spinal conditions

Slip disc or back disc herniation is most common spinal disorder. Slip disc meaning is protrusion of part of the disc in spinal canal causing pressure on spinal cord and nerves.This leads to inflammation around spinal nerves and will cause Sciatica Causes Primary cause of slip disc is age related degeneration (chronic wear and tear). This causes loss of water content of the disc material leading to loss of it’s shock absorbing capabilities. Patients who are overweight and who have poor lifestyle (wrong posture, long sitting, inactivity) are more prone to develop these degenerative changes. Occasionally, acute injury and accident also can be the cause of disc prolapse. Slip Disc Symptoms: A disc herniation can be totally asymptomatic, especially if the size of disc herniation is small. However, in majority of the cases, the slipped disc causes varying amount of symptoms depending upon size herniated disc, duration of pressure on nerves and inflammation around the nerve. Initially, patients will feel pain at the site of disc prolapse (neck in case of cervical disc prolapse, upper back in case of thoracic disc prolapse and lower back in lumbar disc prolapse). When spinal nerves in the vicinity starts getting affected, pain and tingling-numbness in the extremities (radiculopathy or Sciatica) which may lead to loss of sensation or loss of muscle power in severe cases. In extreme situation with sudden and severe pressure on spinal cord, patient might lose bladder-bowel control also, which requires urgent spinal cord decompression surgery to prevent permanent damage to the spinal cord. A disc prolapse in cervical and thoracic spine can also cause rigidity in the body (spasticity) with loss of balance. Slip Disc Diagnosis: Primary diagnosis of a slip disc is made based on typical clinical history of local pain in spine with nerve related symptoms in the extremities. On physical examination, spine specialist may also find evidence of nerve stretch and compression signs on upper/ lower extremity in the form of loss of sensation and muscle weakness. An X-RAY is usually done as first line of investigation to rule out major bone abnormality. In severe cases which are not responding to medical treatment and physiotherapy, an MRI Scan is done which will show the level and degree of prolapsed disc, and will help spine specialist determine which kind of treatment will be best for the patient. In certain situations an EMG-NCV (Electromyography-Nerve Conduction Velocity) is done to assess nerve function. A CT Scan is done when detailed assessment of bone structure is required or when MRI cannot be done. Treatment: A proper medical treatment, some amount of activity restriction and slip disc exercises (physiotherapy) provides sufficient pain relief to most of the patients to help them live an active life. For the patients who don’t get relief by medical treatment, various options are available. 1. Epidural Injections: For patients who primarily present with radiculopathy (arm/ leg pain) and don’t have emergency symptoms (loss of sensation, weakness, loss of bladder-bowel control), epidural injection can be tried to provide pain relief to the patient. A small amount of anaesthetic medication and steroid are injected next to the prolapsed disc. This reduces inflammation on spinal nerve as well as disc material to provide relief to the patient. If symptoms recur, injection can be repeated 2-3 times. • Microdiscectomy: Patients who do not get adequate relief after medical treatment or epidural injection, or those who have emergency symptoms need to undergo slip disc surgery with removal of protruded disc material. Microdiscectomy is most commonly done slip disc surgery. A small hole is made on the skin and only the part of disc which has come out is removed. There is immediate relief of symptoms and recovery is very quick. • Endoscopic Discectomy: A small tube like endoscope is inserted in the body under local/ general anaesthesia and protruded disc is removed under magnified endoscopic vision. Recovery from this surgery is very quick and this procedure can be done as day-care also. In patients with associated significant back pain/ neck pain, severe disc degeneration (spondylosis), vertebral slip (spondylolisthesis), spine fracture (spondylolysis) and spine deformity (scoliosis/ kyphosis), a spine fusion/ instrumentation might also be advised by your spine doctor along with the removal of slipped disc. The information provided here is for general educational purposes only. For specific advice regarding back pain treatment, please book an appointment with one of our surgeons.

Cervical myelopathy is a form of myelopathy that involves compression of the spinal cord in the cervical spine (neck). Your cervical spine contains seven vertebrae (C1 to C7), with six intervertebral discs and eight nerve roots. Causes One common type of cervical myelopathy is cervical spondylotic myelopathy. The term “spondylotic” refers to one of the possible causes of myelopathy — gradual degeneration of the spine that happens as you age. Therefore, cervical spondylotic myelopathy is more common in people 50 and older. The gradual degeneration of the spine often takes the form of cervical spinal stenosis, which is the narrowing of the spinal canal in the neck. Some people are born with a narrow spinal canal (congenital spinal stenosis) and may experience myelopathy sooner than others if further narrowing occurs. Bulging or herniated discs and bone spurs in the neck are other forms of spinal degeneration that can press on the spinal cord and cause myelopathy. Besides the gradual wear and tear of the spine, cervical myelopathy can also be caused by the ossification (hardening) of the ligaments surrounding the spinal cord, such as posterior longitudinal ligament and ligamentum flavum. The ossification of posterior longitudinal ligament (OPLL) is more common. This means that the soft tissue that connects the bones of the spinal column becomes less flexible and slowly turns into bone (ossification). As the ligament becomes thicker, it starts taking up more space and putting pressure on the spinal cord, which leads to myelopathy. The neck portion of the spine is the most common location for OPLL ossification. Other causes of cervical myelopathy may include: • Rheumatoid arthritis of the neck • Whiplash injury or other cervical spine trauma • Spinal infections • Spinal tumors and cancers Symptoms Cervical myelopathy produces two types of symptoms: the ones you may feel in the neck, and the ones appearing elsewhere in the body at or below the compressed area of the spinal cord. The neck symptoms may include: • Neck pain • Stiffness • Reduced range of motion As the disease progresses, one may experience shooting pain that originates in the neck and travels down the spine. Other cervical myelopathy symptoms may include: • Weakness in the arms and hands • Numbness or tingling in the arms and hands • Clumsiness and poor coordination of the hands • Difficulty handling small objects, like pens or coins • Balance issues Diagnosis The earlier cervical myelopathy is diagnosed, the more successful the treatment is expected to be. However, cervical myelopathy symptoms are not unique to this condition and are often mistaken for “normal” signs of aging. To diagnose cervical myelopathy, your doctor may: • Conduct a physical examination and measure your muscle strength and reflexes. • Conduct further tests, including an MRI scan, an X-ray or a CT myelogram of your neck. • Conduct electrical tests to measure how well the nerves in your arms and hands communicate with your brain through the spinal cord. Treatment There are some nonsurgical options for relieving cervical myelopathy symptoms, including physical therapy and a cervical collar brace. However, to eliminate the compression of the spinal cord and prevent worsening of the condition, surgery is often necessary. There are a few surgical procedures your doctor may recommend for treating cervical myelopathy. Widening of the spinal canal (laminoplasty) can be a good motion- sparing option for some patients. Others may benefit from spine decompression surgery with spinal fusion, which is meant to stabilize the spine after herniated discs, bone spurs or ossified ligaments are fully or partially removed. These surgeries can be performed from the back of the neck (posteriorly) or from the front of the neck (anteriorly). Your doctor will recommend a specific surgery approach based on your situation. The information provided here is for general educational purposes only. For specific advice regarding back pain treatment, please book an appointment with our surgeon.

Spinal tuberculosis, also known as Pott's disease or tuberculous spondylitis, is a form of tuberculosis that primarily affects the spine. It is caused by the Mycobacterium tuberculosis bacteria, the same pathogen responsible for pulmonary TB. This condition leads to the gradual destruction of the spinal bones (vertebrae), which can cause severe back pain, stiffness, and deformity. If left untreated, spinal TB can result in serious complications such as spinal instability, neurological deficits, and even paralysis due to the compression of the spinal cord or nerves. Early diagnosis and treatment are crucial to prevent permanent damage and improve outcomes. Symptoms The symptoms of spinal tuberculosis can vary depending on the stage and severity of the infection. Common symptoms include: • Back Pain: Persistent, deep-seated back pain is often the first symptom. The pain may be localised to the spine or radiate to other areas. • Stiffness and Limited Mobility: Patients may experience stiffness in the back and difficulty moving, especially in the morning or after periods of inactivity. • Fever and Night Sweats: Systemic symptoms such as low-grade fever, night sweats, and general malaise can accompany spinal TB, similar to other forms of tuberculosis. • Weight Loss: Unexplained weight loss and loss of appetite are common, as the body fights off the infection. • Neurological Symptoms: If the infection affects the spinal cord or nerves, symptoms may include numbness, tingling, weakness in the limbs, or even paralysis. • Deformity: Advanced spinal TB can cause deformities such as kyphosis (hunchback) due to vertebral collapse and spinal instability. • Abscess Formation: In some cases, paravertebral abscesses (abscesses adjacent to the spine) can form, leading to additional symptoms like a visible swelling or tenderness in the back. • Spinal Instability: Severe cases can result in instability of the spine, making the spine more prone to fractures or deformities.

Spondylosis is age-related wear and tear of the spinal discs and joints, essentially spinal osteoarthritis, common in older adults, causing stiffness, pain, and potential nerve issues like weakness, numbness, or coordination problems if bone spurs or disc issues compress nerves or the spinal cord. Causes are aging and daily stress, while risk factors include heavy lifting, poor posture, or past injury.

Neck pain is commonly caused by muscle strain from poor posture (e.g., “tech neck“), sleeping awkwardly, or overuse. Other causes include age-related wear (osteoarthritis), injury (whiplash), or nerve compression.

Back pain is a common, often temporary, issue frequently caused by muscle strain, poor posture, or injuries to the spine's muscles, ligaments, and discs. Symptoms range from dull aches to severe stabbing pain, sometimes radiating down legs

A painful injury caused when one of the flat things (discs) between the bones in your back (spine) moves out of its correct position.