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Patient Education What
Causes Back Pain? | Understanding
Spinal Anatomy | Pediatric
Spine
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Your spine is at the center of a delicately balanced system that controls all of your body’s movements. Bones, muscles, ligaments, tendons, and nerves all work together to balance the weight of your body. Even minor damage to one component of your back’s structure can upset this fragile balance and make movement painful. It is not surprising, then, that back pain is second only to headache as the most common cause of pain, or that 8 out of 10 people will have a problem with back pain at some time. The causes of back pain can be simple or complex; the vast majority can be treated nonsurgically, but in some serious cases, surgery is necessary. What Causes Back Pain? Back pain occurs when one or more nerves in the spinal column become impinged, or pinched. This is commonly caused by a disc or bone spur pushing into the canal that houses the spinal cord, the cauda equina, and the nerve roots. At birth, discs are comprised primarily of water, but they tend to dry and shrink as a person ages, causing changes in the spinal column. Further changes can occur when a disc ruptures or herniates (protrudes) because of injury. Very often in response to these changes, tissue around the spinal canal thickens, reducing the space in the spinal canal. This narrowing is commonly called stenosis. Additionally, when the facet joints degenerate, they become larger, form spurs, and can pinch the nerve roots or even the spinal cord. If you are unable to function at an acceptable level for your lifestyle, or your neurological deficit is becoming progressively worse in spite of conservative treatment, then surgery is often the recommended treatment. In the vast majority of cases, modern spinal surgery is extremely successful in alleviating pain and restoring mobility. The Spine Center at Tahoe—a highly skilled and experienced orthopaedic surgeon—has helped hundreds of patients like you achieve freedom from pain with spinal surgery. There are a number of different surgical approaches to relieving back pain. The Spine Center at Tahoe has determined which one is best for you based on your specific condition. The following is a general description of some of the most commonly performed procedures: • Discectomy—the removal of all or part of the offending disc • Decompression—the removal of bone spurs • Corpectomy—the removal of a vertebra • Fusion—the joining of discs to prevent motion in the affected area Spinal surgery, as with any major surgery, is not without risks. The Spine Center at Tahoe will discuss with you possible complications of surgery and will tell you how you can help reduce your risks both before and after surgery. top  Understanding
Spinal Anatomy Your spine is a strong and flexible bony structure, made up of five sections from the neck to the tailbone, consisting of 33 bones or vertebrae. 1. Cervical spine (neck) 2. Thoracic spine (upper back) 3. Lumbar spine (lower back) 4. Sacrum 5. Coccyx (tailbone) In the cervical, thoracic, and lumbar areas, cushion-like discs separate the vertebrae, giving the spine the ability to bend and turn. There are five vertebrae in the sacrum, but they are fused naturally and do not have discs to separate them. The coccyx has four smaller vertebrae that also are fused. The Cervical Spine The cervical spine (neck) consists of seven vertebrae numbered C1 through C7 from top to bottom. Each of the top two vertebrae has a unique design. C1 is a two-tiered ring that is attached to the skull. C2 has a protrusion that acts as a post around which C1 rotates. C1 and C2 are primarily responsible for the motion of the head. Each of the remaining vertebrae in the cervical, thoracic, and lumbar regions has a pair of facet joints that connect to muscles and ligaments to keep the vertebra in place, as well as a disc, which cushions the spine and allows it to move. The Thoracic Spine The thoracic spine (upper back) consists of 12 vertebrae that are attached to the ribcage. Very little motion occurs in this region and problems in this area are relatively uncommon. The Lumbar Spine The lumbar spine has five vertebrae. This region endures a lot of stress, especially when you bend, and is a common source of back pain. The Spinal Cord The spinal cord runs from the brain through the cervical and thoracic spine, where the nerve roots come off the cord to form the cauda equina, or “horse’s tail.” At each level of vertebra, a nerve root exits on each side of the spine to the right and the left. In the cervical spine, the nerve root is labeled according to the lower segment that it runs between; in the lumbar spine, the nerve root is named after the upper segment that it runs between. That means that the C5 nerve root runs between C5 and C4, and the L4 nerve root runs between L4 and L5. top Pediatric Spine  The
Young SpineThe spine is made up of vertebrae (or bones) and soft, gel-like discs between the vertebrae that act as spacers and “shock absorbers.” As a child’s spine grows, natural curves develop at the cervical (neck), thoracic (chest), and lumbar (lower back) regions. These curves are also part of the spine’s shock absorbing system and help to distribute the stress created when the body moves. The young spine is much more flexible and resilient than the adult spine, and medically significant back pain is very uncommon, especially in younger children. However, as the spine matures, a number of spinal conditions may develop that are best treated by a specialist trained in pediatric spinal care like Tahoe Fracture Regional Spine Institute. Children with congenital, developmental, and traumatic spinal disorders hold a special place in our practice … and in our heart. When the Spine Gets Thrown a Curve… Scoliosis refers to abnormal side-to-side (lateral) curves in the spinal column. In the majority of cases the cause is unknown (idiopathic), and nearly 80% of idiopathic scoliosis occurs in adolescents. Kyphosis causes the natural curve in the thoracic spine to curve too far forward, sometimes creating the appearance of a hump on the back. The condition can be caused by poor posture or by a structural problem in the spine. Early detection and treatment are important to correcting abnormal spinal curves. If poor posture is to blame, exercise and physical therapy can strengthen the spinal muscles. Tahoe Fracture Regional Spine Institute may also recommend bracing to keep curves from worsening and to relieve pain. Surgery is reserved for severe cases or for curves that do not respond to bracing. Juvenile Arthritis of the Spine When juvenile rheumatoid arthritis affects the spine it is referred to as ankylosing spondylitis (AS). In patients with AS, the joints and discs in the spine become inflamed and painful, and new bone forms between the joints and vertebrae, fusing parts of the spine together and limiting motion. While AS cannot be cured, the good news is that surgery is rarely needed and most patients can lead normal and productive lives. Spinal Injuries in Older Children Children and teens who participate in more competitive and specialized sports are prone to certain types of spinal injuries. Spondylosis is damage to a joint in the spine that can occur in children who regularly hyperextend their backs (bend backwards),as in gymnastics. Spondylolisthesis is a “slipping” of one vertebra on another and is a condition that can progressively worsen through adolescence. Disc injuries and fractured vertebrae frequently result when a teen lands very hard on their feet or buttocks in “extreme” sports like skateboarding, inline skating, and vert biking. A new form of injury has become very common in school-age children and teens – overuse injuries and back strain from carrying backpacks that are too heavy and that put tremendous stress on the developing spine, especially when slung over one shoulder. Conservative Treatments First… The majority of back and neck problems in both children and adults respond to nonsurgical treatment including medication, physical therapy, bracing, and injections. [Practice Name here] will exhaust all conservative treatment options before recommending surgery. When surgery is needed, he has expertise in advanced minimally invasive surgical techniques and spinal instrumentation (special “hardware” like metal rods, plates, and screws) and has performed hundreds of spinal procedures. top
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