Spinal instability is the term for an excess of motion taking place between the vertebrae. It can result from an injury, degeneration, previous surgery, a tumor or a congenital condition. It may also be brought on by fractured vertebrae or another form of damage to the spinal column due to a trauma or osteoporosis.
If a disc in the spine is degenerating, it loses some of its rigidity, which causes the disc to swell. An increasing amount of abnormal movement may then take place between the vertebrae. There can be a resultant loss of disc height, which then shifts the facet joints into a position outside the parameters of their normal alignment.
A person with spinal instability may experience neck or back pain, depending on the area of the spine that is affected. If it is causing compression of the nerves, the pain may radiate into the arms or legs. Patients may also have muscle spasms, weakness, paralysis or numbness in some cases. There may be significant—sometimes extremely sharp—back pain, especially when a sufferer is getting up from a chair to a standing position.
To determine the cause of your back pain, a doctor will perform a full physical and neurological examination. Imaging technology such as X-rays, MRIs and CT scans also can help your doctor diagnose spinal instability. Motion-oriented assessments, such as taking X-rays while a patient is leaning forward and then backward, can give your physician a basis of comparison to see whether any abnormal movements are present.
Initial treatment for spinal instability is often bed rest along with use of a brace for stabilization. If unsuccessful, the next step may be a combination of physical therapy and anti-inflammatory medications.
If non-surgical options do not improve the symptoms, spinal instability is commonly treated with a spinal fusion surgery. Spinal fusion surgery connects two or more of the vertebrae in your spine. A bone graft, with bone from either another part of your body or from a bone bank, is placed between the vertebrae and may be held in place with plates, screws and rods. Eventually, the vertebrae fuse together, expanding the stability of the spine and diminishing pain.
Spinal stenosis is a common condition that involves a narrowing in one or more areas of the spine as a result of injury or deterioration to the discs, joints or bones within the spinal canal.
While some patients may be born with spinal stenosis, most cases develop later in life as a result of the degenerative changes that occur in the spine over time. Osteoarthritis is the main cause of spinal stenosis, as it causes the cartilage in the area to deteriorate and eventually results in the bones rubbing against each other and forming growths called bone spurs. These bone spurs may narrow the spinal canal when they form the facet joints. Spinal stenosis can also be caused by a herniated disc, ligament changes or spinal tumors.
Patients with spinal stenosis may experience cramping, pain and numbness in the legs, back, neck, shoulders or arms, depending on which part of the spine is affected. A loss of sensation, loss of balance and bladder malfunctioning may also occur in some patients.
Some patients may not experience any symptoms from this condition. It is only when the narrowed area of the spine compresses the spinal cord or nerves that symptoms arise.
Spinal stenosis is often difficult to diagnose because its symptoms can come and go and may resemble the symptoms of many other conditions. A diagnosis of spinal stenosis is often achieved after ruling out other conditions after performing imaging exams such as a spinal X-ray, MRI, CT scan, bone scan and others. Your doctor will also ask you several questions about your symptoms and overall health to correctly diagnose your condition and provide an adequate treatment solution.
Most cases of spinal stenosis can be effectively treated through conservative methods such as physical therapy, nonsteroidal anti-inflammatory drugs, rest and a back brace. These treatments are usually administered for at least three months for the spine to heal properly and allow for full function. The specific treatment for your individual condition may vary.
For more severe cases of spinal stenosis, surgery may be required to relieve pressure on the spinal cord while also maintaining the integrity of the site. This may be achieved through procedures such as a decompressive laminectomy, laminotomy or fusion that relieve pressure and join the damaged bone back to its normal state.