Spine

 

Spine Anatomy

The spine also called the back bone is designed to give us stability, smooth movement as well as providing a corridor of protection for the delicate spinal cord.

It is made up of bony segments called vertebra and fibrous tissue called inter vertebral discs.

 

Conditions

Back Pain

The incidence of back pain has drastically increased. Approximately 90% of Americans experience back pain at different stages of their life. In America, the annual expenditure for the treatment of back pain is approximately $50 billion. Back pain is not a disease; rather it is a symptom due to an underlying pathology.

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Neck Pain

The cervical spine comprises of the first 7 vertebrae. It supports the weight of the head and allows its smooth movement. Neck pain refers to pain or discomfort resulting from abnormalities or injuries to any of the structures in the neck including the muscles, ligaments, nerves, bones and vertebral joints. Neck pain is one of the most common health problems experienced by individuals, at some point of their lives.

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Scoliosis

Scoliosis is a condition where the spine or back bone is curved sideways instead of appearing in a straight line. The most common type of scoliosis is adolescent idiopathic scoliosis which occurs after age 10 and is seen more frequently in girls than boys. Scoliosis can occur at any age, however, and the cause is not known in 80% of cases. This is referred to as idiopathic scoliosis. Your physician will investigate other possible causes before diagnosing you with idiopathic scoliosis.

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Cervical Radiculopathy and Myelopathy

The spine, also called the back bone, is designed to give us stability, smooth movement, as well as providing a corridor of protection for the delicate spinal cord. It is made up of bony segments called vertebrae and fibrous tissue called intervertebral discs. Disc protrusion, also called herniated disc, is a condition caused by a tear in an intervertebral disc allowing the disc contents to bulge out.

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Spondylolisthesis

The spine, also called the back bone, is designed to give us stability, smooth movement, as well as providing a corridor of protection for the delicate spinal cord. It is made up of bony segments called vertebrae and fibrous tissue called intervertebral discs. The vertebrae and discs form a column from your head to your pelvis providing symmetry and support to the body.

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Spine Deformities

Scoliosis is a condition characterized by abnormal curvature of the spine causing a deviation to one side. It causes a physical deformity making the spine look like the letter “C” or “S” instead of the letter “I”. Scoliosis can affect either the mid or the lower back but the scoliosis of the mid back is more common. Scoliosis can occur at any age.

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Degenerative Disc Disease

Degenerative disc disease (DDD) refers to gradual deterioration of the intervertebral discs between the vertebrae. DDD is a misnomer as it is not actually a disease but a condition that affects the strength, resiliency and structural integrity of the intervertebral discs due to advancing age, trauma, injury, repetitive movement, improper posture, or poor body mechanics. DDD is commonly seen in individuals over 50 years of age.

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Cervical Herniated Disc

Herniation of a disc is an anomalous spine condition characterized by leakage of the inner contents of the intervertebral disc, due to cracks in its outer wall. Herniated disc is commonly seen in the cervical or neck region, a condition called cervical herniated disc (CHD). CHD is followed by arm or neck pain that may arise due to compression of the spinal nerves by the protruding disc material.

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Cervical Spinal Stenosis

Spinal stenosis is a condition caused from the vertebral column constricting and exerting pressure on the spinal cord or neural foramen (a bony tunnel through which a nerve exits the spinal cord). It usually affects the cervical and lumbar spine. If the spinal canal is narrowed, the disorder is called cervical/lumbar central stenosis. If the foramen is narrowed, it is referred to as cervical/lumbar foraminal stenosis.

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Cervical Disc Protrusion

The spine, also called the back bone, is designed to give us stability, smooth movement, as well as providing a corridor of protection for the delicate spinal cord. It is made up of bony segments called vertebrae and fibrous tissue called intervertebral discs. Disc protrusion, also called herniated disc, is a condition caused by a tear in an intervertebral disc allowing the disc contents to bulge out.

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Cervical Spondylosis

Spondylosis is a degenerative disorder of the spine due to the ageing process which disrupts the normal structure and function of the spine. It affects all the different structural components of the spine including intervertebral discs, ligaments, bones and facet joints. It is also called osteoarthritis of the spine or degenerative joint disease (DJD).

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Adult Kyphosis

Kyphosis is an abnormal curving of the spine usually occurring in the thoracic region resulting in a round back or hunch back appearance. Kyphosis can also occur in the cervical and lumbar regions although this is less frequent.

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Scheuermann’s kyphosis

Scheuermann’s kyphosis causes hunch back in adolescents. Scheuermann’s kyphosis is not caused by poor posture but occurs due to an increased curvature of the thoracic spine. It is more common in adolescent boys than girls.

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Low back pain

Low back pain is the pain felt in the lower back that may originate from muscles, nerves, bones, joints or other structures in the spine. Low back pain is one of the most common medical problems experienced by most people at some time in their life. People with low back pain may have difficulty to perform everyday activities. Low back pain can be acute usually lasting from few days to few weeks, or chronic lasting for more than three months.

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Lumbar Herniated Disc

Herniated disc is a condition in which the outer fibers (annulus) of the intervertebral disc are damaged causing the soft inner material of the nucleus pulposus to rupture out of its space. A herniated disc, common in the lower back (lumbar spine) occurs when there is a tear in the outer lining of the disc (annulus fibrosus).

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Lumbar Stenosis

Lumbar stenosis refers to narrowing of the spinal canal in the lower back (lumbar) region which exerts pressure over the spinal cord resulting in low back and leg pain. Lumbar stenosis occurs due to the narrowing of the spinal canal or the neuroforamen, in the lower back region. Central canal stenosis occurs if the spinal canal is narrowed and foraminal spinal stenosis occurs due to constriction of the neuroforamen, on either side of the vertebrae.

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Lumbar Degenerative Disc Disease

Lumbar degenerative disc disease (DDD) is a common cause of low back pain. The vertebrae are cushioned by intervertebral discs which act as shock absorbers, for the spine. Over time, these natural shock absorbers wear out and degenerate due to aging, trauma or injury leading to DDD. Degenerative disc disease is not actually a disease but refers to the changes in the spine that occur as a part of the normal aging process.

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Piriformis Syndrome

Piriformis Syndrome is an uncommon rare neuromuscular condition caused by the compression of the sciatic nerve by the piriformis muscle. The sciatic nerve is a thick and long nerve that passes below or through the piriformis muscle and goes down the back of the leg and finally ends in the feet in the form of smaller nerves.

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Lumbar Radiculopathy (Sciatica)

Sciatica is a condition characterized by a group of symptoms caused by pressure or damage to the sciatic nerve. The sciatic nerve is one of the longest nerves in the body, extending from the lower back to the foot, passing through the buttock and the back of the leg.

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Ankylosing Spondylitis

The term ankylosis refers to loss of mobility of the spine, whereas spondylitis means inflammation of the spine. Therefore, ankylosing spondylitis is a condition where chronic inflammation of the spine and sacroiliac joint results in complete fusion of the vertebrae leading to pain and stiffness in the spine. Sacroiliac joints are located in the lower back where the sacrum part of the vertebrae joins the iliac bones.

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Procedures

Robotic Spine Surgery

Robotic Assisted Spine Surgery is a minimally invasive spine surgery where the surgeon is assisted by a robotic system (Da Vinci surgical system) to perform the surgery. Robotic systems are becoming increasingly popular in the medical fraternity owing to the unique advantages including the precision, safety and many other advantages. The da Vinci® robotic surgical system is one of the popular and widely employed robotic systems in the specialty of medicine and is used to perform various surgical procedures.

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Anterior Cervical Discectomy

The cervical spine is present in the neck region and supports the weight of the head. Soft pads or intervertebral discs, present between the adjoining vertebrae, act as shock-absorbers and assist in movements of the head. Each disc is composed of a soft inner core called the nucleus pulposus and the fibrous outer band called the annulus fibrosus.

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Anterior Cervical Discectomy with Fusion (ACDF)

Anterior cervical discectomy and fusion (ACDF) is a surgical procedure used in the management of spinal cord and nerve root compression secondary to certain disorders such as degenerative disc disease, herniated disc, spondylosis, and spinal stenosis. ACDF reduces the neck and arm pain and provides stability to the spine.

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Cervical Corpectomy

The cervical spine comprises the first 7 vertebrae of the spinal column. The vertebrae are separated from one another by shock absorbing pads called intervertebral discs. Over time, the discs can become worn out resulting in neck pain. Most patients with neck pain can be managed conservatively. However, surgery needs to be considered when the degenerative changes of the cervical spine exert excessive pressure on the spinal cord.

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Cervical Disc Replacement

Artificial cervical disc replacement surgery is an alternative to spinal fusion surgery, where the damaged intervertebral disc in the neck is removed and replaced with a disc implant. This surgery relieves neck pain as well as restores the normal range of motion of the neck.

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Cervical Foraminotomy

Cervical Foraminotomy is a surgical procedure to enlarge the neural foramina in the neck region. Cervical neural foramina are cavities in the cervical vertebrae which act as transits for the spinal nerves in the neck. Each cervical vertebra has two neural foramina, one on either side. Cervical foraminotomy is indicated in patients with excruciating arm pain due to radiculopathy (compression of the spinal nerves).

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Cervical Laminectomy

Cervical laminectomy is a surgical procedure involving the removal of a small portion of the lamina, the bone forming the roof of the spinal canal, to relieve pressure over the spinal cord due to cervical stenosis. Cervical stenosis is a spinal condition characterized by narrowing of the spinal canal in the neck. Cervical laminectomy is indicated in patients with cervical stenosis associated with myelopathy (compression of spinal cord).

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Cervical Laminoplasty

Laminoplasty is a surgical procedure performed to release pressure over the spinal cord and nerve roots. The lamina is a thin plate of bone located between the facet joints of the cervical (neck), thoracic (mid-back), and lumbar (low back) regions of the spine. The lamina protects the spinal canal that contains the spinal cord and its nerve roots.

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Minimally Invasive Cervical Discectomy

Your spine consists of 24 bones called vertebrae that are arranged one above the other and separated by intervertebral discs which act as shock absorbers during activity. Your neck or cervical area is made up of seven of these vertebrae. The intervertebral discs consist of 2 parts, namely annulus fibrosus (outer flexible ring) and nucleus pulposus (central soft jelly–like region).

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Multilevel Posterior Cervical Laminectomy and Fusion

Cervical stenosis refers to narrowing of the spinal canal in the neck region. This narrowing place pressure over the spinal cord resulting in neck pain. Other symptoms include lack of coordination, loss of balance during walking, tingling in the arms and/or legs, and even loss of bowel and bladder control. Some of the spinal conditions that may compress the spinal cord and nerve roots include disc degeneration, bulging or herniated disc, spinal stenosis, and spondylosis.

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Spine Osteotomy

Spine osteotomy is a surgical procedure in which a section of the spinal bone is cut and removed to allow for correction of spinal alignment. Spine osteotomy is usually needed for correction of severe deformed, rigid and fixed spinal deformity when nonsurgical treatments do not relieve symptoms such as numbness, weakness, or pain due to nerve compression or when deformity is getting worse over time. A mild or flexible deformity is usually corrected through positioning and instrumentation.

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Balloon Kyphoplasty

Balloon kyphoplasty is a minimally invasive surgical procedure that relieves the back pain caused by a vertebral compression fracture. It stabilizes the fracture and restores the vertebral body height.

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Lumbar Discectomy

Lumbar discectomy is a surgical procedure performed for the removal of a herniated or ruptured disc from the lumbar (lower) region. Intervertebral discs are fibrocartilaginous cushions between adjacent vertebrae. The normal intervertebral disc is composed of a semi-liquid substance (nucleus pulposus) at the center surrounded by a fibrous ring (annulus fibrosis). A herniated disc, also known as a bulging disc, is a condition in which the inner gelatinous substance of the disc is forced out through a tear in the outer, fibrous ring (annulus fibrosus).

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Lumbar Laminectomy

Lumbar laminectomy is a surgical procedure to relieve the pressure over the spinal nerves which results in pain and numbness in the legs. The narrowing of the spinal canal can occur either due to wear and tear or degenerative changes of the different parts of the spine. This results in a condition known as spinal stenosis. Laminectomy involves the complete removal of the lamina, a small bony plate covering the spinal canal. Laminectomy is another spinal decompression surgical procedure in addition to foraminotomy and facetectomy.

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Spinal Fusion

Spinal fusion is the surgical technique of combining two or more vertebrae. Fusion of the vertebrae involves insertion of secondary bone tissue obtained either through auto graft (tissues from the same patient) or allograft (tissues from the other person) to augment the bone healing process.

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