SPINE
What is spondylolisthesis?
Spondylolisthesis occurs when one vertebra slips forward over the one below it, most often in the lower back (lumbar spine).
What are the symptoms?
Common symptoms include lower back pain, leg pain or sciatica, and sometimes numbness or weakness that worsens with standing or walking.
How is spondylolisthesis treated?
Non-surgical treatment focuses on physical therapy, core strengthening, and pain management methods. If surgery is needed, it typically involves decompression and spinal fusion to relieve pressure on the nerves and stabilize the affected segment. In select cases of low-grade slips without dynamic instability, decompression alone may be an option.
What is sciatica?
Sciatica is nerve pain that radiates along the sciatic nerve, usually caused by compression of a spinal nerve root between the lower lumbar and upper sacral spine (L4 to S1).
What are the symptoms?
People often experience sharp, burning, or shooting pain down the leg, sometimes with numbness, tingling, or weakness. Symptoms can worsen with sitting, coughing, or prolonged standing.
How can sciatica be treated?
Non-surgical options include medications, physical therapy, and epidural steroid injections. If symptoms persist, the most common surgical option is a minimally invasive lumbar microdiscectomy, where the disc fragment pressing on the nerve is removed. This approach allows for minimal tissue disruption and a quick recovery.
What is degenerative disc disease?
Degenerative disc disease (DDD) describes natural wear and tear of the spinal discs with age. Discs act as cushions between the vertebrae; over time they can lose water, thin, and function less effectively. While age-related disc changes are common, not everyone with DDD has pain.
What are the symptoms?
Many people experience chronic back or neck pain that may wax and wane. Pain often worsens with prolonged sitting, bending forward, lifting, or twisting. Stiffness can also make movement harder.
How can degenerative disc disease be treated?
Most people improve with non-surgical care: activity modification, physical therapy to strengthen and improve flexibility, and medications such as acetaminophen or NSAIDs. In some cases, spinal injections can reduce inflammation. Surgery is reserved for persistent pain despite conservative care or when nerve compression causes weakness, numbness, or difficulty walking.
What is a pinched nerve?
A pinched nerve (radiculopathy) occurs when a spinal nerve is compressed or irritated by a herniated disc, bone spurs, spinal stenosis, or other structural changes.
What are the symptoms?
Pain radiating into the arm or leg, numbness or tingling, and/or muscle weakness are common.
How can a pinched nerve be treated?
Conservative treatments include anti-inflammatory medications, physical therapy, and injections. For cervical radiculopathy, surgical options include anterior cervical discectomy and fusion (ACDF) to remove pressure and stabilize the spine, or cervical disc replacement (CDR) to relieve pressure while preserving motion. For lumbar radiculopathy, a minimally invasive lumbar discectomy may be performed to remove the disc fragment pressing on the nerve.
What is a herniated disc?
A herniated disc occurs when the inner gel-like center of a spinal disc pushes through a tear in the tough outer layer, potentially compressing nearby nerves.
What are the symptoms?
Sudden back or neck pain is common. Pain may radiate down an arm or leg (such as sciatica), and some people notice numbness, tingling, or muscle weakness.
How can a herniated disc be treated?
Non-surgical care includes activity modification, physical therapy, medications for pain and inflammation, and sometimes spinal injections. If symptoms persist or there is significant weakness or nerve dysfunction, surgery may be considered. Options include minimally invasive discectomy for lumbar herniations, and ACDF or CDR for cervical herniations.
What is a bulging disc?
A bulging disc is when the outer layer of a disc protrudes outward without rupturing. It may or may not press on nearby nerves and can result from aging, injury, or routine wear and tear.
What are the symptoms?
Back or neck pain that can begin suddenly; if a nerve is affected, pain may travel down an arm or leg. Symptoms are often milder than with a herniated disc, but numbness, tingling, or weakness can occur if a nerve is compressed.
How can a bulging disc be treated?
Most cases improve with conservative care: physical therapy to strengthen and stretch supporting muscles, medications for pain and inflammation, and posture/activity modifications. If significant nerve compression causes weakness, numbness, or trouble walking, a minimally invasive discectomy may be considered.
