The anterior divisions communicate with the sympathetic trunk . Near the origin of the divisions, they are joined by gray rami communicantes from the lumbar ganglia of the sympathetic trunk. These rami consist of long, slender branches which accompany the lumbar arteries around the sides of the vertebral bodies, beneath the Psoas major . Their arrangement is somewhat irregular: one ganglion may give rami to two lumbar nerves, or one lumbar nerve may receive rami (branches) from two ganglia . The first and second, and sometimes the third and fourth lumbar nerves are each connected with the lumbar part of the sympathetic trunk by a white ramus communicans .
In many cases, vertebral fractures can be treated through conservative methods such as bed rest, a back brace or pain medication. However, patients with osteoporosis or whose fractures have caused severe, long-term pain may benefit from a minimally invasive procedure such as vertebroplasty to relieve symptoms. This procedure is also recommended for patients who are too weak to undergo spinal surgery, or have a malignant tumor within the spine that has caused vertebral damage. Vertebroplasty is most effective when performed on fractures that are less than six months old.
Patients will return for a follow-up visit to see the doctor approximately 12-14 days after surgery. The incision will be inspected. The incision will be inspected and the stitches or staples will be removed. Medications will be refilled if necessary. Patients will usually return to see Dr. Spoonamore every 4-6 weeks thereafter, and an x-ray will be taken to confirm the fusion area is stable and healing appropriately. At 8-12 weeks after surgery, patients will be given a prescription to begin physical therapy for gentle back exercises.