Neck & Back Surgery

Overview

Definitions and Anatomy

The spine has many important roles in the human body. Not only does the spine protect the spinal cord, it also provides the support needed to walk upright. In addition, it supports the head and additional structures for your body and allows you to bend your torso.

The Main Sections of the Spine

Vertebrae

The spine has 33 doughnut-shaped bones called vertebrae. Each vertebra is assigned a letter and a number that identifies its location in the spine.

Discs

Between each pair of vertebrae is a spongy cartilage, or disc. Intervertebral discs act as shock-absorbing cushions. Spongy discs are located between the vertebrae.

Cervical

Commonly referred to as the neck. There are seven cervical vertebrae (doughnut-shaped bones) that connect the skull to the rest of the spine.

Thoracic

The spine’s thoracic section begins at the shoulders and extends down to the end of the rib cage. There are 12 vertebrae in the upper back, with shock-absorbing disks between them. Scoliosis commonly affects the thoracic section of the spine.

Lumbar

The lumbar section, or lower back, has five vertebrae. These vertebrae, separated by disks, are the largest in the spine. The lumbar section is also a common location for scoliosis to occur.

Sacrum

There are five vertebrae that join together to form the sacrum, a wedge- shaped part of the spine that rests at the top of the pelvis.

Coccyx

Often referred to as the tailbone, consists of four vertebrae.

Conditions

Cervical Spondylosis

Is a common degenerative condition of the cervical spine that is caused by age-related changes between the intervertebral disks (cushions between the vertebrae) and your facet joints (the small joints in the back of the neck). Clinical diagnosis usually involves several syndromes that are both distinct and overlapping in this cervical spondylosis. You may experience neck and shoulder pain, headaches, sub-occipital pain, radicular symptoms, and symptoms related to cervical spondylotic myelopathy (CSM). As disk degeneration occurs, mechanical stresses result in osteophytic bars (bone spurs), which form along the ventral aspect (front) of the spinal canal (tube containing the spinal cord).

Herniated Cervical Disc

The vertebrae of your neck are each separated by round, fluid filled soft discs that act like shock absorbers. As we age, these discs lose their flexibility and lose some of their fluid (dehydrated) thus rendering their ability to serve as a shock absorber diminished. Damage to your discs usually occurs from a degenerative process (aging and wear-and-tear), trauma, or an injury by mechanical means (twisting or lifting the improper way). Your discs will begin to show tiny cracks and tears in the outer layers and further may result in injuries to your spine. This is referred to as a herniated disc, which can press against the spinal cord or directly against spinal nerve roots. Pressure on the spinal cord and/or nerve roots can lead to numbness, pain, or loss of strength in the neck, shoulders, arms, chest, hands, and legs.

Herniated Lumbar Disc

Most disc herniations occur in one to two levels of your lumbar spine. The vertebrae of your lower back (lumbar) are each separated by round, fluid filled soft discs that act like shock absorbers. As we age, these discs lose their flexibility and lose some of their fluid (dehydrated) thus rendering their ability to serve as a shock absorber diminished. Damage to your discs usually occurs from a degenerative process (aging and wear-and-tear), trauma, or an injury by mechanical means (twisting or lifting the improper way). Your discs will begin to show tiny cracks and tears in the outer layers and further may result in injuries to your spine. This is referred to as a herniated disc, which can press against the spinal cord or directly against spinal nerve roots. Pressure on the spinal cord and/or nerve roots can lead to numbness, pain, or loss of strength in the neck, shoulders, arms, chest, hands, and legs. When a herniated lumbar disc presses on the nerves and spinal cord of your back, pain, tingling, numbness, or weakness may occur. This condition is called “Sciatica” and usually effects people between the ages of 30 and 50 years old.

Kyphosis

Kyphosis is a progressive spinal disorder that can affect children or adults. This disorder may cause a deformity described as humpback or hunchback. There a number of different forms of Kyphosis and vary based upon the amount of angulation and curvature. Kyphosis is most common in the thoracic or lower lumbar areas.

Lower Back Pain (Lumbar)

Acute or chronic low back pain is a very common symptom that will affect over 80% of all adults at some time in their lives. Lower back pain is the second most common reason for visits to a primary care physician’s office too. Pain in the low back or lumbar region may be caused by a variety of diseases and disorders that need an accurate diagnosis to treat the source of the pain. The most common causes of lower back pain include injuries to the ligaments, discs, muscles, compression of spinal nerves, and degenerative disc disease.

Neck Pain (Cervical)

Acute or chronic neck pain is a common ailment that frequents your primary care physicians office. Neck pain or Cervical pain may be caused by a variety of diseases and disorders that need an accurate diagnosis as many signs or symptoms can be mimicked by shoulder pain or arm pain. The most common causes of neck pain include injuries to the ligaments, discs, muscles, compression of spinal nerves, and degenerative disc disease.

Osteoporosis means “porous bone”

Is a progressive bone disease that occurs when the body loses too much bone, makes too little bone, or both. As a result, bones become weak and may break from a fall or, in serious cases, from sneezing or minor bumps. If you were to look under a microscope, normal, healthy bone looks like a honeycomb pattern. When osteoporosis occurs, the spaces and holes in the honeycomb are much larger than healthy bone. Ultimately, osteoporotic bones lose their structural strength, lose density, and lose their mass to support the bone, and are more likely to break. If you’re 50 or older and have broken a bone, ask your doctor or healthcare provider about a bone density test or DEXA scan.

Sciatica

Usually effects people between the ages of 30 and 50 years old and is best described as a set of symptoms that include pain, numbness, tingling, and/or burning that travels from the low back, down the buttock, and down the back of the thigh and leg. Sciatica can also radiate into the foot causing leg or foot weakness.

Scoliosis

Scoliosis is an abnormal curvature of the spine that can affect adults, adolescents, or children. If you were to look at an X-ray of the spine, the spine of an individual with scoliosis looks more like the letters “S” or “C” rather than a straight line. While it is unclear what actually causes scoliosis, there is definite agreement that it is more often diagnosed in females and that there seems to be a genetic component, meaning that you may be more likely to have scoliosis if others in your family are also affected.

Spinal Osteoarthritis (Lumbar Spondylosis)

Is a spinal degenerative disorder that may cause loss of normal spinal function and structure. The primary cause of degeneration is aging however it also depends upon the individual rate and location. Spondylosis can effect the cervical, thoracic, and/or lumbar regions of the spine affecting the intervertebral discs and facet joints.

Spinal Stenosis

Spinal stenosis refers to the narrowing of the spinal canal. This narrowing of the spinal canal causes a compression or pinching of the spinal cord or nerves within the spinal canal, which can in turn lead to pain in the back, buttocks, thighs, and legs, as well as an overall decrease in physical activity. Spinal stenosis can occur in the neck (cervical) or lower back (lumbar) areas and usually occurs from the degeneration of the aging spine.

Spondylolisthesis

Spondylo meaning spine, and listhesis meaning slippage is a slippage either forward or backward of one vertebrae relative to one another. Spondylolisthesis usually occurs in the lower back towards the base of your spine and is graded on the amount of slippage of the vertebrae. Spondylolisthesis occurs in approximately 5%-6% of males, and 2%-3% of females and becomes apparent more often in people who are involved with very physical activities such as weightlifting, gymnastics, or football. There are also a number of different types of Spondylolisthesis and symptoms usually are related to pain in the low back, especially after exercise, increased lordosis (ie, swayback), pain and/or weakness in one or both thighs or legs, reduced ability to control bowel and bladder functions and tight hamstring musculature. In cases of advanced spondylolisthesis, changes may occur in the way people stand and walk; for example, development of a waddling style of walking.

Sports-Related Neck & Back Injuries

Muscle Strains, Ligament Sprains, and strains usually occur when an already stretched muscle is suddenly forced to contract and shorten. This sudden contraction causes the muscle fibers to tear and injure. The possibility of a muscle strain increases significantly if there has been a previous injury to the same area. Therefore, it is important to warm up properly before exercising and to gradually increase your workload as doing too much too soon can cause a muscle strain too. Muscle strains are categorized as mild, moderate, or severe depending on the extent of the injury.

 

Strains and Sprains

  • A sprain is stretching or tearing of a ligament, the tissues that connect bones to other bones. Sprains will cause pain at or around the joint involved.

  • A strain is a stretching or tearing of a muscle or tendon. Tendons connect muscles to bones. Strains will cause pain and stiffness in the involved muscle or tendon.

Treatments

Anterior Cervical Decompression and Fusion ( ACDF )
Anterior Lumbar Interbody Fusion ( ALIF )
Cervical Disc Replacement Surgery (CDR)
Discectomy/Partial Discectomy
Kyphoplasty & Vertebroplasty
Lumbar Disc Replacement Surgery (LTDR)
Lumbar Laminectomy
Lumbar Microdiscectomy
Pain-Relief and Corticosteroid Injections
Posterior Lumbar Interbody Fusion ( PLIF )
Sacroiliac Joint Fusion (SI Fusion)
Sciatica Treatment
Scoliosis Treatment
Spinal Cord Stimulation/Neuromodulation Placement (SCS)
Transforaminal Lumbar Interbody Fusion ( TLIF )
Lateral Lumbar Interbody Fusion ( LLIF )