- Anatomy of the spine
The spine is made of 33 individual bony vertebrae stacked one on top of the other. This spinal column provides the main support for your body, allowing you to stand upright, bend, and twist, while protecting the spinal cord from injury. Strong bones and muscles, flexible tendons and ligaments, and sensitive nerves contribute to a healthy spine.
- Anterior cervical discectomy and fusion (ACDF)
Anterior cervical discectomy and fusion is a surgery to remove a herniated or degenerative disc in the neck. An incision is made in the throat area to reach and remove the disc. A graft is inserted to fuse together the bones above and below the disc. ACDF may be an option if physical therapy or medications fail to relieve your neck or arm pain caused by pinched nerves. Patients typically go home the same day.
- Anterior lumbar interbody fusion (ALIF)
Anterior lumbar interbody fusion is a surgery to treat disc problems in the low back. Fusion locks together two or more bones to stop painful motion and correct their alignment. Through an incision in the front of the belly, the disc is removed. A bone graft is placed in the empty space to restore the height and relieve nerve pinching. During healing, the bones fuse into one solid piece.
- Artificial disc replacement (cervical arthroplasty)
Artificial disc surgery replaces a worn-out disc in the spine with a device that moves like a natural disc. The device is made of metal plates with a ceramic or polymer core that flexes or glides. It's an alternative to spinal fusion, which stops all motion at the disc. The benefit of an artificial disc is less stress on adjacent discs compared to fusion. But it is not for those with facet joint arthritis or weak bones.
- Axial lumbar interbody fusion (AxiaLIF)
AxiaLIF is a minimally invasive spinal fusion to treat disc problems in the low back. Fusion stabilizes the spine to stop the painful motion and decompress pinched nerves. Through a small incision at the tailbone, the damaged disc is removed and a rod placed to correct the spacing between the vertebrae. During healing, the bones will fuse together. The back muscles are avoided, so recovery is quicker.
- Back pain
Back pain results when the spine is stressed by injury, disease, wear and tear, or poor body mechanics. Acute low back pain is abrupt, intense pain that subsides after a period of days or weeks. It typically resolves with rest, physical therapy, and other self-care measures. You play an important role in the prevention, treatment, and recovery of back pain. Chronic pain that persists may need further evaluation.
- Cauda equina syndrome
Cauda equina syndrome is a rare condition most often caused by a large disc herniation in the lower back that compresses the nerve roots at the end of the spinal cord. Sudden back pain with numbness in the genital area, difficulty urinating, and weakness in the legs is a medical emergency. Prompt surgery to relieve the pressure may prevent permanent damage and restore bladder and bowel function.
- Coccydynia (tailbone pain)
Coccydynia is tailbone pain at the bottom of the spine, an area called the coccyx. The pain can be caused by a fall, childbirth, excessive sitting, or, in rare cases, a tumor. Diagnosis often involves ruling out other conditions that cause pain near the coccyx. A coccyx injury may take weeks to months to heal. Most patients recover by sitting on a shaped cushion, physical therapy, and steroid joint injections.
- Degenerative disc disease
Degenerative disc disease affects the discs that separate the spine bones. As you age, the spine begins to show signs of wear and tear as the discs dry out and shrink. These age-related changes can lead to arthritis, disc herniation, or stenosis. Pressure on the spinal nerves may cause pain. Physical therapy, self-care, medication, and spinal injections are used to manage symptoms. Surgery may be an option if the pain is chronic.
- Facet joint syndrome, arthritis
Facet joint syndrome is an arthritis-like condition of the spine that can be a significant source of back and neck pain. It is caused by degenerative changes to the joints between the spine bones. The cartilage inside the facet joint can break down and become inflamed, triggering pain signals in nearby nerve endings. Medication, physical therapy, joint injections, nerve blocks, and nerve ablations may be used to manage symptoms.
- Herniated cervical disc
A herniated disc occurs when the gel-like center of a disc ruptures through a weak area in the tough outer wall. Neck or arm pain, numbness or tingling may result when the disc material compresses a spinal nerve. Treatment with medication, spinal injections, and physical therapy is the first step to recovery. Most people improve in 6 weeks and return to normal activity. If symptoms continue, surgery may be an option.
- Herniated lumbar disc
A herniated disc occurs when the gel-like center of a disc ruptures through a weak area in the tough outer wall. Back or leg pain, numbness or tingling may result when the disc material compresses a spinal nerve. Treatment with medication, spinal injections, and physical therapy is the first step to recovery. Most people improve in 6 weeks and return to normal activity. If symptoms continue, surgery may be an option.
- Lateral lumbar interbody fusion (LLIF)
Lateral interbody fusion is a minimally invasive surgery to treat disc problems in the low back. In spinal fusion, two or more bones of the spine are joined to stop painful motion, decompress pinched nerves, and correct scoliosis. Through a small incision at the side of the waist, the disc is removed and a bone graft is inserted to restore the height and relieve nerve pinching. During healing, the bones will fuse together.
- Lumbar discectomy
Lumbar discectomy is a surgery to remove a herniated or degenerative disc in the lower spine. The incision is made posterior, through the back muscles, to reach and remove the disc pressing on the nerve. Discectomy may be recommended if physical therapy or medication fail to relieve leg or back pain caused by pinched spinal nerves. The surgery can be performed in an open or minimally invasive technique.
- Neck pain
Neck pain results when the spine is stressed by injury, disease, wear and tear, or poor body mechanics. Acute neck pain is abrupt, intense pain that can radiate to the head, shoulders, arms, or hands. It typically subsides with rest, physical therapy, and self-care measures. You play an important role in the prevention, treatment and recovery of neck pain. Chronic pain that persists may need further evaluation.
- Pain pump (intrathecal)
Intrathecal drug delivery, or "pain pump," is a method of giving medication directly to your spinal cord. The system uses a small pump that is surgically placed under the skin of your abdomen and delivers medication through a catheter to the area around your spinal cord – similar to an epidural that women may have during childbirth. Because the medication is delivered directly to the spinal cord, your symptoms can be controlled with a much smaller dose than is needed with oral medication.
- Posterior cervical surgery
Posterior cervical surgery occurs in the back of the neck to relieve pressure on the nerves or spinal cord. The surgery may involve a single-level discectomy and foraminotomy or may be a more complex multi-level laminectomy and fusion. The surgery can be performed open or minimally invasive.
- Preparing for lumbar spinal fusion
Spinal fusion is a surgery that permanently joins together one or more bony vertebrae of the spine. Abnormal movement of the vertebrae rubbing against one another may result in back, leg, or arm pain. Fusing the vertebrae bones together stabilizes and aligns the spine, maintains the normal disc space between the bones, and prevents further damage to the spinal nerves and cord.
- Q&A: Adjacent segment disease and spinal surgery
Adjacent segment disease is a condition that sometimes occurs after a spinal fusion surgery. Fusion joins or “locks” two or more bones together, stopping the natural motion at that level. While the goal is to relieve painful motion, fusion causes the adjacent discs to work harder. Similar to a domino effect. Degenerative changes can develop on the discs and joints above or below the previous surgery site.
- Sacroiliac joint pain
Sacroiliac (SI) pain is felt in the low back and buttocks. The pain is caused by damage to the joint between the spine and hip. Sacroiliac pain can mimic other conditions, such as a herniated disc or hip problem. Accurate diagnosis is important to determine the source of pain. Physical therapy, stretching exercises, pain medication, and joint injections are used first to manage the symptoms. Surgery can fuse the joint.
- Sciatica (leg pain)
Sciatica is a term used to describe leg pain that radiates from your back into your buttock, and down the back of your leg. It is a general term used to describe symptoms rather than an actual physical condition. Typically the pain is caused by pressure on the nerve roots in your lower back. Doctors often call it lumbar radiculopathy, meaning that the pain begins in the spinal nerve roots and "radiates" to your leg. Depending on the cause, acute sciatica typically resolves with rest, exercise, […]
- Spinal cord stimulation
Spinal cord stimulation delivers low voltage current to block the feeling of pain. A small device implanted in the body transmits an electrical current to the spinal cord. When turned on, the stimulation feels like a mild tingling in the area where pain is felt. It helps patients with chronic pain better manage symptoms and potentially decrease use of pain medications.
- Spinal decompression, Laminectomy
Decompression surgery (laminectomy) removes the bony roof covering the spinal cord and nerves to create more space for them to move freely. Narrowing / stenosis of the spinal canal can cause chronic pain, numbness, and muscle weakness in the arms or legs. Surgery may be recommended if your symptoms have not improved with physical therapy or medications.
- Spinal deformity, Scoliosis
Spinal deformity is an abnormal alignment or curve of the bony vertebral column. Adult scoliosis and kyphosis can be caused by age-related wear and tear on the back or complications from past surgeries. Moderate deformity occurs when the facet joints and discs deteriorate over time and are no longer able to support the spine's normal posture. Pain results from stressed joints and pinched nerves, not the abnormal curve. Treatment can include medications, physical therapy, injections, or surgery.
- Spinal fractures
A fracture of a vertebra can cause bone fragments to pinch and damage the spinal nerves or spinal cord. Most spinal fractures occur from car accidents, falls, gunshot, or sports. Injuries can range from mild ligament and muscle strains, to fractures and dislocations of the bones, to debilitating spinal cord damage. Many fractures heal with conservative treatment; some may require surgery to realign the bones.
- Spinal stenosis
Spinal stenosis is the narrowing of your spinal canal and nerve root canal along with the enlargement of your facet joints. Most commonly it is caused by osteoarthritis and your body's natural aging process. As the spinal canal narrows, there is less room for your nerves to branch out and move freely. As a result, they may become swollen and inflamed, which can cause pain, cramping, numbness or weakness in your legs, back, neck, or arms. Mild to moderate symptoms can be relieved with […]
- Spondylolysis and spondylolisthesis
Spondylolysis (spon-dee-low-lye-sis) and spondylolisthesis (spon-dee-low-lis-thee-sis) are conditions that affect the moveable joints of the spine that help keep the vertebrae aligned one on top of the other. Spondylolysis is actually a weakness or stress fracture in one of the facet joints. This weakness can cause the vertebrae to slip forward out of their normal position, a condition called spondylolisthesis. Treatment options include physical therapy to strengthen the muscles surrounding the […]
- Transforaminal lumbar interbody fusion (TLIF)
Transforaminal lumbar interbody fusion is a surgery used to treat disc problems in the low back. Fusion locks together two or more bones to stop painful motion, relieve pinched nerves, and correct scoliosis. Through small, minimally invasive incisions in the back, the disc is removed. A bone graft spacer is placed in the space to restore the height and relieve nerve pinching. During healing, the bones fuse together.
- Vertebroplasty & kyphoplasty
Vertebroplasty and kyphoplasty are minimally invasive procedures used to treat vertebral compression fractures of the spine. These painful, wedge-shaped fractures can be caused by osteoporosis or injury. Left untreated, they can lead to a humped spine. By restoring the vertebra height with a balloon and injecting a cement into the fractured bone, patients can recover faster and reduce the risk of future fractures.