Conditions Treated
Ankylosing Spondylitis
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.
Top Home Cervical Degenerative Problems
and Stenosis
Degenerative changes of the neck resemble arthritis, with thickening of soft-tissues
and bone spur formation. These bulky ligaments and bone spurs encroach upon the
canals containing the nerves and the spinal cord within the spine of the neck,
causing nerve and/or spinal cord compression. The degenerative changes may themselves
cause
neck and shoulder pain, whilst the nerve compression gives pain in one or both
arms This pain may be associated with weakness and numbness in the arms or hands.
If the spinal cord is compressed, there can be loss of coordination of the hands
and legs. Symptoms of degeneration of the spine may build up slowly or start
suddenly. Often, they will settle with altered activity, physiotherapy, exercises
and medication. Sometimes a cortisone injection is useful.
Surgery is used for unrelenting pain in the arm
or for obvious damage to the spinal cord. There are a number of procedures
that can be used for this condition and the choice is based on associated
symptoms and the appearance of scans. These procedures may be performed
through incisions on the front or the back of the neck. Sometimes
fusion is used as part of releasing the pressure on the nerves and/or
spinal cord and stabilising the neck. Most people having this type
of surgery on the neck return home after 3 or 4 nights in hospital.
Top Home
Cervical Disc Herniation
Disc herniation is also called disc rupture or slipped disc. Disc herniation
occurs when the tough, outer rim of the disc develops a tear, allowing the
soft, central part to squeeze out and enter the canal that contains the nerves
that supply the arms and the spinal cord. Symptoms of disc herniation in
the neck are pain running down the arm with or without pain in the back of
the neck and shoulders. Sometimes weakness and numbness of the arm or hand
may also be present. If the spinal cord is affected, there may be loss of
coordination in the arms or legs. The painful symptoms usually start fairly
suddenly and can be severe, but in the majority of people symptoms resolve
over a few weeks with reduced activity, physiotherapy and medications.
Surgery is used for unrelenting pain in the arm
or for obvious pressure on the spinal cord. There are a number of
procedures that can be used for this condition and the choice is
based on the symptom complex and the appearance of scans. These procedures
may be performed through incisions on the front or the back of the
neck. Sometimes fusion is used as part of removing the disc and stabilising
the neck. Most people having this type of surgery on the neck return
home after 2 or 3 nights in hospital.
Top Home
Lumbar Degenerative Problems
and Stenosis
Degenerative changes of the low back resemble arthritis, with thickening of
soft-tissues and bone spur formation. Bulky ligaments and bone spurs encroach
upon the canals containing the nerves within the spine of the low back, causing
nerve compression and pain. The degenerative changes may themselves cause back
pain,
whilst the nerve compression gives pain in one or both legs (sciatica). This
pain may be associated with weakness and numbness in the legs or feet. In some
people the leg symptoms are worse when walking. Symptoms of degeneration of
the spine may build up slowly or start suddenly. Often, they will settle with
altered activity, physiotherapy, exercises and medication. Sometimes a cortisone
injection is useful.
Surgery is used when pain is persistent or there
are severe problems with walking. Surgery for this condition will
vary according to the details of the problem seen on scans and
can range from relatively minor to very major procedures. The general
aim of surgery is to remove bone and ligaments that are pressing
on the nerves and is often called laminectomy. Sometimes fusion
is also required to halt slippage of one vertebra on another due
to loss of strength of the discs. Hospital stay after this kind
of surgery is from 3 to 7 days. In some cases, rehabilitation is
required for up to another 2 weeks, before returning home.
Top Home
Lumbar Disc Herniation
Disc herniation is also called disc rupture or slipped disc. Disc herniation
occurs when the tough, outer rim of the disc develops a tear, allowing the
soft, central part to squeeze out and enter the canal that contains the nerves
that supply the legs. Symptoms of disc herniation are pain running down the
leg (sciatica) with or without pain in the low back. Sometimes weakness and
numbness of the leg or foot may also be present. Sciatica usually starts
fairly suddenly and can be severe, but in the majority of people symptoms
resolve over a few weeks with a combination of reduced activity, physiotherapy
and medications.
Surgery is reserved for unrelenting pain or when
severe muscle weakness is progressing. In most cases, the operation
for disc herniation is discectomy, which is performed through a
small incision (about 3cm) in the middle of the back. There is
minimal removal of normal tissue in order to reach the ruptured
part of the disc, which is simply plucked out from underneath the
affected nerve. The intact part of the disc is left undisturbed.
People having a discectomy often return home after one to two nights
in hospital.
Top Home
Rheumatoid Arthritis
Rheumatoid arthritis is an inflammatory
disease can affect almost all the joints of the body. Although
it commonly involves the spine of the neck, symptoms are less
common. Damage to the neck by rheumatoid arthritis leads to pain
and sometimes to nerve and spinal cord compression. The latter
conditions may result in altered sensation and weakness in the
arms and possibly loss of coordination of the arms and legs.
Management of such problems is a delicate one
because of associated systemic disease and the powerful medications
required in rheumatoid arthritis. On some occasions surgery is
advisable if neck pain is very severe or instability of the neck
seriously threatens the spinal cord.
Top Home
Spinal Deformity
Abnormal curves of the spine may occur
in childhood, adolescence and adult life. In adult life, such
curves may lead to spinal pain or nerve compression pain. Spinal
cord involvement is rare. It is possible to surgically correct
spine deformities in adult life, but the mainstay of treatment
is exercise and medications.
Top Home
Spinal Infection
The spine may be infected when organisms
enter the blood stream or after spinal surgery. Unrelenting
pain is the most common symptom, though the nerves and spinal
cord may be affected if an abscess forms. Treatment with antibiotics
is the most usual way to control spinal infection. If an abscess
forms and the spinal cord is threatened, then surgery is considered.
Top Home
Spinal Trauma
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.
Top Home
Spinal Tumour
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.
Top Home
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.
Top Home |
