Frequently Asked Questions About Spine Care

The cervical spine consists of seven vertebrae, each separated by discs that act as cushions between the bones. Your cervical discs stabilize your neck and enable a great range of mobility.

Studies show that about 65% of the population will, at some time in their lives, be affected by pain in the cervical spine. Neck pain can result from both degenerative and non-degenerative spine issues.

The repetitive stress of bending and twisting in the neck can take its toll on your cervical spine over time. Degenerative disc disease is generally a slow process in which the disc becomes compressed, putting pressure on the nerves. This can result in neck stiffness, radiating pain, and numbness or weaknesses in the shoulders, arms and hands. Non-degenerative cervical spine problems, often the result of an accident or acute injury, can produce the same symptoms.

The lumbar spine is made up of five vertebrae. These bones are larger than the rest of the spinal column, which aides them in carrying the weight of the torso.

The causes of lumbar strain vary greatly and may be difficult to identify. Incidence of lower back pain appears higher in that population of patients with poor physical health, poor posture and body mechanics and stressful lifestyle. In the younger population, low back pain is most often attributed to a combination of rapid growth, tight musculature (especially the hamstring muscles) and poor posture. Older adults are more likely to suffer from pain related to osteoarthritis, spinal stenosis or other degenerative conditions.

Common spine issues include:

  • Arthritis and osteoarthritis are degenerative diseases in which the cartilage between the vertebrae breaks down
  • Degenerative disc disease refers to the degeneration of space between the discs, usually resulting from wear and tear over time. A fairly common cause of low-level back pain, this condition occurs more often in the lower back than the neck
  • Herniated (ruptured) disc occurs when the inner gel, or cartilage, in the discs leaks out
  • Sacroiliac joint dysfunction is pain in the “SI joint,” which is located at between the base of the spine and the hip
  • Sciatica is a lower back problem that affects the sciatic nerve exiting the lumbar spine, often causing radiating pain down the leg and into the foot
  • Scoliosis is the abnormal side-to-side curvature of the spine, usually developed during adolescence but sometimes caused by aging and arthritis
  • Spinal fractures are often the result of osteoporosis (loss of bone density and structural integrity)
  • Spinal stenosis is a condition in which parts of the spine narrow, leading to compression of a spinal nerve or the spinal cord in the neck
  • Spinal tumors are tumors in the spine that cause pressure on the nerves
  • Whiplash is an injury to the muscles and ligaments in the neck from a sudden jerking or “whipping” the head beyond its normal range of motion

Signs and symptoms of a neck or low back injury may include:

  • Sustained pain at night or when at rest
  • Fever or unexplained weight loss in combination with back pain
  • Pain in very young or elderly (under age 15 or over age 60) that has no apparent cause
  • Extreme and sudden pain following a mild fall or other simple trauma with recurring infection
  • Altered sensation or sharp and shooting pains that radiate down to the lower leg, ankle or foot
  • Radiating pain, numbness, headaches, weakness or loss of function in the limbs

If you are experiencing any of these neck or back injury symptoms, it is recommended that you contact your orthopaedic spine physician without delay.

Low back pain in over 95% of cases is managed conservatively with lumbar spine treatment, without the need for surgery.

Acute lumbar strain may resolve quickly with an adequate amount of rest combined with proper activity. Gentle stretching, occasional anti-inflammatory usage or muscle relaxers can assist the patient during the acute phase of lumbar strain. Excessive bed rest or inactivity may actually delay recovery. For the most part, lumbar strain is only temporary and most patients recover within a 2-12 week time frame, depending on cause and severity of a potential back injury.

For those with serious cases of acute back pain, it is vital to get an accurate diagnosis in order to receive the proper spine treatment. This is important to rule out any serious underlying and progressive disease or problem that can worsen and create permanent damage.

Of most concern with back pain is the incident of recurrence in those that have experienced one episode. Maintaining an adequate level of fitness, flexibility, strength and applying appropriate body maneuvers with lifting techniques can go a long way in avoiding this problem.

Cary Orthopaedics Spine Center offers a comprehensive array of effective, well-researched non-invasive treatments for neck and back pain. Depending on your condition, these may include:

  • Botox for spasticity/migraine headaches
  • Discography
  • EMG/nerve conduction studies
  • Epidural steroid injections
  • Facet injections
  • Joint and soft tissue manipulation
  • Spine physical therapy

We perform many of these spine services in-office.

Traditional spine surgery involves more invasive techniques to accomplish what minimally invasive spine surgery now offers. Utilizing a much smaller incision is only one advantage.

Traditional spine surgery requires more separation or retraction of the muscles and surrounding soft tissues to insert instrumentation and any hardware necessary to address the problem. The endoscope, through minimal invasion, avoids this additional trauma. As a result, excessive blood loss, post operative pain and scarring are significantly lessened.

Additional benefits of minimally invasive spine surgery are that patients also require much less anesthesia, and hospital stays are dramatically shorter. While open spine surgery requires four to five days of inpatient hospitalization, many patients are able to go home the same day after endoscopic spine surgery.

Minimally invasive procedures are performed using a tool called an endoscope, which is a thin tube with a tiny video camera on the end. The “scope” is inserted through a small portal and is guided to the problem area.

Muscles are then expanded apart, rather than incised, and the operation is performed with minimal injury to the surrounding soft tissues. A tiny video camera on the end of the endoscope projects large-scale images of the spine onto a video screen, helping the surgeon to visualize quite easily.

Depending on the specific diagnosis and surgical technique used, minimally invasive procedures may be performed either on an inpatient or outpatient basis.

With the evolution and success of minimally invasive spine surgery, only about 40% of our neck and back cases today involve open surgery. Still, there are times when open surgery is the more appropriate approach to treating a spine problem, like in the case of a surgery revision or large tumor.

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