 |
 |
Return-Path: <[log in to unmask]> Received: from rly-yb05.mx.aol.com (rly-yb05.mail.aol.com [172.18.146.5]) by air-yb03.mail.aol.com (v76_r1.8) with ESMTP; Fri, 06 Oct 2000 16:57:26 -0400 Received: from gadolinium.btinternet.com (gadolinium.btinternet.com [194.73.73.111]) by rly-yb05.mx.aol.com (v75_b3.9) with ESMTP; Fri, 06 Oct 2000 16:56:46 -0400 Received: from [62.7.85.199] (helo=g4l0y4) by gadolinium.btinternet.com with smtp (Exim 3.03 #83) id 13heXt-0000LX-00 for [log in to unmask]; Fri, 06 Oct 2000 21:56:45 +0100 Message-ID: <006c01c02fd7$bebe71c0$c755073e@g4l0y4> From: "Charles Mounteney" <[log in to unmask]> To: <[log in to unmask]> References: <[log in to unmask]> Subject: Re: cold spray (about the disc) Date: Fri, 6 Oct 2000 21:55:21 +0100 MIME-Version: 1.0 Content-Type: text/plain; charset="iso-8859-1" Content-Transfer-Encoding: 7bit X-Priority: 3 X-MSMail-Priority: Normal X-Mailer: Microsoft Outlook Express 5.50.4133.2400 X-MimeOLE: Produced By Microsoft MimeOLE V5.50.4133.2400 There is a likelihood that there isn't repair in the sense that you mean. Circumferential tears and radial fissures may routinely be present and, because they aren't innervated areas, the don't hurt unless you apply a load sufficient to deform the outer 1/3 of the annulus. Thus the difference between a herniation involving a rupture of the annulus(and this may show no LBP but only 2' pain associated with the dura/nerve root being inflamed) and a cleavage tear that haas been forced open by posture/activity and causing some form of increased stretch on the annulus from inside the disc. "Internal disc derangement" is thought to account for > 40% of LBP according to the work done by Bogduk. Now the explanation is plausible but I don't think it is as true as all that . Still it is a plausible explantation of why things change quickly. Move wrong...open the fissure...increase internal pressure...pain++. Change the posture...re-open the fissure..reduce outer annular stretch....patient is happy. AND..this is not going to recover if the cleavages are major in nature.....sort of a lottery as to whether you over load the system to the point where your particular set of circumstances set off an attack or not.... Makes a cetain amount of PT re-ed sound like bunk.....mush like a torn ACL...once gone completely we can never do for the patient what the surgeon's knife might. For the IDD there is now alot of woek on electrocautery to seal the cleavage in patients with chronic problems...initial studies seem quite positive. Sorry for the babble but I have been having problems with my ISP lately. Hope you don't mind these few thoughts between you and me. Cheers, Ross