SPINAL CONDITIONS
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Commonly Diagnosed Spinal Conditions
This refers to a damaged disc that gradually deteriorates between the vertebrae, leading to loss of hydration and elasticity.
This describes disc dehydration and extrusion, where the disc material loses hydration and can protrude, potentially irritating and compressing surrounding spinal nerves. Disc herniations typically occur most often at the lower lumbar levels, specifically L4/L5 and L5/S1. Symptoms can often be managed with lifestyle adjustments, physical therapy, heat/cold therapy, pain relief, and anti-inflammatory medications. Surgical interventions like discectomy, spinal fusion, or artificial disc replacement may be considered if symptoms become severe and difficult to manage.
Stenosis refers to the narrowing of the spinal canal space, commonly observed in older adults and caused by factors such as bony spurs, disc degeneration, spinal fractures, cysts, osteoarthritis-related facet joint degeneration, ligament thickening, or hereditary conditions.
The reduction in spinal disc space can lead to compression of both the spinal cord and nerves, resulting in symptoms like pain, numbness, pins and needles sensation, and limb weakness. Patients often experience radiating leg pain (“sciatica”) and lower back pain.
Symptoms typically improve when bending forward, which helps to create more space within the spinal canal. If conservative treatments such as anti-inflammatory medication, pain relief, and physical therapy fail to provide relief, minimally invasive spinal decompression surgery using a keyhole technique may be recommended.
Spondylosis is a condition characterised by chronic degeneration that can impact any part of the spine, typically associated with aging, natural wear and tear, or hereditary factors.
As discs lose hydration, they may flatten or bulge. Arthritis in facet joints can lead to the formation of bony spurs, while surrounding ligaments weaken. Over time, these changes reduce the space through which spinal nerves exit, resulting in nerve compression and symptoms such as pain, numbness, pins and needles sensation, and weakness in the arms or legs.
Spondylolisthesis refers to the forward slipping of one vertebral body over another, caused by factors such as facet joint arthritis, general wear and tear, ligament weakness, trauma, or metastatic bone disease.
Retrolisthesis, on the other hand, describes the backward displacement of one vertebral body over another. If anti-inflammatory medications, pain relief, and physical therapy do not provide sufficient relief, surgical options are available. This surgery typically involves spinal decompression to relieve pressure on the nerves and spinal cord, followed by spinal fusion to stabilise the spine.
Degenerative disc disease, disc herniation, spinal stenosis, and spondylolisthesis often lead to compression of the lower lumbar nerves, resulting in pain and altered sensations radiating down the sciatic nerve along the back of the legs. This nerve compression can also cause symptoms such as limb weakness and sensations like pins and needles, numbness, and temperature sensitivity.
Scoliosis refers to an abnormal S-shaped lateral curvature, typically affecting both the thoracic and lumbar regions of the spine. It is often observed in adolescents but can occur at any age due to congenital conditions, neuromuscular disorders, or idiopathic (unknown) causes. Treatment includes regular monitoring and x-ray imaging, bracing, and, for significant curvatures greater than 45 degrees, surgical correction through spinal fusion.
This refers to an abnormal rounding or exaggeration of the thoracic spine’s natural curvature or a reversal of the normal cervical and lumbar spine curvature (lordosis). An angle greater than 60 degrees is considered abnormal.
Spinal infections can occur in various parts of the spine, including the bone (osteomyelitis), disc (discitis), spinal muscles (psoas abscess), or the spinal canal (epidural abscess and meningitis). These infections may develop in patients with compromised immunity or following invasive procedures such as spinal surgery, nerve root injections, or facet joint injections.
Symptoms of spinal infection include increased pain, potential nerve irritation, and fever. Diagnosis is typically made through a biopsy, and treatment involves antibiotics and/or surgery to remove the source of the infection.
Myelopathy refers to damage, disease, or pathological changes in spinal tissue. It can result from trauma, inflammation, or vascular disease, leading to spinal cord compression and subsequent neurological changes. Myelopathy is most common in the cervical spine, causing disc degeneration, narrowing of the disc space, and instability of the vertebrae and facet joints.
Symptoms include limb pain, weakness, altered sensation, loss of balance, and, in severe cases, loss of bladder and bowel control. Treatment may involve spinal decompression surgery and instrumented fusion to increase the space in the spinal canal where the cord is compressed and to stabilise the spine.
Spinal tumors are most often secondary tumors resulting from the spread of disease from another (primary) organ or tissue. Progressive primary or secondary spinal tumors can cause neck or back pain, spinal fractures, and spinal nerve compression, leading to limb pain, weakness, and altered sensation.
The primary goals of treatment are to determine whether the tumor is malignant or benign, control the primary tumor with systemic treatments such as radiation and chemotherapy, and, if necessary, surgically stabilise the spine with an instrumented fusion.
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