There are 33 vertebrae in human body from the end of skull to the coccyx; 23 of those vertebrae are mobile. The column formed by those 33 bones are called spine or vertebral column. There is a pillow-like structure, namely intervertebral disc, between each two vertebrae. Spinal cord lies in a canal inside the spine. Similar to brain, spinal cord is also surrounded by a membrane, where the cerebrospinal fluid circulates.
Spinal cord and spine surgery deals with surgical management of all structural, functional and mechanical diseases in spinal cord and spine as well as primary (originating from the spine itself) and metastatic (originating from another organ and spreading to spine and spinal cord) tumors. The spine forms the main frame of our body and enables our movements. The spinal cord is the main communication means between our brain and the rest of our body. Considering all functions of our body are regulated by nerve impulses, any disorder or dysfunction in spine and spinal cord leads to diseases that concern the entire body and sometimes threaten the life.
The diseases that are commonly diagnosed and treated at Spinal Cord and Spine Surgery are explained below.
Congenital Diseases of Spine
In case of diseases that manifest symptoms immediately after birth such as Chiari malformation, tethered cord syndrome, spina bifida, diastematomyelia etc., surgical interventions that corrects and repairs these deformities are performed. In addition to surgical correction, implants are also used to maintain the effects of surgery.
Spinal Stenosis and Hernias
Aging, accidents and traumas cause dysfunction in the disc located between the cervical vertebrae. The outermost layer of disc ruptures, which result in overflow of the content, in time. Thus, the distance between two vertebral bodies decreases, resulting in compression of nerves originating from and entering into the spinal cord. This condition is called hernia.
Herniated Cervical Disc: It implies the herniation of discs located between vertebrae of the neck. The main underlying reason is excessive load on the disc and it may be caused by aging, a sudden movement, an accident or a trauma, such as falling from height. Mostly, it is manifested by neck pain; however, the range of symptoms gets wider depending on the severity of disease: Strength loss in muscles, loss of muscle mass, sensorial loss, numbness and prickling in arms and fingers and loss of reflex. Physiotherapy and medication therapies are primarily tried for the treatment. Spinal injections may be performed to treat the edema and inflammation caused by the hernia. Trigger point injections may be useful to eliminate persistent pain. Surgical treatment is considered if all these methods fail to solve the problem. The surgery performed for herniated disc is called discectomy. Another treatment option is spinal fusion.
Lumbar Hernia: It implies the herniation of disc or discs between the lumbar vertebras. The major symptom is pain and the range of symptoms gets wider depending on the severity of disease, as is the case with cervical disc hernia.
Scoliosis and Spondylolisthesis
The spine lies from skull to coccyx as a straight column without any deviation on the posterior view. However, from lateral point of view, the spine has three natural and anatomic curvatures. The concavities in cervical and lumbar parts of the spine are called lordosis and the front-to-back curvature or mild hump in low-back region is called kyphosis.
Scoliosis: It is defined as a sideways curvature of the spine. For the majority of cases, no underlying cause can be defined for the disorder. It is manifested by poor posture of the body. One shoulder more elevated than the other, prominence in one of the scapulas.
Parents who recognize this kind of a disorder in their children should immediately seek medical attention. As is the case for all diseases, the earlier this curvature is recognized, the higher becomes the possibility to prevent the progression and treat the condition.
Since right or left curvature of the spine will narrow down the chest cavity, the potential adulthood problems are minimized when scoliosis is treated in childhood; however, there is a risk of recurrence for scoliosis treated in childhood.
Kyphosis: Thoracic spine already has a certain level of kyphosis. Physiological kyphosis range is quite wide in an individual who is deemed healthy and it ranges from 20 degrees to 45 degrees. Kyphosis diagnosed in children and elderly people causes far more serious health problems than scoliosis. The symptoms vary depending on nerve compression and narrowing in chest cavity. Pain in back and shoulder, dyspnea, excess tiredness and poor exercise capacity are among the common symptoms. Kyphosis is considered if angle of kyphosis measures above 45 degrees in the imaging tests performed following a comprehensive physical examination and if the mentioned symptoms are experienced. Pulmonary functions should be measured following the diagnosis. Treatment of kyphosis is determined according to severity of condition and patient’s age. Corset and surgical correction are among the treatment options.
Spondylolisthesis: Spondylolisthesis is defined as a vertebra slipping out forward or backward on top of the other and it causes certain symptoms secondary to nerve and tissue impingement. These symptoms include but not limited to low-back, hip and leg pains, numbness in fingers and toes, prickling, severe pain in arms and urinary incontinence in advanced stage cases. For most of the cases, the condition is managed with surgical approach and spine stabilization surgery is performed.
Stenosis of Lumbar Spinal Canal
Lumbar stenosis occurs when intervertebral discs and joints degenerate due to aging and protrude into the spinal canal in most of the patients. Nerve roots are compressed when the spinal canal narrows. The compression is manifested by certain symptoms such as pain, numbness, muscle cramp and prickling. The condition may lead to weakness in legs in time. Physical activity (working in standing position and walking) worsens the symptoms. After the severity of the disease is determined with further imaging methods (MRI, CT), physiotherapy, medical therapy and spinal injections are primarily considered for the treatment. If there is no response, the last treatment option is surgery.
Dealing with diagnosis and treatment of a very wide range of diseases, spinal cord and spine surgery department cooperates with all other medical departments and intensive care units before and after the treatment. Physiotherapy and rehabilitation is necessary for almost all patients undergoing a surgical treatment.
Promising Outcomes, A Pain-free Life
Laparoscopic and robotic surgeries, implants enabling movement of vertebral bones, the ground breaking developments in imaging methods boosted the success of spinal cord and spine surgeries and currently, satisfactory outcomes are achieved in most of the cases.
Please contact us to consult the spine and spinal cord surgeons in global hospital and physician network of Hera Healthcare and have a personal treatment plan.