Spine Care

Common Spinal Disorders

Common spinal disorders include:

• Degenerative Disc Disease (DDD): Degenerative disc disease refers to the gradual deterioration of the intervertebral discs that cushion the vertebrae. DDD affects the strength, resiliency, and structural integrity of the intervertebral discs due to advancing age, trauma, injury, repetitive lifting of heavy objects, smoking, and obesity.
• Herniated Disc: A herniated disc is a condition in which the outer fibrous annulus of the intervertebral disc is damaged, causing the nucleus to protrude through the ruptured annulus and compress the adjacent nerve root and/or spinal canal. A herniated disc is also known as a slipped disc or ruptured disc.
• Stenosis: Spinal stenosis is a condition caused when the vertebral column constricts and exerts pressure on the spinal cord or neural foramen (a bony tunnel through which a nerve exits the spinal cord). It usually affects the cervical and lumbar spine. If the spinal canal is narrowed, the disorder is called cervical/lumbar central stenosis. If the foramen is narrowed, it is referred to as cervical/lumbar foraminal stenosis.
• Spondylolisthesis: Spondylolisthesis is a condition in which the breakdown of the cartilage between the vertebrae of the spine causes one vertebra to slip out of place on top of the one below it. This causes misalignment and narrowing of the spinal column, a condition called spinal stenosis, which can put pressure on the nerves, resulting in pain in the buttocks or legs with walking or standing.
• Scoliosis: Scoliosis is a condition where the spine or backbone is curved sideways instead of appearing in a straight line. It can occur at all ages but commonly occurs in children before puberty during their growth spurt.
• Osteoporosis: Osteoporosis is a bone disease characterized by a decrease in bone mass and density, resulting in brittle, fragile bones that are more susceptible to fractures. The condition most commonly affects elderly women. Osteoporosis-related fractures are more common at the vertebral bodies of the spine. Osteoporosis is called a "silent disease" because many patients may be unaware of their condition until they develop a bone fracture.
• Fractures: Vertebral compression fractures occur when the normal vertebral body of the spine collapses due to excessive pressure on the vertebrae, resulting in pain, limited mobility, loss of height, and spinal deformities. Fragile and weak bones in the elderly and those suffering from osteoporosis or cancer can develop compression fractures with little or no force.
• Tumors: Spinal tumors are abnormal growths of tissue or cells in and around the spinal cord or vertebral bones. Tumors can be cancerous (malignant) or non-cancerous (benign). Tumors from other parts of the body can also spread and affect the spinal column.
• Infections: The spinal cord and its surrounding structures can become infected by bacteria or fungal organisms. Risk factors that increase susceptibility include obesity, malnutrition, a weakened immune system, HIV infection, diabetes, and cancer.

Treatment Options for Back and Neck Pain

Pain in the back and neck is a common symptom of injury, damage, or deformity of the spine. Pain may range from a mild ache to a sharp shooting pain that can spread down the arms and legs. There are many conservative and surgical treatment options that can relieve pain by targeting the symptoms or the underlying cause.

Non-Surgical Treatment

Some common non-surgical treatment options to relieve back and neck pain include:

• Hot or Cold Compresses: Applying heat or ice over a towel to the affected region of the back or neck can help relieve pain and inflammation.
• Physical Therapy: Staying active and performing core strengthening, muscle strengthening, and stretching exercises can help relieve pain and improve strength, flexibility, and endurance.
• Manipulation, mobilization, and massage.
• Relaxation techniques such as deep breathing and meditation.
• Pain Relievers: Non-steroidal anti-inflammatory drugs (NSAIDs), opioid medications, anticonvulsants, muscle relaxants, and antidepressants.
• Nerve Blocks: Corticosteroids and/or anesthetics are typically injected into the epidural space or facet joints to help reduce pain.
• Maintaining good posture.
• Transcutaneous Electrical Nerve Stimulation (TENS): Low-voltage electrical pulses are used to stimulate nerves that carry pain signals.
• Bracing: Braces support the back or neck and allow healing after a sprain, strain, or fracture.

Surgical Treatment

There are many surgical procedures indicated for severe cases of back and neck pain that do not improve with conservative treatments. Surgery treats the underlying cause of pain and may include:

• Discectomy: Removal of a diseased intervertebral disc that is compressing spinal nerves and causing pain.
• Spinal Fusion: Removal of a problematic intervertebral disc followed by fusion of adjacent vertebrae using a bone graft.
• Artificial Disc Replacement: Removal of the damaged disc and replacement with an artificial metal disc.
• Spinal Decompression: Removal of part of the bone that is compressing a nearby nerve.
• Laminectomy: Removal of portions of bone, bone spurs, or ligaments.
• Foraminotomy: Widening the space through which nerve roots exit by trimming bone at the sides of the vertebrae.
• Corpectomy: Removal of one or more vertebral bodies and associated discs, followed by replacement with a bone graft.
• Vertebroplasty and Kyphoplasty: Injection of bone cement to fuse fragments of compression fractures and stabilize the vertebra.
• Reduction: Use of metal rods, screws, and cages to support and stabilize reduced fractures.