WHAT MAKES YOUR BACK?
Anatomy of the human spine
Have you ever wondered what makes your back and neck bend, stretch and even rotate so swiftly and smoothly? These movements are possible due to the spinal column or vertebral column in your body which extends from the skull to the pelvis and is made up of 33 individual bones termed vertebrae. The vertebral column is not actually a column but is sort of a spiral spring in the form of the letter S.
The following figure illustrates the human spinal column:
Between each vertebra are strong connective tissues which hold one vertebra to the next, and acts as a cushion between the vertebrae. The disc allows for movements of the vertebrae and lets you bend and rotate your neck and back. The type and degree of motion varies between the different levels of the spine: cervical (neck), thoracic (chest) or lumbar (low back).
The cervical spine is a highly mobile region that permits movement in all directions. The thoracic spine is much more rigid due to the presence of ribs and is designed to protect the heart and lungs. The lumbar spine allows mostly forward and backward bending movements (flexion and extension).
WHAT BREAKS YOUR BACK?
Spinal arthritis or osteoarthritis of the spine is a common cause of back pain. It is the mechanical breakdown of the cartilage between the vertebral joints in the back portion of the spine leading to mechanically induced pain. The joints become inflamed and pain may be felt when performing even the simplest of activities like standing, sitting or walking. Over time, bone spurs – small irregular growths on the bone, also called osteophytes – typicaly form on the vertebral joints and around the spinal vertebrae which may become so large as to cause irritation or entrapment of nerves passing through spinal structures and result in spinal stenosis (diminished room for the nerves to pass).
Classification of spinal osteoarthritis
- Lower back (lumbar spine) osteoarthritis or lumbosacral arthritis, which produces stiffness and pain in the lower spine and sacroiliac joint (between the spine and the pelvis)
- Neck (cervical spine) osteoarthritis or cervical spondylosis, which causes stiffness and pain in the upper spine, neck, shoulders, arms and head.
Causes of spinal osteoarthritis
The most common causes are repetitive trauma to the spine from repetitive strains caused by accidents, surgery, sports injuries and poor posture. Other risk factors include aging, gender (more common in post-menopausal women), excess body weight, genetics, and associated diseases (like infections, diabetes, rheumatoid arthritis, etc.)
WHAT REMAKES A BROKEN BACK?
Surgical treatment of spinal arthritis
For spinal arthritis, the only effective surgical treatment is spine fusion surgery, to stop motion at the painful joint. In fusion, one or more of the vertebrae of the spine are united (fused together) using bone grafts so that motion no longer occurs between them.
Uses of spinal fusion surgery
Spinal fusion surgery is used to treat:
- a fractured (broken) vertebra e.g. spondylolisthesis
- deformity e.g. scoliosis or kyphosis (spinal curves or slippages)
- pain from painful motion
- some cervical disc herniations (fusion together with discectomy)
- weak or unstable spine caused by infections or tumors
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