Spine Conditions and treatment

Spinal disc herniation or Slipped disc

Disc or intervertebral disc is a rubbery tissue present in between each spinal bones. They act like shock absorbers, aiding in movement of the spinal column. It has a soft central core and a tough fibrous outer ring. When the soft central core moves out through the outer fibrous ring, it is called disc herniation or disc prolapse. It usually happens due to degeneration (wear and tear) of the spine and discs. It is commonly seen in the lower back (lumbar) than in the neck and upper back(cervical and dorsal region).

Symptoms of disc herniation depends on the size, position, extent and relationship with the spinal nerves. It ranges from mild pain to severe ache, pain moving down the arm or leg, numbness of the limbs. In severe cases it may lead to weakness of the limbs, severe restriction of movements and even loss of bowel and bladder control.

Physical examination, MRI scan and electrical studies help in understanding the location, severity and extent of disc herniation and the treatment required. Treatment is tailored to patient’s symptoms and examination and scan findings. Bed rest, medicines to relax the muscles, pain killers and physiotherapy are advised for small disc herniations which does not cause significant compression of the neural tissues. Symptomatic patients with large disc herniation would require surgical treatment.

Microdiscectomy - is the removal of the protruding portion of the disc through a small opening. It involves minimal tissue dissection and bone removal leading to safe removal of the offending disc without damage or injury to the nerves or spinal cord. Minimally invasive procedures like disc preserving surgery and endoscopic discectomy are suitable for some patients.

After discectomy, individuals have relief of their symptoms, but may still require medication and physical exercises. In rare cases, if the spinal column is unstable, the surgeon would stabilize the spine with metal hardware along with discectomy.

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Traumatic spine injury

Spine injury can be caused by motor vehicle accidents, sports injuries, falls, assaults and industrial accidents. Injury may be limited only to the spinal bone or it may involve the spinal cord or nerves. Symptoms vary depending on the location of the injury, involvement of neural tissue etc. Surgical intervention is required if there is compression of the spinal cord or nerves. stabilization of the spine is indicated if the spine is unstable.

Spinal Tumors

Spinal tumors include tumors arising from spinal cord and those arising from the bone. spinal cord tumors are classified as benign or malignant. MRI imaging gives a detailed view of the tumor its extent and to an extent the nature of the tumor. Most of the spinal tumors require surgical excision. Outcome depends on the type of tumor and involvement of neural tissue. Radiotherapy or chemotherapy may be required for certain types of tumors.

Degenerative diseases of the spine

Spinal degenerative disease refers to any condition of the spinal column that results from the aging process and wear and tear that occurs to the bone and soft tissues of the spine. Spinal canal stenosis, disc herniation certain types of spinal instabilities are due to the degenerative process. Disease which is diagnosed early, can be managed conservatively while severe degenerative diseases causing neurological problems or chronic pain or instability needs surgical intervention.