Spine

Normal Spine Anatomy

The spine, also called the back bone, is made up of vertebral bones with cushioning intervertebral discs between them. The spine is designed to give us stability and smooth movement, as well as providing a corridor of protection for the delicate spinal cord. It is supported by muscles, tendons and ligaments, and innervated by nerves that branch out from the centrally placed spinal cord.

Common Spine Problems

Spinal Stenosis

Animation provided by AAOS

Spinal stenosis is the compression of spinal nerves caused by narrowing of the spinal canal and it is one of the common causes of low back pain. It can also cause arm or leg weakness, pain, tingling, or numbness. The symptoms may include burning, cramping, or aching pain in the neck or back that may radiate to the extremities. Sciatica is an example of this. Stenosis may cause a sensation of fatigue or weakness in the legs. As we age, the natural degeneration of the intervertebral discs, formation of bone spurs, and thickening of spinal ligaments can cause spinal stenosis.

Disc Herniation

Animation provided by AAOS

A herniated disc, also referred to informally as slipped, bulged, or ruptured disc, is a condition caused from wear and tear of the cushioning discs present between the bones of the vertebral column. These discs act as a sort of shock absorbers while walking or running. They are made up of a tough, outer layer (called the annulus) that surrounds a softer center (called the nucleus). Disc herniation occurs when a part of the nucleus is pushed beyond the annulus through a rupture, or tear. The displaced nucleus extends into the spinal canal and inflames and presses against the spinal nerves, causing pain and at times, weakness. Disc herniation is one of several causes of spinal stenosis.

Spondylosis

Spondylosis is essentially arthritis of the spinal joints. It is the degeneration, or wear and tear, of the small joints at the back of the spine, known as facet joints, as well as of the discs. It is a natural part of aging for many people and may be associated with stenosis, or other spinal problems.

Radiculopathy

Radiculopathy is a spinal condition where a nerve root in the spine is pinched, producing pain or weakness across the whole length of the nerve. It is sometimes referred to as a pinched nerve or sciatica. It occurs most commonly in the neckand lower back.

What we can treat:

  • Back and neck pain
    • Acute (short term, 3 months or less in duration):
      • Sprains and strains
      • Disc herniation
      • Fractures
    • Chronic (long term, 3 months or greater in duration):
      • Stenosis
      • Arthritis
      • Spondylolisthesis
      • Degenerative disc
      • Scoliosis
    • Other causes of back pain:  Sacroiliac joints
  • Nerve pain (arm or leg)
    • Sciatica
    • Stenosis
    • Neuropathy
  • Spinal deformity - severe, imbalanced scoliosis
  • Urgent or emergent spine disorders
    • Cervical myelopathy
    • Cauda equina syndrome
    • Unstable fractures from trauma or osteoporosis

How We Can Help

  • Diagnosis:  In making a diagnosis, the patient’s story, exam, x-rays, MRI, CT scan, electromyography (EMG), previous spinal injections, and other treatments all help.
  • Recommendations for non-surgical treatments:  physical therapy, chiropractor, acupuncture, yoga, pain management, and others.
  • Spinal injections
  • Spinal cord stimulator
    • Trial and implantation
  • Surgery
    • Decompression
      • Microdiscectomy
      • Laminectomy
    • Spinal fusion
      • Anterior Cervical Discectomy and Fusion (ACDF)
      • Posterior cervical fusion
      • Lumbar interbody fusion
        • Minimally invasive
          • Lateral lumbar interbody fusion (LLIF)
          • Transforaminal lumbar interbody fusion (TLIF)
          • Sacroiliac joint fusion
          • Oblique lumbar interbody fusion (OLIF)
        • Anterior lumbar interbody fusion (ALIF)
      • Posterolateral lumbar fusion
      • Deformity correction surgery
        • Scoliosis
        • Kyphoplasty
        • Corpectomy
    • Motion Preservation
      • Cervical disc replacement
  • Advanced Surgical Spine Technology
    • Neurologic monitoring
    • O-arm computer navigation
    • Minimally invasive surgical techniques
      • Smaller incisions, less bleeding, less post-operative pain
    • Advanced surgical implants
      • Titanium interbody spacers with ingrowth technology, Titan Spine®
      • Titanium sacroiliac joint fusion, SI Bone®iFuse System®
      • Artificial disc replacements
    • Bone graft and Biologics
      • Autograft (local bone)
      • Allograft (donor bone or bone cells)
      • Bone morphogenic protein
      • Bone marrow aspirate

Definitions

Arthritis - a condition where the natural wear and tear on a joint, or disc, results in inflammation and pain

Cauda Equina Syndrome - a spinal condition where sudden and severe pinching of all of the spinal nerves in the low back occurs and may result in back and leg pain, weakness, numbness in the inner thighs, and an inability to control the bladder

Cervical Myelopathy - a spinal condition where the whole spinal cord in the neck is pinched, causing damage to the nerves below

Decompression - a surgical procedure to take pressure off of pinched nerves

Degenerative Disc - a natural part of aging where the spinal discs dry out and it is occasionally associated with pain

Disc Herniation - a spinal condition where the soft, inner disc pushes out into the nerve canal, irritating spinal nerves

Sacroiliac Joints - the joints where the back meets the pelvis

Sciatica - a spinal condition where a pinched nerve in the low back causes pain to radiate down the leg

Spinal Fusion - a surgical procedure to make two bones fuse, or grow, together

Neuropathy - a condition where a nerve becomes injured, which can cause symptoms in the arms or legs, such as pain, numbness, or weakness. There are many causes of neuropathy.

Scoliosis - abnormal curvature of the spine; sometimes associated with pain

Spondylolisthesis - a spinal condition where one of the vertebrae (back bones) slowly slips out of alignment

Stenosis - a spinal condition where a nerve canal is narrowed, pinching the spinal nerves

Educate Yourself

The following links will take you to pages created by and maintained by AAOS.org, American Association of Orthopedic Surgeons.

Spinal Anatomy

Treatment options for back pain

Healthy Spine Exercises

Preventing Back Pain

Spinal Injections