Diseases of the spine

A MOVING INTERPLAY. WHY STABILITY AND MOBILITY ARE NOT A MATTER OF COURSE.

Mostly we don’t think about it; walking upright, bending and stretching are all a matter of course for us. Thanks to the healthy harmony of 24 free vertebrae, sacrum and coccyx, 23 discs, 133 joints, 143 muscles and 224 ligaments. Various causes can disrupt this interplay and give rise to deformities or degenerative diseases. In my clinic I treat both congenital spinal diseases as well as those acquired over time by wear and tear or stress.

Deformities
Degenerativs
Fractures
Tumours
Infections

OVERVIEW

OF DEFORMITIES

When vertebrae turn on their own axis and bend, the result is a sideways curvature of the spine. This deformity, congenital or acquired later in life, often displays the following symptoms:

  • Shoulders at different heights
  • Protruding shoulder blade
  • Crooked position of pelvis
  • Noticeably skewed head position
  • Pain in the back, shoulders, neck and head
  • Problems with the knee and foot joints

Typical for this deviation from the “normal” form of the spine is the profile of a rounded back. Whether the cause is congenital, acquired during growth or because of bad posture, accident, disease or wear and tear – this “hump” as it is colloquially known is formed by excessive curvature in the thoracic area and displays the following effects, among others:

  • Excessive curvature in the thoracic spine area
  • Pain in the rib area
  • Increased difficulty in walking upright
  • Feeling of falling forwards
  • Breathing and digestive problems
  • Heart and circulation problems

When vertebrae slip or slide out of their proper position, this is referred to as spondylolisthesis. There is a congenital form that develops slowly, as well as a form that frequently affects top athletes, whose spines are subject to powerful stretching. Frequent symptoms are:

  • Lower back pain in movement of the small of the back under stress
  • Feeling of instability in the spine
  • Reflex failures
  • Sensitivity and motor disturbances

OVERVIEW OF DEGENERATIVE

DISEASES OF THE SPINE

Too little exercise and constant sitting, serious excess weight or lifting heavy objects can lead to a slipped disc. In addition, older people often lose elasticity of the discs, which can also be responsible for the core of a disc breaking through its fibrous ring and thereby pressing painfully in the nerves. A slipped disc can be the cause behind the following symptoms:

  • Back pain that starts suddenly
  • Hardening of the musculature in the affected area of the spine
  • Pain radiating into the buttocks, legs or arms
  • Pins and needles, numbness or a feeling of cold in the arms or hands

Chronic incorrect stress such as constant sitting with no exercises to compensate can lead to this degenerative disease. Signs of wear appear that make bony changes to the spine. This can affect various areas, causing the corresponding problems:

  • Pain independent of stress and also occurring at night in the back of neck and general neck area
  • Headache
  • Restricted capacity for movement in the back of the neck and general neck area
  • Severe or chronic back pain if the lumbar vertebrae are affected

If the body’s own connective tissue shrinks over the course of the years, the protective buffer will decrease. The body tries to defend itself against this process and the little vertebral joints in the vertebral arch increase in size. This forms bony spurs – with painful results:

  • Back pain in the lumbar spine region
  • Pain radiating into the buttocks and legs
  • Neck pain
  • Feeling of coldness or pins and needles in the legs
  • Numbness
  • Mobility problems and paralysis

Arthritis in the small vertebral joints is also frequently a sign of ageing. But spondylarthrosis can also be caused by excessive strain in certain sports disciplines or jobs, or by excess weight, leading to the following typical symptoms:

  • Back pain under stress
  • Tension in the lower back area
  • Feeling of coldness or pins and needles in the legs
  • Limited movement in the lumbar vertebrae area

If the canal in the spine narrows, this puts pressure on the spinal cord, blood vessels and nerves – permanent nerve damage can result. The narrowing of the spinal canal is also one of the signs of ageing and displays itself particularly in:

  • Increasing pain in the legs when walking and standing
  • Immediate reduction of pain when sitting down or bending forwards
  • Back pain radiating into the legs
  • Muscular cramp in the legs
  • Disrupted coordination and insecurity in walking

With degenerative scoliosis of the lumbar spine, several segments of the vertebrae are subjected to wear, creating a sideways curvature of the lumbar spine, typically accompanied by the following symptoms:

  • Pain in the area of the lumbar spine and hip
  • Limited movement in the lumbar vertebrae area

A totally upright, stiff-looking walk is a typical sign of a “flat back”. Even if this is hardly visible, in contrast to a rounded back, those affected suffer pain that is just as severe. The missing natural curve of the spine can develop as the result of poor posture and growth spurts in youth, muscular dysbalance or also a lack of exercise and displays the following symptoms:

  • Striking upright walk
  • Stiff positioning of head and neck
  • Severe pain due to imbalanced distribution of stress

FRACTURES

OF THE SPINE

Traffic accidents and serious falls, but also reduced bone quality due to osteoporosis, can be the case for the fracture of one or several vertebrae. With osteoporosis, even a coughing fit or a small stumble can result in the fracture of a spine component. It is very important in this case to get a rapid diagnosis.

TUMOURS

ON THE SPINE

So-called spinal tumours can occur on the bone and on the nerves – as benign or malignant tumours. In the case of benign tumours, symptoms can range from localised pain to to limited mobility and instability of the spine and even to neurological disturbances. Fever, swelling of the lymph nodes, night sweats and lethargy can be signs of a malignant tumour.

As an experienced specialist in spinal surgery, I accompany my tumour patients from the initial diagnosis diagnosis through consultation on options for treatment to operation, follow-up care and rehabilitation.

INFECTIONS

OF THE SPINE

Generally these are the results of an undetected sepsis, but infection of the spine – caused by penetrating bacteria – can come about due to injuries or operations. There is for example a particular risk for patients with diabetes or kidney insufficiency, with chronic alcohol or drug abuse or with long-term treatment with cortisone or cytostatics. The inflammation processes caused by the infection can lead to localised destruction of the spine, causing the formation of kinks and if left untreated for too long even to paralysis. At first, the symptoms are very non-specific:

  • Deep-seated backache, independent of stress
  • Generally feeling unwell, with fever or shivering
  • Lethargy
  • Poor performance