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Common Conditions, Symptoms and Treatments

Common Conditions, Symptoms and Treatments

CAS technology may be used to help implant pedicle screws during spinal fusion procedures to treat spinal instability.  Such instability may be caused by the below conditions.  Here you will find a brief description of these conditions including their symptoms, causes and possible treatment options.  To learn more about spine conditions and spine surgery procedures please visit www.understandspinesurgery.com

Sciatica

Sciatica is the irritation of the largest nerve in the body, the sciatic nerve. The sciatic nerve begins with several nerves in the lower back and travels down the legs. This irritation can stem from a disc herniation, inflammation, bone spurs or foraminal stenosis. Pain occurs when any or all of these conditions compress the nerve roots or spinal cord.

Symptoms:

  • Irritation in one leg often down to the foot
  • Shooting leg pain
  • Weakness or numbness
  • Burning leg pain
  • Pain is usually worse when sitting

Causes:

  • Degeneration or rupture of a disc
  • Development of bone spurs or thick ligaments
  • Normal aging process
  • Sudden twisting
  • Episode of heavy lifting
  • Other physical trauma

Possible Treatment Options:

Non Operative Treatment - Medications, physical therapy or spinal cortisone injections are indicated for pain relief.

Decompression - Surgical procedure to remove all or portions of the lamina, removing bone spurs and /or enlarging foramina to help relieve pressure or compression on the nerve roots or spinal cord. This pressure is often the cause of pain.

Decompression & Posterolateral Fusion - Instrumented posterolateral fusion of inserting a series of screws and rods coupled with the placement of bone graft to provide increased spinal stability.

Anterior Lumbar Interbody Fusion (ALIF) - Removal of disc material causing the nerve compression from the front of the abdomen. Once this material is removed an interbody cage or bone spacer is placed at the site filled with bone graft.

Posterior Transforaminal Interbody Fusion - Same procedure as the ALIF, but the approach and exposure are performed from the back.

Herniated Disc

A herniated disc occurs when a portion of the vertebral disc ruptures. This ruptured portion may push on nerves in the cervical, thoracic or lumbar areas. This pressure on the nerves can often lead to numbness and pain. Smaller herniations are sometimes called protrusions.

Symptoms:

Cervical

  • Discomfort in one of both arms
  • Shooting pains in one or both arms
  • Weakness or numbness in one or both arms
  • Burning arm pain

Lumbar

  • Discomfort in leg, ankle, or foot
  • Shooting pain, weakness or numbness in leg
  • Leg pain is usually worse when sitting

Causes:

Cervical

  • Degeneration due to normal aging process
  • Trauma
  • Episode of heavy lifting

Lumbar

  • Degeneration due to normal aging process
  • Trauma
  • Episode of heavy lifting
  • Sudden twisting

Possible Treatment Options:

Non Operative Treatment - Medications, physical therapy and occasional epidural injections are used for pain relief.

Anterior Cervical Discectomy Fusion Instrumented - Removal of ruptured disc and replacement by a bone graft. An anterior cervical plate is implanted for stability.

Posterior Cervical Laminotomy - Spinous process and lamina are removed to decrease pressure on the spinal cord. Instrumentation may be used to help increase post-operative stability.

Lumbar Partial Discectomy - Removal of herniated portion of the disc to relieve pressure on the painful nerve.

Stenosis

Stenosis is a narrowing of the spinal canal or the foramen, the opening through which nerve roots pass. Stenosis can develop in any area of the spine.  Degenerative changes in the spine, a collapsed disc, bone spurs, or cysts can cause the spinal canal to narrow. This narrowing places pressure on the nerve roots and/or spinal cord, often resulting in pain.

Symptoms:
Cervical

  • Stiffness in neck
  • Weakness in arms causing difficulty using the hands
  • Pain and Numbness in hands and/or arms

Lumbar

  • Tired, heavy feeling in the back, buttocks, and legs while walking or standing
  • Cramping sensation in these areas
  • Decreased walking due to weakness, numbness or pain in legs

Causes:

Cervical

  • Arthritic changes in neck
  • Bone spurs push on nerves and spinal cord
  • Compression can be caused by large disc herniations

Lumbar

  • Degenerative changes limit nerve space; lack of blood supply induces symptoms

Possible Treatment Options:

Non Operative Treatment - Medications, physical therapy or spinal cortisone injections are indicated for pain relief.

Cervical Laminectomy - Spinous process and lamina are removed to help decrease pressure on spinal cord. Instrumentation can be used to help ensure stability.

Lumbar Decompression - Removal of all or portions of the lamina, bone spurs and/or enlarging foramen to help relieve pressure or compression on the nerve roots or spinal cord.

Decompression & Posterolateral Fusion - Instrumented posterolateral fusion by inserting a series of screws and rods coupled with the placement of a bone graft to help provide increased spinal stability.

Anterior Lumbar Interbody Fusion (ALIF) - Surgical approach from the front of the abdomen where the disc material causing the nerve compression is removed. An interbody cage or bone spacer is then placed in the disk site and filled with bone graft.

Posterior Tranforaminal Interbody Fusion - Same procedure as the ALIF but the approach and exposure are preformed from the back.

Scoliosis

Scoliosis is the most common abnormal curvature of the spine. It is most common in adolescent females. Scoliosis is a genetic condition that frequently runs in families. Small curves usually cause no pain. The curve is commonly in the upper back. The patient may have one hip higher than the other, and frequently one shoulder blade appears more prominent than the other. 

Symptoms and Signs:

  • One hip may be higher then the other
  • One shoulder blade appears more prominent
  • Small curves in the back; usually upper back
  • Deformity in back
  • Cork screwing effect from rotation

Causes:

  • There is no known cause for Scoliosis
  • Scoliosis tens to run in families

Possible Treatment Options:

Bracing - Braces are used as a first option in an attempt to restrain the curve during the growth years.

Instrumentation and Fusion - Insertion of pedicle screws and hooks at various points in the spine in conjunction with rods to straighten the spine. The rods are locked into position and a bone graft is applied to create fusion.

Trauma

Spinal trauma results from significant physical injury sustained as a result of high energy impacts or falls. Motor vehicle accidents and common falls account for a large portion of spinal trauma. These injuries can lead to compression of one or more vertebrae. Weakened bones (osteoporosis) can also lead to fracture at a low level of trauma. A traumatic episode can result in the sudden onset of back pain.

Symptoms:

  • Back pain after an incident
  • Weakness or numbness
  • Paralysis

Causes:

  • High energy impact trauma
  • Motor vehicle accident
  • Falls
  • Weakened bones (Osteoporosis)

Possible Treatment Options:

Non Operative Treatment - Pain medications, patience, and bracing are sometimes needed.

Lumbar Vertebral Body Replacement - If the vertebral body has been severely fractured, the entire vertebral body may be replaced with a stabilized metal cage or bone strut.

Decompression - Removal of all or a portion of the lamina, bone spurs and/or enlarging the foramen to help relieve pressure on the nerve roots or spinal cord.

Posterolateral Fusion - Instrumented posterolateral fusion by inserting a series of rods and screws coupled with the placement of bone graft to help provide increased spinal stability.

Tumors of the Spine

Tumors of the spine are usually metastatic, meaning they originate from a primary tumor elsewhere in the body and spread to the spine via the lymph nodes or bloodstream. Tumors can grown into the spinal cord causing neurological problems. In addition, tumors may destroy vertebral bodies causing collapse and thus, local or radiating pain.

Symptoms:

  • Back pain caused by a destroyed bone
  • Radiating leg pain or weakness
  • Neurological problems

Causes:

  • Growth of a primary tumor in a vertebral body
  • Spread of distant primary organ tumors to the spine
  • Growth of tumors in spinal canal
  • Collapse of vertebral bodies causing nerve pressure

Possible Treatment Options:

Non Operative Treatment - Chemotherapy and radiation are sometimes needed.

Anterior Vertebral Body Replacement - Removal of tumor and affected vertebrae. Once removed, a metal implant is inserted to help provide stability and replace the void caused by the removed tumor.

Laminectomy and Instrumentation - Performed when a tumor has spread to the spine and is pushing on the spinal cord, the laminectomy removes a portion of the bone pushing on the nerves or spinal cord causing pain.

Degenerative Disc Disease

Degenerative disc disease occurs in many people during the normal aging process, and is often referred to as “arthritis of the back.” With age, the discs or “shock absorbers” located between the vertebral bodies lose their elasticity and may cause one vertebral body to collapse down onto another. This collapsed body may compress nerve roots or the spinal cord, causing back and/or leg pain.

Symptoms:
·         Aching lower back pain
·         Stiffness in back
·         Radiating pain that descends into the legs
·         Pain is usually worse with activity or prolonged sitting or standing

Causes:
·         Normal changes in disc during the natural aging process
·         Trauma (injury)
·         Repetitive lifting
·         Smoking, obesity and hereditary factors lead to advanced degeneration

Possible Treatment Options:

Non Operative Treatment - Medications, physical therapy or spinal cortisone injections are indicated for pain relief.

Decompression - Surgical procedure to remove all or portions of the lamina, removing bone spurs and /or enlarging foramina to help relieve pressure or compression on the nerve roots or spinal cord. This pressure is often the cause of pain.

Decompression & Posterolateral Fusion - Instrumented posterolateral fusion of inserting a series of screws and rods coupled with the placement of bone graft to provide increased spinal stability.

Anterior Lumbar Interbody Fusion (ALIF) - Removal of disc material causing the nerve compression from the front of the abdomen. Once this material is removed an interbody cage or bone spacer is placed at the site filled with bone graft.

Posterior Transforaminal Interbody Fusion - Same procedure as the ALIF, but the approach and exposure are performed from the back.

Disc Replacement – Spinal disc is removed and replaced with an artificial prosthesis.

Spondylolisthesis

Spondylolisthesis is defined as a slip of one vertebral body relative to an adjacent vertebral body. This spinal condition most commonly presents as a degenerative disease in adults but may be present in adolescents as a result of deformity or trauma. Often there is mild to moderate back pain. If the slip is compressing a nerve, leg pain often develops.

Symptoms:
·         Lower back pain
·         Leg pain and numbness may develop if there is nerve compression

Causes:

Adults

·         Arthritic changes
·         Disc degeneration
·         Pars defect

Adolescents

·         Trauma due to athletic activities
·         Congenital deformity
·         Isthmic spondylolisthesis
 
Possible Treatment Options:

Non Operative Treatment - Medications, physical therapy or spinal cortisone injections are indicated for pain relief.

Decompression - Surgical procedure to remove all or portions of the lamina, removing bone spurs and /or enlarging foramina to help relieve pressure or compression on the nerve roots or spinal cord. This pressure is often the cause of pain.

Decompression & Posterolateral Fusion - Instrumented posterolateral fusion of inserting a series of screws and rods coupled with the placement of bone graft to provide increased spinal stability. Depending on the severity of the slip and degree of malalignment, the slipped vertebral body is sometimes pulled back to its original position using special instrumentation.

  • Fractures
  • Infections
 

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