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Spine Care and Treatments

Understanding the Different Spine Conditions and Procedures Available to You

The spine is one of the most important and heavily used parts of the body. It plays a vital role in overall health and quality of life. The spinal column is the body’s central support structure, carrying the weight of the head, torso, and arms. It allows people to stand upright, bend, twist, and move in any direction they please. Even more importantly, the spinal column houses the body’s spinal cord.

Spine health is essential to maintaining an active lifestyle without back pain. Developing the habits of exercising, sustaining a healthy weight, avoiding smoking, and proper posture are all good behaviors to incorporate into our daily lives to increase our spine health. Patients throughout Birmingham and Hoover, Alabama, who believe their spine health is declining can receive comprehensive care from the board-certified orthopedic spine specialists at Southlake Orthopaedics.

Spine Conditions Requiring Orthopedic Care

The spine is comprised of 33 individual bones called vertebrae. Each vertebra is stacked one on top of the other. Ligaments and muscles connect bones and keep them aligned. When viewed from the side, an adult spine has a natural S-shaped curve. The curves work like a coiled spring to absorb shock, maintain balance, and allow a range of motion throughout the spinal column.

Given the complexity of the spine, it’s susceptible to a variety of health concerns that require expert medical attention. Patients can receive the care they need for the following types of spine injuries and illnesses:

Acute, Mechanical, Neck Pain

Acute, mechanical neck pain is defined as episodes of pain lasting less than three months and not associated with a neurological injury. Episodes are treated with rest and over-the-counter medications. When pain persists and impacts a patient’s ability to function, many nonsurgical treatment options exist to treat the condition, including physical therapy, chiropractic care, acupuncture, prescription medications, and injections.

Patient clenching back of neck in pain

Cervical radiculopathy, better known as a pinched nerve, results in pain that radiates from the neck and shoulder to down the arm. Treatment options depend on the severity of the pain, although many patients improve with time. The best course of action is determined after a thorough medical evaluation.

Cervical fractures are normally the result of traumatic injury. They commonly occur while driving, diving, or playing high-impact sports. Any type of injury to the cervical spine is serious, especially if it damages the spinal cord. Surgical intervention may be required to treat a break in one or more cervical vertebrae. One common procedure is known as the anterior cervical discectomy and fusion.

Diagram of segments of the spine

Fracture of the Thoracic and Lumbar Spine

Any fracture in the thoracic or lumbar spine could jeopardize the spinal cord’s ability to conduct nerve signals from the brain to the rest of the body. Therefore, immediate medical attention is required. Symptoms often include numbness, muscle weakness, and an inability to control the bowels and bladder.

When a patient experiences arthritis of the neck, it’s referred to as cervical spondylosis. Typically, nonsurgical measures are taken to treat this condition. Physical therapy, rest from aggravating activities, and medications are often prescribed to alleviate the pain. In other cases, physician-administered injections, such as an epidural block or facet joint block, are used to provide relief. Patients should always discuss the risks and benefits with their physician.

In cases of cervical spondylotic myelopathy, the spinal cord is slowly compressed. That interrupts the cable of nerves that send and receive signals from the body to the brain, leading to several concerning symptoms. Surgery is often needed to relieve the symptoms brought on by spinal cord compression.

Spinal discs experience wear and tear with age, leading to flattening, bulging, and similar concerns. That is degenerative disc disease. Many patients experience chronic or intermittent neck and back pain that radiates to other areas of the body or worsens with certain motions, such as bending or twisting. Others develop bone spurs, which cause spinal compression that may lead to numbness and tingling in the arms and legs, loss of bladder or bowel function, or difficulty walking.

Intervertebral discs separate each of the vertebrae in the spinal column. Discs are made up of a ring of fibrous tissue surrounding a nucleus. The primary job of the discs is to absorb the shock of activity.

Discs can become herniated. That means the nucleus of cushioning jelly presses through a tear in the outer ring of fibrous tissue and begins to press on the extremely sensitive spinal nerves. Many treatment options exist, including physical and occupational therapy and epidural injections. Depending on the severity of the herniation, surgical intervention may be necessary. 

Osteoporosis

Osteoporosis is a common condition that weakens the bones without any actual symptoms. However, osteoporosis-weakened vertebrae are at a high risk for injuries. That’s because bone mineral density decreases, causing bones to become brittle. Injuries for patients with osteoporosis can occur during everyday activities, such as bending, reaching, and even sneezing. Southlake Orthopaedics offers many treatment options for relieving pain related to osteoporosis in the Osteoporosis Clinic.

Two people walking in a park while holding hand weights
Physician consulting with patient on back pain caused by scoliosis

A healthy spine has three natural curves forming an S-shape: an inward curve at the neck, an outward curve at the upper back, and an inward curve at the lower back. When the natural S-shape is distorted by a side-to-side curve, it is called scoliosis. The cause of this spine condition remains unknown, although evidence suggests that it runs in families. If left uncorrected, it can lead to chronic and severe back pain in adults.

As part of the natural aging process, changes in the shape and size of the spinal canal can occur. If the canal narrows, it can put pressure on spinal nerves or even the spinal cord itself. If this happens, it’s what’s known as lumbar spinal stenosis. The result is often many painful symptoms. While nonsurgical methods do not improve the actual narrowing of the spinal canal, they can help relieve pain associated with the condition. There are two main surgical options to treat lumbar spinal stenosis: laminectomy and spinal fusion.

Image depicting healthy spine, spondylolysis, and spondylolisthesis

Spondylolysis and spondylolisthesis are two of the most common causes of lower back pain in adolescent athletes. Spondylolysis is a deformity in a vertebra caused by a stress fracture. Spondylolisthesis occurs when the stress fracture weakens the bone so that it shifts out of its proper position. If the condition worsens over time, or if symptoms are not alleviated using nonsurgical treatment, spinal fusion surgery may be needed.

Spine Surgery Procedures For Common Spine Conditions

Southlake Orthopaedics is a complete center for orthopedic services and utilizes advanced medical technology to deliver a range of treatments. Solutions include:

Anterior cervical discectomy and fusion refers to several surgeries for treating damaged intervertebral discs. Discectomy is the removal of a herniated disc, while fusion involves placing a bone graft where the disc was removed to ensure spinal stability. Cervical means the uppermost area of the spine, around the neck. The main reason for ACDF surgery is cervical radiculopathy, which is primarily caused by cervical disc herniation and cervical spondylosis.

During a laminectomy, the surgeon removes the lamina. These are bony arches protruding from the spine and putting pressure on the spinal cord. That can result in pain, numbness, and weakness. A laminectomy provides more space in the spinal canal, reducing pressure and pain. Herniated discs, spinal stenosis, and degeneration/arthritis of the spine are just some of the conditions surgeons use laminectomy to treat.

Lumbar disc microsurgery removes a damaged portion of an intervertebral disc. That helps relieve radiculopathy and other symptoms. If conservative approaches for treating a herniated disc are ineffective, doctors may recommend lumbar disc microsurgery. It can also treat lumbar disc rupture, a complication of disc herniation.

With lumbar spinal fusion, the surgeon fuses two or more bones to prevent them from shifting and causing back pain. The procedure helps stabilize the back, reshape the spine, and alleviate symptoms like pain, numbness, and weakness. There are several approaches to lumbar spine fusion, such as ALIF, PLIF, and XLIF.

Anterior lumbar interbody fusion connects two or more vertebrae in the lower back using a bone graft. ALIF restricts the movement of vertebrae, which causes pain, and helps stabilize the spine.

Posterior lumbar interbody fusion is similar to ALIF surgery, but the surgeon accesses the spine by making an incision on the back. Screws or rods are added to stabilize the spine.

gentleman experiencing back pain that required Posterior Lumbar Interbody Fusion surgery

Lateral lumbar interbody fusion, or extreme lateral interbody fusion, is a minimally invasive procedure where the surgeon accesses the spine from the side instead of the back or abdomen. This approach eliminates disruption to the muscles and surrounding tissues, reducing pain and allowing for smoother recovery times.

If a patient has chronic pain that has not subsided with other treatments, surgeons may perform spinal cord stimulator implant surgery. This procedure involves placing a spinal cord stimulator inside the body that emits low levels of electricity directly to the spinal cord. This stimulator disrupts pain signals, preventing the brain from receiving them. That can work to relieve pain.

Why Choose Southlake Orthopaedics for Spine Procedures and Conditions

At Southlake Orthopaedics, patients receive complete orthopedic care from diagnosis to surgery to rehabilitation. The board-certified physicians deliver compassionate and personalized care to patients of all ages throughout central Alabama. With an on-site osteoporosis clinic, prosthetics and orthotics lab, and in-house physical therapy department, patients find the orthopedic care they need at Southlake Orthopaedics.

Receive Care from Orthopedic Spine Specialists in AL

Patients suffering from a variety of spinal conditions can find expert medical care at Southlake Orthopaedics. With locations in Hoover and Birmingham-Grandview, AL, our team of board-certified spine and orthopedic specialists is proud to provide comprehensive, personalized orthopedic care. We have helped countless patients find relief through several advanced treatment methods, including surgery and rehabilitation. For more information about our services and our commitment to Less Pain, More Living, contact us today.

FRACTURES

FRACTURE OF THE CERVICAL SPINE

There are seven bones in your neck that support your head. These are your cervical vertebrae. Any break in your cervical spine is serious, especially if it damages your spinal cord which is the conductor of nerve signals between the brain and body. If the spinal cord is compromised at the neck, it can result in paralysis from the neck down.

Cervical fractures are normally the result of traumatic injury, accidents that commonly occur while driving, diving, or playing high-impact sports. Wearing your seat belt, avoiding diving into shallow areas, and wearing the proper equipment for your sport are all important safety precautions when it comes to protecting your cervical vertebrae.

Should you experience a break in one or more cervical vertebrae, surgical intervention may be required. One common procedure is known as the Anterior Cervical Discectomy & Fusion.

FRACTURE OF THE THORACIC AND LUMBAR SPINE

In addition to the cervical vertebrae in the neck, there are twelve thoracic vertebrae which span from your shoulders to the end of your rib cage. Below these vertebrae are the five lumbar vertebrae of your lower back.

Any fracture in the thoracic or lumbar spine is significant due to the fact that it could jeopardize the spinal cord’s ability to conduct nerve signals from the brain to the rest of the body. When you experience a traumatic injury to your back, especially if you notice numbness, muscle weakness, or that your can’t control your bowels and bladder, you should seek immediate medical attention.

VERTEBRAL COMPRESSION FRACTURES AND OSTEOPOROSIS

Osteoporosis is a common condition that weakens your bones. Unfortunately, there are no actual symptoms. There are only outward signs such as the classic “dowager’s hump” where the back becomes rounded due to weakened vertebrae, and sometimes becoming shorter over time.

Osteoporosis-weakened vertebrae are at a high risk for vertebral compression fractures, because as the bone mineral density decreases, bones become brittle. When pressure is placed on a brittle vertebra, it cracks and collapses, becoming compressed. Vertebral compression fractures can occur when you are doing everyday activities, such as bending, reaching, and even sneezing.

Fortunately, many treatment options exist for relieving the pain related to a compression fracture. You should see your physician for a full evaluation.

Image depicting healthy spine, spondylolysis, and spondylolisthesis

SPONDYLOLYSIS AND SPONDYLOLISTHESIS

These tongue-twisting names are two of the most common causes of lower back pain in the adolescent athlete. Spondylolysis (spon-dee-low-lye-sis) is a deformity in a vertebra caused by a stress fracture. As opposed to fractures brought on by a distinct traumatic event, a stress fracture is caused by repeated and unusual pressure on a bone.

If the stress fracture weakens the bone so that it shifts out of its proper position, a related condition called spondylolisthesis (spon-dee-low-lis-thee-sis) occurs. Spondylolisthesis can eventually cause nerve impingement so severe that surgery may be required to alleviate the pain.

Taking a break from activities that aggravate the pain can sometimes help, as can anti-inflammatories. Sometimes, a back brace can assist in resting the spine enough to alleviate the pain.

If the vertebral slippage worsens over time, or if back pain does not respond to nonsurgical treatment, spinal fusion surgery may be needed.

HERNIATED DISC

The intervertebral discs separate each of the vertebrae in the spinal column. These discs act both as a joint to allow movement and as a ligament to hold the adjacent vertebrae together. Discs are made up of a ring of fibrous tissue surrounding a nucleus that is the consistency of jelly. The primary job of the nucleus is to absorb the shock of our activity, cushioning the bony vertebrae as they are stacked on top of each other.

Sometimes, your disc can become herniated. In other words, the nucleus of cushioning jelly presses through a tear in the outer ring of fibrous tissue and begins to press on the extremely sensitive spinal nerves. Depending on the area where the disc lies, you may experience pain in your back, or it may travel sharply down your leg or arm. It can also cause muscle weakness or interfere with your bladder and bowel control.

Depending on the severity of the herniation, you may be able to recover without surgical intervention. Professional physical and occupational therapy can be a key not only to healing, but to preventing recurrence of the injury. Epidural injections may also be used to lessen nerve irritation and allow more effective participation in physical therapy. This type of injection is usually administered at an outpatient surgery center using x-ray guidance.

SPINAL STENOSIS

The spinal canal is the empty space (foramen) in the center of each vertebra. The spinal cord passes through this space as the main trunk of nerve activity, with nerves branching through the vertebrae to pass information to and from the body and brain.

Changes in the shape and size of the spinal canal can happen over time as a part of the natural aging process. When the canal narrows, it can put pressure on your spinal nerves, or even the spinal cord itself. This condition is called lumbar spinal stenosis. When your spinal nervous system is compromised, many painful symptoms can occur:

Although nonsurgical methods do not improve the actual narrowing of the spinal canal, many people report that physical therapy, anti-inflammatory medications and steroid injections are effective in relieving pain.

There are two main surgical options to treat lumbar spinal stenosis: Laminectomy and Spinal Fusion. Be sure to discuss the advantages and disadvantages of both procedures with your doctor.

SCOLIOSIS

Everyone’s spine has a natural s-shaped curve, rounding our shoulders and bending slightly inward at the waist. When that arc is distorted by a side to side curve, it is called scoliosis. Unlike slumping or sway-back, these curves cannot be corrected with attention to posture.

Though the cause of scoliosis is not usually known, it does tend to run in families. Generally it develops in childhood. If it is allowed to progress uncorrected, it can lead to chronic and severe back pain in adults.

Parents should keep an eye out for proper development in their children, looking for indications of unevenness in the shoulders or waist, prominence in the shoulder blades, or leaning to one side. Any one of these signs warrant an examination by your family physician, a pediatrician, or an orthopaedist.

You may need a brace to keep the condition from progressing. Your orthopaedist will recommend the best type of brace for you.

CERVICAL RADICULOPATHY (PINCHED NERVE)

Pain that radiates from the neck and shoulder down the arm is often due to an injury at the root of a nerve. Commonly called a “pinched” nerve, the term for this condition is called cervical radiculopathy.

Most patients with cervical radiculopathy get better with time. Treatment options depend upon the severity of your pain, presence of weakness or any evidence of spinal cord compression. The procedure that is right for you will depend on many factors, and is best determined after a thorough medical evaluation.

CERVICAL SPONDYLOSIS (ARTHRITIS OF THE NECK)

Arthritis of the neck is referred to as cervical spondylosis. Although it is a form of arthritis, which is painful, cervical spondylosis rarely results in disability.

Typically, treatment for cervical spondylosis is not surgical. Physical therapy, rest from aggravating activities, and medications can often help alleviate your pain. For some, physician-administered injections such as an epidural block or facet joint block can bring relief.

Although less invasive than surgery, steroid-based injections are prescribed only after a complete evaluation by your doctor. Before considering these injections, discuss with your doctor the risks and benefits of these procedures for your specific condition.

CERVICAL SPONDYLOTIC MYELOPATHY (SPINAL CORD COMPRESSION)

As you age, normal wear-and-tear on the vertebrae in your neck can lead to a narrowing of the spinal canal, which in turn presses upon the spinal cord. Several conditions can cause CSM. Rheumatoid arthritis, cervical disc degeneration, and injury are typical sources of spinal cord compression. Less common causes of CSM include tumors, infections, or congenital abnormalities of the vertebrae.

In CSM, as the spinal cord is slowly compressed, the cable of nerves that send and receive signals from the body to the brain is interrupted. This may cause disconcerting symptoms such as: tingling and numbness, trouble lifting objects, a tendency to drop things, difficulty walking, balance and coordination problems, and clumsiness.

Surgery is often required to relieve CSM. However, many conditions can mimic those of CSM. A thorough evaluation by your physician should be done to accurately diagnose CSM and determine the need for surgery.