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Spine Conditions
Herniated Disc
The bones (vertebrae) that
form the spine in your back are cushioned by small,
spongy discs. When these discs are healthy, they act as
shock absorbers for the spine and keep the spine
flexible. But when a disc is damaged, it may bulge or
break open. This is called a herniated disc. It may also
be called a slipped or ruptured disc.
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Spinal Stenosis
Spinal Stenosis
is a condition due to narrowing in and around the spinal
canal causing nerve pinching which leads to persistent
pain in the buttocks, limping, lack of feeling in the
lower extremities, and decreased physical activity.
There are several different types of spinal stenosis
affecting all regions of the spine (cervical, thoracic
and lumbar spine). The most common is degenerative
stenosis, occurring in virtually the entire adult
population as a result of the natural process of aging.
It is a degenerative narrowing of the spinal canal,
nerve root canals and/or intervertebral foramina caused
by bone and/or ligament hypertrophy in local, segmental
or generalized regions. The narrowing results in
compression of spinal nerves and nerve roots, causing a
constellation of symptoms, including lower back pain,
neurogenic claudication and lower extremity pain.
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Whiplash Syndrome
Whiplash is a nonmedical
term used to describe
neck pain following an injury to the soft tissues of
your neck (specifically ligaments, tendons, and
muscles). It is caused by an abnormal motion or force
applied to your neck that causes movement beyond the
neck's normal range of motion. The most frequent cause
of whiplash is a car accident. The speed of the cars
involved in the accident or the amount of physical
damage to the car may not relate to the intensity of
neck injury; speeds as low as 15 miles per hour can
produce enough energy to cause whiplash in occupants,
whether or not they wear seat belts.
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Arthritis
Arthritis of the spine can be a
very painful and debilitating problem that often affects
individuals 40 or older. If left untreated, it can lead
to physiological problems such as muscle breakdown or
weakness, as well as psychological problems such as
anxiety and depression. Sometimes, a person with
arthritis of the spine can suddenly suffer excruciating
pain that will keep him or her bedridden and unable to
perform normal daily activities. Classic symptoms
include pain and numbness in the back, neck, head, and
shoulders. Symptoms may be different for different
people, and the frequency and intensity will also vary.
Some areas may ache from time to time and be all right
other times. Bending and other everyday movements may
also cause pain. Numbness is the neck area is very
common, although other areas, including the arms and
legs, may also experience numbness. In some cases,
frequent urination or the urgent need to urinate may
occur.
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Scoliosis
Scoliosis is not a disease—it is a descriptive term. All
spines have curves. Some curvature in the neck, upper trunk
and lower trunk is normal. Humans need these spinal curves
to help the upper body maintain proper balance and alignment
over the pelvis. However, when there are abnormal
side-to-side (lateral) curves in the spinal column, we refer
to this as scoliosis.
Scoliosis is not a disease—it is a descriptive term. All
spines have curves. Some curvature in the neck, upper trunk
and lower trunk is normal. Humans need these spinal curves
to help the upper body maintain proper balance and alignment
over the pelvis. However, when there are abnormal
side-to-side (lateral) curves in the spinal column, we refer
to this as scoliosis.
Scoliosis affects 2% of women and 0.5% of men in the general
population. There are many causes of scoliosis, including
congenital spine deformities, genetic conditions,
neuromuscular problems and limb length inequality. Other
causes for scoliosis include cerebral palsy, spina bifida,
muscular dystrophy, spinal muscular atrophy and tumors. Over
80% of scoliosis cases, however, are idiopathic, which means
that there is no known cause. Most idiopathic scoliosis
cases are found in otherwise healthy people.
Idiopathic scoliosis is broken down into four categories
based on age: (1) infantile: children ages 3 and under, (2)
juvenile: 3-9 years old, (3) adolescent: 10-18 years old,
and (4) adult: after skeletal maturity. The most common form
of scoliosis, representing approximately 80% of idiopathic
scoliosis cases, is Adolescent Idiopathic Scoliosis (AIS),
which develops in young adults around the onset of puberty.
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Kyphosis
Kyphosis is a forward rounding of your upper back. Some
rounding is normal, but the term "kyphosis" usually refers
to an exaggerated rounding, more than 50 degrees. This
deformity is also called round back or hunchback.
With kyphosis, your spine may look normal, or you may
develop a hump. Kyphosis can occur as a result of
developmental problems; degenerative diseases, such as
arthritis of the spine; osteoporosis with compression
fractures of the vertebrae; or trauma to the spine. It can
affect all ages.
Mild kyphosis may cause few problems. But severe cases
can affect your lungs, nerves, and other tissues and organs,
causing pain and other problems. Treatment for kyphosis
depends on your age, the cause of the curvature and its
effects.
Because kyphosis initially often produces no signs and
symptoms, it may go unnoticed until a routine physical
examination or a school screening for scoliosis. But some
people may notice pain, a rounding of the shoulders or a
hump on the upper back.
Have your child examined if you see any of the signs of
kyphosis. Also, if you develop any of the signs or symptoms,
see your doctor for an examination to determine whether you
need further evaluation.
Although rare, kyphosis can lead to serious health
problems, such as physical deformity, breathing difficulties
or damage to internal organs that are affected by the
postural changes. So it's important to see a doctor if you
experience signs or symptoms of kyphosis.
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Spondylolisthesis
Spondylolisthesis is a condition of the spine whereby one
of the vertebra slips forward or backward compared to the
next vertebra. Forward slippage of one vertebra on another
is referred to as anterolisthesis, while backward slippage
is referred to as retrolisthesis. Spondylolisthesis can lead
to a deformity of the spine as well as a narrowing of the
spinal canal (central spinal stenosis) or compression of the
exiting nerve roots (foraminal stenosis).
There are five major types of lumbar spondylolisthesis.
- Dysplastic spondylolisthesis: Dysplastic
spondylolisthesis is caused by a defect in the formation
of part of the vertebra called the facet that allows it
to slip forward. This is a condition that a patient is
born with (congenital).
- Isthmic spondylolisthesis: In Isthmic
spondylolisthesis, there is a defect in a portion of the
vertebra called the pars interarticularis. If there is a
defect without a slip, the patient has spondylolysis.
Isthmic spondylolisthesis can be caused by repetitive
trauma and is more common in athletes exposed to
hyperextension motions including gymnasts, and football
linemen.
- Degenerative spondylolisthesis: Degenerative
spondylolisthesis occurs due to arthritic changes in the
joints of the vertebrae due to cartilage degeneration.
Degenerative spondylolisthesis is more common in older
patients.
- Traumatic spondylolisthesis: Traumatic
spondylolisthesis is due to direct trauma or injury to
the vertebrae. This can be caused by a fracture of the
pedicle, lamina or facet joints that allows the front
portion of the vertebra to slip forward with respect to
the back portion of the vertebra.
- Pathologic spondylolisthesis: Pathologic
spondylolisthesis is caused by a defect in the bone
caused by abnormal bone, such as from a tumor.
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Spinal Stenosis
Spinal Stenosis
is a condition due to narrowing in and around the spinal
canal causing nerve pinching which leads to persistent pain
in the buttocks, limping, lack of feeling in the lower
extremities, and decreased physical activity. There are
several different types of spinal stenosis affecting all
regions of the spine (cervical, thoracic and lumbar spine).
The most common indication for surgery in persons aged
over 60 in the United States is Lumbar Spinal Stenosis.
Currently, it is estimated that as many as 400,000
Americans, most over the age of 60, may already be suffering
from the symptoms of lumbar spinal stenosis and this number
is expected to grow as members of the baby boom generation
begin to reach their 60s over the next decade.
According to the U.S. Census Bureau, people over 60 will
account for 18.7% of the domestic population in 2010 versus
16.6% in 1999. According to the United Nations' Population
Division, Department of Economic and Social Affairs, the
trend is global with the number of persons aged 60 years or
older estimated to be nearly 600 million in 1999 and is
projected to grow to almost 2 billion by 2050, at which time
the population of older persons will be larger than the
population of children (0-14 years) for the first time in
human history. The majority of the world's older persons
reside in Asia (53 per cent), while Europe has the next
largest share (25%).
The prevalence of musculoskeletal disorders and the cost
to treat them led the World Health Organization and the
United Nations to declare 2000-2010 be the Decade committed
to improving quality of life to people with bone and joint
disease and injuries throughout the world.
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Radiculopathy
Radiculopathy is a condition due to a compressed nerve in
the spine that can cause pain, numbness, tingling, or
weakness along the course of the nerve. Radiculopathy can
occur in any part of the spine, but it is most common in the
lower back (lumbar radiculopathy) and in the neck (cervical
radiculopathy). It is less commonly found in the middle
portion of the spine (thoracic radiculopathy).
Risk factors for radiculopathy are activities that place
an excessive or repetitive load on the spine. Patients
involved in heavy labor or contact sports are more prone to
develop radiculopathy than those with a more sedentary
lifestyle. A family history of radiculopathy or other spine
disorders also increase the risk of developing
radiculopathy.
Radiculopathy is caused by compression or irritation of
the nerves as they exit the spine. This can be due to
mechanical compression of the nerve by a disk herniation, a
bone spur (osteophytes) from osteoarthritis, or from
thickening of surrounding ligaments.
Other less common causes of mechanical compression of the
nerves is from a tumor or infection. Either of these can
reduce the amount of space in the spinal canal and compress
the exiting nerve.
Scoliosis can cause the nerves on one side of the spine to
become compressed by the abnormal curve of the spine.
Other causes of radiculopathy include diabetes which can
decrease the normal blood flow to the spinal nerves.
Inflammation from trauma or degeneration can lead to
radiculopathy from direct irritation of the nerves.
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Degenerative Disk
Disease
Degenerative disc disease refers to a syndrome in which a
compromised disc causes low back pain. Lumbar degenerative
disc disease usually starts with a torsional (twisting)
injury to the lower back, such as when a person rotates to
put something on a shelf or swing a golf club. However, the
pain is also frequently caused by simple wear and tear on
the spine.
Despite its rather dramatic label, degenerative disc disease
is fairly common, and it is estimated that at least 30% of
people aged 30-50 years old will have some degree of disc
space degeneration, although not all will have pain or ever
receive a formal diagnosis. In fact, after a patient reaches
60, some level of disc degeneration is deemed to be a normal
finding, not the exception.
Lumbar Degenerative Disc
Disease Pain and Symptoms
Most patients with lumbar degenerative disc disease will
experience low-grade continuous but tolerable pain that will
occasionally flare (intensify) for a few days or more. Pain
symptoms can vary, but generally are:
Centered on the lower back, although it can radiate to
the hips and legs
- Frequently worse when sitting, when the discs
experience a heavier load than when patients are
standing, walking or even laying down
- Exacerbated by certain movements, particularly
bending, twisting or lifting
The low back pain associated with lumbar degenerative
disc disease is usually generated from one or both of two
sources:
- Inflammation, as the proteins in
the disc space irritate the surrounding nerves, and/or
- Abnormal micro-motion instability,
when the outer rings of the disc - the annulus fibrous –
are worn down and cannot absorb stress on the spine
effectively, resulting in movement along the vertebral
segment
Excessive micro-motion, combined with the inflammatory
proteins, can produce ongoing low back pain.
Fortunately, over time the pain from lumbar degenerative
disc disease usually decreases, rather than becoming
progressively worse. This is because a fully degenerated
disc no longer has any inflammatory proteins (that can cause
pain) and usually collapses into a stable position,
eliminating the micro-motion that generates the pain.
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Cervical Radiculitis is a spinal disorder in which the
nerve roots located in the upper portion, or cervical, of
the spine are compressed. When one or more of the spinal
disc located in the cervical portion of the spine push
against the various nerves connected to the spinal cord,
pain results.
Unfortunately, the spinal nerves run throughout he entire
body. This means that the pain associated with Cervical
Radiculitis can be felt throughout the body, not just in the
cervical disc that is affected. Pain from Cervical
Radiculitis may be felt in the shoulders, neck, chest or
arms, depending on which of the cervical disc and associated
nerves are affected. You may also experience numb or
tingling fingers or a weakness of the muscles located in the
chest and arms.
It is relatively easy to diagnosis Cervical Radiculitis.
Doctors rely on a variety of imaging tools to view the
cervical spine and any disks that may be affected. These
include MRI's and CT Scans. Doctors may also order
electrodiagnostic test to confirm the diagnosis.
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