Spinal Trauma :: Spinal Tumour
Thoracic Disc Herniation :: Ankylosing Spondylitis
Trauma to the spine is usually treated as an emergency by admission to hospital. On occasions, spinal injury is missed or late problems arise in the course of its treatment. At such times consultation and assessment can be of help.
The most common type of spinal tumour is spread of a cancer from another part of the body. Tumours arising from the spine itself are rare. Both forms of tumour cause spinal pain and if advanced, can lead to instability of the spine and pressure on the nerves and/or spinal cord. First line treatment involves cancer specialists and chemotherapy or radiation therapy. Only if pain is unrelieved or the spinal cord is threatened is surgery considered. Sometimes the large amount of cancer spread precludes surgical help.
Thoracic Disc Herniation
Disc herniation in the thoracic spine (mid-back) is quite distinct from lumbar disc herniation by being much less common and causes very different symptoms. Whereas lumbar disc herniation commonly causes sciatic pain in a leg, thoracic disc herniation may cause girdle pain around the chest and/or lack of coordination in the legs due to spinal cord compression. Treatment is based on the severity of symptoms and may include exercises, medication, injection of cortisone or surgery.
Ankylosing spondylitis is an uncommon inflammatory condition that starts in young adult life and affects the spine in a progressive way over decades. Pelvic and spinal pains are the early symptoms and these are treated with medications on the advice of a specialist physician. The end result of the disease is automatic fusion of the spine, which becomes rigid. Two problems may result from this. Firstly, relatively minor trauma can break the spine and threaten the spinal cord because there is reduced flexibility of the spine, clearly this is an emergency and is managed as such.
Secondly, the spine may fuse in a bent over position, leading to difficulties looking forward. If this is the case, consideration may be given to surgical correction of the deformity to permit forward gaze and easier walking.