Low back pain: trattamento chirurgico e mini invasivo

Le sindromi del low back pain rappresentano, senza dubbio, una delle esperienze più comuni dell’uomo tali da meritare un interesse di medici a differente professionalità: medico di famiglia, fisiatra, ortopedico, neurochirurgo e terapista del dolore.
Da numerosi studi è stato messo in evidenza che questa patologia vertebrale è in costante aumento e ciò sembra collegarsi con il cambiamento delle abitudini di vita che la moderna civiltà impone, con il maggiore sviluppo di professioni che costringono a posizioni obbligate per lunghe ore e a condurre una vita sempre più sedentaria.
Esistono situazioni enfatizzate che ricorrono frequentemente nella diagnosi eziologica delle lombalgie: è il caso dell’artrosi a cui fino ad ora si è dato troppa importanza e che ha costituito il capro espiatorio di molte patologie del rachide caratterizzate da dolore.
Ormai è stato accertato che non esiste alcun parallelismo assoluto tra artrosi e dolore vertebrale: studi clinici hanno infatti dimostrato che gruppi randomizzati di lombalgici cronici non presentano una maggiore incidenza di anomalie radiografiche, invece pazienti che hanno anomalie radiografiche importanti non mostrano una maggiore incidenza di lombalgia rispetto ai controlli.
D’altra parte non esiste in iter terapeutico omogeneo con una proliferazione di pratiche terapeutiche sia ufficiali che alternative, e questo ci dimostra la confusione di idee sorta intorno alla patologia della colonna vertebrale.

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