A condition where the spine is curved to one side (the spine is normally straight when seen from behind). The deformity may be mobile and reversible, or fixed; if fixed, it is accompanied by vertebral rotation and does not disappear with changes in posture. Most cases of fixed scoliosis are of unknown cause. In infants, it usually gets better but older children may have a progressive type. Treatment may be by using a fixed brace, or surgical fusion if the curve is greater than 45 degrees. Scoliosis can occur as a congenital condition and in neuromuscular diseases where there is muscle imbalance, such as in FRIEDREICH'S ATAXIA.
The atlas (first cervical vertebra) and axis (second cervical vertebra) vertebrae and a lumbar vertebra seen from above. (Top) the spinal column.
is a forward curvature of the spine causing a hump back. It may be postural and reversible in obese people and tall adolescent girls who stoop, but it may also be fixed. Scheuermann's disease is the term applied to adolescent kyphosis. Senile kyphosis occurs in elderly people who probably have osteoporosis (bone weakening) and vertebral collapse.
is a normal consequence of AGEING. The disc loses its resilience and becomes unable to withstand pressure. Rupture (prolapse) of the disc may occur with physical stress. The jelly-like central nucleus pulposus is usually pushed out backwards, tearing the annulus fibrosus and putting pressure on the nerves as they leave the spinal canal. (See PROLAPSED INTERVERTEBRAL DISC.)
An arthritic disorder of the spine in young adults, mostly men. It is a familial condition which starts with lumbar pain and stiffness and progresses to involve the whole spine. The discs and ligaments are replaced by fibrous tissue, making the spine rigid. Other organs may be affected, including the eyes, heart and lungs. Treatment is physiotherapy with anti-inflammatory drugs, to try to keep the spine supple for as long as possible. A few patients may need a hip replacement in due course. Many benefit from anti-TNF (tumour necrosis factor) drugs.
A combination of disc degeneration and joint degeneration in the back, usually due to OSTEOARTHRITIS. The neck and lumbar region may be painful, with pain down the arms and/or SCIATICA. Joints may become unstable, putting pressure on the nerves leaving the spinal cord. Treatment is physiotherapy; often a neck collar or lumbar support helps. Rarely surgery is needed to remove the pressure from the nerves.
means that part of the spine is shifted forward. This is nearly always in the lower lumbar region and may be familial, or due to degeneration in the joints. Pressure may be put on the cauda equine (see SPINAL CORD; cauda equina syndrome). The usual complaint is of pain after exercise. Treatment is bed rest in a bad attack, with surgery only if there are worrying signs of cord compression.
A genetic disease that causes muscle weakness and progressive loss of movement, caused by deterioration in the nerve cells (motor neurones) connecting the brain and spinal cord to the body's muscles.
Narrowing of the spinal canal so that the nerves become squashed together. This causes numbness with pins and needles (paraesthesiae) in the legs. MAGNETIC RESONANCE IMAGING (MRI) scans can show the amount of cord compression. If improving posture does not help, surgical decompression may be needed.
occur to the neck, usually as the result of a car accident when the head and neck are thrown backwards and then forwards rapidly. This causes pain and stiffness in the neck; the arm and shoulder may feel numb. Often a support collar relieves the pain, but full recovery may take between 18 months to three years.
occurs as a result of trauma when the vertebral column protecting the spinal cord is fractured and becomes unstable, for example in a sports injury. The cord may be concussed or it may have become sheared by the trauma and not recover (transected). Spinal concussion usually recovers after 12 hours. If the cord is transected the patient remains paralysed. (See PARALYSIS and see also CAUDA EQUINA SYNDROME).)