Spinecare Topics

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Spine - Health and Disease
The Healing Spine

The proliferative stage generally lasts for two to three days up to six to eight weeks after injury.  During this stage damaged and compromised tissue is either repaired or replaced.  This process results in the formation of scar tissue (fibrosis).  The development of too much scar tissue can result in adhesions that restrict joint and soft tissue movement.  The repair process during the proliferative stage can be adversely influenced by inappropriate activity, age, underlying medical disorders, malnutrition, poor general health, and re-injury during this stage.  The tissues remain weak and are susceptible to be re-injured during this stage.

The period of scar formation is also referred to as fibroplasia.  This generally develops within the first few hours after the injury, and it can last for as long as 4-8 weeks.  During phase II of the repair process many of the clinical signs and symptoms associated with the acute inflammatory response resolve or diminish.

During the second phase of healing there is growth of endothelial capillary buds or small blood vessels into the wound stimulated by a localized lack of oxygen.  With increased delivery of blood flow and oxygen, there is a corresponding increased delivery of nutrients that is essential for tissue repair, regeneration, and remodeling of the injured region.

There is formation of a delicate transient form of connective tissue referred to as granulation tissue occurs paralleling the breakdown of the fibrin clot.  Granulation tissue consists of fibroblasts collagen, and capillaries.  It helps fill the gaps during the healing process.  Specialized cells referred to as fibroblasts begin to accumulate at the wound site, arranging themselves parallel to the capillaries.  They begin to synthesize an extracellular matrix or material, which contains protein, fibers of collagen, and blastin.  These cells also produce a ground substance in the form of glue, which helps bind the tissue elements together.  Approximately 6-7 days after injury, fibroblasts begin laying down collagen fibers.  The fibers assume a random fashion forming the initial phase of scar becoming more organization as the injury site continues to heal.  As the collagen proliferates the strength of the wound increases.

The presence of persistent or recurrent inflammatory response with continued release of inflammatory chemicals can promote extended scar tissue development of fibroproliferation.  Excessive fibrogenesis can lead to irreversible tissue damage.  This can result in adhesive changes within the tissue.

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