Disorders of the spine

Disorders of the spine affect the spinal cord, vertebrae or disks.

These disorders include:

• Herniated disk
• Kyphosis
• Mild spinal asymmetry
• Scoliosis
• Spina bifida
• Spinal stenosis 

Herniated disk refers to a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine. A spinal disk is a little like a jelly donut, with a softer center encased within a tougher exterior. Sometimes called a slipped disk or a ruptured disk, a herniated disk occurs when some of the softer “jelly” pushes out through a crack in the tougher exterior. A herniated disk can irritate nearby nerves and result in pain, numbness or weakness in an arm or leg. On the other hand, many people experience no symptoms from a herniated disk. Most people who have a herniated disk don’t need surgery to correct the problem.

Kyphosis is a forward rounding of your upper back. Some rounding is normal, but the term “kyphosis” usually refers to an exaggerated rounding—sometimes called round back or hunchback. While kyphosis can occur at any age, it’s most common in older women, where the deformity is known as a dowager’s hump. Mild kyphosis may cause few problems. But severe cases can affect your lungs, nerves, and other tissues and organs, causing pain and other problems. Treatment for kyphosis depends on your age, the cause of the curvature and its effects. If the kyphosis curve is very severe, particularly if the curve is pinching the spinal cord or nerve roots, your doctor might suggest surgery to reduce the degree of curvature. The most common procedure, called spinal fusion, connects two or more of the affected vertebrae permanently. Surgeons insert bits of bone between the vertebrae and then fasten the vertebrae together with metal wires, plates and screws.

Mild spinal asymmetry is the presence of a slight curvature of the spine. It should be monitored regularly, as it can progress into scoliosis, particularly during growth spurts.

Scoliosis is a sideways curvature of the spine that occurs most often during the growth spurt just before puberty. Most cases of scoliosis are mild, but some children develop spine deformities that continue to get more severe as they grow. Severe scoliosis can be disabling. An especially severe spinal curve can reduce the amount of space within the chest, making it difficult for the lungs to function properly.

Spina bifida is part of a group of birth defects located in the neural tube, which is the embryonic structure that develops into the baby’s brain and spinal cord and the tissues that enclose them. Normally the neural tube is fully formed and closed 28 days after conception, but in babies with spina bifida, it fails to develop completely, leaving a portion of the spinal cord exposed. There are three types of spina bifida:

• Myelomeningocele, the most severe form, is a condition where the baby’s spinal cord and its coverings protrude through an opening in the skin of the back. The membranes and spinal cord protrude and form a sac on the baby’s back. Tissues and nerves are usually exposed, however, which can leave the child prone to life-threatening infections. It can lead to many orthopedic problems, such as scoliosis, deformed feet, and uneven hips, which we can treat individually. Surgery on the spinal defect usually occurs 24 to 48 hours after birth.
• Meningocele is a rare form in which the meninges (protective membranes around the spinal cord) push out through the opening in the vertebrae. The spinal cord develops normally, so this condition can be treated easily through surgery by removing the meninges with little or no damage to nerve pathways.
• Spina bifida occulta is the mildest form, resulting in a gap or separation between one or more bones in the spine. Since spinal nerves are not involved, children with this condition will not have neurological issues and won’t show any symptoms. There are sometimes visible indications above the site of the spinal defect, such as a birthmark, tuft of hair or collection of fat, but most cases of this condition are not noticed unless discovered during an unrelated x-ray or imaging test. Treatment is usually not required for spina bifida occulta.

Spinal stenosis occurs when part of your spine narrows, putting pressure on your spinal cord or nerves. That pressure can cause pain, numbness or weakness in your back, neck, shoulders or limbs. Spinal stenosis can result from injuries, tumors and other diseases. The most common cause is changes in your spine as you age. If your spinal stenosis is severe, you may need surgery.