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Spine

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Normal anatomy of the Spine

The spinal system combines bones, nerves and muscles. The spine holds up your head, shoulders, and upper body. It gives you support to stand up straight, and gives you flexibility to bend and twist. The bony components of the spine protect the spinal cord and nerve roots that are contained within the spinal canal and provide a site of attachment for muscles and ligaments. Movement of the spine is controlled by the contraction of the muscles which attach to the spine.

Your spine is made up of three segments. When viewed from the side, these segments form three natural curves. The "c-shaped" curves of the neck (cervical spine) and lower back (lumbar spine) are called lordosis. The "reverse c-shaped" curve of the chest (thoracic spine) is called kyphosis.

These curves are important to balance and they help us to stand upright. If any one of the curves becomes too large or small, it becomes difficult to stand up straight and our posture appears abnormal.

 


Back Pain

Back pain is often a common symptom of many disease conditions and the pain may range from simple or dull pain to sudden and sharp pain. If the pain persists for few days, it is acute pain whereas if continues for more than 3 months, it is considered as chronic pain. In most cases, back pain may resolve without any treatment.

A common cause of low back and leg pain is lumbar spinal stenosis. As we age, our spines change. These normal wear-and-tear effects of aging can lead to narrowing of the spinal canal. This condition is called spinal stenosis. Degenerative changes of the spine are seen in up to 95% of people by the age of 50. Spinal stenosis most often occurs in adults over 60 years old. Pressure on the nerve roots is equally common in men and women.

A common source of back or neck pain is a herniated disk. Sometimes called a "slipped" or "ruptured" disk, this condition most often occurs in the lower back, as well as the smaller disks in the neck. Although a herniated disk can sometimes be very painful, most people feel much better with just a few months of simple, nonsurgical treatment.

Neck pain

The first 7 vertebral bones on the spinal column form the cervical spine and are located in the neck region. The neck bears the weight of the head, allows significant amount of movement, and also less protected than other parts of spine. All these factors make the neck more susceptible to injury or other painful disorders. Common neck pain may occur from muscle strain or tension in everyday activities including poor posture, prolonged use of a computer and sleeping in an uncomfortable position

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Spine trauma

Spine trauma is damage to the spine caused from a sudden traumatic injury caused by an accidental fall or any other physical injury. Spinal injuries may occur while playing, performing normal activities, operating heavy machines, lifting heavy objects, driving automobiles, or when you suffer a fall. Injury to spine may cause various conditions including fractures, dislocation, partial misalignment (subluxation), disc compression (herniated disc), hematoma (accumulation of blood) and partial or complete tears of ligaments

 

Spinal Deformity

The Spine or backbone provides stability to the upper part of our body. It helps to hold the body upright.  When viewed from the front the spine should appear to be straight, but when viewed from the side the spine has two gentle curves. 

Abnormal curvatures of the spine are also referred to as spinal deformity. These types of conditions include kyphosis of the thoracic spine and lordosis of the lumbar spine ("swayback"). Scoliosis is another type of spinal deformity. When viewing the spine from the front or back, scoliosis is a sideways curvature that makes the spine look more like an "S" or a "C" than a straight "I."

 

Kyphosis
(roundback)

Kyphosis (roundback) is an excessive outward curve of the spine results in an abnormal rounding of the upper back. The condition is sometimes known as "roundback" and can be quite severe. Kyphosis can occur at any age, but is common during adolescence. In the majority of cases, kyphosis causes few problems and does not require treatment. Occasionally, a patient may need to wear a back brace or do exercises in order to improve his or her posture and strengthen the spine. In severe cases, however, kyphosis can be painful, cause significant spinal deformity, and lead to breathing problems. Patients with severe kyphosis may need surgery to help reduce the excessive spinal curve and improve their symptoms.


Scoliosis

Scoliosis is a condition that causes the spine to curve sideways. There are several different types of scoliosis that affect children and adolescents. By far, the most common type is "idiopathic," which means the exact cause is not known. Most cases of idiopathic scoliosis occur between age 10 and the time a child is fully grown. Scoliosis is rarely painful—small curves often go unnoticed by children and their parents, and are first detected during a school screening or at a regular check-up with the pediatrician. In many cases, scoliosis curves are small and do not require treatment. Children with larger curves may need to wear a brace or have surgery to restore normal posture.


Spondylolysis and Spondylolisthesis are common causes of low back pain in young athletes.

Spondylolysis is a crack or stress fracture in the vertebrae. The injury most often occurs in children and adolescents who participate in sports that involve repeated stress on the lower back, such as gymnastics, football, and weight lifting.

In some cases, the bone with the stress fracture is unable to maintain its proper position in the spine—and the vertebra starts to shift or slip out of place. This condition is called spondylolisthesis.

For most patients with spondylolysis and spondylolisthesis, back pain and other symptoms will improve with conservative treatment. This always begins with a period of rest from sports and other strenuous activities.

Spondylolysis and Spondylolisthesis


If you suddenly start feeling pain in your lower back or hip that radiates to the back of your thigh and into your leg you probably have a condition known as sciatica. Non-surgical intervention is the initial approach. Surgery would be considered if symptoms do not improve.

Sciatica


Although leg pain is common and usually goes away without surgery, cauda equina syndrome, a rare disorder affecting the bundle of nerve roots (cauda equina) at the lower (lumbar) end of the spinal cord, is a surgical emergency. It may be caused by a herniated disk, tumor, infection, fracture, or narrowing of the spinal canal. An extension of the brain, the nerve roots send and receive messages to and from the pelvic organs and lower limbs.

Cauda equina syndrome occurs when the nerve roots in the lumbar spine are compressed, cutting off sensation and movement. Nerve roots that control the function of the bladder and bowel are especially vulnerable to damage. If patients with cauda equina syndrome do not seek immediate treatment to relieve the pressure, it can result in permanent paralysis, impaired bladder and/or bowel control, loss of sexual sensation, and other problems. Even with immediate treatment, some patient may not recover complete function.

Cauda Equina Syndrome

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Our specialist spine surgeon is:

 
 
  Dr Nicholas Tsai  MB BS, FRACS(Orth)

Dr Nicholas Tsai
MB BS, FRACS(Orth)

A graduate of the University of Sydney Dr Nicholas Tsai did his internship and residency in Westmead Hospital. 

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