Recent advances in spinal-fusion surgery include the use of microscopes and tubes to minimize tissue trauma, as well as the introduction of computerized image guidance, also called surgical navigation. Removing the lamina takes the pressure off the spine. This minimally invasive technique requires a small incision in the back, where the muscles are pushed aside rather than cut. This surgical procedure involves removing part of the vertebra bone called the lamina in order to access the disk. Laminectomy: A laminectomy is performed to relieve pressure on the nerve roots. This has the advantage of aiding the surgeon in optimal placement of screws and avoiding injury to delicate nerve tissue. A recent advance is the use of a computerized image-guidance system for many patients undergoing lumbar fusion. Patients undergoing this procedure have a faster recovery time. Minimally invasive lumbar fusions do not require the large incision or the muscle retraction typically used in conventional fusions. This reduces spinal pressure, pain, and nerve damage. Minimally Invasive Lumbar Fusion: This surgery fuses the bones of the spine in the lower back together so that there is no longer any motion between them. Surgical intervention is also often used to treat problems in the cervical spine that EDS can cause, especially in cases where the lower brain pushes down into the spine (see Chiari malformation). Issues affecting the lumbar (lower) spine, such as pressure or swelling of the nerves, may be treated with spinal fusion or a laminectomy to address weakness or numbness, loss of bladder/bowel control, or sexual dysfunction. Surgical joint stabilization and nerve-release procedures may be the only reasonable option for those with certain neurological and spinal manifestations of Ehlers-Danlos Syndrome, such as those who suffer from debilitating pain or complications from spine instability, degenerative disc disease, and malformation of the spine or ribs, which can affect heart and lung function. Minimally invasive surgical techniques are preferable.
Surgery can improve quality of life, and a medical team will recommend surgery for life-altering EDS issues not addressed by conservative treatment. Treatment for Ehlers-Danlos Syndrome will depend upon the severity of the condition and its complications, as well as on the health and age of the patient. Medications for pain relief can be helpful, but they do not change the root cause of the pain. Conservative treatment, such as physical therapy and RICE (rest, ice, compression, elevation) is preferable to surgery since EDS can lead to less-predictable healing and excessive bleeding. Treatment and management are focused on preventing serious complications and pain relief. Women with Ehlers-Danlos syndrome should be questioned regarding incontinence, genital prolapse, endometriosis, and dyspareunia.There is no specific cure for Ehlers-Danlos Syndrome (EDS). Prolapse was diagnosed in 12 (29.3%).Ĭareful attention should be paid to women with Ehlers-Danlos syndrome because of an association with many gynecologic complaints. Incontinence could not be demonstrated objectively. The frequencies of incontinence complaints (59%), endometriosis (27%), dyspareunia (57%), and previous hysterectomy (44%) were higher than expected for a population with a mean age of 41 years. Qualitative and quantitative data were analyzed to determine means for various gynecologic disorders of Ehlers-Danlos syndrome. Each had a comprehensive standardized evaluation, including gynecologic history, physical examination, urodynamic testing, and physical therapy evaluation. We characterized the population with Ehlers-Danlos syndrome with regard to genital prolapse, urinary incontinence, and other gynecologic disorders.įorty-one adult women who had registered for a first-ever Ehlers-Danlos multidisciplinary clinic participated in the study.