Treatment of Destructive Spondylopathy in Israel

At Ichilov, we strive to provide maximum comfort and quality of life for patients and their relatives. The clinic has psychological support programs and unique complexes of physiotherapeutic and rehabilitation activities. Foreign patients receive comprehensive support: in organizing travel, selecting accommodation, transfers, and personal translator services.

About the Disease

Destructive spondylopathy is a pathological condition of the spine characterized by destructive changes in the vertebrae. This can result from various diseases or conditions leading to the destruction of bone tissue and degradation of the discs that connect the vertebrae.

The complexity of diagnosing and treating this disease lies in the heterogeneity of the processes leading to the destruction or degradation of tissues, which have different mechanisms and causes.

Types of destructive spondylopathy are classified based on a complex of factors, including the cause of the disease, the degree of damage, localization, and the nature of the process (acute or chronic). Several forms of pathology are distinguished:

• infectious (bacterial, viral), caused by infectious agents such as tuberculosis, brucellosis;
• metabolic, associated with metabolic disorders, for example, osteoporosis;
• post-traumatic – as a result of spinal injuries;
• degenerative, arising from age-related changes, wear of the spine.

Signs of destructive spondylopathy vary significantly but often include:

• pain localized in the affected area of the spine;
• reduced mobility in the damaged segment;
• muscle weakness;
• numbness or tingling in the limbs if nerve roots are affected;
• postural changes.

Treatment Methods for the Disease

Treatment of destructive spondylopathy is multifaceted and depends on the causes of the disease, the stage of the process, the degree of destruction, and the presence of comorbidities

Medication Therapy

Modern pharmacology plays a key role in the treatment of destructive spondylopathy. It aims to:

• alleviate pain and inflammation, improve the quality of life of the patient. Non-steroidal anti-inflammatory drugs (NSAIDs) and, in some cases, corticosteroids may be used for this purpose;
• relieve muscle spasms, improve mobility, and reduce discomfort;
• improve the condition of cartilage and bone tissue. Although direct methods of influencing cartilage condition are limited, there are medications that help maintain bone tissue health. Some drugs used in the treatment of osteoporosis also show a positive effect on bone tissue in destructive spondylopathy.

Medication treatment can be used either as monotherapy or in combination therapy depending on the severity of the disease, comorbidities, and individual response to treatment.

Physiotherapy

Physiotherapy for destructive spondylopathy alleviates symptoms and affects factors that contribute to disease progression. Physiotherapeutic procedures do not eliminate the underlying causes but significantly improve the condition of patients and slow the progression of the disease.

At Ichilov clinic, the following are used:

• electrophoresis, ultrasound, laser therapy, magnetotherapy to improve blood circulation, stimulate tissue regeneration, and relieve pain;
• therapeutic physical education. Specially selected exercises help strengthen the muscle corset, improve the statics and dynamics of the spine.

Physiotherapy contributes to the restoration of mobility of spinal elements and strengthening of the muscle corset and ligaments, making movements more confident and reducing the risk of re-injury, maintaining a sufficient level of physical activity, which helps slow down the processes of degradation and destruction in the spine.

Physiotherapy plays a comprehensive role in the treatment of destructive spondylopathy, helping not only to alleviate symptoms but also to activate the body's internal resources for stabilizing the condition and slowing disease progression.

Blocks

Local injections made directly into the area of pathology using anesthetics and anti-inflammatory agents. Blocks are used to relieve pain syndrome and reduce the inflammatory process.

The use of blocks allows for:

• anesthesia (pain relief). The most common and immediate goal of a block is rapid pain relief, achieved by injecting a local anesthetic into the area around the affected site.
• anti-inflammatory effect. Often, corticosteroids with pronounced anti-inflammatory action are included in the block medications. This not only relieves pain but also reduces the inflammatory process in the affected area, thereby slowing the progression of destructive changes.
• restoration of mobility. Reducing pain and inflammation contributes to improved spinal function, increased mobility, and consequently, the quality of life of the patient.

At Ichilov clinic, blocks are performed under the control of imaging equipment (ultrasound or X-ray), allowing for precise delivery of the medication to the required area.

Minimally Invasive Operations

Vertebroplasty and kyphoplasty. Minimally invasive surgical procedures involving the injection of special cement into the body of the damaged vertebra for stabilization and pain relief. The difference in kyphoplasty is the preliminary stage, during which the surgeon creates space inside the damaged vertebra that requires stabilization.

Surgical Treatment

Surgical treatment of destructive spondylopathy is considered as an option in cases of:

• ineffectiveness of conservative treatment. If medication therapy, physiotherapy, blocks, and other conservative methods do not lead to a reduction in disease symptoms, improvement in the patient's quality of life over a long period, the next step is considered surgical intervention;
• progressive impairment of nerve functions. If the disease leads to compression of spinal nerves, causing acute or increasing pain, sensory disturbances, decreased strength in the limbs, loss of control over the bladder or bowel, surgical intervention may be required to prevent further damage;
• significant structural changes in the spine: instability, significant narrowing of the spinal canal (stenosis), extensive destructive changes in vertebral bodies, potentiating spinal deformation (scoliosis, spondylolisthesis);
• presence of a tumor or infection;
• severe and persistent pain.

The decision on the necessity of surgery at Ichilov clinic is made based on a complete examination, risk assessment, and the overall condition of the patient. During surgical treatment, the following may be performed:

• decompressive surgeries to relieve compression of the spinal cord and nerve roots;
• spinal fusion – surgical stabilization of the spine using implants and metal structures. Used in cases of significant destruction and instability of the spine;
• reconstructive surgeries to restore the structure and function of the spine.

Alternative Methods

In addition to basic treatment methods, Ichilov Medical Center conducts acupuncture, massage, and osteopathy sessions. These methods aim to reduce pain and improve overall condition, maintain social activity, and enhance psychological well-being.

Diagnostic Methods for the Disease

Although the result of various forms of spondylopathy is the destruction of spinal tissues, the mechanisms underlying this destruction and the consequences can vary significantly. For example, in degenerative spondylopathy, the destruction of bone tissues and intervertebral discs is a result of natural age-related changes, while in the infectious form, destruction occurs due to the impact of an infectious agent. At Ichilov clinic, a series of tests, studies, and consultations with narrow specialists precede the confirmation of the diagnosis of spondylopathy.

First Day

Collection of medical history and physical examination. The visit to the doctor begins with a patient interview about their complaints, duration of symptoms, history of spinal injuries, and presence of chronic diseases. The doctor then conducts a physical examination, during which posture, spinal mobility, pain points are assessed, and neurological tests are performed to identify signs of compression of nerve roots or the spinal cord.

Second Day

• Laboratory tests. General and specific blood and urine tests.
• X-ray of the spine
• Magnetic Resonance Imaging (MRI)
• Computed Tomography (CT)

In some cases, specialized studies may be required, such as myelography, densitometry – to assess bone tissue density, or electromyography.

Third Day

A careful selection of diagnostic methods and specialists involved in treatment allows for accurate determination of the cause and nature of spondylopathy and the development of an optimal treatment plan for each specific case. The multidisciplinary team includes orthopedic trauma surgeons, neurologists, rheumatologists, infectious disease specialists, surgeons, and other specialists. This approach facilitates a deep analysis of the condition and the selection of the most effective treatment methods, taking into account the specific cause, nature of the process, and degree of spinal damage.

What is the Cost of Treatment

Advantages of Treatment at Ichilov Clinic

1. High-quality medicine
2. Latest equipment for diagnosis and therapy
3. Specialists with clinical experience in successfully treating destructive pathologies of the spine
4. Individually developed treatment programs
5. Comfortable conditions for treatment and rehabilitation

The medical field in Israel is known for innovations and progressive technologies. With the help of modern means of internet communication, it is possible to organize a video meeting (via Zoom or Skype) with doctors specializing in the treatment of degenerative-dystrophic pathologies of the spine and receive a professional assessment regarding your case.