Importance of the Spine Intervention

Adrienne Clermont^*
*Correspondence: Adrienne Clermont, Neurosurgical Spine Division, University Hospital Heidelberg, Heidelberg, Germany, Tel: 9492601433, Email:

Brief Report

The aim of this study is to present current knowledge approaching spine pathology from the clinical, diagnostic and therapeutic point of view. First approach to spine pain must be always clinical evaluation; physicians shouldn't treat images but patients after a clinical-diagnostic analysis. It seems quite obvious sentence but unfortunately sometimes it's not the case looking the numbers of spine surgery and mini-invasive spine devices implanted increasing year by year. It is important to recollect ethical analysis to avoid useless intervention especially in spine disease during which the foremost important problem is to know the source of spine pain. Multimodality diagnostic approach essentially understands the source of the pain and even just in case during which the imaging shows clearly abnormality it's important to know the correlation between the imaging and therefore the spine pain. X-ray, dynamic X-ray, MR, CT, bone scan and PET scan are all very important choose the simplest therapeutic approach for our patients. Very often it's necessary to perform quite one examination to succeed in the right diagnosis and to make a decision about the best treatment.

     It is useful to remind to perform always MR with T2 STIR or fat suppressed sequences to point out bone marrow edema when porotic fracture doesn't heal. There are not any doubts that any sort of mini-invasive spine approach being less destructive for paravertebral muscles will create less complications and augur good biomechanical modifications. This is often the rationale for the event of numerous mini-invasive spine devices creating less muscular and bony damage and less spine rigidity. Expectancy of life is becoming longer and longer and one among the major problems is that the so called “silent epidemy” mentioned minor and major collateral effects of osteoporosis in elderly people. New drugs are improving the life quality by reducing the danger of porotic vertebral fractures but still now very often medical therapy, bedrest, orthesis devices and physiotherapy can fail in treating this disease and for this reason vertebral cementoplasty is a valid alternative choice to cure spine pain thanks to porotic insufficiency fracture in those patients. Even if it's well demonstrated that clinical efficacy is analogous between vertebroplasty and assisted technique, it's been pointed out if which cases and that reason assisted technique should be preferred to the straightforward cement injection.

   While primary spine tumors are quite rare, spine metastasis represents a standard condition in patients with a primary breast, lung or prostatic adenocarcinoma. Even just in case of primary or secondary spine tumors, miniinvasive spine treatment are often very helpful to enhance clinical symptoms and to stabilize the spine with an identical approach of spine surgeons regarding the concept of spine stability and instability. New sorts of cement (choosing the viscosity), frequency Ablation and prosthesis material can help patients with spine pain to improve their quality of life. Other common pathological conditions are represented by degenerative disk disease with acute low back pain and/or sciatica which will be present up to 80% of population in western country at least once within the life. Facet joints degeneration, herniated disk and vertebral canal stenosis represent different sides of an equivalent problem: the degenerative spine. New system to stabilize the spine has also been proposed and applied rather than the standard screw fixation. One of the foremost common therapeutic options remains epidural steroid injection; it's simple, fast, cheap and effective and this is often related to the inflammatory pathogenesis of spine pain. Failed back surgery syndrome is described in up to twenty of cases and for this reason it's important to acknowledge the foremost typical MR and CT patterns of those pathological conditions.

  In conclusion, this study wants to offer a summary on the most advanced treatment option without forgetting the importance of the clinical diagnostic analysis to pick the patients to reach the simplest clinical results.