Eight out of 10 Americans will experience back pain at least once or more in their lifetimes. In fact, a third of people ages 18 to 29 already have back problems, while nearly half of those ages 65 and older do. The back, or spine, is one of the most important body parts and one of the most complex. With various non-surgical and surgical treatments designed to address different spinal issues, it’s crucial to understand the anatomy of the spine and the treatment options available.
The Anatomy of the Spine
The human spine, or vertebral column, is a complex structure composed of 33 individual vertebrae, divided into five regions: cervical (neck), thoracic (upper back), lumbar (lower back), sacral (pelvic area), and coccygeal (tailbone). Each region serves a unique function and is subject to distinct types of disorders.
The cervical spine consists of seven vertebrae and is responsible for supporting the head and allowing for a wide range of motion. The thoracic spine contains twelve vertebrae and serves as an attachment for ribs, providing stability. The lumbar spine, made up of five vertebrae, bears most of the body’s weight and is often the source of back pain. The sacral spine consists of five fused vertebrae, forming the back of the pelvis, while the coccygeal spine comprises four fused vertebrae, known as the tailbone.
Vertebrae are connected at facet joints that facilitate spinal movement. Intervertebral discs, positioned between the vertebrae, act as shock absorbers and provide flexibility and support. Tough ligaments connect the vertebrae while surrounding muscles help maintain the spinal column’s integrity. The spinal cord, a bundle of nerves that extends from the brainstem through the spine, transmits messages from the brain to various body parts via smaller nerves branching out through the vertebrae.
Common Spine Conditions
Spinal disorders can stem from a variety of causes, including degenerative diseases, traumatic injuries, infections, tumors, and congenital abnormalities. Common conditions that may require surgical intervention include:
– Herniated Discs: Occurs when the soft inner gel of a disc protrudes through the outer layer, often causing pain and nerve compression.
– Spinal Stenosis: A narrowing of the spinal canal that puts pressure on the spinal cord and nerves.
– Spondylolisthesis: A condition where a vertebra slips out of place, often leading to pain and instability.
– Fractures: Trauma can lead to vertebral fractures, which may require stabilization.
Types of Spine Surgery
– Discectomy: This procedure removes herniated disc material pressing on a nerve, often using minimally invasive techniques to reduce recovery time and tissue damage.
– Laminectomy: In cases of spinal stenosis, a laminectomy may be performed to remove the lamina, the bony arch of the vertebra, thereby widening the spinal canal and alleviating pressure on the spinal cord.
– Spinal Fusion: Aims to permanently connect two or more vertebrae. Commonly used for conditions like spondylolisthesis, it often involves bone grafts or implants.
– Artificial Disc Replacement: This alternative to spinal fusion removes a damaged disc and replaces it with an artificial one, preserving spinal motion.
– Kyphoplasty and Vertebroplasty: Minimally invasive procedures for treating vertebral compression fractures. Kyphoplasty uses a balloon to restore vertebra height before filling it with cement, while vertebroplasty involves injecting cement directly into the vertebra.
– Foraminotomy: This surgery involves enlarging the foramen—the space where spinal nerves exit the spine—by removing bone or tissue to relieve nerve compression.
Is Surgery the Best Option?
Before considering spine surgery, thorough evaluations are essential. Individuals should discuss symptoms, medical history, and treatment options with their healthcare provider. Diagnostic imaging, such as MRI or CT scans, can help identify specific issues and guide surgical planning.
It’s also crucial to explore non-surgical treatments first. Physical therapy, medication, and lifestyle modifications can often manage symptoms effectively without invasive procedures. Always consult your healthcare provider to find the best options tailored to your individual needs. Understanding your spine and its conditions can empower you to make informed decisions about your health.
by Nancy Abu-Bonsrah, M.D.
Neurosurgeon, UPMC Neurological Institute
Nancy Abu-Bonsrah, M.D., sees patients at UPMC Neurological Institute, 740 High St., Williamsport. To make an appointment with Dr. Abu-Bonsrah, call 570-321-2820, and to learn more about UPMC Neurological Institute services in northcentral Pa., go to UPMC.com/NeuroNCPA.
