Spinal Arthritis


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:

Human Vertebral Column or Spinal Column

Human Vertebral Column or 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 osteoarthritis

Back pain

Back pain

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.

Interbody Spine Fusion System

Interbody Spine Fusion System

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

– instability

– some cervical disc herniations (fusion together with discectomy)

– weak or unstable spine caused by infections or tumors

For more information about spine fusion surgery, check out medical tourism for spine fusion surgery through Healthbase.

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Spinal Arthritis

What is arthritis?

“Arthritis” is a general term that describes many different diseases causing tenderness, pain, swelling, and stiffness of joints as well as abnormalities of various soft tissues of the body. Of the combined term, “arthros” means a joint and its attachments, and “–itis” means inflammation. Various forms of arthritis affect nearly 50 million Americans and contribute to the majority of all physical disabilities.

Of the several varieties of arthritis, the most common, the most frequently disabling, and often the most painful is osteo- (meaning bone) arthritis, mostly affecting the weight bearing joints (hips and knees) plus the hands, feet and spine. Osteoarthritis is also known as degenerative joint disease and affects up to 30 million Americans, mostly women and usually those over 45 or 50 years of age.

Osteoarthritis of the spine
Spinal arthritis is one of the common causes of back pain. Spinal arthritis is the mechanical breakdown of the cartilage between the aligning facet joints in the back portion (posterior) of the spine that quite often leads to mechanically induced pain. The facet joints (also called vertebral joints or zygophyseal joints) become inflamed and progressive joint degeneration creates more frictional pain. Back motion and flexibility decrease in proportion to the progression of back pain induced while standing, sitting and even walking. Over time, bone spurs (small irregular growths on the bone also called osteophytes) typically form on the facet joints and even around the spinal vertebrae. Bone spurs are also seen as a normal part of aging and do not directly cause pain, but may become so large as to cause irritation or entrapment of nerves passing through spinal structures, and may result in diminished room for the nerves to pass (spinal stenosis). Osteoarthritis in the spine is anatomically divided into:

  • Lower back (lumbar spine) osteoarthritis, sometimes called lumbosacral arthritis, which produces stiffness and pain in the lower spine and sacroiliac joint (between the spine and pelvis).
  • Neck (cervical spine) osteoarthritis, sometimes called cervical spondylosis (spondy- implies the spine, and –osis is an abnormal condition), which can cause stiffness and pain in the upper spine, neck, shoulders, arms and head.

Causes of osteoarthritis and spinal arthritis
Repetitive trauma to the spine from repetitive strains caused by accidents, surgery, sports injuries, poor posture, or work-related activities are common causes of spinal arthritis. Other known risk factors for developing spinal arthritis include:

  • Aging: steady and advanced aging of spinal structures, beginning in the 30’s, often work-related
  • Gender: osteoarthritis being more common in post-menopausal women (although below age 45, it is more common in males)
  • Excess weight: causing more stress on weight-bearing joints and the spine, particularly during the middle age years
  • Genetics: having a family history of osteoarthritis or congenital defects of joints, spine, or leg abnormalities
  • Associated diseases: the presence of other associated diseases, infections, diabetes, and various other forms of circulating arthritis, such as rheumatoid arthritis or gout

Surgery for spinal arthritis
For spinal arthritis, the only effective surgical treatment is spine fusion surgery to stop the motion at the painful joint. Spinal fusion may also be referred to as “arthrodesis”. Fusion is a surgical technique in which one or more of the vertebrae of the spine are united together (“fused”) so that motion no longer occurs between them. During spinal fusion surgery bone grafts are placed around the spine during surgery. The body then heals the grafts over several months – similar to healing a fracture – which joins, or “welds,” the vertebrae together.

When Is Fusion Needed?
There are many potential reasons for a surgeon to consider fusing the vertebrae. These include: treatment of a fractured (broken) vertebra; correction of deformity (spinal curves or slippages); elimination of pain from painful motion; treatment of instability; and treatment of some cervical disc herniations.

How Long Will It Take To Recover?
The immediate discomfort following spinal fusion is generally greater than with other types of spinal surgeries. Fortunately, there are excellent methods of postoperative pain control available, including oral pain medications and intravenous injections. Another option is a patient-controlled postoperative pain control pump. With this technique, the patient presses a button that delivers a predetermined amount of narcotic pain medication through an intravenous line. This device is frequently used for the first few days following surgery.

Recovery following fusion surgery is generally longer than for other types of spinal surgery. Patients generally stay in the hospital for three or four days, but a longer stay after more extensive surgery is not uncommon. A short stay in a rehabilitation unit after release from the hospital is often recommended for patients who had extensive surgery, or for elderly or debilitated patients.

The decision whether or not to undergo spinal fusion is complex and involves many factors related to the condition being treated, the age and health of the patient, and the patient’s anticipated level of function following surgery. This decision must therefore be made carefully and should be discussed thoroughly with your surgeon.

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Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.

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