Spinal vertebrae can be damaged by trauma due to a major injury. When this happens, the soft, inner pulposis – the center of the vertebral discs – can leak through a small tear in the disc’s wall, applying too much pressure upon spinal nerves. This is known as a herniated disc, and causes pain, tingling and/or burning in the area where the nerves are affected. The most common form - lumbar radiculopathy - affects the sciatic nerve, which runs from the lower spine to the legs and feet. Cervical radiculopathy, which occurs in the neck, causes pain that can radiate to the arm and shoulder.
Canals in the spine protect the network of nerves responsible for carrying signals to and from the brain for movement and sensation. Spinal stenosis is a form of narrowing within the spine that affects this nerve function. This condition causes excess bone growth on the inside of the vertebrae - where the nerve rests - causing pressure and pinching the spinal cord or nerve roots. Spinal stenosis causes a tingling sensation in the lower back, legs and feet.
Approximately two percent of the U.S. population is affected by scoliosis, a developmental disease that causes the spine to curve slightly to one side. Scoliosis can affect the upper portion of the spine, known as the thoracic section, or the lower portion, known as the lumbar section. Screenings for scoliosis look for indicators such as a misshapen torso or uneven shoulders. Treatments may include a back brace or, in more advanced cases, surgical straightening.
While most back surgeries are successful, a small percentage of patients can receive an incorrect diagnosis or a faulty surgery, resulting in a need for a revision - or follow-up - surgery. Complications and excess scar tissue can also necessitate revision surgery. While open surgery may still be used for this procedure, minimally-invasive surgical methods have a high rate of success. Physical therapy is an important part of recovery to strengthen the muscles surrounding the spine and reduce the chances of additional problems.
While uncommon, infections of the bones and discs of the spine are serious health concerns. Those who have a compromised immune system, use intravenous drugs, or have other conditions (such as diabetes or arthritis) are at greater risk for a spinal infection.
Osteomyelitis is an infection of the spinal vertebrae, often due to Staphylococcus aureus, the bacteria commonly known as “staph.” If left untreated, osteomyelitis can damage the bone. Discitis – an infection of the discs between the vertebrae – is most common in children. As with most infections, antibiotics are the preferred treatment for any spinal infection (discitis treatment may also include the use of a brace). Severe infections may require surgery.
When cancer cells spread to other organs or body structures, it is said to have metastasized. Cancer cells can spread to the spine, often from the lung or breast, causing symptoms ranging from back pain to bowel/bladder problems and paralysis. Metastatic disease can also weaken the bones of the spine, making them more prone to fracture.
Radiotherapy (external-beam radiation) is the most common treatment for spinal metastasis. If tumors are present, they can often be surgically removed. A procedure known as radiosurgery, in which a precise, focused beam of radiation is used to treat cancerous tissue, can be very beneficial in the treatment of metastatic spinal disease.
Small discs made of fibrous tissues serve as cushions between spinal vertebrae, so the bones do not rub against each other. Degenerative disc disease is a very common condition in which these discs deteriorate over time. The center of the disc (pulposis) contains a water-like substance that keeps the disc’s shape. If the disc dries out and flattens, the spinal vertebrae will become misaligned. If the vertebrae are forced together, small growths called bone spurs can form and pinch the spinal nerves, causing pain, numbness and/or tingling.
Cervical degenerative disc disease affects the cervical spine (between the shoulders and the skull). Pain may be felt in the neck alone, or may radiate to the shoulder or even the arm. Lumbar degenerative disc disease occurs in the lower back, and pain can occur in the hips and legs. Bending or twisting motions may increase this pain, as can sitting down for too long.
Spondylolisthesis is often caused by a stress fracture or deterioration within the vertebrae of the spine. The spinal nerves running through these vertebrae can be damaged by this condition, causing what is known as a pinched nerve. The pain of spondylolisthesis is felt in the lower back, but can spread as far as the lower legs and feet. The condition may also cause changes in posture, and - in the long term - spinal damage.
Spondylolisthesis can be classified as degenerative or isthmic. Degenerative spondylolisthesis results from the gradual deterioration of the vertebrae, and can cause pain and aching in the legs, especially with activity. Isthmic spondylolisthesis is caused by a stress fracture (making it more common among athletes) or by a defect in a vertebra that allows it to slip. This slippage of the vertebra often causes pain and/or weakness in the lower back and legs, but it may also produce no symptoms.
Diseases that can cause inflammation or other damage to the spine may be systemic (affecting other parts of the body as well) or localized (generally affecting only the spine). One example of a mostly localized, autoimmune disease is ankylosing spondylitis, a chronic arthritis that causes the spinal vertebrae to fuse together. Rheumatoid arthritis (RA) usually begins within the cervical spine, between the shoulders and the base of the skull, but can ultimately attack other joints, tissues and organs. Treatment for inflammatory diseases affecting the spine will usually include anti-inflammatory medications and physical therapy.