Introduction
This page aims to provide you with information on conditions that affect the Whole Spine. The Spine is made up of 24 individual bones, which sit upon each other and form the spinal column. These 24 bones are known as vertebra, which are separated by ‘discs’ known as the intervertebral discs, and are split as followed:-
- Cervical (7 vertebra)
- Thoracic (12 vertebra)
- Lumbar (5 vertebra)
A number of conditions can affect the Whole Spine, several of which are explored in the relevant sections below:
Overview
This page aims to provide you with useful information about Spondylolisthesis, which occurs when one vertebra slips forward on another. It most commonly occurs as a result of the normal ageing process in the spine but can occur as a result of spondylolysis (pars defect) from childhood.
Many people will not require intervention for this but, in some cases, the slip causes pressure on the nerves. If it cannot be resolved by non-operative treatment, an operation may be appropriate to decompress the nerves and, in some people, this will also require a fusion procedure.
Videos
This film is about spinal decompression surgery, an operation where a portion of some of the spinal structure is removed to create more space for the nerves to pass through or exit the spine at that level.
This film is about spinal fusion, an operation where two or more spinal segments are joined together to prevent movement at these levels.
In this film spinal decompression post operative care one of our advanced nurse practitioners talks through three important recovery care stages: wound care, painkillers and posture.
In this film pre-operative exercise and balance, our physiotherapist Patrick talks through some key pre-operative exercises. Please complete as prescribed by your physiotherapist.
External Links
NHS.UK
This page provides further information regarding Spondylothesis and its symptoms and treatment
Overview
This page aims to provide you with useful information about Ankylosing Spondylitis (AS), which is a type of arthiritis that mainly affects the back and causes inflamation of the spine.
Videos
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External Links
NASS
The following link if for the chariatble organisation the National Ankylosing Spondylitis Society (NASS) which has information on the symptoms and living with ankylosing spondylitis.
https://nass.co.uk/
NHS.UK
This page provides further information regarding AS and its symptoms.
https://www.nhs.uk/conditions/ankylosing-spondylitis/
Versus Arthiritis
The following link if for the chariatble organisation Versus Arthiritis which has information on the symptoms and living with ankylosing spondylitis.
https://www.versusarthritis.org/about-arthritis/conditions/ankylosing-spondylitis/
Overview
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury.
Injury can occur at any level of the spinal cord and can be complete, with a total loss of sensation and muscle function at lower sacral segments, or incomplete, meaning some nervous signals are able to travel past the injured area of the cord up to the Sacral S4-5 spinal cord segments.
Depending on the location and severity of damage, the symptoms vary, from numbness to paralysis, including bowel or bladder incontinence. Long term outcomes also range widely, from full recovery to permanent tetraplegia (also called quadriplegia) or paraplegia. Complications can include muscle atrophy, loss of voluntary motor control, spasticity, pressure sores, infections, and breathing problems.
In the majority of cases the damage results from physical trauma such as car accidents, gunshot wounds, falls, or sports injuries, but it can also result from nontraumatic causes such as infection, insufficient blood flow, and tumors.
Videos
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External Links
Spinal Injuries Association (SIA)
The following link takes you to the charitable organisation SIA which has lots of information about SCI and living with a SCI.
https://www.spinal.co.uk/
Overview
Spinal Tumours most commonly occur where a malignant tumour spreads from another part of the body to the spine – this is known as a secondary (or metastatic) tumour. Tumours which originate in the spine are known as primary tumours but are far less common, such tumours can be both malignant and non-malignant.
Treatment for Spinal Tumours varies from individual to individaul and your medical team will discuss the most appropriate options for you which can include:-
-Surgery – to remove all or part of the tumour
-Radiotherapy – to damage or destroy the tumour
-Chemotherapy – drugs to destory the tumour
-Radiosurgery – similar to radiotherapy but a more specialist & targeted dose of radiation to damage or destory the tumour.
Metastatic Spinal Cord Compression (MSCC) is a rare medical emergency where the tumour in the spine compresses on the spinal cord causing a range of symptoms.
Symptoms of spinal cord compression include:
-New and persistent localised back or neck pain, chest wall pain or other unexplained pain that is unusual for you
-Severe pain in the lower back that gets worse or doesn’t go away
-Pain in the back that is worse when coughing, sneezing or straining
-Back pain that is worse at night
-Numbness, heaviness, weakness or difficulty using arms or legs
-A band of pain around the chest or abdomen or pain down an arm or leg
-Changes in sensation, for example pins and needles or electric shock sensations
-Numbness in the area around the back passage (the saddle area)
-Not being able to empty the bowel or bladder
-Problems controlling the bowel or bladder
(The Christie NHS Foundation Trust)
Whilst rare, any combination of the above symptoms could indicate MSCC – please seek immediate medical advice.
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External Links
Brain & Spine Foundation
The following link takes you to the charitable organisation the Brain & Spine Foundation which has an information booklet on Spinal Tumours.
https://www.brainandspine.org.uk/our-publications/booklets/spinal-tumours/
Macmillan Cancer Support
The following link takes you to the charitable organisation Macmillan Cancer Support which has further information on MSCC.
https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/malignant-spinal-cord-compression
Overview
Scoliosis is a sideways curvature of the spine when viewed from the back or front. It is often accompanied by a twisting of the body resulting in prominence of the ribs.
Typical signs include:
• A visibly curved spine
• One shoulder being higher than the other
• One shoulder or hip being more prominent than the other
• Clothes not hanging properly
• A prominent ribcage
• A difference in leg lengths
Back pain is common in adults with scoliosis. Young people with scoliosis may also experience some discomfort but it’s less likely to be severe.
Scoliosis can occur at any age, but most commonly it develops during early adolescence. This is a period of rapid growth when a child’s body starts to grow and becomes more adult.
There is no known way of preventing scoliosis from occurring. In most cases (around 8 in 10 cases) the cause is unknown. This is called idiopathic scoliosis.
A small number of cases are caused by other conditions, including, but not limited to:
• Cerebral palsy
• Muscular dystrophy
• Marfan syndrome
• Wear and tear of the spine associated with ageing – Degenerative Scoliosis
Videos
The video below gives an overview of spinal correction surgery that can be performed in relation to Degenerative Scoliosis
In this film pre-operative exercise and balance, our physiotherapist Patrick talks through some key pre-operative exercises. Please complete as prescribed by your physiotherapist.
External Links
Scoliosis Association UK (SAUK)
The following link takes you to the charitable organisation SAUK which has lots of information and support about Scoliosis and living with the condition
NHS.UK
The following link contains a brief overview of Scoliosis and its treatment in Adults
Overview
Degenerative disc disease or spondylosis is a condition that sometimes causes low back pain or radiating pain from damaged discs in the spine. A lumbar spinal disc acts as a shock absorber between vertebrae, and allows the joints in the spine to move easily.
The strong, fibrous outer portion of a spinal disc, known as the annulus fibrosus, contains the soft inner core of the disc, the nucleus pulposus.
Each person’s spinal discs undergo degenerative changes as they age, but not all people will experience symptoms as a result of these changes. Symptoms are most commonly seen in 30 to 50-year-olds.
Pain from degenerative disc disease is usually tolerable, with flare-ups that last for a few days or more. It is normally felt in the lower back, but it can radiate into the hips and legs. The pain tends to be worse when sitting, as the discs have to bear a heavier load.
One way degenerative disc disease causes pain is through inflammation of the nerves. When the outer part of a disc breaks down, the inner portion of the disc can leak out, releasing proteins that irritate surrounding nerves. Another cause of pain is when degenerated discs cannot properly absorb stress, leading to abnormal movement along the vertebral segment. Back muscles may spasm painfully in order to stabilise the spine.
In some cases, the disc space may collapse enough to compress a nerve root, leading to leg pain known as radiculopathy. Low back pain from degenerative disc disease often goes away with time as inflammatory proteins decrease and the disc collapses into a stable position. The causes and effects of degenerative disc disease are relatively straightforward: You age, your discs change, your bones can be affected, and you can develop pain. It even helps to think of this process as a cause and effect process or cascade: One anatomical change occurs, which leads to more degeneration and changes in your spine’s structures. These changes combine to cause degenerative disc disease and its symptoms.
Degenerative disc disease begins with changes in your intervertebral discs, but eventually it will affect the other motion segments of the spine, such as the facet joints.
Over time, the collagen (protein) structure of the annulus fibrosus (that’s the outer portion of the intervertebral disc) changes.
Additionally, water-attracting molecules—and hence water—in the disc decreases.
These changes reduce the disc’s ability to handle back movement.
Degenerative disc disease can cause discs to become thin. The disc will become less spongy and much thinner. A thinner disc means that the space between the vertebra above and below the disc gets smaller, which causes a new problem, this time with the facet joints. They help stabilize the spine, and if the disc loses height, the way the facet joints move changes. Then the cartilage that protects the facets begins to wear away, and they start to move too much: They “override” and become overly mobile (hypermobility).
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External Links
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Overview
Some people fracture their back during a high energy collision or impact and will usually be assessed in a Major Trauma Centre to see if urgent stabilisation is required, especially if there is any spinal cord injury or nerve injury.
Many other people will have a lower energy fall from a low height or from standing height which will cause their fracture. Most of these people will try and pursue non-operative treatment in the first instance and the majority will heal within 2-4 months. However, in a small number of people, the fractures may not heal and they could have ongoing pain. In these people, they can continue non-operative measures or may wish to consider kyphoplasty or vertebroplasty to reduce pain.
Such lower impact spinal fractures can often be due to Osteoporosis or more rarely due to tumours of the spine.
Videos
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External Links
BASS
The following link takes you to a booklet produced by the British Association of Spinal Surgeons (BASS) which has further information on the operations Kyphoplasty and Vertebroplasty which is used to treat spinal fractures.
Royal Osteoperosis Society (ROS)
The following link takes you to the chatitable organisation the ROS which contains further information reagrding spinal fractures related to Osteroperosis.
https://theros.org.uk/information-and-support/osteoporosis/spinal-fractures/