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DEGENERATIVE SPINE CONDITIONS OVERVIEW

"It is important to remember that ALL Spine operations are being done to protect and/or repair the Brain, Spinal Cord or Spinal Nerves. Only a Neurosurgeon is trained sufficiently thoroughly to manage the surgical treatments of Nervous System problems related to the interior of the Skull and Spinal Column."

"Degenerative" change in the Spine is a normal process of "aging". While it is accurate to state that the process begins fairly early, the rate at which it progresses depends on a number of factors, some of which can be influenced by "life style" and habits. Others are less amenable to an individual's control.

FACTORS INFLUENCING THIS PROCESS

  1. "Uncontrollable" Factors

    Humans, by virtue of their bipedal (walking on two lower extremities) nature along with their various activities, subject their Spines to forces on a daily, relentless basis that combine to influence a natural aging process. It is important to recognize that this affects all of the joints of the Spine as well as the Discs. Some Spinal areas are subject to more stress than others. For example the Fifth, Sixth and Seventh (C5,6 and C6,7) levels of the Cervical Spine generally show evidence of more "wear' and "degenerative changes" than the other Cervical levels. The lower two Lumbar levels (Fourth and Fifth Lumbar, L4-5; Fifth Lumbar and First Sacral, L-5, S-1) assume a disproportionate weight-bearing burden by virtue of their location in the mechanism and function of the Spine. This "daily trauma" is, to a large extent, unavoidable.

    Other uncontrollable factors that further accelerate this process include congenital abnormalities of the Spine (defects in the bone and/or muscular parts of the Spine that we are born with) or developmental defects of these structures (those diseases which develop after birth —such as progressive abnormal curvatures called Scoliosis).

    Genetics or inherited factors probably do not play any significant factor for the average patient.

  2. "Controllable" Factors

    For each person there are many more factors affecting the "aging" or progressive "degenerative" process, that we can control, which are influenced by daily activities and life styles. Obesity and "over-weight" conditions add an unnecessary weight-bearing requirement. Heavy lifting and repetitive bending (particularly when leaning over at the waist to lift something) are two factors that are frequent contributors in all societies that require or encourage heavy work. Athletes or individuals who pursue certain sports activities add another dimension of accelerated Disc and Joint deterioration because of the added repetitive trauma to these structures. Whether it is in a weight lifter, jogger, football player, golfer or tennis enthusiast, each pursuit exacts some price with respect to the Spine and Discs.

    None of this should be misconstrued by the reader as suggesting that these activities are either dangerous or undesirable. GOOD PHYSICAL CONDITIONING HELPS TO ASSURE GENERAL WELLNESS and is very desirable from the point of view of slowing the progressive degenerative processes that the Spine is inevitably subject to. IT IS merely a QUESTION OF DEGREE. We all must recognize that WE PAY A PRICE FOR THE THINGS WE DO. The Spine and its components are among those parts of the body where added "wear and tear" frequently results in an accelerated degenerative condition that ultimately may cause that part to fail to continue to function adequately.

Pain is the most frequent symptom that brings the patient with a "neck" or "back" problem to the physician. One must keep in mind that neck and back pain may be a symptom of some other medical conditions and completely unrelated to actual spine problems. Your physician will review the history of the problem as it affects you and conduct a physical examination that will include an evaluation of the Spinal Column and Nerve Roots.

The experience of a painful, stiff neck or back is familiar to most of us. The "stiffness" is usually the result of muscle spasm or tightness. The muscle spasm is the body's way to attempt to immobilize the joints that are injured. When the muscles contract (tighten), they reduce the amount of movement that the joints would ordinarily have. However, muscle spasm itself may be quite painful. Some patients describe the tightness of the muscle as "knots."

Some Things to Try at Home

Local application of heat (heating pad, moist or dry "packs") or ice frequently offers significant relief for the muscle spasm in conjunction with lying down. Careful attention not to injure skin with the ice or heat is important. Massage (with or without liniment, balms, salves or oils) also may offer welcome relief from the pain of muscle spasm. In many cases of neck or back pain, the problem is only with the muscle (such as a muscle strain), and these measures often provide satisfactory relief. However, any persistent or recurring, severe neck, shoulder, arm, back, hip or leg pain deserves a thorough evaluation by your physician.

Medications are frequently used to help relieve some of the pain of these problems. Mild pain relievers are often necessary. Muscle relaxing and anti-inflammatory medications are frequently used. However, some caution is needed. It should be remembered that pain is one way that the body has to alert you that something is wrong. If you take medication to relieve pain and continue to pursue the activities that are producing damage, then you are probably doing a serious disservice to yourself.

NEUROSURGICAL CONSULTANT'S SPECIAL FOCUS

Minimally Invasive Techniques

The Neurosurgeons of Neurosurgical Consultants have extensive experience in the diagnosis and treatment of Spine Abnormalities. Our primary focus is on the surgical treatment of these diseases. We bring some of the very latest Minimally Invasive Techniques to successfully manage problems such as Herniated Lumbar Disc, Cauda Equina Claudication, Nerve Root and Spinal Cord Compression as a result of Degenerative Spine Conditions that produces Spinal Stenosis, Spondylolisthesis and Herniated Thoracic Disc.

One of the areas of our intense Neurosurgical interest involves the MINIMALLY INVASIVE METHODS FOR REMOVING Spinal Cord Tumors.

Cervical Spine Problems

We specialize in the reconstruction of the Cervical Spine for complex and extensive problems such as High-Grade Spinal Stenosis (resulting from Calcified Posterior Longitudinal Ligament, Large Bone Spurs and/or Migrated Extruded Disc), Bone Tumors and Spinal Instability.

For those patients whose condition requires a procedure of this magnitude, we can remove and then replace entire Vertebral Bodies with highly advanced and engineered materials such as with Medtronic Sofamor-Danek's Titanium "Pyramesh" Cage System. We use the patient's own bone (harvested from the Vertebral Bone that we remove as part of the operation) to fill the Cage. This usually obviates any requirement to obtain bone from any other area of the patient nor do we generally need cadaver bone.

There are some other remarkably Advanced Materials for Spine Surgery that make this surgery more reliable than ever before.

What follows on this website is information relating to many of these conditions and how we manage them. We would also like to encourage our readers to visit our disease specific monographs found on this website under DOWNLOADS & INFORMATION LIBRARY.

DISCLAIMER: Every effort has been made by the author(s) to provide accurate and up-to-date information. However, the medical knowledge base is dynamic and errors can occur. By using the information contained herein, the viewer willingly assumes all risks in connection with such use. Neither the author nor Neurosurgical Consultants, p.a. shall be held responsible for errors, omissions in information herein nor liable for any special, consequential, or exemplary damages resulting, in whole or in part, from any viewer(s)' use of or reliance upon, this material.

CLINICAL DISCLAIMER: Clinical information is provided for educational purposes and not as a medical or professional service. Person(s) who are not medical professionals should have clinical information reviewed and interpreted or applied only by the appropriate health professional(s).


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This page last edited on 2/19

All content ©2016 by Neurosurgical Consultants, P.A.
Author, Martin L. Lazar, MD, FACS
All Rights Reserved. See Usage Notices.