Radiculopathy Treatment
Radiculopathy at a glance
• Radiculopathy is a feeling of radiating pain from a compressed or pinched nerve in the spine.
• Cervical radiculopathy causes pain in the upper extremities and lumbar radiculopathy causes pain in the lower extremities.
• Radiculopathy is caused by the spinal nerves becoming compressed or pinched by spinal discs or bone material, causing nerve damage.
• Pain, tingling and numbness in and around the area of the pinched nerve are symptoms of radiculopathy.
• Treatment options for radiculopathy include pain medications and physical therapy. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Causes of radiculopathy or pinched nerves
Radiculopathy is caused by the nerves becoming compressed or pinched between spinal discs. A pinched nerve can be caused by loose material from a ruptured disc becoming lodged in the space between spinal discs, or a herniated disc (a disc that has moved out of place).
Radiculopathy can also occur during the aging process as bones and discs degenerate over time or from conditions such as arthritis. Additionally, spine injuries can put pressure on spinal nerves.
Symptoms of pinched nerve
Radiculopathy can cause pain, tingling and numbness that extend from the damaged nerve root to the areas surrounding the injury. For example, cervical radiculopathy symptoms can occur in the upper extremities such as the neck, shoulders and even chest and hands.
Pain from a pinched or compressed nerve in older people is often caused by normal bone degeneration, whereas a ruptured disc or other spinal injury often is the cause of radiculopathy in young people.
Radiculopathy treatments
Treatment for a pinched nerve includes pain medication combined with physical therapy. The medications may include anti-inflammatory steroids, which can be injected into the spine or taken orally, or non-steroidal pain medication such as Aleve.
Physical therapy methods usually include mobilization, exercise and other techniques to alleviate back pain. If the pinched or compressed nerve causes a decrease in motor skills or other significant effects, then surgery may be necessary to relieve pressure.
If you are experiencing symptoms and pain associated with a pinched nerve, contact our spinal specialists to learn more about the treatment option that is best for you.
Kyphosis Treatment
Kyphosis at a glance
• Kyphosis also known as hunchback or dowager’s hump is an abnormal outward curvature of the upper back (thoracic spine) that causes hunching.
• Kyphosis can be caused by several conditions affecting the spine; postural kyphosis can be caused from excessive slouching.
• In addition to the exaggerated curve of the back, symptoms can include back pain or stiffness; in severe cases, kyphosis can affect organs, nerves, and other parts of the body.
• Treatment for kyphosis may include medication, physical therapy, or spinal surgery.
Causes of kyphosis
Kyphosis is caused by vertebrae (which are normally block-shaped) becoming wedge-shaped, causing the spine to curve. This condition develops due to a number of precursor conditions.
Disc degeneration
Soft discs between the vertebrae cushion the bones of the spine. With age and/or other spinal conditions, these discs can become brittle or shrink, lessening the support between vertebrae and damaging the bone, also known as degenerating discs.
Osteoporosis
Osteoporosis is a bone-thinning disorder most commonly seen in older women. The weakened vertebrae can develop compression fractures even during normal activity. This can alter the shape of the vertebrae.
Cancer and treatments
Cancer, as well as treatments for cancer such as radiation or chemotherapy, can weaken the vertebrae, causing compression fractures, which deform the shape of the vertebrae.
Scheuermann’s disease
Scheuermann’s disease is a hereditary disorder that can cause kyphosis during the growing period before a child hits puberty. This disease is generally seen more often in boys an girls. It is believed to cause the cartilage that normally turns to bone to develop unevenly, causing the vertebrae to develop into wedge shapes.
Slouching
Postural kyphosis does not involve an actual deformity in the spine, but an exaggerated curve in the upper spine can develop from excessive slouching, seen more commonly in teenage girls.
Birth defects
I rare cases, a baby’s spinal column does not develop fully or properly in the womb, leading to kyphosis.
Symptoms of kyphosis
The most evident symptom of kyphosis is the abnormally curved portion of the upper spine. Mild cases of kyphosis may not have any other symptoms; however, people with kyphosis may experience back pain and stiffness.
Severe cases of kyphosis can affect the nerves, lungs, organs, and tissue with pain and other issues. In very severe cases, the spine can cause the rib cage to press against the lungs, making it difficult to breathe.
The extent of effects caused by kyphosis depends on the underlying condition and age.
Treatment of kyphosis
The best treatment option for kyphosis depends on the underlying condition and the symptoms.
Medication options include over-the-counter pain relievers, such as Tylenol, Advil, or Aleve if the condition is related to osteoporosis. There are also special osteoporosis drugs that help strengthen the bones, preventing further damage. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Stretching and flexibility back exercises can alleviate kyphosis symptoms, as well as improve posture. Wearing a body brace is another option, especially for children whose bones are still growing.
For severe cases of kyphosis with a severe curve or pinched nerves, surgery may be necessary to correct or reduce the deformity. Spinal fusion, which fuses two or more vertebrae together, is the most common surgery to correct kyphosis.
Contact us to schedule an appointment with our orthopedic spine specialists if you have a hunched upper back associated with kyphosis and would like to learn more about your treatment options.
Lordosis Treatment
Lordosis at a glance
• Lordosis (also known as swayback) is the abnormal inward curving of the lower back (lumbar spine).
• Lordosis can be caused by a number of other conditions that affect the spine, as well as poor posture and obesity.
• Symptoms include the inward curve of the spine, back pain and discomfort.
• Treatment may include medication, physical therapy, bracing, weight loss, or spinal surgery.
What is lordosis and what causes it?
Curves are a normal part of the spine’s structure. These curves help position the head and neck, while also working as shock absorbers during movement of the body.
When the spine curve arches too far inward, however, it creates a condition called lordosis (or sometimes referred to as swayback). Lordosis can affect the lower back and neck.
Lordosis can develop from other conditions that affect the spine, as well as bad posture, hip problems, back surgery, or problems with the vertebrae from birth.
Conditions that cause lordosis to include :
• Spondylolisthesis which causes one vertebra to slide out of position over another vertebra.
• Kyphosis which causes an abnormal outward curving of the upper spine.
• Discitis, an inflammation of the discs that cushion the space between vertebrae, most commonly caused by an infection.
• Achondroplasia, which stunts normal bone growth (this condition is often associated with dwarfism).
• Obesity, which causes the spine to support the excessive weight.
Symptoms of Iordosis
The primary symptoms of lordosis, or swayback, are the prominence of the buttocks and a pronounced inward curve of the lower spine. This is evidenced by a large gap between the lower back and a hard surface when laying down that does not change when leaning forward.
Other symptoms can include excess pressure on the spine, causing back pain and discomfort. Symptoms can also include difficulty moving in certain ways, especially if left untreated.
Treatment of Iordosis
For most people, lordosis does not cause significant health problems and significant treatment (if at all).
Treatment for lordosis may include medication to relieve swelling and pain, as well as physical therapy or exercise to help improve spinal flexibility and build muscle strength.
A back brace may be necessary to support the back or prevent the condition from worsening.
If obesity is the cause or is worsening the condition, weight loss may be another effective treatment.
Surgery for extreme lordosis, such as spinal fusion, is rarely performed.
Sciatica Treatment
Sciatica at a glance
• Sciatica is the result of sciatic nerve roots being compressed or pinched as they exit the spinal cord in the lower back.
• Disc herniation is the most common cause of sciatica. People often use the two terms interchangeably.
• Sciatica can cause severe pain, numbness and weakness in a leg and/or foot, as well as nagging lower back pain.
• Treatment usually starts with physical therapy and pain management methods.
What is sciatica?
Sciatica is a condition of the sciatic nerve roots, the longest nerves in the body, such as being pinched or compressed as they exit the spinal cord. It is most often associated with pain.
Symptoms of sciatica
Sciatica typically causes pain in the lower back or buttocks that continues down the leg and often to the foot. Pain may also be accompanied by weakness, tingling or numbness in the leg. Pain severeness can vary widely, from a mild ache to sharp or excruciating pain.
Typically, sciatica affects only one side of a person’s body.
Symptoms vary, depending on which of the sciatic nerve roots are compressed. Sitting or standing for a long time can worsen the symptoms, as can bending the spine in certain ways.
Causes of sciatica
Sciatica is usually the result of a herniated or ruptured disc pressing against the sciatic nerve, a large nerve group leading out of the foraminal canals between each vertebra of the spine.
As one of four spinal nerves exiting the spine, the sciatic nerve runs behind the buttocks and down the back of the thigh. At the knee down, the nerve splits into several other branches.
In addition to disc herniation, another cause of sciatica is a muscular compression of the sciatic nerve in the buttocks. The most common type of this condition is called piriformis muscle syndrome, named for the buttocks muscle overlying the nerve.
Sciatica may also be a symptom of spinal stenosis, a narrowing of the spinal canal, as well as bone spurs or a nerve pinched by an injury.
Treatments for sciatica
In order to diagnose sciatica, a physical exam is usually required, often along with X-rays and/or a magnetic resonance imaging (MRI) test.
Some sciatica sufferers find their pain improves over time with little or no treatment. Many gain immediate relief from lying down or doing exercises that ease pressure on the sciatic nerve.
As a first course of treatment, many doctors prefer non-surgical alternatives such as physical therapy and pain medication. Spine specialists also emphasize a daily regimen that reduces sitting and increases walking. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
In other cases, doctors may recommend pain management therapy for a herniated disc, in which injections help ease the nerve swelling and pain around the disc.
In more extreme cases, various types of spinal surgery can reduce or eliminate the disc pressure.
If you are experiencing sciatica pain and symptoms, contact us to request an appointment with our orthopedic spine specialists to learn which treatment options are best for you.
Spondylolisthesis Treatment
Spondylolisthesis at a glance
• Spondylolisthesis is also called slipped vertebra or shifted spine occurs when a vertebra in the spine slips forward and backward from its correct position in relation to other vertebrae, usually in the lower back.
• A slipped vertebra is often caused by degenerative spondylolisthesis, which is more common in older people, or spondylolysis more common in younger people.
• Depending on severity, spondylolisthesis may be treated by medication, physical therapy, or back surgery. If non-symptomatic, a patient may choose to not pursue treatment.
Causes of spondylolisthesis
Spondylolithesis can be caused by a vertebra being defective from birth, breaking due to a stress fracture or trauma, or discs degenerating from disease, infection, or old age. A fracture or defect in part of the vertebra (called spondylolysis) can cause the vertebra to slip forword, backward, side-to-side, or over the vertebra below.
Spondylolysis occurs due to multiple underlying conditions. The two most common are spondylolytic spondylolisthesis and degenerative spondylolisthesis.
Spondylolysis is more common in younger people, especially athletes, and is usually developed early on and present through life.
Degenerative spondylolisthesis generally affects people over age 60, occurring due to the natural spinal degeneration process that accompanies aging.
Symptoms of spondylolisthesis
Spondylolisthesis symptoms May include :
• Muscle weakness, numbness, tightness, and/or stiffness.
• Back pain, often in the lower back.
• Pain in the buttocks or hips.
• Pain extending down through the legs or through other extremities (due to pressure on nerve roots).
• Sciatica
Spondylolytic spondylolisthesis can sometimes cause weakness in the lower extremities, including the feet (foot drop).
Degenerative spondylolisthesis can be a crippling condition, with symptoms including those commonly associated with a pinched spinal nerve and inability to walk due to pain.
With back pain caused by spondylolisthesis, the affected area feels hot to the touch. Patients often describe the sensation as a burning pain, and may also experience sciatica.
Scoliosis (curvature of the spine) may also be present with spondylolisthesis.
Other conditions that can develop due to spondylolisthesis are : flat back, a posture change where the lower back becomes straight or flat and spinal instability where a segment of the spine moves too much, either side-to-side, front-to-back, or up and down.
Treatment of spondylolisthesis
Diagnosing spondylolisthesis in its earlier stages can help manage the condition, prevent more serious symptoms in the future, and can allow for less-invasive treatments.
Depending on severity, spondylolisthesis may be treated by medication, physical therapy and pain management, or surgery. If non-symptomatic, a patient may choose to not pursue treatment.
Medications may help with pain management or treat spondylolisthesis symptoms, such as anti-inflammatory drugs (like Advil) or epidural steroid injections. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Physical therapy treatment options may include massages, core-strengthening exercises, spinal support (bracing), and traction. Pain management techniques can also include epidural injections.
Surgery
If other treatment options do not improve the condition, surgery may be necessary or desirable. Minimally invasive repair surgery may be an option for less-advanced spondylolisthesis cases.
For advanced degeneration and spinal instability caused by spondylolisthesis, spinal fusion and other techniques may be necessary, including :
• Percutaneous spinal fusion (a minimally invasive procedure).
• Simple spinal fusion (without implants).
• Complex spinal fusion (with implants).
If you are experiencing back pain or other symptoms associated with spondylolisthesis, contact us to request an appointment our orthopedic spine specialists to learn about treatment options available to you.
Spondylolysis Treatment
Spondylolysis at a glance
• Spondylolysis is a defect or fracture of one or both of the wing-shaped parts of a vertebra (bone in the spine). This can cause the bone to slide forward or backward over another vertebra, a condition called spondylolisthesis.
• Spondylolysis can be caused by a birth defect, sports injury or trauma.
• Symptoms of spondylolysis include lower back pain, leg pain, and the feeling of spinal instability.
• Treatment should start with rest and stretching to alleviate pain, but back surgery may be necessary for severe cases of spondylolysis with spondylolisthesis.
Causes of spondylolysis
Spondylolysis is commonly caused by a stress fracture or broken vertebra from trauma that never fully heals.
Spondylolysis can also be caused by a birth defect, in which one or both of the wing-shaped parts of the vertebra is defective from birth.
Symptoms of spondylolysis
Spondylolysis is more commonly seen in younger people and often affects the lower region of the spine.
Spondylolysis may not cause any symptoms, but the effects of spondylolysis can include lower back pain and leg pain, which generally feel like muscle strains.
Sometimes the fracture or break in the vertebra can cause it to slide out of place in relation to the other vertebrae, a condition called spondylolisthesis. This can cause spinal instability, as well as compress the spinal nerves.
Spondylolytic spondylolisthesis symptoms can include:
• Back spasms that cause the back and hamstring muscles to feel tight or stiff.
• Muscle weakness.
• Pain in the buttocks.
• Pain extending through the legs or other extremities due to compressed nerves.
Treatment of spondylolysis
Home treatment to alleviate pain associated with spondylolysis includes resting after sports and other strenuous activity, strengthening exercises and stretching, and over-the-counter pain medications such as Advil or other ibuprofen. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
An orthopaedic physician can also administer epidural steroid injections to relieve pain or suggest physical therapy options such as massages, core exercises, and spinal support (bracing).
For advanced spinal instability due to the vertebra sliding out of position (spondylolisthesis), surgery may be necessary. Minimally invasive repair surgery may be an option for less-advanced spondylolisthesis cases, while spinal fusion and other techniques may be necessary for more advanced cases.
If you are experiencing spondylolysis symptoms from an injury or other trauma, contact us to request an appointment with our spinal specialists to learn more about the treatment options available.
Spinal Stenosis Treatment
Spinal stenosis at a glance
• Spinal stenosis is a narrowing of the open spaces within the spine. This can put pressure on the spinal cord and the nerves.
• Spinal stenosis occurs most often in the lower back or the neck, and is a common and very treatable condition.
• Common symptoms include difficulty walking, back pain, numbness, and weakness.
• Treatments include physical therapy, medication and numerous procedures, including nerve blocks and spinal surgery.
Causes of spinal stenosis
Spinal stenosis is often caused by every day wear-and-tear changes in the spine related to aging. It may also occur when something happens to compress the available space within the spine.
Causes of spinal stenosis can include:
• Herniated discs The cushions between the vertebrae dry out with age. Cracks in the disc’s exterior allow some of the inner material to escape and press on the nerves or spinal cord.
• Thickened ligaments : Ligaments may become stiff and thick and can bulge into the spinal canal.
• Overgrowth of bone : Bone spurs can form due to wear and tear on the spinal bone. These can grow into the spinal canal.
• Spinal injuries : Trauma to the spine may damage the contents of the spinal canal. Swelling of adjacent tissue after back surgery can also put pressure on spinal cord or nerves.
• Tumors : Abnormal growths that have formed within the spinal cord, within membranes that cover the spinal cord or the space between the vertebrae and spinal cord.
Symptoms of spinal stenosis
Some people have no symptoms of spinal stenosis, and it is revealed through diagnostic imaging. When symptoms do occur, they often worsen gradually over time. Depending on the location of the stenosis, symptoms will vary.
Neck
Narrowing in the cervical spine may cause weakness, tingling or even numbness in the arms, hands, leg or foot. Sometimes, nerves to the bowel or bladder can be affected and lead to incontinence.
Lower back
Compressed nerves in the lower part of the spine may cause cramping or pain in the legs after standing or walking. The pain may ease when sitting down or bending forward.
Treatment of spinal stenosis
Treatment depends on the location and severity of the stenosis. Treatment could include :
Medication
Medication can help to control pain associated with spinal stenosis. These medications may include :
• Over-the-counter medications to relieve pain and reduce inflammation.
• Antidepressants can help to ease chronic pain.
• Muscle relaxants can calm muscle spasms.
• Opioids can reduce pain but can be habit forming.
• Anti-seizure medications can be used to reduce pain caused by damaged nerves.
Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Therapy
Physical therapy can assist in building strength and endurance, and can help to improve balance and stability.
Steroid injections
Steroid injections can help reduce inflammation and relieve pressure. However, repeated steroid injections can weaken nearby tissue and bone, so must be used sparingly.
Surgery
Back surgery may be considered if more conservative treatments have failed or if symptoms are disabling. The goal of surgery is to relieve pressure on the nerve roots and spinal cord.
Surgery is helpful in must cases. In some cases, however, some patients may experience no change in symptoms or symptoms may become worse.
If you have been diagnosed with spinal stenosis and would like to learn more about treatment options to relieve your pain and symptoms, contact us to request an appointment with one of our spinal specialists.
Herniated Disc Treatment
Spine herniated disc at a glance
• Herniated discs are common and can often go undetected.
• Herniated disc symptoms often disappear after a few days or weeks, while some people may experience disabling or severe pain.
• Herniated discs tend to occur in patients who are 20 to 50 years old.
• Most treatments initially focus on reducing pain.
• Surgery is sometimes needed when severe pain is present or nerve damage is occurring.
Causes of herniated disc
Herniated discs are often caused by gradual, aging-related wear and tear. With age, the spinal disks lose some of their water content, making them less flexible and more prone to tearing or rupturing with even a minor strain, twist, or physical injury.
Lifting a heavy object can also sometimes lead to a herniated disc. Other times, people can’t pinpoint when the exact injury occurred.
Some factors increase your risk, including being between the ages of 35 and 45, overweight and in a physically demanding occupation that involves lifting, pushing or pulling.
Symptoms of herniated disc
In many cases, herniated discs cause few problems. However, some can lead to severe and disabling back pain. In addition, herniated discs may lead to numbness, weakness, and balance or walking problems. Other symptoms may include muscle spasms and deep muscle pain.
Herniated discs in the neck or upper back can cause pain in the upper arms, neck, and shoulders. When herniated discs are lower in the back they may also cause shooting pain and numbness in the buttock and down the leg. This is called sciatica and is the most common symptom when the problem is located in the lower back. Lower back pain may. also occur, though it is usually less intense than leg pain.
A rare, hut serious condition known as Cauda Equina Syndrome can develop in the lower back, affecting bowel and bladder function as well as leading to partial paralysis of the lower limbs if left untreated.
See your medical provider if your neck or back pain travels down your leg or arm, or if it is accompanied by numbness, tingling or weakness.
Treatment for herniated disc
In many cases, herniated disc treatment will include medication, physical therapy, and occasionally injections for pain management. Back surgery may be required if these measures fail.
Non-surgical treatments
Many patients can he helped with minimally-invasive treatments that may include non-prescription medicine and an exercise plan designed to improve strength and flexibility. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Non-surgical treatment options include :
• Non-prescription medicine.
• Prescription medication.
• Physical therapy.
Pain management treatments
Strategies often include a nerve block or various types of epidurals, a procedure where medicine is placed directly into the spinal area to block pain. The most common approach to treating a herniated disc is addressing the pain caused by the condition.
Pain Management options include :
• Caudal-epidural
• Epidural
• Transforaminal epidural
• Selective nerve block
Surgical treatment
For herniated discus that requires surgery, the standard operation is a microdiscectomy, an operation to remove the herniated part of a disc. The surgeon performs a microdiscectomy with a microscope or similar device, often as an outpatient procedure. Microdiscectomies have a very good success rate. Disc herniation can recur in up to 10 percent of cases.
Other surgical options range from nucleus replacement, a new form of surgery still under investigation in which a surgeon replaces the centre part of the disc with an artificial implant to a percutaneous laser discectomy. In which the surgeon makes a small incision, inserts a tiny probe and operates with the aid of x-rays.
Surgical options for herniated disc include :
• Laminotomy
• Laminectomy
• Microdiscectomy
• Percutaneous laser discectomy
• Percutaneous nucleoplasty coblation
• Transformainal microdiscectomy
• Nucleus replacement disc stabilization arthroplasty
If you are experiencing back pain and symptoms of a herniated disc, contact us to request an appointment with our spine specialists to learn about your treatment options.
Spinal Tumors Treatment
Spinal tumors at a glance
• A spinal tumor is a mass or growth of cells in or surrounding the spinal cord and spine.
• Various types of tumors may occur in the spine.
• Spinal tumors can be cancerous (malignant) or non-cancerous (benign).
• Spinal tumors can affect nerves in the area of the tumor, cause pain, neurological problems and sometimes even paralysis.
• Spinal tumors can be life threatening or cause permanent disability even if they are not cancerous.
• Spinal tumors are often treated through a combination of back surgery, medications, chemotherapy and/or radiation. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Causes of spinal tumours
While the specific cause of most spinal tumors is not known, experts believe that defective genes may play a role. It’s not clear whether the defective genes are caused by environmental factors, inherited or occur spontaneously. Some spinal tumors are linked to known inherited syndromes, such as von Hippel-Lindau disease and neurofibromatosis.
The parts of the spine most likely to be affected by a spinal tumor are vertebrae and the spinal cord.
Types of spinal tumours
There are several types of spinal tumors, which are classified according to the location in the spine.
• Intradural-extramedullary tumors
These tumors develop in the nerve roots that extend out from the spinal cord or in the spinal cord’s arachnoid membrane, and can be cancerous or non-cancerous.
• Extradural (vertebral) tumors
Some tumors affecting the vertebrae have spread from another site in the body (i.e. breast, lung, kidney, or prostate). Although the primary cancer is usually diagnosed before the back problems develop, back pain can be the first symptom in those with metastatic spinal tumors. Vertebral tumors can arise from bone cells within the spine.
• Itramedullary tumors
Intramedullary tumors can be cancerous or noncancerous, and begin in the supporting cells within the spinal cord.
Symptoms of spinal tumours
Signs and symptoms of spine tumors vary depending on the location and type, especially as the tumor develops and affects the nerve roots, blood vessels, bones or spinal cord.
Back pain is a common symptom of spinal tumors, and pain may spread to the hips, legs or feet. The pain may become more severe over time.
Keep in mind that back pain has many different causes. Most back pain is not a result of spinal tumors.
See your doctor if your back pain is persistent and growing progressively worse, if the pain is worse at night, or if it is not activity related. You should seek medical attention if you have a history of cancer and develop back pain. Seek immediate help if you experience progressive muscle weakness or numbness in your legs or have changes in bladder or bowel function.
Treatment of spinal tumours
Treatment is coordinated through your team of physicians, including your oncologist, your primary care doctor and surgeon.
Ideally, the goal of spinal tumor treatment is to eliminate the tumor completely, but this is not always possible due to the risk of permanent damage to the surrounding nerves and organ structures. Treatment will depend on the type of tumor, the patient’s health and age and whether or not the tumor has spread from somewhere else in the body.
Spinal tumor treatment options include :
Monitoring
If a small tumor is noncancerous and isn’t growing or pressing on surrounding tissues, your doctor may decide no other treatment is needed except to monitor it closely through periodic scans.
Surgery
If the tumor can be removed with minimal risk of nerve damage, your doctor may decide to remove it through surgery. New technology and techniques allow surgeons to remove tumors that were once though inaccessible. Your medical team may use sound waves to break up the tumor and remove the fragments. Not all tumors can be removed completely.
Radiation therapy
If a tumor cannot be removed completely, surgery may be followed by radiation therapy. Radiation is often used for metastatic tumors, or when surgery cannot be performed.
Chemotherapy
This is a standard treatment for many cancers, and uses medication to destroy the cancerous cells.
Stereotactic radiosurgery (SRS)
This is a new method of radiation therapy that focuses radiation beams on the tumor with pinpoint accuracy.
Medications
Your physician may prescribe corticosteroids to reduce the swelling following surgery or during radiation therapy.
Scoliosis Treatment
Scoliosis at a glance
• Scoliosis is a side-to-side curvature of the spine that forms either in a “C” shape or an “S” shape.
• Curvature of the spine generally does not require treatment, although bracing or spinal fusion surgery may be required in severe cases.
•
Curvature of the spine may also occur with spondylolisthesis in which one vertebra shifts out of position relative to the vertebrae below it.
Symptoms of scoliosis
Symptoms of scoliosis are rare but can include :
• Backaches or lower back pain.
• Spine fatigue after long periods of sitting or standing.
• Uneven hips or shoulders.
• A spine curvature more to one side than the other.
Scoliosis types & causes
The most common type cause of scoliosis is what doctors call idiopathic scoliosis, meaning that it has no known cause.
Idiopathic scoliosis in children younger than three years of age is known as infantile scoliosis. In children ages 4 to 10, it is called juvenile scoliosis, and in ages 11 to 18, it is adolescent scoliosis.
The cause may be known in other cases :
• Congenital scoliosis is present a birth and is the result of a baby’s ribs or spine bones not forming properly.
• Neuromuscular scoliosis is caused by a nervous system problem affecting muscle function such as cerebral palsy, muscular dystrophy, spina bifida, and polio.
Treatments for scoliosis
Most people with idiopathic scoliosis do not need treatment, although doctors generally recommend a spinal exam twice a year.
Back braces
Children sometimes must wear a back brace in order to prevent further curving of the spine while they grow. Back braces work best for children older than age 10.
Back braces vary in design, and the best kind to use depends on the size and location of the curve. For children and teens, many back braces are adjustable for changes in body growth.
Unfortunately, braces do not work for treating congenital or neuromuscular scoliosis.
Additionally, the patient may also need :
• Emotional support : Wearing a back brace may make children and teens painfully self-conscious of their condition.
• Physical therapy : Specially trained therapists can help fit the brace correctly and minimize physical and psychological discomfort.
Surgery
Sometime spinal surgery is necessary for severe or rapidly worsening scoliosis. An orthopedic surgeon inserts one or two metal rods with hooks and screws to hold the spine in place until the bone heals together.
To access the spine, the surgeon may make an incision through the back, belly area, or beneath the ribs. Following surgery, the patient may wear a temporary brace.
Contact us to request an appointment with one of our spinal specialists to learn more about the treatment options available for scoliosis.
Radiculopathy at a glance
• Radiculopathy is a feeling of radiating pain from a compressed or pinched nerve in the spine.
• Cervical radiculopathy causes pain in the upper extremities and lumbar radiculopathy causes pain in the lower extremities.
• Radiculopathy is caused by the spinal nerves becoming compressed or pinched by spinal discs or bone material, causing nerve damage.
• Pain, tingling and numbness in and around the area of the pinched nerve are symptoms of radiculopathy.
• Treatment options for radiculopathy include pain medications and physical therapy. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Causes of radiculopathy or pinched nerves
Radiculopathy is caused by the nerves becoming compressed or pinched between spinal discs. A pinched nerve can be caused by loose material from a ruptured disc becoming lodged in the space between spinal discs, or a herniated disc (a disc that has moved out of place).
Radiculopathy can also occur during the aging process as bones and discs degenerate over time or from conditions such as arthritis. Additionally, spine injuries can put pressure on spinal nerves.
Symptoms of pinched nerve
Radiculopathy can cause pain, tingling and numbness that extend from the damaged nerve root to the areas surrounding the injury. For example, cervical radiculopathy symptoms can occur in the upper extremities such as the neck, shoulders and even chest and hands.
Pain from a pinched or compressed nerve in older people is often caused by normal bone degeneration, whereas a ruptured disc or other spinal injury often is the cause of radiculopathy in young people.
Radiculopathy treatments
Treatment for a pinched nerve includes pain medication combined with physical therapy. The medications may include anti-inflammatory steroids, which can be injected into the spine or taken orally, or non-steroidal pain medication such as Aleve.
Physical therapy methods usually include mobilization, exercise and other techniques to alleviate back pain. If the pinched or compressed nerve causes a decrease in motor skills or other significant effects, then surgery may be necessary to relieve pressure.
If you are experiencing symptoms and pain associated with a pinched nerve, contact our spinal specialists to learn more about the treatment option that is best for you.
Kyphosis Treatment
Kyphosis at a glance
• Kyphosis also known as hunchback or dowager’s hump is an abnormal outward curvature of the upper back (thoracic spine) that causes hunching.
• Kyphosis can be caused by several conditions affecting the spine; postural kyphosis can be caused from excessive slouching.
• In addition to the exaggerated curve of the back, symptoms can include back pain or stiffness; in severe cases, kyphosis can affect organs, nerves, and other parts of the body.
• Treatment for kyphosis may include medication, physical therapy, or spinal surgery.
Causes of kyphosis
Kyphosis is caused by vertebrae (which are normally block-shaped) becoming wedge-shaped, causing the spine to curve. This condition develops due to a number of precursor conditions.
Disc degeneration
Soft discs between the vertebrae cushion the bones of the spine. With age and/or other spinal conditions, these discs can become brittle or shrink, lessening the support between vertebrae and damaging the bone, also known as degenerating discs.
Osteoporosis
Osteoporosis is a bone-thinning disorder most commonly seen in older women. The weakened vertebrae can develop compression fractures even during normal activity. This can alter the shape of the vertebrae.
Cancer and treatments
Cancer, as well as treatments for cancer such as radiation or chemotherapy, can weaken the vertebrae, causing compression fractures, which deform the shape of the vertebrae.
Scheuermann’s disease
Scheuermann’s disease is a hereditary disorder that can cause kyphosis during the growing period before a child hits puberty. This disease is generally seen more often in boys an girls. It is believed to cause the cartilage that normally turns to bone to develop unevenly, causing the vertebrae to develop into wedge shapes.
Slouching
Postural kyphosis does not involve an actual deformity in the spine, but an exaggerated curve in the upper spine can develop from excessive slouching, seen more commonly in teenage girls.
Birth defects
I rare cases, a baby’s spinal column does not develop fully or properly in the womb, leading to kyphosis.
Symptoms of kyphosis
The most evident symptom of kyphosis is the abnormally curved portion of the upper spine. Mild cases of kyphosis may not have any other symptoms; however, people with kyphosis may experience back pain and stiffness.
Severe cases of kyphosis can affect the nerves, lungs, organs, and tissue with pain and other issues. In very severe cases, the spine can cause the rib cage to press against the lungs, making it difficult to breathe.
The extent of effects caused by kyphosis depends on the underlying condition and age.
Treatment of kyphosis
The best treatment option for kyphosis depends on the underlying condition and the symptoms.
Medication options include over-the-counter pain relievers, such as Tylenol, Advil, or Aleve if the condition is related to osteoporosis. There are also special osteoporosis drugs that help strengthen the bones, preventing further damage. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Stretching and flexibility back exercises can alleviate kyphosis symptoms, as well as improve posture. Wearing a body brace is another option, especially for children whose bones are still growing.
For severe cases of kyphosis with a severe curve or pinched nerves, surgery may be necessary to correct or reduce the deformity. Spinal fusion, which fuses two or more vertebrae together, is the most common surgery to correct kyphosis.
Contact us to schedule an appointment with our orthopedic spine specialists if you have a hunched upper back associated with kyphosis and would like to learn more about your treatment options.
Lordosis Treatment
Lordosis at a glance
• Lordosis (also known as swayback) is the abnormal inward curving of the lower back (lumbar spine).
• Lordosis can be caused by a number of other conditions that affect the spine, as well as poor posture and obesity.
• Symptoms include the inward curve of the spine, back pain and discomfort.
• Treatment may include medication, physical therapy, bracing, weight loss, or spinal surgery.
What is lordosis and what causes it?
Curves are a normal part of the spine’s structure. These curves help position the head and neck, while also working as shock absorbers during movement of the body.
When the spine curve arches too far inward, however, it creates a condition called lordosis (or sometimes referred to as swayback). Lordosis can affect the lower back and neck.
Lordosis can develop from other conditions that affect the spine, as well as bad posture, hip problems, back surgery, or problems with the vertebrae from birth.
Conditions that cause lordosis to include :
• Spondylolisthesis which causes one vertebra to slide out of position over another vertebra.
• Kyphosis which causes an abnormal outward curving of the upper spine.
• Discitis, an inflammation of the discs that cushion the space between vertebrae, most commonly caused by an infection.
• Achondroplasia, which stunts normal bone growth (this condition is often associated with dwarfism).
• Obesity, which causes the spine to support the excessive weight.
Symptoms of Iordosis
The primary symptoms of lordosis, or swayback, are the prominence of the buttocks and a pronounced inward curve of the lower spine. This is evidenced by a large gap between the lower back and a hard surface when laying down that does not change when leaning forward.
Other symptoms can include excess pressure on the spine, causing back pain and discomfort. Symptoms can also include difficulty moving in certain ways, especially if left untreated.
Treatment of Iordosis
For most people, lordosis does not cause significant health problems and significant treatment (if at all).
Treatment for lordosis may include medication to relieve swelling and pain, as well as physical therapy or exercise to help improve spinal flexibility and build muscle strength.
A back brace may be necessary to support the back or prevent the condition from worsening.
If obesity is the cause or is worsening the condition, weight loss may be another effective treatment.
Surgery for extreme lordosis, such as spinal fusion, is rarely performed.
Sciatica Treatment
Sciatica at a glance
• Sciatica is the result of sciatic nerve roots being compressed or pinched as they exit the spinal cord in the lower back.
• Disc herniation is the most common cause of sciatica. People often use the two terms interchangeably.
• Sciatica can cause severe pain, numbness and weakness in a leg and/or foot, as well as nagging lower back pain.
• Treatment usually starts with physical therapy and pain management methods.
What is sciatica?
Sciatica is a condition of the sciatic nerve roots, the longest nerves in the body, such as being pinched or compressed as they exit the spinal cord. It is most often associated with pain.
Symptoms of sciatica
Sciatica typically causes pain in the lower back or buttocks that continues down the leg and often to the foot. Pain may also be accompanied by weakness, tingling or numbness in the leg. Pain severeness can vary widely, from a mild ache to sharp or excruciating pain.
Typically, sciatica affects only one side of a person’s body.
Symptoms vary, depending on which of the sciatic nerve roots are compressed. Sitting or standing for a long time can worsen the symptoms, as can bending the spine in certain ways.
Causes of sciatica
Sciatica is usually the result of a herniated or ruptured disc pressing against the sciatic nerve, a large nerve group leading out of the foraminal canals between each vertebra of the spine.
As one of four spinal nerves exiting the spine, the sciatic nerve runs behind the buttocks and down the back of the thigh. At the knee down, the nerve splits into several other branches.
In addition to disc herniation, another cause of sciatica is a muscular compression of the sciatic nerve in the buttocks. The most common type of this condition is called piriformis muscle syndrome, named for the buttocks muscle overlying the nerve.
Sciatica may also be a symptom of spinal stenosis, a narrowing of the spinal canal, as well as bone spurs or a nerve pinched by an injury.
Treatments for sciatica
In order to diagnose sciatica, a physical exam is usually required, often along with X-rays and/or a magnetic resonance imaging (MRI) test.
Some sciatica sufferers find their pain improves over time with little or no treatment. Many gain immediate relief from lying down or doing exercises that ease pressure on the sciatic nerve.
As a first course of treatment, many doctors prefer non-surgical alternatives such as physical therapy and pain medication. Spine specialists also emphasize a daily regimen that reduces sitting and increases walking. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
In other cases, doctors may recommend pain management therapy for a herniated disc, in which injections help ease the nerve swelling and pain around the disc.
In more extreme cases, various types of spinal surgery can reduce or eliminate the disc pressure.
If you are experiencing sciatica pain and symptoms, contact us to request an appointment with our orthopedic spine specialists to learn which treatment options are best for you.
Spondylolisthesis Treatment
Spondylolisthesis at a glance
• Spondylolisthesis is also called slipped vertebra or shifted spine occurs when a vertebra in the spine slips forward and backward from its correct position in relation to other vertebrae, usually in the lower back.
• A slipped vertebra is often caused by degenerative spondylolisthesis, which is more common in older people, or spondylolysis more common in younger people.
• Depending on severity, spondylolisthesis may be treated by medication, physical therapy, or back surgery. If non-symptomatic, a patient may choose to not pursue treatment.
Causes of spondylolisthesis
Spondylolithesis can be caused by a vertebra being defective from birth, breaking due to a stress fracture or trauma, or discs degenerating from disease, infection, or old age. A fracture or defect in part of the vertebra (called spondylolysis) can cause the vertebra to slip forword, backward, side-to-side, or over the vertebra below.
Spondylolysis occurs due to multiple underlying conditions. The two most common are spondylolytic spondylolisthesis and degenerative spondylolisthesis.
Spondylolysis is more common in younger people, especially athletes, and is usually developed early on and present through life.
Degenerative spondylolisthesis generally affects people over age 60, occurring due to the natural spinal degeneration process that accompanies aging.
Symptoms of spondylolisthesis
Spondylolisthesis symptoms May include :
• Muscle weakness, numbness, tightness, and/or stiffness.
• Back pain, often in the lower back.
• Pain in the buttocks or hips.
• Pain extending down through the legs or through other extremities (due to pressure on nerve roots).
• Sciatica
Spondylolytic spondylolisthesis can sometimes cause weakness in the lower extremities, including the feet (foot drop).
Degenerative spondylolisthesis can be a crippling condition, with symptoms including those commonly associated with a pinched spinal nerve and inability to walk due to pain.
With back pain caused by spondylolisthesis, the affected area feels hot to the touch. Patients often describe the sensation as a burning pain, and may also experience sciatica.
Scoliosis (curvature of the spine) may also be present with spondylolisthesis.
Other conditions that can develop due to spondylolisthesis are : flat back, a posture change where the lower back becomes straight or flat and spinal instability where a segment of the spine moves too much, either side-to-side, front-to-back, or up and down.
Treatment of spondylolisthesis
Diagnosing spondylolisthesis in its earlier stages can help manage the condition, prevent more serious symptoms in the future, and can allow for less-invasive treatments.
Depending on severity, spondylolisthesis may be treated by medication, physical therapy and pain management, or surgery. If non-symptomatic, a patient may choose to not pursue treatment.
Medications may help with pain management or treat spondylolisthesis symptoms, such as anti-inflammatory drugs (like Advil) or epidural steroid injections. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Physical therapy treatment options may include massages, core-strengthening exercises, spinal support (bracing), and traction. Pain management techniques can also include epidural injections.
Surgery
If other treatment options do not improve the condition, surgery may be necessary or desirable. Minimally invasive repair surgery may be an option for less-advanced spondylolisthesis cases.
For advanced degeneration and spinal instability caused by spondylolisthesis, spinal fusion and other techniques may be necessary, including :
• Percutaneous spinal fusion (a minimally invasive procedure).
• Simple spinal fusion (without implants).
• Complex spinal fusion (with implants).
If you are experiencing back pain or other symptoms associated with spondylolisthesis, contact us to request an appointment our orthopedic spine specialists to learn about treatment options available to you.
Spondylolysis Treatment
Spondylolysis at a glance
• Spondylolysis is a defect or fracture of one or both of the wing-shaped parts of a vertebra (bone in the spine). This can cause the bone to slide forward or backward over another vertebra, a condition called spondylolisthesis.
• Spondylolysis can be caused by a birth defect, sports injury or trauma.
• Symptoms of spondylolysis include lower back pain, leg pain, and the feeling of spinal instability.
• Treatment should start with rest and stretching to alleviate pain, but back surgery may be necessary for severe cases of spondylolysis with spondylolisthesis.
Causes of spondylolysis
Spondylolysis is commonly caused by a stress fracture or broken vertebra from trauma that never fully heals.
Spondylolysis can also be caused by a birth defect, in which one or both of the wing-shaped parts of the vertebra is defective from birth.
Symptoms of spondylolysis
Spondylolysis is more commonly seen in younger people and often affects the lower region of the spine.
Spondylolysis may not cause any symptoms, but the effects of spondylolysis can include lower back pain and leg pain, which generally feel like muscle strains.
Sometimes the fracture or break in the vertebra can cause it to slide out of place in relation to the other vertebrae, a condition called spondylolisthesis. This can cause spinal instability, as well as compress the spinal nerves.
Spondylolytic spondylolisthesis symptoms can include:
• Back spasms that cause the back and hamstring muscles to feel tight or stiff.
• Muscle weakness.
• Pain in the buttocks.
• Pain extending through the legs or other extremities due to compressed nerves.
Treatment of spondylolysis
Home treatment to alleviate pain associated with spondylolysis includes resting after sports and other strenuous activity, strengthening exercises and stretching, and over-the-counter pain medications such as Advil or other ibuprofen. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
An orthopaedic physician can also administer epidural steroid injections to relieve pain or suggest physical therapy options such as massages, core exercises, and spinal support (bracing).
For advanced spinal instability due to the vertebra sliding out of position (spondylolisthesis), surgery may be necessary. Minimally invasive repair surgery may be an option for less-advanced spondylolisthesis cases, while spinal fusion and other techniques may be necessary for more advanced cases.
If you are experiencing spondylolysis symptoms from an injury or other trauma, contact us to request an appointment with our spinal specialists to learn more about the treatment options available.
Spinal Stenosis Treatment
Spinal stenosis at a glance
• Spinal stenosis is a narrowing of the open spaces within the spine. This can put pressure on the spinal cord and the nerves.
• Spinal stenosis occurs most often in the lower back or the neck, and is a common and very treatable condition.
• Common symptoms include difficulty walking, back pain, numbness, and weakness.
• Treatments include physical therapy, medication and numerous procedures, including nerve blocks and spinal surgery.
Causes of spinal stenosis
Spinal stenosis is often caused by every day wear-and-tear changes in the spine related to aging. It may also occur when something happens to compress the available space within the spine.
Causes of spinal stenosis can include:
• Herniated discs The cushions between the vertebrae dry out with age. Cracks in the disc’s exterior allow some of the inner material to escape and press on the nerves or spinal cord.
• Thickened ligaments : Ligaments may become stiff and thick and can bulge into the spinal canal.
• Overgrowth of bone : Bone spurs can form due to wear and tear on the spinal bone. These can grow into the spinal canal.
• Spinal injuries : Trauma to the spine may damage the contents of the spinal canal. Swelling of adjacent tissue after back surgery can also put pressure on spinal cord or nerves.
• Tumors : Abnormal growths that have formed within the spinal cord, within membranes that cover the spinal cord or the space between the vertebrae and spinal cord.
Symptoms of spinal stenosis
Some people have no symptoms of spinal stenosis, and it is revealed through diagnostic imaging. When symptoms do occur, they often worsen gradually over time. Depending on the location of the stenosis, symptoms will vary.
Neck
Narrowing in the cervical spine may cause weakness, tingling or even numbness in the arms, hands, leg or foot. Sometimes, nerves to the bowel or bladder can be affected and lead to incontinence.
Lower back
Compressed nerves in the lower part of the spine may cause cramping or pain in the legs after standing or walking. The pain may ease when sitting down or bending forward.
Treatment of spinal stenosis
Treatment depends on the location and severity of the stenosis. Treatment could include :
Medication
Medication can help to control pain associated with spinal stenosis. These medications may include :
• Over-the-counter medications to relieve pain and reduce inflammation.
• Antidepressants can help to ease chronic pain.
• Muscle relaxants can calm muscle spasms.
• Opioids can reduce pain but can be habit forming.
• Anti-seizure medications can be used to reduce pain caused by damaged nerves.
Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Therapy
Physical therapy can assist in building strength and endurance, and can help to improve balance and stability.
Steroid injections
Steroid injections can help reduce inflammation and relieve pressure. However, repeated steroid injections can weaken nearby tissue and bone, so must be used sparingly.
Surgery
Back surgery may be considered if more conservative treatments have failed or if symptoms are disabling. The goal of surgery is to relieve pressure on the nerve roots and spinal cord.
Surgery is helpful in must cases. In some cases, however, some patients may experience no change in symptoms or symptoms may become worse.
If you have been diagnosed with spinal stenosis and would like to learn more about treatment options to relieve your pain and symptoms, contact us to request an appointment with one of our spinal specialists.
Herniated Disc Treatment
Spine herniated disc at a glance
• Herniated discs are common and can often go undetected.
• Herniated disc symptoms often disappear after a few days or weeks, while some people may experience disabling or severe pain.
• Herniated discs tend to occur in patients who are 20 to 50 years old.
• Most treatments initially focus on reducing pain.
• Surgery is sometimes needed when severe pain is present or nerve damage is occurring.
Causes of herniated disc
Herniated discs are often caused by gradual, aging-related wear and tear. With age, the spinal disks lose some of their water content, making them less flexible and more prone to tearing or rupturing with even a minor strain, twist, or physical injury.
Lifting a heavy object can also sometimes lead to a herniated disc. Other times, people can’t pinpoint when the exact injury occurred.
Some factors increase your risk, including being between the ages of 35 and 45, overweight and in a physically demanding occupation that involves lifting, pushing or pulling.
Symptoms of herniated disc
In many cases, herniated discs cause few problems. However, some can lead to severe and disabling back pain. In addition, herniated discs may lead to numbness, weakness, and balance or walking problems. Other symptoms may include muscle spasms and deep muscle pain.
Herniated discs in the neck or upper back can cause pain in the upper arms, neck, and shoulders. When herniated discs are lower in the back they may also cause shooting pain and numbness in the buttock and down the leg. This is called sciatica and is the most common symptom when the problem is located in the lower back. Lower back pain may. also occur, though it is usually less intense than leg pain.
A rare, hut serious condition known as Cauda Equina Syndrome can develop in the lower back, affecting bowel and bladder function as well as leading to partial paralysis of the lower limbs if left untreated.
See your medical provider if your neck or back pain travels down your leg or arm, or if it is accompanied by numbness, tingling or weakness.
Treatment for herniated disc
In many cases, herniated disc treatment will include medication, physical therapy, and occasionally injections for pain management. Back surgery may be required if these measures fail.
Non-surgical treatments
Many patients can he helped with minimally-invasive treatments that may include non-prescription medicine and an exercise plan designed to improve strength and flexibility. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Non-surgical treatment options include :
• Non-prescription medicine.
• Prescription medication.
• Physical therapy.
Pain management treatments
Strategies often include a nerve block or various types of epidurals, a procedure where medicine is placed directly into the spinal area to block pain. The most common approach to treating a herniated disc is addressing the pain caused by the condition.
Pain Management options include :
• Caudal-epidural
• Epidural
• Transforaminal epidural
• Selective nerve block
Surgical treatment
For herniated discus that requires surgery, the standard operation is a microdiscectomy, an operation to remove the herniated part of a disc. The surgeon performs a microdiscectomy with a microscope or similar device, often as an outpatient procedure. Microdiscectomies have a very good success rate. Disc herniation can recur in up to 10 percent of cases.
Other surgical options range from nucleus replacement, a new form of surgery still under investigation in which a surgeon replaces the centre part of the disc with an artificial implant to a percutaneous laser discectomy. In which the surgeon makes a small incision, inserts a tiny probe and operates with the aid of x-rays.
Surgical options for herniated disc include :
• Laminotomy
• Laminectomy
• Microdiscectomy
• Percutaneous laser discectomy
• Percutaneous nucleoplasty coblation
• Transformainal microdiscectomy
• Nucleus replacement disc stabilization arthroplasty
If you are experiencing back pain and symptoms of a herniated disc, contact us to request an appointment with our spine specialists to learn about your treatment options.
Spinal Tumors Treatment
Spinal tumors at a glance
• A spinal tumor is a mass or growth of cells in or surrounding the spinal cord and spine.
• Various types of tumors may occur in the spine.
• Spinal tumors can be cancerous (malignant) or non-cancerous (benign).
• Spinal tumors can affect nerves in the area of the tumor, cause pain, neurological problems and sometimes even paralysis.
• Spinal tumors can be life threatening or cause permanent disability even if they are not cancerous.
• Spinal tumors are often treated through a combination of back surgery, medications, chemotherapy and/or radiation. Be sure to talk to your pharmacist before purchasing anti-inflammatories as these medications may be contraindicated as they may interact with other medications and medical conditions.
Causes of spinal tumours
While the specific cause of most spinal tumors is not known, experts believe that defective genes may play a role. It’s not clear whether the defective genes are caused by environmental factors, inherited or occur spontaneously. Some spinal tumors are linked to known inherited syndromes, such as von Hippel-Lindau disease and neurofibromatosis.
The parts of the spine most likely to be affected by a spinal tumor are vertebrae and the spinal cord.
Types of spinal tumours
There are several types of spinal tumors, which are classified according to the location in the spine.
• Intradural-extramedullary tumors
These tumors develop in the nerve roots that extend out from the spinal cord or in the spinal cord’s arachnoid membrane, and can be cancerous or non-cancerous.
• Extradural (vertebral) tumors
Some tumors affecting the vertebrae have spread from another site in the body (i.e. breast, lung, kidney, or prostate). Although the primary cancer is usually diagnosed before the back problems develop, back pain can be the first symptom in those with metastatic spinal tumors. Vertebral tumors can arise from bone cells within the spine.
• Itramedullary tumors
Intramedullary tumors can be cancerous or noncancerous, and begin in the supporting cells within the spinal cord.
Symptoms of spinal tumours
Signs and symptoms of spine tumors vary depending on the location and type, especially as the tumor develops and affects the nerve roots, blood vessels, bones or spinal cord.
Back pain is a common symptom of spinal tumors, and pain may spread to the hips, legs or feet. The pain may become more severe over time.
Keep in mind that back pain has many different causes. Most back pain is not a result of spinal tumors.
See your doctor if your back pain is persistent and growing progressively worse, if the pain is worse at night, or if it is not activity related. You should seek medical attention if you have a history of cancer and develop back pain. Seek immediate help if you experience progressive muscle weakness or numbness in your legs or have changes in bladder or bowel function.
Treatment of spinal tumours
Treatment is coordinated through your team of physicians, including your oncologist, your primary care doctor and surgeon.
Ideally, the goal of spinal tumor treatment is to eliminate the tumor completely, but this is not always possible due to the risk of permanent damage to the surrounding nerves and organ structures. Treatment will depend on the type of tumor, the patient’s health and age and whether or not the tumor has spread from somewhere else in the body.
Spinal tumor treatment options include :
Monitoring
If a small tumor is noncancerous and isn’t growing or pressing on surrounding tissues, your doctor may decide no other treatment is needed except to monitor it closely through periodic scans.
Surgery
If the tumor can be removed with minimal risk of nerve damage, your doctor may decide to remove it through surgery. New technology and techniques allow surgeons to remove tumors that were once though inaccessible. Your medical team may use sound waves to break up the tumor and remove the fragments. Not all tumors can be removed completely.
Radiation therapy
If a tumor cannot be removed completely, surgery may be followed by radiation therapy. Radiation is often used for metastatic tumors, or when surgery cannot be performed.
Chemotherapy
This is a standard treatment for many cancers, and uses medication to destroy the cancerous cells.
Stereotactic radiosurgery (SRS)
This is a new method of radiation therapy that focuses radiation beams on the tumor with pinpoint accuracy.
Medications
Your physician may prescribe corticosteroids to reduce the swelling following surgery or during radiation therapy.
Scoliosis Treatment
Scoliosis at a glance
• Scoliosis is a side-to-side curvature of the spine that forms either in a “C” shape or an “S” shape.
• Curvature of the spine generally does not require treatment, although bracing or spinal fusion surgery may be required in severe cases.
•
Curvature of the spine may also occur with spondylolisthesis in which one vertebra shifts out of position relative to the vertebrae below it.
Symptoms of scoliosis
Symptoms of scoliosis are rare but can include :
• Backaches or lower back pain.
• Spine fatigue after long periods of sitting or standing.
• Uneven hips or shoulders.
• A spine curvature more to one side than the other.
Scoliosis types & causes
The most common type cause of scoliosis is what doctors call idiopathic scoliosis, meaning that it has no known cause.
Idiopathic scoliosis in children younger than three years of age is known as infantile scoliosis. In children ages 4 to 10, it is called juvenile scoliosis, and in ages 11 to 18, it is adolescent scoliosis.
The cause may be known in other cases :
• Congenital scoliosis is present a birth and is the result of a baby’s ribs or spine bones not forming properly.
• Neuromuscular scoliosis is caused by a nervous system problem affecting muscle function such as cerebral palsy, muscular dystrophy, spina bifida, and polio.
Treatments for scoliosis
Most people with idiopathic scoliosis do not need treatment, although doctors generally recommend a spinal exam twice a year.
Back braces
Children sometimes must wear a back brace in order to prevent further curving of the spine while they grow. Back braces work best for children older than age 10.
Back braces vary in design, and the best kind to use depends on the size and location of the curve. For children and teens, many back braces are adjustable for changes in body growth.
Unfortunately, braces do not work for treating congenital or neuromuscular scoliosis.
Additionally, the patient may also need :
• Emotional support : Wearing a back brace may make children and teens painfully self-conscious of their condition.
• Physical therapy : Specially trained therapists can help fit the brace correctly and minimize physical and psychological discomfort.
Surgery
Sometime spinal surgery is necessary for severe or rapidly worsening scoliosis. An orthopedic surgeon inserts one or two metal rods with hooks and screws to hold the spine in place until the bone heals together.
To access the spine, the surgeon may make an incision through the back, belly area, or beneath the ribs. Following surgery, the patient may wear a temporary brace.
Contact us to request an appointment with one of our spinal specialists to learn more about the treatment options available for scoliosis.
