The spinal column consists of 24 separate bones, called vertebrae, plus
the fused bones of the sacrum and the coccyx. Your spinal column is the
central support for the upper body, carrying most of the weight of your
head, chest, and arms. Together with the muscles and ligaments of your
back, your spinal column enables you to walk upright.
The cervical region has seven vertebrae (C1 through C7), the thoracic
region has 12 vertebrae (T1 through T12) and the lumbar region has five
vertebrae (L1 through L5). The sacral region consists of five vertebrae,
all fused together to form one continuous bone mass known as the sacrum.
The coccygeal region consists of four vertebrae, all fused together to
form the coccyx or tailbone.
The vertebrae in the cervical (or upper back) portion of your spine
carry the weight of your head. The pressure from this weight along with
the "wear and tear" associated with the constant turning and bending of
your head and neck is what usually leads to problems associated with the
cervical vertebrae.
The vertebrae in the lumbar (or lower back) portion of your spine are
under constant pressure from the weight of your upper body, even when
you are simply sitting in a chair. The "wear and tear" of this pressure
is what usually leads to problems associated with the lower back.
The intervertebral discs are composed of a fiber-like outer lining (the
annulus) and a gelatin-like inner core (the nucleus). These discs act as
the spine's "shock absorbers," preventing vertebra from rubbing against
one another and providing much of the flexibility found in your spine.
Because they are under constant pressure, it is the intervertebral discs
which first show signs of the "wear and tear" associated with the aging
process.
Running through the center of the spinal column is the spinal cord,
which ends in the lumbar spine in a bundle of nerves called the cauda
equina. At each disc level, a pair of spinal nerve roots branch off from
the spinal cord or cauda equina and pass through an opening called the
foramen.
As your spine ages, the gelatin-like centers of your discs begin to dry
out, thereby reducing their effectiveness as "shock absorbers." As this
protection is lost, the simple "wear and tear" of everyday activity can
cause the bone matter of your vertebrae to develop jagged edges, called
bone spurs. As these spurs develop and extend outward, they can cause
both the spinal canal and the foramen to become narrowed. The result is
often the pinching (compression) of the spinal cord and/or a spinal
nerve root.
As discs dry out, your vertebrae begin to "settle." This "settling"
causes the window-like openings of the foramen and the spinal canal to
become smaller and smaller. Eventually, these openings can become so
small that a spinal nerve(s) becomes "pinched" against a vertebra. It's
similar to slowly closing a window on your hand. There will be a point
at which you begin to feel the pressure. The more the window is closed,
the greater the pressure and the greater the pain
Spinal Conditions - Definitions
Basic Problem - As a result of the
natural wear and tear that occurs with aging, certain parts of the spine
start to degenerate and wear out, as we grow older. This process makes
some of the anatomic structures of the spine, the bones, intervertebral
discs, ligaments, and muscles less flexible and less resistant to
injury.
Spondylolysis is a defect in the lamina of the vertebrae in the pars
interarticularis, usually the fourth or the fifth lumbar vertebrae in
the lower (lumbar) spine. Spondylolysis may occur as a congenital defect
or be the result of repetitive trauma. Some physicians believe
spondylolysis may be caused by genetics, and that someone could be born
with thin vertebral bones causing them to be vulnerable to the
condition. Spondylolysis is common in teenage gymnasts and football
players, and presents with lower back pain that is worse with strenuous
exercise or activity. Radiographic findings are subtle, but bone scans
or CT scans will usually detect the lesion. Activity modification,
bracing, or surgical treatment may be indicated for persistent symptoms.
Spondylolysis is a prerequisite for
spondylolisthesis. Spondylolisthesis occurs when spondylolysis weakens
one of the vertebrae so much that the bone slips out of place.
The condition can also be caused by degenerative disc disease. If the
vertebrae slip too much and begin to press on nerves, surgery may become
necessary. Spondylolisthesis may also be caused by degenerative
conditions that affect the vertebral joints, such as cerebral palsy.
Early treatment usually involves rest and medication. Progressive
spondylolisthesis usually requires surgical treatment.
There are five types of Spondylolisthesis - here are the three
most common.
1. Type I is called dysplastic
spondylolisthesis and is secondary to a congenital defect of either the
superior sacral or inferior L5 facets or both with gradual slipping of
the L5 vertebra.
2. Type II, isthmic or
spondylolytic, in which the lesion is in the isthmus or pars
interarticularis, has the greatest clinical importance in persons under
the age of 50. If a defect in the pars interarticularis can be
identified but no slipping has occurred, the condition is termed
spondylolysis. If one vertebra has slipped forward on the other
(horizontal translation), it is
 referred
to as spondylolisthesis.
3. Type III, is a degenerative
spondylolisthesis, and occurs as a result of the degeneration of the
lumbar facet joints. The
alteration in these joints can allow forward or
backward vertebral displacement. This type of spondylolisthesis is most
often seen in older patients. In Type III, degenerative
spondylolisthesis there is no pars defect and the vertebral slippage is
never greater than 30%
Most acute pain in the back results from sustaining a mild strain in the
back or back musculature. Sprains and strains in your lower back usually
happen during a sudden and stressful injury, causing stretching or
tearing of the muscles, tendons, or ligaments in your lower back. When
you strain or sprain your lower back it causes a lot of stress on your
spine, irritating it. If you have this condition you may also suffer
from painful muscle spasms which can occur during your daily activities
or at night while you're sleeping. The pain is usually limited to five
or ten days.
Sciatica is the descriptive term for when pain runs from your back or
buttocks down your leg and into your foot
It is a condition caused by either compression or trauma of the sciatic
nerve. Sciatica is made worse when you cough or if someone lifts your
leg up while you are laying down. Symptoms may begin abruptly or
gradually, are usually irritated by movement, and often grow worse at
night. Sciatica implies that there is an irritation of your nerve root
in the lower part of your spine. In some instances, this could be due to
a ruptured or herniated disc in your lower back.
A herniated ("slipped") or ruptured disc in your
back can cause each of these pain patterns. The ways in which a slipped
disc causes different pain patterns and problems with your back is
related to the location of the slipped disc along your spine, and also
to the anatomy of your spinal column.
The spinal column, or backbone, consists of 33 bones (vertebrae) and can
be divided into five segments, called the cervical, thoracic, lumbar,
sacral, and coccygeal sections of the spine. Each of these sections
corresponds to a particular part of your body. The cervical spine is
that part of the spine in your neck, the thoracic spine supports your
trunk, the lumbar spine supports your lower back and abdomen, the sacrum
supports your pelvis, and the coccyx is your tailbone.
Stenosis produces a dull, aching pain in the lower
back when standing or walking. The pain usually radiates down into the
buttocks and thighs, and can be relieved by stopping to rest, or by
using a walker or a shopping cart in the grocery store. These symptoms
usually slowly get worse over time, and people who suffer from spinal
stenosis will notice a slow decrease in their ability to walk shorter
and shorter distances.
Lumbar stenosis is a natural product of aging, and the wear and tear on
the spine throughout our lives. As our bodies grow older, the ligaments
and bones that make up the spine grow thicker and become stiffer. The
spinal canal gradually narrows, and the spinal cord is slowly
compressed. The lack of space interferes with the normal function of the
spinal cord and the body becomes less able to function normally.
Call
412-630-7640 or 1-877-635-5234 with questions.
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