Adult/Adolescent Correction of Spinal Deformities – Scoliosis
Scoliosis is a curvature of the spine to either side of the body. The curve can resemble a “C” or an “S.” This condition’s cause is often unknown and treatment is typically not needed. Care options depend on the patient’s age and the condition’s severity. Adolescents whose bones are still growing may benefit from the use of a brace to prevent the curve from becoming more acute. Surgery for adolescents aims at preventing later disfigurement and restriction of the heart and lungs. Surgeons will try to reduce curving and may opt for fusing vertebrae. Adult patients may experience discomfort. This is usually addressed with exercise, physical therapy and anti-inflammatory medicine. If surgery is needed, the doctors will try to realign the spine, which may require removing vertebrae, and may fuse vertebrae.
Degenerative Spinal Disease and Disc Herniation
The spine has vertebrae stacked atop one another. Sandwiched between each vertebra is a cushion – a disk of cartilage. These disks serve as shock absorbers. Each disk has a soft interior and firm exterior. Herniation occurs when the soft interior pushes through the firm exterior. This can irritate nerves in the spinal canal. That can result in pain, numbness and weakness in various body parts. Often, herniation occurs when disks lose flexibility from degeneration due to aging. As this happens, disks tend to tear or rupture. Fortunately, the overwhelming majority – 90 percent – of herniated discs do not require surgery. Instead, rest, physical therapy, over-the-counter pain medicine and alternate use of cold packs and heat are all that’s needed. If required, surgical options may include fusing vertebrae, laminectomy to enlarge the spinal canal or microdiskectomy to relieve pressure on an affected nerve.
This minimally invasive technique is used when a vertebra has a compression fracture, a type of vertical break. A surgeon makes a small skin incision and places a tiny tube through it. Using the tube and small instruments, the doctor makes a hole in the vertebra. He or she then inserts into the bone a balloon-like device at the tube’s end and gently makes a cavity in the vertebra with it. The physician removes the device and fills the cavity with a quick-drying, cement-like substance. This procedure relieves pain, stabilizes the break and allows for a quick return to normal activities.
Lumbar Disk Surgery
The lower five vertebrae of your backbone comprise the lumbar spine. Sometimes, the cartilage disks in this region are damaged, requiring medical attention. Up and down your spine, vertebrae are stacked atop one another. Sandwiched between each vertebra is a cushion – a disk of cartilage. These disks serve as shock absorbers. Each disk has a soft interior and firm exterior. Herniation occurs when the soft interior pushes through the firm exterior. This can irritate nerves in the spinal canal. That can result in pain, numbness and weakness in various body parts. In rare cases, a “ruptured disk” can affect bowel and bladder control. Herniation occurs for several reasons: aging, smoking, not exercising, driving a lot, improperly lifting heavy weights and repeated movements that stress the spine. Fortunately, most patients do not need surgery. Instead, rest, physical therapy, over-the-counter pain medicine and steroid injection aid recovery. Surgery usually involves a microdiskectomy to relieve pressure on an affected nerve. During this procedure, a surgeon removes the herniated part of the disk and any fragments in the area.
Minimally Invasive Spinal Surgery
This is one of the great advances of modern medicine. Minimally invasive surgery involves the use of tiny incisions and small viewing devices and instruments that allow surgeons to see and work within a patient’s body. These procedures replace open surgery, which involves large incisions. Compared to open surgery, minimally invasive operations allow for quicker healing, less muscle disruption and lower infection risks. Minimally invasive techniques are used for various spinal operations, including those for ruptured disks, scoliosis and compression fractures.
These injuries are serious and demand a physician’s care. They can also take many forms. For instance, a traumatic event like a car wreck or a fall can lead to fractures. Plus, young athletes are prone to stress fractures brought on by putting too much pressure on the lower back. Older adults may suffer from osteoporosis, which weakens vertebrae. Once this occurs, pressure on a fragile spine bone may cause a vertical break, known as a compression fracture. These injuries affect about 700,000 people annually. Because spinal fractures vary greatly, so do treatments, which depend on a break’s type, location, cause and severity. The mildest cases may heal with little more than rest, medication and perhaps the use of a brace. When surgery is needed, doctors want to fit bone together, allow early movement and relieve pressure on nerves and the spinal cord.
This occurs when the spinal canal narrows and the spinal cord and nerves are squeezed. The results vary with where the narrowing occurs. However, typical symptoms include a drop in endurance for walking or other activities, pain from standing too long, and numbness, tingling and weakness in the arms and legs. In rare cases, patients may experience reduced bowel and bladder control. Often, spinal stenosis comes with aging. Obesity, poor posture and high-impact sports may also cause it. In most situations, treatment is simple: rest, physical therapy, over-the-counter pain relievers and steroid injections. If needed, surgeons will widen the spinal canal to relieve pressure on the cord and nerves.
A spinal tumor is a growth in bone or in or near the spinal cord. These growths can be either cancerous or noncancerous. Symptoms vary, but back pain is a frequent one. Doctors use several approaches to get an accurate diagnosis. Both MRIs and CT scans are valuable medical tools, and biopsies are another option. Given the variety of spinal tumors and places they may grow, treatments range widely. Under the best circumstances, however, a tumor is easily reached and nowhere near a nerve. If this is the case, surgeons simply remove it. Radiation therapy may be used on inaccessible tumors or those close to nerves. Chemotherapy may also be appropriate.