the tissue formed in cartilage transfers is not aligned with the surface. The hyaline cartilage implanted with the appropriate technique allows the defect to enter the superficial healing process and reshape.

Carbon fiber filler, which is another method used for the closure of the cartilage defect, aims to stimulate the formation of a smooth surface hyaline matrix while preventing excessive development of fibrocartilage tissue. However, since the cartilage surface formed after the method does not provide the expected lubricity, such methods are rarely applied.

In conclusion, arthroscopic treatment is the indisputable gold standard in the diagnosis and treatment of cartilage lesions. However, planning by considering cartilage healing physiology during treatment directly affects patient satisfaction and treatment success.

Closed Lumbar Hernia Surgery

Closed lumbar hernia surgery is performed by piercing the skin without opening the skin. The spinal cord is reached through the natural hole we call the foramen by using normal anatomical pathways and the intervals between the muscles. A nerve emerges from the foramina, the hernia that presses on the nerve is reached with the help of a tube by piercing the skin without damaging that nerve. The hernia is removed with the help of the camera image, without damaging another anatomical structure inside, in the surgery performed with the camera.

What is the difference between closed lumbar hernia surgery and other lumbar hernia surgeries?

Closed surgery is surgery performed by piercing the skin without opening the skin. Any anatomical structure is not damaged. Arthroscopy performed on joints in orthopedic surgery is an example of closed surgery. Since these surgeries are performed without cutting the skin, the bleeding is not more than a teaspoon.

An optical device, namely a camera, is absolutely used. In the camera-guided surgery, without damaging another anatomical structure inside, a direct diagnosis and treatment for the ailment is performed.

Is closed lumbar hernia surgery more comfortable than other surgeries, is there any difference with the old system, how is the healing process?

Surgery means opening a wound. To treat a tissue, it is necessary to open a wound. In modern surgery, the wound is minimized and the problem is reached directly. In all endoscopic surgery, laparoscopy, arthroscopy, closed lumbar hernia surgery and neck hernia operations, the lesion and problematic area are reached with a minimum of wound and the disease is treated.

Therefore, there is a rapid recovery, because no harm can be done. Since a place is not cut and no tissue is removed, the patient can get rid of his discomfort and return to work immediately, even walking from the operating table.

Cartilage Regeneration Therapy

Cartilage Regeneration Therapy; Since cartilage tissue has limited ability to regenerate itself, when it disappears with aging, they leave their places to cells that cannot function as cartilage cells, which we call fibrocytes.

However, the cartilage cell that forms the cartilage structure is “Chondrocyte”. Its task is to provide lubricity and smooth the joint surface. For this function, the cell mechanically settles in the collagen connective tissue called matrix in chambers called lacunae.

Its chemical task is to produce the continuously renewable matrix in which it is contained, thus ensuring the production of collagen, and most importantly, to produce substances that regulate fluid dynamics by exchanging with joint fluid.

In this respect, cartilage is the basic cells of the joint structure.

From this point of view, if the cartilage damage is a loss at the matrix level, that is, if the cartilage cell protected in the lacunae is not damaged by a simple crush, the cartilage replaces the damaged matrix immediately and makes a new one, and the cartilage is overcome without loss. If the cell loss is at the millimeter level and less, those regions are covered with a matrix even if new cells do not form. Other cells can develop to take over the functions of the lost cells.

If the cartilage loss to be searched is over 1mm, there is no repair with the matrix and fibrocytes come to the area and make the repair, but the cartilage structure formed is “fibrous” and does not produce matrix like cartilage tissue and causes an irregular formation in that area as a non-slippery structure in regeneration. This is not a preferred healing way as it causes abrasion on the opposite surface.

Here, the healing form created by the “enriched plasma” cells that we call PRP provides such a cartilage repair and only slows down the erosion.

The only way to repair cartilage with cartilage cells is to bring cartilage cells to the area. We call this cartilage transplantation. If we transfer our own cell, “autologous” cells of another human being, “allo” is called “Xenograft” if we take it from another species (cattle, etc.). Since applying allo and xenografts at the cellular level requires risks such as tissue rejection or long regeneration time, we only use antigen-removed crystals at the matrix level. These can be given as an example of hyaluronic acid injected into the joint. These items are for supporting the matrix. It is called (viscosupplementation).

“Autologous chondrocyte transplantation”, which is used in the treatment of cartilage damage especially in the joint areas, is a safe, biological and effective method.

Cartilage Regeneration Therapy

Autologous Chondrocyte does not necessarily require cartilage cells, but it is the easiest and ethical method of obtaining permissions. Therefore, the cartilage cells of the patient must be surgically removed by arthroscopic method. Cartilage cells are taken and extracted from Lakuna in the laboratory and the ability to multiply is gained. Within a week, thousands of cells can be produced and ready for transfer. The material obtained in this method is cartilage cell culture and not cartilage.

In some laboratories, these cells can be frozen and stored. For example, the cartilages produced in specialized GPS centers such as the FloenCell laboratory are delivered to the operating room in this way.

In the meantime, the production of personalized chondrocytes is continued. The newly obtained chondrocyte cells are frozen and stored in liquid nitrogen tanks at -196 ° C to be used as the 2nd and 3rd dose when desired.

Cellular products taken out from FlorenCell Laboratories to be applied to the patient are delivered to the patient to the place of application within 24 hours at the latest in transport boxes that can be monitored with a GPS module and a software.

We use chondrocyte usage areas to close cartilage defects. Since the defects do not consist of cells only, a matrix is ​​needed and a barrier to prevent the cells from mixing with the joint fluid is essential. If the cartilage prepared in the laboratory is not embedded in such a matrix (composite cartilage graft), we place it on the cartilage defect with open joint surgery and close it with a collagen membrane.

Treatment of shoulder impingement

Before we provide any information on shoulder impingement treatment, let’s first answer the question “What is shoulder impingement?

Shoulder impingement (impingement impact syndrome) is a condition that occurs as a result of the narrowing of the space (subacromial space) between the acromioclavicular-bony-ligament complex that surrounds the shoulder rotator muscle group and the joint occurs where the bursa is located and the muscle.

Conditions such as previous innocent shoulder trauma, recurrent shoulder dislocations, subacromial space in people working on their hands; The thickening of the bursa narrows due to osteophyte protrusions developing in the bones, and the inflammation (inflammation) that arises due to injury to the muscular structures in this space is known to compress over the years along with the healing tissue developed.

How do you treat shoulder impingement?

Shoulder compression involves cleaning and flattening the bony prominences under the acromion that narrow the subacromial space (acromiaplasty), removing the thickened muscle-bone pad (bursectomy), and repairing any muscle tears (rotator cuff). Repair).

Medicines such as cortisone should not be administered before or after these procedures.

In which situations is arthroscopy preferred for shoulder impingement syndrome?

Arroscopic decompression is the gold standard for shoulder impingement. In rare cases, open surgery may be considered.

Arthroscopic treatments are at the forefront of modern orthopedic surgery.

How to perform shoulder impingement arthroscopy?

Standard shoulder arthroscopy is performed through a new subacromial portal in addition to entry holes.

After the bursectomy, the bone is leveled and muscle tears are checked. It is standard to penetrate the joint and control the joint structures.

How long does an arthroscopy operation take?

It takes 30-60 minutes.

How is the recovery process after the operation?

Immediate action begins. If there is a rotator muscle tear, the rotator muscle tear protocol is used.

Does it come back after the surgery?

This is not possible, as inflammation that has lasted for decades can lead to a recurrence.

What is the operation fee?

It depends on the patient’s budget.

What is Foraminoplasty?

Foraminoplasty is a type of endoscopic surgery used to surgery the spine. Foramen is a general name given to canal-shaped holes in bone structures. Spinal Foramen has two on the right and left at each spinal level.

Spinal nerves and root nerves exit from this structure with a proper distribution to the segment. The spinal nerve enters the foramen structure approximately one and a half cm (it may show variations) above by separating from the spinal cord and exits by entering the slight S-shaped foramen 2-3 cm. Since the foramen is a canal surrounded by the pedicle and cassette of an upper vertebra, the pedicle and the pedicle of the lower vertebrae are invaded by the problems developing in these structures, causing compression of the nerve. This condition is defined as “Foraminal stenosis-Foraminal Stenosis”.

If the cause of foraminal stenosis is not eliminated, it impairs the function of the relevant nerve, for example, L4-5 level left foramenal stenosis Due to left L4-5 nerve dysfunction, pain in the form of sciatica spreading from around the knee and thigh to the foot, loss of sensation and muscle loss in severe cases. causes loss of power.

Treatment of foraminal stenosis, evacuation of the occupied structures (discectomy, fasciitis cyst excision, cassette osteophyte excision) Expansion of the foramen is possible with foraminoplasty.

Foraminoplasty is possible with surgical methods using the Transforaminal route. Traditional open and microscopic methods cannot clean the inside of my jersey. With foraminoscopy, foramen structures can be cleaned and nerve compression can be relieved by using an optical camera in the foramen and a surgical working channel.

Endoscopic Foraminoplasty does not disrupt the spinal architecture and does not cause instability, so fixation between the vertebrae with a cage and screws is not required. Therefore, it is a surgery that does not require fusion. Endoscopic foraminoplasty is very effective in eliminating stenosis that develops in spinal fusion surgeries that are often neglected. Endoscopic Foraminoplasty is a successful and effective method in the treatment of Failed Back Spine Surgery.

If necessary, it can be applied under local anesthesia in patients who cannot receive anesthesia in a hole smaller than one cm. There is little to no bleeding. You can return to normal life on the same day.

Alas I Have a Hernia I Can’t Do Sports!

I have a hernia. Can I exercise? According to the data of the World Health Organization, one out of every 4 people has to have bed rest until the age of thirties at least once in their life due to spinal pain (neck, back and waist). Half of those who suffer from spinal pain need medical treatment.

Every year, one million of 9 million people who do not respond to medical treatment all over the world need severe surgical treatments (absolute treatment-elimination of the cause), while the remaining eight million seek a solution to spinal pain by restricting their activity with conservative treatments.

This situation results in psychological destruction and unhappiness for those who live actively and make daily sports activities a lifestyle, and every year millions of people give up sports, that is, life.

I Have a Hernia. Can I Exercise?

Why is that?

Open surgical procedures are often performed with certain medical indications. No physician will apply an initiative that will not further improve the quality of life of his patient. If open surgery is useless, it recommends activity restriction instead. Benefit-harm ratio is always considered in treatment.

The problem is that the old physical activity cannot be guaranteed due to the damage to normal tissues while reaching the diseased area during surgical treatment. Therefore, terminal treatment with classical surgical interventions cannot be applied to the millions of active living people who suffer from paralysis and severe pain that cannot be treated, except perhaps the lucky one million patients.

In the last two decades, surgeons trying to reach the relevant segment of the spine without damaging the normal anatomical structures laid the foundations of minimally invasive surgery. Previously, they used a thin steel tube and their tools among dangerous anatomical structures.

Initially, the results were promising, but not very bright. However, with the development of endoscopic systems, this time they were able to project the area on the screen and enlarge it, and at the same time treat the affected tissues. Physicians who have been trained by authors such as Hijikata and Kambin over time have made it common to lift their inpatients all over the world by walking from the operating table without pain.

Why?

Minimally invasive treatment indication is centered on quality of life. Pain that requires bed rest more than three times a year requires treatment because the person may be out of work. Not being able to do sports or restricting daily activities is a reason for treatment, because health by definition; “it is a state of complete mental and physical well-being”. There is no health without movement.

How?

Treatments are applied in sterile surgical settings (operating rooms). Appropriate equipment (endoscopic camera, endoscopic surgical instruments and fluoroscopy – simultaneous x-ray) support, trained spine surgeon should be available.

It is imperative that the person to be treated is compatible and not overly obese.

Because the intervention is performed under local anesthesia by percutaneous skin puncture through a 0.5-1 cm hole. The patient is fully awake, there is almost no blood loss, he can confirm that he has recovered during the surgery and terminate the procedure himself. It is possible to be discharged the same day or even sunbathe on the beach.

Driving for a short time and doing sports can be prevented. However, patients can immediately return to desk jobs. In addition to the low duration of hospitalization and low cost, making the person productive immediately is a great contribution to the country’s economy.

Where?

Minimally invasive spine surgery was born in America and has developed to form academies in Asia and Europe. Among hundreds of physicians who have undergone systematic training today, successful Turkish physicians have also started to implement these initiatives in our country, especially in the last two years.

There are only specialized centers in the world for minimally invasive endoscopic spine surgery. In the near future, the centers mentioned with finger in our country will be out of the ordinary.

Who?

This intervention is applied by spine surgeons who have applied and know the classical methods of spine surgery (Orthopedics and Neurosurgery specialists), who have completed their endoscopic surgery training and have proven that they can perform appropriate minimally invasive surgical techniques with certificates.

Do not forget;

Medical treatment and recommendations should be made to ensure a better quality, happier and healthier life. Otherwise it’s useless. Do you have a hernia, have you been excluded from sports? Do not be afraid there is a cure.

Is Waist and Back Pain Normal During Pregnancy?

Back Pain – Back Pain During Pregnancy

Fertility, beyond being a reproductive function, includes sacred motherhood; It is a very difficult process where temporary but serious hormonal and emotional peaks are experienced. The expressions on the mother’s face created by the accompanying back and back pain have been a source of inspiration for many artists.

It is a fact that motherhood constitutes the most serious step of transition to womanhood. Some changes, especially in the genitals and characters, give a “mature woman” appearance by slightly regressing. Such a sacred and respected life experience is like an honorable medallion that emerged with this differentiation in female identity.

The response of the musculoskeletal system to hormonal fluctuations in pregnancy is not as rapid as the uterus and breast tissue. Skeletal adaptation develops over months and can be described as the defense that responds to destruction in the adaptation process. The bone roof loses strength, its destruction can cause widespread bone pain. The ligament structures that begin to loosen can cause the limits of the joints to be strained during movement and cause injuries. That is why the excessive load on the disc by loosening ligaments of the spine joints causes ruptures in the wall and waist-neck hernias. Spine pain during pregnancy occurs in different stages at different stages. Therefore, different measures will be required at each stage.

Pregnancy is examined in the trimester. However, it would be appropriate to approach pre-pregnancy, pregnancy and puerperium. A mother with a spinal problem before pregnancy should know that her spinal pains will increase and hernias, if any, may progress, and should solve these problems if necessary.

In the first trimester, the weight and mass effect of the baby is negligible, but the hormonal effects are severe enough to change the cycles of the skeletal system. At this stage when placenta formation begins, maternal hormones and fetal hormones compete in the maternal circulatory system.

First of all, we need to know that female hormones have effects that enable skeletal metabolism and bone cycle to work in the direction of construction, increase carrying power and endurance. It is almost usual for estrogen and progesterone to cause complaints characterized by rhythmic cramps and joint pain, even on the moon. These effects are in the direction of construction, but pregnancy hormones suppress this.

Back Pain During Pregnancy – Back Pain During Pregnancy

Pregnancy hormone HCG works in the opposite direction by imitating them, just like the genitals, in the steroid structure we call a kind of gonadotropin. With a slow rise, it begins to suppress this cycle of female hormones and literally takes its place, while bones in the skeletal system prepare a calcium store for destruction, the muscles are forced into a sequence that will work in the direction of pushing. All ligaments tend to increase the elastic tissue structure and loosen. All these hormonal influences are essential for the baby to feed, to provide room for growth in the abdomen, and to progress through the birth canal.

In the second phase, hormonal effects begin to balance. Maternal and infant circulation begin to diverge. As the gestational months increase, the weight of the fetus becomes increasingly vulnerable to daily traumas with asymmetrical loads on the joints due to loose ligaments and the loading of the muscles working in different directions against a moment that will change the body weight center. The second trimester is the transition phase in this respect, the muscles increase their strength against load. In the first two stages, the biggest difficulty in diagnosing the pain of the musculoskeletal system is that the radiological examinations cannot be performed and the drugs that will harm the baby cannot be used.

In the third stage, there is a spine placed in the birth canal in the abdomen that resists an extra 10-15 kg of overload. In this period, if there is aches of muscles that are tired of contraction, joints and ligaments that are injured and healed during pregnancy, pain due to progress in waist and neck hernias occur. When the causes of pain become unbearable, radiological examinations that will cause less harm to the baby are often not accepted by mothers. Drug use may be more appropriate if or not to cross the placental barrier. When our mothers do not agree to take these drugs, it is not possible to relieve the pain.

Labor at the end of pregnancy is a painful process in which the musculoskeletal system is subjected to extraordinary loads. While this miracle is happening, all muscle structures put serious strains on weak and loose bone structures. With a new burden after birth, miraculous hormones (oxytocin, prolactin) that help the milk secretion grow to the rescue of the mother in the postpartum phase. These hormones release growth hormone-equivalent replacement agents (somatomedins). Mothers literally reach the capacity of renewal in a child’s development. This does not occur in normal situations in women who are not mothers, as in men

Breastfeeding mothers suffer less pain after childbirth, and these hormones, which have an endorphin-like effect, relieve pain and also have a miraculous healing function, enter a dramatic production / repair phase within 3-6 weeks. However, the repair process is also painful. These are responsible for the mothers of fatigue, sleepiness, and the tendency to consume sugary foods (puerperal sherbet).

So what should we do so that we can fight back pain?

Spine problems, if any, should be known before pregnancy and their aggravation should be prevented during later pregnancy.

From the first stage of pregnancy, weight training can be performed in addition to exercises such as plates that strengthen the carrier properties of the back and abdominal muscles. However, as we approach the second stage, where the risk of miscarriage will continue to increase, exercises should be performed with plates and isometric movements. Painful situations should be eliminated with cold-hot applications and medical massage, especially without triggering fibromyalgia. Pregnancy is the period of life when ergonomic life is most necessary. Strict compliance with the rules is essential, from the preferred stair step while walking, your seat setting in the vehicle, the way you travel in the bus, the seat at home, to the bench level in the kitchen.

Nutrition, and especially a diet containing calcium, phosphate and plenty of protein, greatly reduces the destruction of the skeletal and muscle structure for the baby’s needs. The mother who is not well nourished is weakened primarily by the body code that nourishes the baby, and it is inevitable that the spine-muscle-originated pains will increase.

If you have a weak body before pregnancy, you should definitely do muscle strengthening in the first months. In the advancing 2nd and 3rd stages, birth preparation groups in pregnancy centers will greatly reduce the pain caused by the skeletal system. Considering that the muscle groups that are tired in the last phase will need more breaks, less repetitive exercises with frequent breaks are preferred.

The needs of the skeleton that heals and regenerates rapidly in the 3-6 week period after pregnancy should be met with rich contents with low calories during pregnancy. The weight gained should be lost, the loads on the spine should be reduced. Pain reduces the transition to some drug treatments in mothers who are not breastfeeding, but I would like to emphasize the presence of natural painkillers for breastfeeding mothers, in this respect, breastfeeding is a great advantage with reducing spinal pain and increasing regeneration.

Pregnancy is the most beautiful period of holy motherhood. Let’s not forget that this period will pass with the least pain and a smiling face, with a healthy diet and regular exercise.

Shoulder Dislocation Surgery – What is Shoulder Dislocation?

Dislocations are very common in the shoulder joint, which is the most mobile joint in our body. What is Shoulder Dislocation? How is Shoulder Dislocation Surgery and Treatment Performed? You can find out all about Shoulder Dislocation in this article.

What is Shoulder Dislocation?

It is when the shoulder joint comes out of its socket. In reality, the shoulder joint does not have a seat. Instead of a slot covering the sphericity of the shoulder head, the labrum lip of approximately 1 mm, which acts as a suction cup on a flat structure that we call the gleonoid, and the capsule, ligament and muscles covering it, can keep the shoulder joint in place.

This allows the shoulder to rotate nearly 360 degrees, allowing it to function as the most mobile joint of our body.

In Which Situations Is Arthroscopy Preferred For Shoulder Dislocation?

Treatment of shoulder dislocation is immediate placement in the first 6 hours and fixation with a bandage. Detection should not be less than 6 weeks. Although this period of recurrent shoulder dislocation is reduced to 3 weeks, 6 weeks is recommended as a safer period in our clinic.

The diagnosis of “habitual dislocation” (Habituel) is made in people who have shoulder prolapse more than three times. The ligament and labrum structures of the shoulder should be repaired in the habitual shoulder dislocation and primary (first) shoulder dislocation with tears in the anterior region of the labrum.

Arthroscopic shoulder dislocation repair is the gold standard. Today, open surgery is very rare and cannot be performed.

How is Shoulder Dislocation Arthroscopy Performed?

It is like standard shoulder arthroscopy. If the width of the labyrinth tear is large, an additional portal can be opened.

Stitches placed in the labraum are repaired and shoulder stability is checked. If necessary, the capsule can be intervened in the same session.

How Long Does Shoulder Dislocation Arthroscopy Take?

The optimal time varies between 30-60 minutes.

What Should the Patient Do Before Shoulder Dislocation Arthroscopy?

Preparation for shoulder arthroscopy is done in the hospital.

What is the Recovery Process After the Surgery?

After arthroscopic shoulder dislocation surgery, rehabilitation and movement are started immediately. First of all, after pandular movements, joint range of motion is actively provided.

After 3 weeks, passive, active resistive exercises can be started in the presence of a physiotherapist. The rehabilitation period may vary depending on the patient’s location and profession.

Will It Repeat After Surgery?

It is not expected to reappear in sedentary life. It is possible for the shoulder to dislocate after a new trauma that pushes the shoulder limits, but in daily life, it is not seen as a spontaneous or habitual dislocation.

How Much is the Surgery Fee?

It is determined according to the options suitable for the hospital and the patient’s budget.

What is a fracture? How to Tell a Fracture?

A fracture is a condition in which our bone integrity is impaired. So how do you understand the fracture? You can read about this and other details below.

What are the Differences Between Fracture and Crack?

Although an unallocated fracture is considered a crack, it is essentially a fracture as both break bone integrity.

How to Tell a Fracture? How Is A Fracture Diagnosed?

Fracture findings; pain, swelling, excessive movement are in the form of deformity. In cases where there is no deformity, a definitive diagnosis should be avoided without radiological imaging of the bone. Some fractures line a fairly thin line and can be missed, in which case MRI or tomography may be required.

Fatigue fractures can only be noticed on MRI. If it is not compatible with conventional x-ray examination, MRI should be considered without hesitation. For fractures that cannot be localized, the location may be determined by bone scintigraphy and diagnosed by localized MRI or tomography.

What is the Fracture Treatment Process?

Fractures heal with a plaster splint in 6-12 weeks if the contact surface is more than 50 percent, there is no rotation, the angulation is not more than 15 degrees in the direction of movement, the anterior-posterior 10 degrees and is stable during fixation. Non-healing delay exceeding 5 months, nonunion is accepted in cases exceeding 7 months.

At Which Stage Is Fracture Surgery Required?

If there is no contact between the fracture ends or if it is less than 50 percent, angulation is high and stability cannot be achieved, surgery should be performed. Some fractures (hip neck fracture, muscle attachment ruptures, epicondyle and malleolus fractures) are treated promptly.

If muscle and connective tissue have entered between the broken ends, surgery is also performed.

What Are The Surgery Options – How Is It Done – How Long Does It Take?

In open surgery, the fracture ends are brought face to face and fixation is provided with plates and metals from the bone marrow (intramedullary) long bones from the surface. In rigid and solid fixings, joint movement can be given immediately and weight can be given. If the surgical fixation is insufficient, timing should be done with the surgeon’s decision.

What is the Recovery Process After the Surgery?

Fracture healing is best achieved without surgery. Fracture union is completed in 6-12 weeks with or without surgery. Weight-bearing and joint movement are planned according to the load carried by the bone.

Does It Recur After Surgery?

If the boiling is not completed, it can be separated from the same place again. The probability of breaking the unbroken bone is the same as the fracture at the same place after union.

How Much is the Surgery Fee?

It is planned according to the patient’s budget.