Degenerative Conditions/Arthritis

Cervical spondylosis refers to arthritic or “wear and tear” changes to the cervical spine (the part of the spine that is in the neck) including the intervertebral discs, the facet joints, and the associated ligaments.  As we age, our spines undergo these types of changes; this process occurs at different rates for different people and can cause pain and/or lead to narrowing of the spinal column. This narrowing is referred to as “stenosis”. The cervical spondylosis and stenosis can pinch the spinal cord or nerve roots causing pain, weakness/paralysis, as well as other symptoms. These conditions include cervical radiculopathy and myelopathy. By identifying the cause of a patient’s pain, numbness/tingling, or weakness patient’s we can determine the best treatment course. This may include non-surgical treatments, for example physical therapy, or cervical spine surgery including minimally invasive spine surgery.

Read more about Cervical Spondylosis/stenosis (arthritis) on the AANS website.

Lumbar spondylosis/stenosis refers to arthritic or “wear and tear” changes to the lumbar vertebrae (bones that make up our spine) including the intervertebral discs, the facet joints, and the associated ligaments. As we age, our spines undergo these types of changes. This arthritic process occurs at different rates for different people. Unfortunately, lumbar spondylosis/stenosis can cause disability as the result of musculoskeletal pain or by compression of the nearby lumbar nerve roots and rootlets. This condition may be related/overlapping with Neurogenic claudication, radiculopathy, and herniated intervertebral disc. By identifying the cause of a patient’s pain, numbness/tingling, or weakness patient’s we can determine the best treatment course. This may include non-surgical treatments, for example physical therapy, or lumbar spine surgery including minimally invasive spine surgery.

Read more about Lumbar Spondylosis/stenosis (arthritis) on the AANS website.

Lumbar spondylolisthesis is a specific form of lumbar spondylosis that refers to lumbar vertebrae (bones that make up our spine) “slipping” forward or backward. The abnormal movement of lumbar spine can cause severe musculoskeletal pain or may lead to compression of nearby lumbar nerve roots and rootlets. This nerve compression can cause pain, numbness/tingling, and weakness among other symptoms. This condition may be related/overlapping with Neurogenic claudication, radiculopathy, and herniated intervertebral disc. By identifying the cause of a patient’s pain, numbness/tingling, or weakness patient’s we can determine the best treatment course. This may include non-surgical treatments, for example physical therapy, or lumbar spine surgery including minimally invasive spine surgery.

Read more about Lumbar spondylolisthesis on the AANS website.

Herniated (and related terms, “bulging” and “compressive”) discs refer to a problem whereby the intervertebral disc pushing or exerting pressure on one or more nerve roots or the spinal cord. The intervertebral disc is the structure between each of our vertebrae (bones in the spine) and provides cushion and movement to the spine. When the disc material is not contained in its normal location between the vertebrae, it can exert pressure onto the nervous system causing severe pain, weakness, and a host of other symptoms (for example radiculopathy, myelopathy, and Neurogenic claudication).

Fortunately, many disc herniations can be treated without surgery. This is in part because typically the abnormal/misplaced disc will dry up and shrink, thereby naturally relieving the pressure that is causing a patient’s symptoms. One rule of thumb is to try and wait about three months before considering a microdiscectomy, which can usually be performed with minimally invasive spine surgery.

Read more about Herniated disc on the AANS website.

Cervical myelopathy or cervical spondylotoic myelopathy refers to compression of the spinal cord associated with arthritis in the neck. Cervical spondylosis/stenosis may lead to narrowing of the spinal canal and thereby pinching of the spinal cord. This is typically a slow (chronic) process that occurs over many months/years. The symptoms may range from mild to severe and include pain, numbness/tingling, and weakness. This includes difficulty using ones hands or difficulting walking. Cervical myelopathy may improve with non-surgical treatments such as physical therapy but often times requires cervical spine surgery.

Read more about Myelopathy on the AANS website.

Radiculopathy refers to a problem with one of the nerve roots branching from the spine leading to pain, numbness/tingling, or weakness. Most commonly, radiculopathy is the result of arthritic or “wear and tear” changes including herniated intervertebral disc in the cervical or the lumbar spine (commonly referred to as “sciatica”).  Many times the symptoms associated with radiculopathy will go away on their own. However, when symptoms persist imaging tests and consultation with a spine specialist may be necessary. Many forms of radiculopathy can be treated with non-surgical treatments, for example, physical therapy. When non-surgical treatment is not effective patients may benefit from spine surgery including minimally invasive spine surgery.

Read more about radiculopathy on the Johns Hopkins University site.

Neurogenic claudication most commonly refers to the symptoms caused by chronic lumbar stenosis, or narrowing of the spinal canal in the low back. When arthritic changes in the lumbar spine lead to narrowing of spinal canal, the nerve roots in this area are compressed and don’t function properly. Commonly, patients will describe symptoms in their legs especially when standing or walking, for example, numbness, tingling, or weakness. These symptoms are commonly received by leaning forward, sitting, or lying down.

The word claudication comes from the Latin claudicare meaning ‘to limp’.

If non-surgical treatments, for example physical therapy, are not effective, a spinal decompression may be recommended to relieve the pressure on the nerve roots. This surgery can often be performed as minimally invasive spine surgery.

Read more about Neurogenic claudication on wikipedia.

Degenerative adult scoliosis refers to an abnormal shape of the spine leading to symptoms such as pain, numbness/tingling, and weakness in the arms or the legs. This abnormal shape or alignment of the spine may be the result of several process including severe arthritis (so-called degenerative spinal deformity). Imaging tests (for example X-rays and MRI) are important both to diagnose and treat spinal deformity. By understanding the nature of the abnormal spine curve we are able to determine if spine surgery is necessary.

Read more about degenerative adult scoliosis at the University of Maryland website.