A Look at Common Spine Conditions and Treatments
Spinal health is key for a person's overall well-being. Composed of a stack of small bones known as vertebrae, which also protect the spinal cord, the spine supports the head, shoulders, and upper body. Issues with the spine, whether through injury, disease, or age-related degradation, can cause pain in the lower back and extremities. Fatigue, headaches, neck pain, uneven shoulders, and muscle weakness are among the other common symptoms associated with spine conditions.
Here are some of the most common conditions, how they occur, and the treatment options available.
Slipped Disc
Discs are small cushions between each vertebrae that function like a swivel, enabling the body to rotate and tilt. They also keep the vertebrae from scraping against each other. Discs are made up of a tough outer layer and jelly-like inner layer with high water content. This inner layer loses water as part of the natural aging process, which can result in compressed spinal nerves and contribute to back pain.
A slipped or herniated disc occurs when a disc tears or breaks when under too much stress, like when lifting a heavy object with poor form. Some people might not experience any symptoms with a slipped disc, while others may notice pain, numbness, or tingling in their back, arms, or legs. Slipped discs most commonly occur in your lower back.
In most cases, painkillers and physical therapy can help to resolve a slipped disc, but surgery may be required in extreme examples. Depending on the severity, a surgeon might recommend either a laminectomy, discectomy, spinal fusion, or artificial disc surgery.
Osteoporosis
Most commonly occurring in older adults, osteoporosis is a degenerative disease in which bones in the spine become more fragile as a result of lower bone mass. This can lead to a hunched posture and more serious issues like fractures and a collapsed vertebrae. Osteoporosis is a difficult condition to detect, as there are no symptoms that indicate the early stages of bone loss. However, patients should consult their doctor if they experience frequent back pain, a stooped posture or loss of height, and bones that break easily and often.
There are various bone-building medicines (teriparatide and romosozumab) and hormone-related therapies that can help people with osteoporosis. Preventative measures include eating a healthy diet with foods rich in vitamin D (cod liver oil and some cereals) and calcium (low-fat dairy products, leafy green vegetables, and salmon).
Cervical Spondylosis
Cervical spondylosis refers to degradation of the spinal discs in the neck and affects in excess of 85 percent of people 60 and older. The discs shrink as they lose some of their water content, often resulting in vertebrae rubbing against each other or bone spurs.
Fortunately, most people who have cervical spondylosis don't experience any symptoms. However, there are some cases in which the spinal canal narrows as a result of these shrinking discs, causing pinched nerve roots. This can present symptoms like a lack of coordination, numbness or tingling in the extremities, or a loss of bladder control.
Prescription pain medicine, steroid injections, anti-seizure medications, and physical therapy can help alleviate pain from cervical spondylosis. Surgical interventions include fusion and the removal of impacted discs or bone spurs.
Scoliosis
More common in childhood or adolescence, scoliosis refers to an irregular twisting of the spine that often develops during growth spurts prior to puberty. It affects roughly 9 million Americans. Some have mild cases of spinal curvature that don't require treatment, while those with moderate or large curves may need to wear a brace or undergo corrective surgery. Braces are recommended for children whose bones are still growing; the brace won't correct the shape of the spine, but it will keep it from getting worse.
For larger curves, there are multiple surgical interventions that can correct the shape of the spine and allow patients to live a mostly pain-free life. Surgeons may fuse together the most affected vertebrae using metal rods and special screws or recommend expanding rods or vertebral body tethering, the latter of which involves a strong cord thread through screws along the outside edge of the curve.
Spinal Myelopathy
Spinal myelopathy is a compression-related condition associated with symptoms such as tingling or numbness in the extremities, difficulty with fine motor skills, balance issues, and loss of bladder control. The condition occurs due to traumatic injuries or natural age-related degradation. It can also be caused by infection and inflammation and neurodegenerative diseases, like ALS or Parkinson's.
Treatment for spinal myelopathy varies based on the severity, location, and cause. Nonsurgical interventions include physical therapy, a brace, and pain medication. Disc replacements, laminectomies, and discectomies can help to reduce pressure and pain.
Spinal Arteriovenous Malformation
A rare condition that can cause long-term damage to the spine, spinal arteriovenous malformation (AVM) occurs when blood vessels tangle in or near the spinal cord, creating abnormal connections between veins and arteries. When someone has spinal AVM, their blood cycles from their arteries to their veins rather than first passing through capillaries, which route oxygen to cells surrounding the spinal cord. Without adequate oxygen, cells in the spinal tissue can die, and the tangled arteries can burst and result in significant bleeding.
Spinal AVM symptoms differ based on the severity, but can include numbness or pain in the legs, weakness, and trouble climbing stairs. The AVM can be removed via conventional surgery, while endovascular embolization, which involves a catheter placed into an artery in the leg and an injection of a glue-like substance to limit blood flow, is also an effective intervention.