SPINAL CONDITIONS

Refers to a damaged, gradually deteriorating disc between the vertebrae with loss of disc hydration and elasticity.

Refers to disc dehydration and extrusion. This disc material can come in contact, irritate and cause compression of surrounding spinal nerves. Disc herniations are most commonly seen at the lower lumbar levels of L4/L5 and L5/S1. Symptoms can be treated with lifestyle changes, physical therapy, heat/cold packs, analgesia and anti-inflammatory medication. There are several surgical options available such as a discectomy, spinal fusion or artificial disc replacement if symptoms become unmanageable.

Stenosis is the narrowing of space in the spinal canal, most often seen in the elderly and can occur as a result of bony spurs, disc disease, spinal fractures, cysts, facet joint degeneration due to osteoarthritis, thickening of surrounding ligaments and/or hereditary conditions.

The reduction of disc space can lead to compression of both the spinal cord and spinal nerves. This compression can cause symptoms that may present as pain, numbness, pins and needles and/or weakness in the limbs. The patient will complain of “sciatica”, radiating leg pain and lower back pain.

Symptoms are generally relieved on bending forward as this creates more space within the spinal canal. If anti-inflammatory medication, analgesia and physical therapy provide no relief, spinal decompression surgery via a minimally invasive key-hole technique is available.

Spondylosis refers to chronic degeneration that can affect any level of the spine and usually occurs with an increase in age, general wear and tear or as a result of hereditary conditions.

Discs become dehydrated, flatten out and/or bulge. Facet joints become arthritic and produce bony spurs and the surrounding ligaments become weaker. The space for spinal nerves to exit eventually becomes reduced, causing nerve compression and the onset of pain, numbness, pins and needles and weakness in the arms and/or legs.

Refers to a slipping forward of one vertebral body over another due to conditions such as facet joint arthritis, general wear and tear with time and age, weakness of surrounding ligaments, trauma or metastatic bone disease.

Retrolisthesis refers to a backwards displacement of one vertebral body over another. If anti-inflammatory medication, analgesia and physical therapy provide no relief, surgical management options are available.  This surgery involves a spinal decompression to decompress the nerves and spinal cord with a spinal fusion to help stabilize the spine.

Degenerative disc disease, disc herniation, spinal stenosis and spondylolisthesis often result in compression of the lower lumbar nerves, causing pain and altered sensation to radiate down the sciatic nerve which runs down the back of the legs. This pinched nerve can also lead to symptoms such as limb weakness and altered sensation such as pins and needles, numbness, and the feeling of hot and cold.

Refers to an abnormal S shaped (lateral/side to side) like curvature usually involving both the thoracic and lumbar spines. Scoliosis is often seen in developing adolescents but can occur at any age as a result of congenital conditions, neuromuscular disorders or (idiopathic) unknown cause. It is treated by regular observation and x-ray imaging, bracing and/or surgical correction of a significant curvature greater than 45 degrees with a spinal fusion.

Refers to an abnormal rounding or exaggeration of the thoracic spine normal curvature or a reversal of the normal curvature (lordosis) of the cervical and lumbar spine. An angle greater than 60 degrees is considered abnormal.

Spinal infections can be either contracted in the bone (osteomyelitis), in the disc (discitis), spinal muscles (psoas abscess) or the spinal canal (epidural abscess and meningitis). These infections can occur in patients with an already compromised immunity or post invasive procedures such as spinal surgery and nerve root or facet joint injections.

Infection can produce symptoms of increased pain, potential nerve irritation and fever. The infection is diagnosed through a biopsy and the symptoms are treated with antibiotics and/or surgery to remove the source of the infection.

Myelopathy refers to damage, disease or a change in pathology of the spinal tissue. This can occur as a result of trauma, inflammation or vascular disease and may lead to spinal cord compression and subsequent neurological changes. Myelopathy is most common in the cervical spine and causes disc degeneration and narrowing of the disc space with instability of the vertebrae and facet joints.

Symptoms include limb pain, weakness and altered sensation, loss of balance and in severe cases, loss of bladder and bowel control. Treatment may include spinal decompression surgery and an instrumented fusion to increase the space in the spinal canal where the cord is being compressed and stabilize the spine.

Spinal tumours are most often secondary tumours related to the spread of disease from another (primary) organ or tissue. Progressive primary or secondary spinal tumours can lead to neck or back pain, fractures of the spine and/or spinal nerve compression resulting in limb pain, weakness and altered sensation.

The main aim of treatment is to determine if the tumour is malignant or benign, control the primary tumour with systemic treatment such as radiation and chemotherapy and if required, surgically stabilise the spine with an instrumented fusion.