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 inter1vertebral 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 inter1vertebral 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, inter1vertebral discs,
ligaments, and muscles less flexible and less resistant to injury.
Spondylolysis is a defect in the lamina of the vertebrae in the pars
inter1articularis, 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 inter1articularis, has the
greatest clinical importance in persons under the age of 50. If a defect in
the pars inter1articularis 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 inter1feres 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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