The major column of nerve tissue that is connected to the brain and lies within the vertebral canal and from which the spinal nerves emerge. Thirty-one pairs of spinal nerves originate in the spinal cord: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal. The spinal cord and the brain constitute the central nervous system. The spinal cord consists of nerve fibers that transmit impulses to and from the brain.
While there are many issues that may result in back pain, most of patients suffer from the following disorders:
Your spine's natural curves help balance your body, however, if the curves become too pronounced, or if your spine develops a twist or an extra curve, it puts extra pressure on the vertebrae and discs.
Abnormal curvatures include:
Scoliosis – a side-to-side curve in your back Kyphosis – increased curve ("hump") in your upper back Lordosis – increased curve in your lower back ("swayback")
Degenerative disc disease (DDD) is used to describe changes of the
spinal discs – most commonly thinning, hardening and drying out. Disc degeneration can result from normal aging or wear-and-tear, but can start or accelerate because of injury, disease or unusual stress. Degenerated discs can irritate the spinal nerves and cause instability.
If the outer wall of a spinal disc weakens, it may push out, or bulge, toward the nerves. This can cause painful nerve irritation.
If the outer wall of a spinal disc tears (ruptures), the soft material inside the disc can squeeze out and press on nearby nerves. This can cause pain, numbness or weakness in your legs or back.
Vertebrae that crack or break can be caused by an injury, repeated stress or a condition like osteoporosis, which can make bones weak and brittle.
Spinal instability is when adjoining vertebrae slip back and forth, or have permanently shifted out of position. This instability can be caused by a damaged spinal disc, a bone injury, arthritis in the facet joints, or just something you were born with.
Stenosis is a narrowing of the spinal canal. Stenosis can press on the spinal cord and nerves and cause pain and other symptoms.
All of the conditions described above can irritate or press on (pinch) the spinal cord or nerves. This can cause pain, numbness, weakness and other problems throughout your body. Common examples include leg or arm pain when problems are related to the lower spine or neck
Treatment plans include surgical and non-surgical options and sometimes a combination of both.
Most back and spine patients will not require surgery and there are numerous non-operative treatments that can help spine patients avoid, or delay surgery. For patients who do require surgery, there is good news too; advanced tools, techniques, equipment and implants are available, including minimally invasive spinal surgery to help correct your back pain.
In thissurgery spinal bones, called vertebrae,are joined together. This limits the motion between them and how far your nerves can stretch. But it won’t limit your activity.
In this procedure, a surgeon removes parts of the bone, bone spurs, or ligaments in your back. This relieves pressure on spinal nerves and can ease pain or weakness. It can make your spine less stable. If that happens, you’ll probably need a spinal fusion. Doctors sometimes do the two procedures together.
The surgeon cuts away bone at the sides of your vertebrae to widen the space where nerves exit your spine. The extra room may relieve pressure on the nerves and ease your pain. Like a laminectomy, this procedure can also make your spine less stable. So the surgeon may do a spinal fusion at the same time. That’ll increase the amount of time you need for recovery.
Sometimes a disk, the cushion that separates your vertebrae, can slip out of place, press on a spinal nerve, and cause back pain. In a diskectomy, the surgeon removes all or part of the disk. He may have to make a big cut in your back, or he may be able to do it through a small one. Sometimes it’s part of a larger surgery that includes laminectomy, foraminotomy, or spinal fusion.
A surgeon removes the damaged spinal disk and inserts an artificial one between your vertebrae. Unlike fusion, this lets you continue to move your spine. Recovery time may be shorter than for a spinal fusion, too. But there is a slight chance the new disk could slip or fall out of place and require repair.
The surgeon implants a U-shaped device between two vertebrae in your lower back. It helps keep the space between them open and eases pressure on your spinal nerves. It can be done at the same time as a laminectomy. Unlike spinal fusion, the implant provides stability and lets you move your back almost like normal. You may not be able to bend backward as easily in that area.