Spine Problems

Bone Spur / Stenosis

A bone spur is an excess growth of bone around a vertebral body. It is not the bone spur itself that is the real problem, but rather pain and inflammation can occur when the bone spur rubs against nerves and bones. If bone spurs grow too much, they can impinge on nerve roots.

Stenosis is another issue that can affect people as they age past 50 years old. The spinal canal can become more narrow with age, causing back pain that worsens as a person arches their back.

Treatment of stenosis can be done with a surgical procedure that re-opens the space in the spinal canal providing immediate relief of symptoms.

Degenerative Disc

Degenerative disc disease can also occur as a person ages or when they lift something too heavy. Over the years, discs become more brittle, less resilient and more prone to herniation. In many cases, the space between vertebrae can shrink and compress, which in turn can impinge upon nearby nerve roots, causing radiating pain into a leg or arm, or worse, numbness and weakness into a leg or arm.

When a disc herniates in the spine, the surgeon can remove a portion of the disc. In other cases, where the disc is more damaged and must be removed, something must be placed into the disc space. Otherwise, the two vertebrae will collapse on top of one another, placing pressure on the nerve roots that branch off from the spinal cord. Treatment may involve artificial disc implantation surgery.

In the event of a fall or heavy strain, these discs can rupture, causing the nucleus to break through the wall of the disc and place pressure on the nerves that branch out from the spinal cord. This results in a herniated disc, accompanied by back or neck pain.

The good news is that in many cases, the pain and inflammation originating from damaged discs can be treated nonsurgically by reducing the inflammation and by strengthening the musculature surrounding the damaged disc to give it more support.

Herniated Disc

The spine is composed of many vertebrae stacked on top of each other. Between these bones are discs, which act as shock absorbers. The shock absorbing discs resemble jelly donuts, each having a jelly-like center. As we age, the discs naturally become less flexible and more brittle.

In the event of a fall or heavy strain, these discs can rupture, causing the nucleus to break through the wall of the disc and place pressure on the nerves that branch out from the spinal cord. This results in a herniated disc, accompanied by back or neck pain.

The good news is that in many cases, the pain and inflammation originating from damaged discs can be treated nonsurgically by reducing the inflammation and by strengthening the musculature surrounding the damaged disc to give it more support.

Spinal Tumors

Spinal cord tumors are abnormal growths of tissue found inside the bony spinal column, which is a primary component of the central nervous system. Benign tumors are noncancerous, while malignant tumors are cancerous. Because the central nervous system is found in rigid, bony quarters (i.e., the spinal column), any abnormal growth, whether benign or malignant, can place pressure on sensitive tissues and impair function.

The most frequent symptom of benign and malignant spinal tumors is back pain. However, this type of back pain doesn’t not start with an injury, stress or physical activity. The type of back pain may worsen with activity or when lying down. The back pain may also worsen over time and spread to the hips and legs, which is a sign that the tumor is pressing on nerve roots. Spinal cord tumor symptoms include back pain, numbness in a leg, muscle weakness, incontinence, loss of bowel and bladder control and muscle spasms. Other symptoms may include changing sensitivity to heat or cold, and difficulty walking.

The goal in the treatment of spinal cord tumors is to minimize nerve damage related to compression of the spinal cord. The three most commonly used treatment options are surgery, radiation and chemotherapy to kill any remaining cancer cells. Steroids may also be used to reduce swelling.

Spine surgeons use an array of diagnostic tests including MRI and CT to visualze the tumor and determine treatment options including surgical removal of the tumor. Lab tests can include an EEG and a spinal tap. A biopsy may also be performed, to remove a piece of the tumor tissue to diagnose the type of tumor. The tumor may be classified as benign or malignant and graded to enable the surgeon or oncologist to develop a prognosis or outcome for the patient.

Spondylolysis / Spondylolisthesis / Spinal Deformity

Spondylolysis relates to instability of specific bones in the low back. It a very common cause of back pain, particularly in young athletes.

Gymnasts who perform routines that bend and arch the back are often victims of spondylolysis or spondylolisthesis.

With spondylolysis there may be a fracture in the vertebra, but the spine has not moved out of position. With spondylolisthesis, the fracture has allowed the spine to shift out of position to become unstable.

When there is a fracture, the vertebral bones can shift our of position, called spondylolisthesis. Surgery may be needed to treat such a fracture and prevent that spinal instability.

Symptoms of spondylolysis or spondylolisthesis can incude:

• A stiff back
• Difficulty walking or standing for long period of time
• Pain when bending over
• Numbness/weakness in a foot

Spondylolysis or spondylolisthesis can affect about 5% of adults, sometimes without any symptoms. After age 50, such spinal deformity occurs more often, affecting women more than men because of osteoporosis weakening the strength of bones.

Nonsurgical treatment options include:

• Rest and anti-inflammatories
• Spinal Injections
• Physical therapy and exercises to strengthen the stomach and back
• Bracing to stabilize the back

Surgery may be recommended if the spine has become unstable or pain symptoms are severe. During surgery, a fusion may be performed and space provided to nerve roots which can relieve symptoms.