Author: MinSurg

Disc Herniation

1 Comment

What is cervical disc herniation?

The bones (vertebrae) that form the spine in your back are cushioned by round, flat discs. When these discs are healthy, they act as shock absorbers for the spine and keep the spine flexible. If they become damaged, they may bulge abnormally or break open (rupture), in what is called a herniated or slipped disc. Herniated discs can occur in any part of the spine, but they are most common in the neck (cervical) and lower back (lumbar) spine. The seven vertebrae between the head and the chest make up the cervical spine.

What causes cervical disc herniation?

A herniated disc usually is caused by wear and tear of the disc (also called disc degeneration). As we age, our discs lose some of the fluid that helps them stay flexible. A herniated disc also may result from injuries to the spine, which may cause tiny tears or cracks in the outer layer (annulus or capsule) of the disc. The jellylike material (nucleus) inside the disc may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments.

Herniated discs are much more common in people who smoke.

What are the symptoms?

Herniated discs in the neck (cervical spine) can cause pain, numbness, or weakness in the neck, shoulders, chest, arms, and hands. In some cases a very large herniated disc in the neck may cause weakness or unusual tingling affecting other parts of the body, including the legs.

How is cervical disc herniation diagnosed?

A doctor usually can diagnose a herniated disc from your history of symptoms and a physical exam. Your doctor will ask about pain and numbness that might be caused by irritation of one or more of the nerves in the cervical spine. If your symptoms suggest a cervical herniated disc, rest and rehabilitation (rehab) often are recommended before further testing is done. If other conditions are suspected, or if there is no improvement in symptoms after a period of rest and rehab, imaging tests such as X-ray, magnetic resonance imaging (MRI), or computerized tomography (CT scan) may be done.

How is it treated?

In most cases, cervical herniated discs are first treated with nonsurgical treatment, including rest or modified activities, medicines to relieve pain and inflammation, and exercises, as recommended by your doctor. Your doctor may recommend that you see a physical therapist to learn how to do exercises and protect your neck, and perhaps for other treatment such as traction. Traction is gentle, steady pulling on the head to stretch the neck and allow the small joints between the neck bones to spread a little. If symptoms continue, your doctor may try stronger medicine such as corticosteroids. Symptoms usually improve over time. But if the herniated disc is squeezing your spinal cord or nerves and/or you are having weakness, constant pain, or decreased control of your bladder or bowels, surgery will be considered. In rare cases, an artificial disc may be used to replace the disc that is removed.

Info by: http://www.webmd.com/a-to-z-guides/cervical-disc-herniation-topic-overview

Spinal Stenosis

Spinal stenosis is the narrowing of spaces in the spine (backbone) which causes pressure on the spinal cord and nerves. About 75% of cases of spinal stenosis occur in the low back (lumbar spine). In most cases, the narrowing of the spine associated with stenosis compresses the nerve root, which can cause pain along the back of the leg.

What Causes Spinal Stenosis?

There are many potential causes for spinal stenosis, including:

  • Aging: With age, the body’s ligaments (tough connective tissues between the bones in the spine) can thicken. Spurs (small growths) may develop on the bones and into the spinal canal. The cushioning disks between the vertebrae may begin to deteriorate. The facet joints (flat surfaces on each vertebra that form the spinal column) also may begin to break down. All of these factors can cause the spaces in the spine to narrow.
  • Arthritis: Two forms of arthritis that may affect the spine areosteoarthritis and rheumatoid arthritis.
  • Heredity: If the spinal canal is too small at birth, symptoms of spinal stenosis may show up in a relatively young person. Structural deformities of the involved vertebrae can cause narrowing of the spinal canal.
  • Instability of the spine, or spondylolisthesis: When one vertebra slips forward on another, that can narrow the spinal canal.
  • Tumors of the spine: Abnormal growths of soft tissue may affect the spinal canal directly by causing inflammation or by growth of tissue into the canal. Tissue growth may lead to bone resorption (bone loss due to overactivity of certain bone cells) or displacement of bone and the eventual collapse of the supporting framework of the spinal column.
  • Trauma: Accidents and injuries may either dislocate the spine and the spinal canal or cause burst fractures that produce fragments of bone that penetrate the canal.

What Are the Symptoms of Spinal Stenosis?

Spinal stenosis may result in low back pain as well as pain in the legs. Stenosis may pinch the nerves that control muscle power and sensation in the legs. Additional symptoms may include:

  • Frequent falling, clumsiness
  • Pain and difficulty when walking
  • Numbness, tingling, hot or cold feelings in the legs

How Is Spinal Stenosis Diagnosed?

Spinal stenosis can be difficult to diagnose because its symptoms can be caused by other conditions. Usually, people who develop stenosis have no history of back problems or any recent injury. Often, unusual leg symptoms are a clue to the presence of spinal stenosis.

If simple treatments, such as postural changes or nonsteroidal anti-inflammatory drugs, do not relieve the problem, special imaging studies may be needed to determine the cause of the problem. An MRI (magnetic resonance image) or CT (computed tomography) scan may be requested. Amyelogram (an X-ray taken after a dye is injected into the spine) may be performed. These and other imaging studies can offer details about the bones and tissues and help with diagnosis.

How Is Spinal Stenosis Treated?

Spinal stenosis can be treated several ways. Treatment options include:

  • Changes in posture: People with spinal stenosis may find that flexing the spine by leaning forward while walking relieves their symptoms. Lying with the knees drawn up to the chest also can offer some relief. These positions enlarge the space available to the nerves and may make it easier for people with stenosis to walk longer distances.
  • Medications: In some cases, the pressure on the nerves is caused by inflammatory swelling. Nonsteroidal anti-inflammatory medications(NSAIDS) such as aspirin or ibuprofen may help relieve symptoms.
  • Rest: Rest, followed by a gradual resumption of activity, can help. Aerobic activity such as bicycling is often recommended.
  • Surgery: If other treatments do not ease the pain, surgery may be recommended to relieve the pressure on affected nerves.

Info by: http://www.webmd.com/back-pain/guide/spinal-stenosis

Spondylolisthesis

What is spondylolisthesis?

Spondylolisthesis is a condition in which one bone in your back (vertebra) slides forward over the bone below it. It most often occurs in the lower spine (lumbosacral area). In some cases, this may lead to your spinal cord or nerve roots being squeezed. This can cause back pain and numbness or weakness in one or both legs. In rare cases, it can also lead to losing control over your bladder or bowels. See a doctor right away if you begin losing bladder or bowel control.

Sometimes when a vertebra slips out of place, you may have no symptoms at all or no symptoms until years later. Then, you may have pain in your low back or buttock. Muscles in your leg may feel tight or weak. You may even limp.

What causes spondylolisthesis?

The bones in your spine come together at several small joints that keep the bones lined up while still allowing them to move. Spondylolisthesis is caused by a problem with one or more of these small joints that allows one bone to move out of line.

Spondylolisthesis may be caused by any of a number of problems with the small joints in your back. You could have:

  • A defective joint that you’ve had since birth (congenital).
  • A joint damaged by an accident or other trauma.
  • A vertebra with a stress fracture caused from overuse of the joint.
  • A joint damaged by an infection or arthritis.

Spondylolisthesis affects children and teens involved in sports. Some sports, such as gymnastics or weight lifting, can overuse back bones to the point of causing stress fractures in vertebrae, which can result in spondylolisthesis.

Older adults can develop spondylolisthesis, because wear and tear on the back leads to stress fractures. It can also occur without stress fractures when the disc and joints are worn down and slip out of place.

What are the symptoms?

Symptoms of spondylolisthesis may include:

  • Back or buttock pain.
  • Pain that runs from the lower back down one or both legs.
  • Numbness or weakness in one or both legs.
  • Difficulty walking.
  • Leg, back, or buttock pain that gets worse when you bend over or twist.
  • Loss of bladder or bowel control, in rare cases.

Sometimes spondylolisthesis causes no symptoms at all.

Info by: http://www.webmd.com/back-pain/tc/spondylolisthesis-topic-overview