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Back pain is pain felt in the back. It may be classified as neck pain (cervical), middle back pain (thoracic), lower back pain (lumbar) or coccydynia based on the segment affected. The lumbar area is the most common area affected. An episode of back pain may be acute, subacute or chronic depending on the duration. The pain may be characterized as a dull ache, shooting or piercing pain or a burning sensation. Discomfort can radiate to the arms and hands as well as the legs or feet, and may include numbness or weakness in the legs and arms.
Lumbar spinal stenosis (LSS) is a medical condition in which the spinal canal narrows and compresses the nerves and blood vessels at the level of the lumbar vertebrae. Spinal stenosis may also affect the cervical or thoracic region, in which case it is known as cervical spinal stenosis or thoracic spinal stenosis. Lumbar spinal stenosis can cause pain in the low back or buttocks, abnormal sensations, and the absence of sensation (numbness) in the legs, thighs, feet, or buttocks, or loss of bladder and bowel control.
Spinal tumors are neoplasms located in either the vertebral column or the spinal cord. There are three main types of spinal tumors classified based on their location: extradural and intradural. Extradural tumors are located outside the dura mater lining and are most commonly metastatic. Intradural tumors are located inside the dura mater lining and are further subdivided into intramedullary and extramedullary tumors. Intradural-intramedullary tumors are located within the dura and spinal cord parenchyma, while intradural-extramedullary tumors are located within the dura but outside the spinal cord parenchyma. The most common presenting symptom of spinal tumors is nocturnal back pain. Other common symptoms include muscle weakness, sensory loss, and difficulty walking. Loss of bowel and bladder control may occur during the later stages of the disease.
Spondylosis is the degeneration of the vertebral column from any cause. In the more narrow sense it refers to spinal osteoarthritis, the age-related wear and tear of the spinal column, which is the most common cause of spondylosis. The degenerative process in osteoarthritis chiefly affects the vertebral bodies, the neural foramina and the facet joints. If severe, it may cause pressure on the spinal cord or nerve roots with subsequent sensory or motor disturbances, such as pain, paresthesia, imbalance, and muscle weakness in the limbs.
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury. Injury can occur at any level of the spinal cord and can be complete, with a total loss of sensation and muscle function at lower sacral segments, or incomplete, meaning some nervous signals are able to travel past the injured area of the cord up to the Sacral S4-5 spinal cord segments. Depending on the location and severity of damage, the symptoms vary, from numbness to paralysis, including bowel or bladder incontinence. Long term outcomes also range widely, from full recovery to permanent tetraplegia or paraplegia. Complications can include muscle atrophy, loss of voluntary motor control, spasticity, pressure sores, infections, and breathing problems.
Myelopathy describes any neurologic deficit related to the spinal cord. The most common form of myelopathy in humans, cervical spondylotic myelopathy (CSM), also called degenerative cervical myelopathy, results from narrowing of the spinal canal ultimately causing compression of the spinal cord. When due to trauma, myelopathy is known as (acute) spinal cord injury. When inflammatory, it is known as myelitis. Disease that is vascular in nature is known as vascular myelopathy.
Degenerative disc disease (DDD) is a medical condition typically brought on by the normal aging process in which there are anatomic changes and possibly a loss of function of one or more intervertebral discs of the spine. DDD can take place with or without symptoms, but is typically identified once symptoms arise. The root cause is thought to be loss of soluble proteins within the fluid contained in the disc with resultant reduction of the oncotic pressure, which in turn causes loss of fluid volume. Normal downward forces cause the affected disc to lose height, and the distance between vertebrae is reduced. The anulus fibrosus, the tough outer layers of a disc, also weakens. This loss of height causes laxity of the longitudinal ligaments, which may allow anterior, posterior, or lateral shifting of the vertebral bodies, causing facet joint malalignment and arthritis; scoliosis; cervical hyperlordosis; thoracic hyperkyphosis; lumbar hyperlordosis; narrowing of the space available for the spinal tract within the vertebra ; or narrowing of the space through which a spinal nerve exits with resultant inflammation and impingement of a spinal nerve, causing a radiculopathy.
Cauda equina syndrome (CES) is a condition that occurs when the bundle of nerves below the end of the spinal cord known as the cauda equina is damaged. Signs and symptoms include low back pain, pain that radiates down the leg, numbness around the anus, and loss of bowel or bladder control. Onset may be rapid or gradual.
Spinal fusion, also called spondylodesis or spondylosyndesis, is a neurosurgical or orthopedic surgical technique that joins two or more vertebrae. This procedure can be performed at any level in the spine and prevents any movement between the fused vertebrae. There are many types of spinal fusion and each technique involves using bone grafting—either from the patient (autograft), donor (allograft), or artificial bone substitutes—to help the bones heal together. Additional hardware is often used to hold the bones in place while the graft fuses the two vertebrae together. The placement of hardware can be guided by fluoroscopy, navigation systems, or robotics.
A spinal disc herniation is an injury to the cushioning and connective tissue between vertebrae, usually caused by excessive strain or trauma to the spine. It may result in back pain, pain or sensation in different parts of the body, and physical disability. The most conclusive diagnostic tool for disc herniation is MRI, and treatment may range from painkillers to surgery. Protection from disc herniation is best provided by core strength and an awareness of body mechanics including posture.
Central cord syndrome (CCS) is the most common form of cervical spinal cord injury. It is characterized by loss of motion and sensation in arms and hands. It usually results from trauma which causes damage to the neck, leading to major injury to the central corticospinal tract of the spinal cord. The syndrome is more common in people over the age of 50 because osteoarthritis in the neck region causes weakening of the vertebrae. CCS most frequently occurs among older persons with cervical spondylosis, however, it also may occur in younger individuals.
MedStar National Rehabilitation Network is located in Washington, D.C., and specializes in treating persons with physical disabilities, including spinal cord injury, brain injury, stroke, arthritis, amputation, multiple sclerosis, post-polio syndrome, orthopedic, and other neurological conditions. National Rehabilitation Hospital was founded in 1986 by Edward A. Eckenhoff, and is a member of the MedStar Health system, the Washington, D.C.-Baltimore region's largest non-profit healthcare organization.
Spinal stenosis is an abnormal narrowing of the spinal canal or neural foramen that results in pressure on the spinal cord or nerve roots. Symptoms may include pain, numbness, or weakness in the arms or legs. Symptoms are typically gradual in onset and improve with leaning forward. Severe symptoms may include loss of bladder control, loss of bowel control, or sexual dysfunction.
Arthur L. Jenkins III is an American fellowship-trained neurosurgeon, co-director of the Neurosurgical Spine Program, and Director of Spinal Oncology and Minimally Invasive Spinal Surgery (MIS) Program at the Mount Sinai Hospital, New York. Additionally, he is an associate professor of Neurosurgery and of Orthopedic Surgery at the Mount Sinai School of Medicine. Dr. Jenkins has multiple patents and patent applications for spine-related implants and support systems, and is developing new minimally invasive treatments for patients with cancer that has spread to the spine. He is an innovator in the treatment of acute spinal cord injury as well as degenerative and congenital anomalies of the spine, taking a minimally invasive or minimal-impact approach where possible. He is board certified in Neurological Surgery and is licensed in New York and Connecticut.
Mary Pauline Galea is an Australian physiotherapist and neuroscientist at University of Melbourne. She resides in Melbourne, Australia. Galea is a professorial fellow at the University of Melbourne's Department of Medicine at the Royal Melbourne Hospital and a Senior Principal Fellow in the Florey Institute of Neurosciences and Mental Health. She was foundation professor of clinical physiotherapy and director of the Rehabilitation Sciences Research Centre at the University of Melbourne and Austin Health. She is internationally recognised for her work in spinal cord injury and rehabilitative interventions.
Michael Fehlings is a Canadian neurosurgeon based at Toronto Western Hospital in Toronto, Ontario, Canada. Dr. Fehlings specializes in complex spine surgery with a special interest in traumatic and non-traumatic spinal cord injury and spine oncology. He mainly focuses on preclinical and clinical translational research related to enhancing repair and regeneration of the injured central nervous system. He holds many positions, including Head of the Spinal Program at the Toronto Western Hospital, Professor of Neurosurgery at the University of Toronto, Vice Chair Research at the University of Toronto, Halbert Chair in Neural Repair and Regeneration, Scientist at the McEwen Centre for Regenerative Medicine, McLaughlin Scholar in Molecular Medicine, and Co-Director of the University of Toronto Spine Program. He is the past inaugural Director of the University of Toronto Neuroscience Program, and was the previous Medical Director at Toronto Western Hospital. Dr. Fehlings is a Fellow of the American College of Surgeons and a Fellow of the Royal College of Surgeons of Canada.
Spinal cord injury without radiographic abnormality (SCIWORA) is symptoms of a spinal cord injury (SCI) with no evidence of injury to the spinal column on X-rays or CT scan. Symptoms may include numbness, weakness, abnormal reflexes, or loss of bladder or bowel control. Neck or back pain is also common. Symptoms may be brief or persistent. Some do not develop symptoms until a few days after the injury.
Spinal cord injury research seeks new ways to cure or treat spinal cord injury in order to lessen the debilitating effects of the injury in the short or long term. There is no cure for SCI, and current treatments are mostly focused on spinal cord injury rehabilitation and management of the secondary effects of the condition. Two major areas of research include neuroprotection, ways to prevent damage to cells caused by biological processes that take place in the body after the injury, and neuroregeneration, regrowing or replacing damaged neural circuits.
Branko Kopjar is a physician and epidemiologist at the University of Washington. He is best known for his contributions in the 1990s to the field of injury prevention and his later work on spine, orthopedic and spinal cord injury research. In addition, he has been published in several top journals in the fields of cardiology, oncology, public health and neurosurgery resulting in a total of more than 500 articles, reports, reviews and abstracts.
Bizhan Aarabi is an Iranian-American neurosurgeon, researcher, author and academic. He is Professor of Neurosurgery at University of Maryland and the Director of Neurotrauma at the R Adams Cowley Shock Trauma Center.
References
- 1 2 3 4 5 "Sarah Dunlop". the UWA Profiles and Research Repository. Retrieved 26 July 2019.
- 1 2 "Clinical trials for spinal cord injury: Acute care to the community". The John Curtin School of Medical Research. Retrieved 21 October 2022.
- ↑ "ANS org" (PDF).
- ↑ http://www.spinalnetwork.org.au Spinal Network
- ↑ "Sarah A Dunlop | BSc (Hons Zoology), London; PhD, London | University of Western Australia, Perth | UWA | School of Animal Biology | ResearchGate". ResearchGate. Retrieved 27 July 2019.
- ↑ "Professor Sarah Dunlop". www.spinalnetwork.org.au. Retrieved 27 July 2019.
- ↑ "Research Award, Spine Society of Australia, for "The most outstanding contribution in the fields of basic science, biomechanics or clinical studies of the spine"". the UWA Profiles and Research Repository. Retrieved 26 July 2019.
- ↑ "Finalist (1 of 3), West Australian Scientist of the Year Award". the UWA Profiles and Research Repository. Retrieved 26 July 2019.
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