BACK AND SPINE SPECIALITIES
an overview
The human spine is made up of 24 bones or vertebrae in the cervical (neck) spine, the thoracic (chest) spine, and the lumbar (lower back) spine, plus the sacral bones.
Vertebrae are connected by several joints, which allow you to bend, twist, and carry loads. The main joint between two vertebrae is called an intervertebral disc. The disc is made of two parts, a tough and fibrous outer layer (annulus fibrosis) and a soft, gelatinous center (nucleus pulposus). These two parts work in conjunction to allow the spine to move, and also provide shock absorption.
Each vertebra has an opening (vertebral foramen) through which a tubular nervous structure travels. Beginning at the base of the brain to the upper lumbar spine, this structure is called the spinal cord. Below the spinal cord, in the lumbar spine, the nerves that exit the spinal cord continue to travel through the vertebral foramen as a bundle known as the cauda equina. At each level of the spine, spinal nerves exit the bony spine then extend throughout the body.
What can cause pain?
There are several primary causes of spine problems. The majority of the symptoms are caused by either instability or by disc, bone, or ligaments pressing onto the nerve roots and/or spinal cord.
Degenerative Disc Disease (DDD)
During the natural aging process, the discs between each vertebral body can lose their flexibility, height, and elasticity which can cause a tear in the tough outer layer of the disc, causing the disc to herniate, bulge, or leak the gelatinous core. The bulges or leakages can end up compressing the nerve roots and/or spinal cord, causing symptoms including, but not limited to lower back and/or leg pain.
Degenerative Spondylolisthesis
Degenerative spondylolisthesis is a condition where one vertebra has slipped forward over another one below it. This instability typically occurs as a result of degenerative changes but may also be caused by stress fractures, or congenital abnormalities (birth defects), and in rare cases from a tumor or trauma.
Degenerative Scoliosis
Adult degenerative scoliosis is a condition where a right-left or lateral curve develops in a previously straight spine. This curvature occurs as a result of deterioration of the disc and joints in the back of the spine. As the joints degenerate they create a misalignment in the back, resulting in a bend or curvature, causing symptoms including lower back and/or leg pain.
What are the treatment options?
Many symptoms can be treated without surgery including rest, heat, ice, medication, injections, and physical therapy. It is important to schedule an appointment with our office to meet and define the best option for your specific diagnosis. If symptoms do not improve with conservative treatment, we may recommend spinal surgery. Surgery is reserved for those who do not gain relief from non-operative forms of treatment, patients whose symptoms are increasing or worsening, and/or patients that present with a spinal condition which indicates the need for surgery.
