Lumbar spine instability treatment

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• Streamlining the Journey of Research Into Clinical Practice: Making Your Patients and Practice Flourish: When to Fuse? An Evidence Based Review of Treatment Strategies in Degenerative Spondylolisthesis
• Transforaminal Percutaneous Endoscopic Discectomy for L3/4 and L4/5 Foraminal and Extraforaminal Lumbar Disc Herniation: Clinical Outcomes and Technical Note

Depending on the severity and underlying cause, treatment options may include:

Physical therapy: Exercises and stretches to strengthen the supporting muscles, improve posture, and enhance spinal stability. Pain management: Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, or epidural injections, may help manage pain and inflammation. Bracing: The use of lumbar support or bracing can provide temporary stability and pain relief. Activity modification: Avoiding activities that exacerbate symptoms and adopting proper body mechanics can help protect the spine. Surgical intervention: In cases of severe instability or if conservative treatments fail, surgery may be considered to stabilize the spine, correct structural abnormalities, or decompress nerve roots if compression is present.

The classic treatment for Degenerative lumbar spinal stenosis is traditional total laminectomy decompression, bilateral laminotomy decompression, unilateral laminectomy bilateral decompression, and fusion, which are only considered in cases of lumbar spine instability ^{1) 2)}.

The most diffused surgical techniques for stabilization of the painful degenerated and instable lumbar spine, represented by transpedicular screws and rods instrumentation with or without interbody cages or disk replacements, require widely open and/or difficult and poorly anatomical accesses. However, such surgical techniques and approaches, although still considered “standard of care”, are burdened by high costs, long recovery times and several potential complications. Hence the effort to open new minimally-invasive surgical approaches to eliminate painful abnormal motion. The surgical and radiological communities are exploring, alternative, minimally-invasive or even percutaneous techniques to fuse and lock an instable lumbar segment.

see Dynamic stabilization