Geriatric Spine Care
Diet and Nutrition
Diet, nutrition and maintaining a healthy weight are essential components of balanced spinal health, especially in the elderly. The reasons for poor nutrition in geriatric patients could be due to a combination of the physiological, psychological and social changes associated with food intake and body weight as they age. The structures in the spine need correct nutrition to support the body and perform properly. The consumption of calcium, magnesium, vitamin D3 and B12 in the diet is crucial for good bone health. Including lots of leafy greens, eggs, cod liver oil, and meaty proteins in the diet is recommended. The geriatric spine care program covers a comprehensive dietary regimen designed by the in-house nutritionists.
Psychiatric Mental Health Management
Most geriatric patients experience some deterioration in motor function and cognitive abilities as they age. Coupled with the state of being ill and possibly constant pain, the slowing down of functions can cause confusion, depression and hopelessness. This is why the elderly in particular require mental health support. Patients may be unwilling or unable to communicate the extent of their pain. The trauma of having a chronic illness, fear of pain and suffering can take a very large toll on the patient. The presence of good mental health resources is also associated with more effective recovery from surgery.
As humans age, the requirements of their bodies change and require specialised attention. Geriatric patients are typically afflicted with arthritis, osteoporosis, decreased balance (making them susceptible to falls) or wear-and-tear of the joints. In addition to this, most senior citizens tend to lead a sedentary, inactive life. Geriatric physiotherapy focuses on restoring mobility, increasing fitness and stamina levels, reducing pain and maintaining balance and co-ordination. Fitness training is essential to help geriatric patients maintain their strength and ability to function independently. The training focuses on strengthening the musculoskeletal system as well as the nervous system.
Elderly patients with osteoporosis often do not discover the condition until they experience a fall. The weakened muscles and bones can lead to severe injuries resulting in vertebral fractures. Fractures in geriatric patients have a high morbidity rates, so this is of concern. Timely screening for osteoporosis and regular check-ups can help to prevent the onset of this condition
A Vertebroplasty is a minimally invasive procedure used to stabilize an osteoporotic vertebral compression fracture. The doctor performs the procedure by injecting a cement mixture into the fractured bone, under the guidance of fluoroscopy or X-ray imaging. Kyphoplasty achieves the same objective, but by inserting a balloon catheter into the crushed vertebrae to create a hollow under fluoroscopy, into which surgical cement is injected.
Vertebroplasty and Kyphoplasty procedures are effective in the treatment of vertebral compression fractures, vertebral compression due to a malignant tumour or osteoporosis due to long-term steroid use or a metabolic disorder.
Percutaneous pedicle screws
Percutaneous pedicle screw fixation is a minimally invasive surgical procedure to implant rods and screws in the vertebrae to stabilize the spine. The pedicle screws are inserted into the spine through very tiny surgical incisions in the skin. This technique is sometimes used during a spinal fusion surgery in which a fragment of transplanted bone is used to encourage the vertebral fusion. Percutaneous pedicle screw fixation is performed under general anaesthesia. Modern techniques use navigation or robotic assistance and fluoroscopy to place the screws accurately. The percutaneous technique is advantageous as infection rates are lower compared to traditional open surgery.
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