Spinecare Topics

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Spinehealth and Disease
The Healing Spine

Phase III: The Maturation/Remodeling Stage

During the remodeling stage collagen and extracellular material become arranged in an organized manner thus repairing the compromised area.  Remodeling is the third and final stage of healing.  During this stage the body attempts to put the finishing touches on the healing process.  The remodeling stage overlaps with the proliferative stage and can take over twelve months to complete.  During the remodeling stage the changing tissue integrity is influenced by the stresses placed upon them while they are healing.  Proper tissue strength and resiliency is required to restore support, function and to prevent re-injury.

This phase of healing is a fairly long process.  It requires realignment and remodeling of collagen fibers.  The ongoing cycle of collagen synthesis is associated with increased strength of scar.  Influenced by the type of stress and strain placed upon the tissue, the collagen fibers will realign in a position of maximum efficiency parallel to the lines of physical stressors.  The maturation or remodeling phase of tissue healing can occur up to a few years after the onset of injury.

Factors Which May Impede Spinal Tissue Healing:

  • The Extent of Injury:  The nature and amount of inflammatory changes will be determined by the degree or severity of tissue injury.  Loss of blood supply or injury to the nerves will substantially increase the recovery time. Injury with fracture or severe polytraumatic injuries complicate the recovery process. Tissues can be reinjured with overuse and repetitive-type strains. These small micro tears of soft tissue are often associated with a slow to heal or chronic condition. 
  • Edema:  Increased tissue pressure caused by swelling slows down the healing process.  The presence of excessive edema also reduces the delivery of nutrients to injured tissues, subsequently slowing down the healing process.
  • Hemorrhage:  Bleeding occurs with injury to tissues. Excessive bleeding will often lead to a greater prevalence of inflammation and scar formation (fibroproliferation).

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