Spine Center Conditions and Treatments

A type of inflammatory arthritis–ankylosing spondylitis can eventually cause bones in the spine (the vertebrae) to fuse together, making movement painful and difficult. This fusing can also restrict breathing if the ribs are affected. There is no cure for ankylosing spondylitis which affects more men than women, but treatment can slow disease progression, relieve pain, and reduce the extent of spinal deformity. Early treatment is most effective–before ankylosing spondylitis causes irreversible damage. Therapies include medication to reduce pain and inflammation, injection of tumor necrosing factor or interleukin-17 inhibitors, physical therapy, and lifestyle and behavior changes. Severe, disabling pain that does not respond to other treatments may require surgery.

A rare medical emergency–cauda equina syndrome is caused by compression of the spinal nerve roots in the low back (lumbar spine). Early symptoms include leg weakness or numbness and urinary or bowel problems (incontinence or retention). A very large disc herniation is the most common cause but infections, spinal anesthesia, and structural abnormalities can cause cauda equina syndrome. Surgical repair is often necessary to prevent permanent nerve damage and/or disability.

Localized neck pain that does not radiate into the arms or shoulders–cervicalgia is very common and can be caused by a sports injury, vehicle accident, arthritis, pinched nerve, or poor posture. For most people, rest and over-the-counter medications to reduce pain and inflammation are sufficient. If there is accompanying arm or hand numbness or loss of strength, or the pain shoots down into the shoulders and arms, neck pain may signal a serious problem that requires medical diagnosis and treatment. Prescribed treatments include medications such as muscle relaxants and tricyclic antidepressants, physical therapy, transcutaneous electrical nerve stimulation (TENS), traction, a neck brace, steroid injections, and, in rare cases, surgery to relieve pressure on the nerve root or spinal cord.

Excess movement at the very top of the spine between the base of the skull and the first two spinal vertebrae (C1 and C2)–craniocervical instability is a condition of pathological hypermobility. It is caused by over-stretched, ‘loose’ ligaments in the back of the neck and upper (cervical) spine that can produce severe symptoms including migraine, vertigo, and nausea. Craniocervical instability can also lead to permanent nerve damage. Although the condition is not curable, treatment can relieve symptoms and includes medications, physical therapy, a neck brace, traction, injections, and, in some cases, surgery to fuse the unstable neck vertebrae.

A tear in the outer shell of a disc that allows some of the jelly-like, inner-substance to leak out–a herniated disc can irritate nearby nerves, causing back pain and arm or leg numbness or weakness. However, some people have no symptoms at all and only discover they have a herniated disc when it appears on medical imaging that’s been done for another reason. While a disc in any part of the spine can become herniated, it is most common in the low back. Herniated discs usually do not require surgery but medical evaluation is needed for worsening pain or numbness, tingling, or weakness in the arms and legs. Seek immediate medical attention for bowel or bladder dysfunction (retention or incontinence), or if there is a loss of sensation in the buttocks and back of the thighs (called, saddle anesthesia) as these symptoms can signal rare but serious nerve compression that requires surgery.

A boney hardening of the ligaments–diffuse idiopathic skeletal hyperostosis (DISH), which is also called Forestier's disease, usually affects the upper spine. However, it can also affect the shoulders, elbows, knees, and heels. DISH most often causes stiffness and mild to moderate pain that can be managed with over-the-counter medications and lifestyle changes. If it worsens over time, DISH can cause serious complications including disabling loss of movement, difficulty swallowing, and spinal fractures. Treatments for severe pain and disability include steroid injections, physical therapy, and surgery to remove bone spurs in the throat or relieve pressure on affected nerves. Although the cause of DISH is unknown, the risk for it is highest among men over age 50, people with diabetes or obesity, and those who have taken retinoid medications for long periods of time.

A boney hardening of the ligaments–diffuse idiopathic skeletal hyperostosis (DISH), which is also called Forestier's disease, usually affects the upper spine. However, it can also affect the shoulders, elbows, knees, and heels. DISH most often causes stiffness and mild to moderate pain that can be managed with over-the-counter medications and lifestyle changes. If it worsens over time, DISH can cause serious complications including disabling loss of movement, difficulty swallowing, and spinal fractures. Treatments for severe pain and disability include steroid injections, physical therapy, and surgery to remove bone spurs in the throat or relieve pressure on affected nerves. Although the cause of DISH is unknown, the risk for it is highest among men over age 50, people with diabetes or obesity, and those who have taken retinoid medications for long periods of time.

A group of genetic disorders that cause connective tissue to be overly flexible–Ehler’s Danlos Syndrome causes hypermobile joints and fragile, stretchy skin. Joint pain, dislocations, and early-onset arthritis are common because tissues that should stabilize the joints are too loose, allowing them to move well beyond their normal end-ranges of motion. The skin is also very fragile and tears easily. Hypermobile Ehler’s Danlos Syndrome is the most common type and a parent with this inherited disorder has a 50% chance of passing it on to their children. While there is no cure, there are treatments to help manage Ehler’s Danlos Syndrome and reduce or prevent joint and skin damage. These include medications to reduce pain and blood pressure, physical therapy, and surgery to repair damaged joints, blood vessels or organs.

A condition caused by the arthritis-like degeneration of joints between the spinal bones (the vertebrae)–facet joint pain can cause a diffuse or dull aching and stiffness in the back and neck. The facet joints, where one vertebra meets the next one above or below it, can break down over time and become inflamed. When more than one facet joint is involved, the condition is called facet joint syndrome or facet arthropathy. Dysfunctional facet joints cannot distribute body weight or the force of movement evenly, causing extra wear and tear to discs and cartilage and the formation of bone-spurs. Facet joint pain commonly begins between the ages of 40 and 70 and people who have arthritis or a previous spinal injury are at higher risk. There is no cure for facet joint pain but it can be managed in most cases with exercise, lifestyle changes, and over-the-counter medications to reduce pain and inflammation. Severe pain may require steroid injections, radiofrequency nerve ablation, or surgery to fuse the affected vertebrae.

New or continued severe low back (lumbar) pain after surgery to relieve it–failed back surgery syndrome (FBSS) can be challenging to treat. It is important to use a step-wise approach to reduce the risk of FBSS by first: correctly determining the causes of the low back pain; trying all less invasive treatments before choosing surgery; and identifying patients at high risk for FBSS. People at high risk for FBSS include those with foraminal stenosis, a history of depression or anxiety, and current smokers. Multi-modal therapy is the best way to manage FBSS, including medications to manage pain and inflammation, physical therapy, and lifestyle and behavior changes. If pain persists or worsens, other treatments may be needed such as steroid injections, radiofrequency nerve ablation, adhesion lysis, spinal cord stimulation, or reoperation.

Breaks that split a bone into two or more pieces–fractures can run across or down the length of a bone. The characteristics of a fracture determine how it is categorized and treated. If the skin is broken, it is an open or compound fracture as opposed to a closed fracture; if the break goes entirely through the bone, it is a complete fracture as opposed to an incomplete or partial fracture. A stress fracture is a type of partial or incomplete fracture that involves one or more small cracks in the bone that can be difficult to see on diagnostic imaging. When there is a gap at the break, it is called a displaced fracture which may require surgery to heal. Fractures can be cause by a sudden, strong force (eg, from falls and vehicle accidents) or from less intense, repetitive impacts (eg, from running). People with osteoporosis, a condition that causes bone deterioration, are at very high risk for fractures from the simple activities of daily and normal weight bearing. Depending on the type of fracture, treatments can include wrapping, splinting, casting, traction, or surgery to stabilize the fracture with screws, plates, or fixators while the bone grows back together.

The most common type of spinal infection–osteomyelitis occurs when a bacterial or a fungal infection invades the spinal bones (vertebrae, vertebral osteomyelitis) or the soft tissues of the spinal canal. Discitis is an infection of the inter-vertebral disc space. Osteomyelitis most often occurs in the low back (lumbar) area and can develop after direct spinal trauma or surgery, or when an infection in another part of the body is carried to the spine by the bloodstream. Infections can develop from three days to three months after surgery. Symptoms include severe back pain, fever and chills, weight loss, muscle spasms, painful or difficult urination, weakness or numbness in the arms and legs, and bowel or bladder incontinence. Treatment usually involves a long course (six to eight weeks) of intravenous (IV) antibiotic or antifungal medication and, if necessary, immobilizing the spine to stabilize damaged bones. Surgery may be needed in cases with significant bone destruction and spinal instability, neurological deficits, sepsis, or after unsuccessful IV antibiotic or antifungal treatment. People at high risk for spinal infections include those who are older, use IV drugs, have diabetes, or regularly take steroids, and people with immunosuppression due to an organ transplant, cancer treatment, or human immunodeficiency virus (HIV).

An episode of severe, spasming low back pain and muscle tension that restricts movement–lumbago is very common and often occurs with simple, everyday actions like bending, lifting, or standing up from sitting. The back muscles contract in a spasm to protect the nerves and spine from damage. Although it’s very painful and restrictive, lumbago doesn’t directly damage the spine. Rather, it is a reflexive reaction intended to protect important structures in the back. Because it does not change the vertebrae, discs, or ligaments of the spine, it is sometimes called, non-specific low back pain. Lumbago can be caused by muscle and tendon strains or sprains, arthritis, or disc injuries. Although acute lumbago can cause severe pain and restrict mobility, it usually gets better with over-the-counter medications for pain and inflammation, rest, and physical therapy as appropriate. In some cases, steroid injections can help with healing and pain relief. In rare cases, surgery may be necessary. People at high risk for lumbago include those who are older, have obesity, are sedentary, have depression or anxiety, and those who have conditions such as osteoarthritis, scoliosis, and certain types of cancer.

A spinal cord injury caused by severe compression–myelopathy can result from traumatic injury, disc herniation or degeneration, stenosis, tumors, cysts, or bone spurs. Spinal cord compression can damage nerves in the neck (cervical myelopathy, the most common type), midback (thoracic myelopathy), or lower back (lumbar myelopathy). While myelopathy most often develops gradually, acute myelopathy is also possible due to injury, inflammatory disease, or certain neurological disorders. Symptoms may involve the neck, low back, arms, or legs and include pain, loss of function, numbness, tingling, weakness, abnormal reflexes, balance or coordination problems, urinary or bowel incontinence, and difficulty walking. Myelopathy treatment can be surgical or non-surgical, and, when the nerve damage is not reversible, focuses on symptom relief and maintaining function. Nonsurgical treatments include medication, physical therapy, braces, and lifestyle changes. Surgery such as laminoplasty or decompression and spinal fusion may be useful to relieve spinal cord compression. Minimally invasive surgical techniques may be used which have the advantage lower risks for complications and faster recovery times than conventional surgery.

Pressure on the spinal cord from any one of a variety of conditions–nerve compression can develop anywhere along the spine. It may come on suddenly or quite slowly, depending on the cause. Symptoms of nerve compression include loss of coordination, sexual function, and/or bowel and bladder control, as well as pain, numbness, and/or weakness in the arms, hands, or legs. Some people develop a limping gait due to weakness in the muscles of one foot. While osteoarthritis of the spinal bones (vertebrae) is a common cause of nerve compression in people over age 50, nerve compression can occur at any age due to abnormal spinal structures (eg, scoliosis), acute injury, tumors, bone diseases, infection, or rheumatoid arthritis. Treatment for nerve compression ranges from supportive care to urgent surgery depending on the severity and cause. Surgery is usually reserved as a last resort after less invasive treatments such as medication, physical therapy, injections, acupuncture, lifestyle changes, and chiropractic care have failed.

Symptoms from a pinched nerve root–radiculopathy can originate in the neck (cervical spine), mid-back (thoracic spine), or low back (lumbar spine). The nerve root is where an individual nerve diverges from the spinal cord and exits the spinal column through a small hole in the vertebrae (called, the foramen). A range of conditions can cause this hole to become smaller, including stenosis, bone spurs, disc herniation, infections, tumors, cysts, and thickening of the spinal ligaments. As the nerve root’s passage gets narrower, a cycle of inflammation and increased pressure begins. Radiculopathy symptoms vary based on where the pinched nerve root is located and can include sharp pains, numbness, weakness, loss of sensation or unusual sensations, and tingling in the arms, hands, hips, legs, or torso. Lumbar radiculopathy, the most common type, is also called sciatica because the sciatic nerve is usually affected. Cervical radiculopathy from a compressed nerve root in the neck, generally causes symptoms in the arms and hands. Thoracic radiculopathy, affecting nerves in the torso, is the least common type. While some people experience constant symptoms, others experience symptoms that come and go. Nonsurgical treatments such as medication, physical therapy, weight loss, and steroid injections are usually offered first. Surgery to relieve the pressure by widening the nerve’s passageway (the foramen) are reserved for resistant cases. Minimally invasive surgical techniques can often be used which reduce the risk of complications and may shorten recovery time.

Pain and inflammation at one or both joints where the pelvis meets the spine–sacroiliac joint pain is often felt in the buttocks, low back, groin, or radiating down the legs–sometimes even as far as the feet. For many people, spending long periods of time sitting or standing, climbing stairs, running, or taking wide steps aggravates their sacroiliac joint pain. Causes vary across a wide range of conditions including traumatic injury, osteoarthritis, ankylosing spondylitis, pregnancy, and infections. Because sacroiliac joint pain is associated with several inflammatory diseases of the spine, diagnosis may take some time. Treatment ranges from medication and physical therapy to steroid injections, radiofrequency denervation, implanted electrostimulation, and surgical joint fusion. The recommended treatment varies by cause and whether the sacroiliac joint pain is likely to resolve on its own in time or progress to a chronic pain syndrome.

Pain that radiates from the lower back into the hip and leg–sciatica is a common symptom of nerve compression in the low back. Usually, sciatica only affects one side of the body. The characteristic shooting pain can reach the lower leg or foot and is sometimes accompanied by numbness or tingling along the pain pathway. Some people have pain in the upper leg and numbness or tingling lower down. Common causes of sciatica include a herniated disc, bone spur, or spinal stenosis that puts pressure on the sciatic nerve causing a cycle of inflammation and increasing pressure. Less commonly, pressure is caused by a tumor or growth or by nerve damage due to a disease such as infection or diabetes. People at high risk for sciatica include those who are over age 50, have overweight or obesity, have diabetes, spend long periods of time sitting, or participate regularly in work or leisure activity that requires lifting heavy loads or twisting at the waist. Often sciatic pain will resolve with over-the-counter anti-inflammatory medication and rest. People who have severe pain may require medical evaluation and further treatment–especially if their pain began after a traumatic injury such as a fall or motor vehicle accident. Those whose pain gets progressively worse, is accompanied by leg weakness, or bowel or bladder incontinence should also be medically evaluated. Non-surgical treatments for sciatica include medication, physical therapy, and lifestyle changes. Surgery may be recommended in severe cases that do not respond to nonsurgical treatments.

A neural tube defect that is present at birth–spina bifida occurs when the spinal bones and cord do not form properly. There are several types of spina bifida that range in severity from mild to disabling, depending on the size of the defect and which spinal sections are affected. The mildest and most common form, spina bifida occulta, occurs when there is a small gap between one or more spinal bones (vertebrae). Some people with this type have no symptoms at all and may not even know they have spina bifida until it is identified on imaging being done for another reason. The most severe type, spina bifida myelomeningocele, leaves the spinal canal open along a portion of the mid- or low back, exposing spinal tissues and nerves. Sometimes called “open spina bifida”, this severe form can cause paralysis and bowel and bladder dysfunction, and make the child vulnerable to life-threatening infections. A third, very rare, type is spina bifida meningocele, in which a sac of spinal fluid–without nerves or cord tissue–bulges through an opening in the spine. Although it puts pressure on surrounding nerves, this very rare type typically causes less severe symptoms than the “open” form. Complications of spina bifida include: bone and joint deformities; bladder and bowel complications; mobility difficulties; abnormal growth; curvature of the spine; feeding and breathing difficulties; and seizures. Risk factors for having a child with spina bifida include: a family history of neural tube defects; lack of folic acid (folate, vitamin B-9) in the diet during pregnancy; taking certain anti-seizure medications during pregnancy; having overweight or obesity; having uncontrolled diabetes; and experiencing higher than normal body temperature (hyperthermia) in early pregnancy. The most severe form, spina bifida myelomeningocele, is diagnosed before or immediately after birth and often requires immediate surgical intervention. Children with this type of spina bifida need lifelong care from a specialized team of healthcare providers. In milder forms, treatment varies based on the severity of symptoms and other complications and may also require surgery at an early age.

Abnormal curves in the spinal column–scoliosis and kyphosis have several causes and produce symptoms ranging from undetectable to severe. Adult scoliosis is when the spine develops a permanent bend toward the left or right side that is usually due to uneven wear and tear on the spinal joints and discs or complications from a past back surgery. Kyphosis, when the back rounds abnormally far forward in a curve greater than 50-degrees, usually occurs in the upper back (the thoracic spine) but can occur in the lower back (the lumbar spine). Adult kyphosis is usually caused by compression fractures from a degenerative bone disease (eg, osteoporosis, arthritis) or complications of a prior surgery. Symptoms of a spinal deformity depend on its severity and range from back pain and stiffness to sharp shooting pains, numbness, tingling, and weakness in the legs and feet. Severe deformities can reduce mobility by restricting the ability to sit up, stand, or walk. Because scoliosis and kyphosis tilt the spine too far in one direction, people with these conditions typically develop muscular imbalances that put strain on other joints throughout the body including the hips, knees, neck, and shoulders. Abnormal posture often leads to poor balance, increasing the risk of falls and accidental injury. While the majority of adults aged 60 and older have mild to moderate scoliosis or kyphosis, younger adults can also develop these spinal deformities. Treatment focuses on symptom relief and starts with non-surgical interventions such as medications to reduce pain, inflammation, and bone loss, in addition to physical therapy, braces, steroid injections, and lifestyle changes. Surgery may be recommended in severe cases particularly if there is progressive damage to nerves or other spinal structures. Surgical options range from minimally invasive fusions and bone grafts to more invasive, multi-stage procedures to stabilize the spine using rods and screws.

Too much movement at one or more spinal joints–spinal instability can cause abnormal wear and tear on adjacent structures such as discs, ligaments, and tendons. Over time, spinal instability can contribute to disc degeneration, arthritis, and bone spurs which lead to pain and loss of mobility. Spinal instability most often occurs in the low back (the lumbar spine) but can happen anywhere along the spinal column. Its causes range from traumatic injury to tumorous growths, abnormal spinal curvatures (eg, scoliosis, kyphosis), and congenital defects. Hypermobility in one area of the spine can cause a chronic aching pain, muscle spasms, or shooting pains and numbness in the arms, hips, or legs. Risk factors for spinal instability include being over age 50, doing repetitive lifting or bending movements at work or for exercise, prior back surgery, and having arthritis or overweight/obesity. Treatment depends on the severity of complications and symptoms caused by the instability and include medications to manage pain and inflammation, physical therapy, braces, lifestyle changes, steroid injections, and minimally-invasive or conventional surgery (eg, fusion, bone grafting, discectomy).

Sharp or rough formations on the edge of a vertebral joint–spinal bone spurs are most often caused by osteoarthritis which can degrade the cushioning cartilage on the ends of bones. Many people don’t experience any symptoms from their spinal bone spurs and may not even know they have them. Some, however, aggravate nearby structures such as nerves, muscles, tendons, or ligaments, causing pain and inflammation that can range from mild to severe. Loss of sensation or tingling and weakness in the arms or legs may signal that a bone spur is compressing a nerve root or the spinal cord itself. People at high risk for spinal bone spurs include those who are over age 50 and/or have osteoarthritis, spinal bone deformities such as scoliosis or kyphosis. Other risk factors include being overweight or obese and doing work or leisure activities that include repetitive bending or twisting at the waist or neck. When spinal bone spurs cause substantial pain or loss of mobility, they are typically treated with medications to reduce inflammation and pain, physical therapy, lifestyle changes, braces, or steroid injections first. In severe or resistant cases, surgery may be necessary, and minimally invasive surgeries are often available.

Lower back pain that occurs when one vertebra or disc slips out of place–spondylolisthesis is a condition of spinal instability where the vertebrae and discs move more than normal. When the vertebra or disc slips, it can put pressure on nearby nerves and cause low back pain. Although the name sounds like another condition, spondylolysis, they are not the same. Spondylolysis features stress fractures or cracks in the spinal bones (vertebrae), whereas spondylolisthesis is when one or more vertebra or discs slide out of place. The hypermobility that allows this abnormal movement can be caused by: degenerative conditions (eg, osteoporosis); traumatic injury; normal wear-and-tear; the fusing of two or more vertebrae by disease, injury or prior surgery; and bony overgrowth at the spine’s facet joints. Spondylolisthesis may be present at birth (congenital) or develop over time through normal aging or degenerative disease processes. People at high risk for this condition include athletes, those with certain genetic spinal conditions, and those over age 50. Many people have spondylolisthesis but do not experience any symptoms and may not even know they have it. Low back pain is the most common symptom, and other symptoms can include: radiating pain in the hips or down the leg; hamstring muscle spasms; stiffness in the low back or hip; back pain when walking or standing for long periods of time or when bending over; and numbness, weakness or tingling in the lower leg or foot. Most people with spondylolisthesis get adequate relief with over-the-counter medications to reduce pain and inflammation, rest, physical therapy, steroid injections, and/or braces. Although most people do not need surgery, some will, and the extent and type of surgery is determined by severity of symptoms of the spinal structures involved.

Narrowing of the spaces (the foramen) where nerves pass into and out of the spinal column–stenosis most commonly occurs in the low back (lumbar spine) but may also occur in the neck (cervical spine). If the narrowed passageway puts pressure on a nerve, pain, bowel or bladder incontinence, loss of sensation, and weakness or tingling in the arms and legs may develop. While some people don’t experience any symptoms at all, for many, stenosis causes progressive mobility limitations including: difficulty walking, sitting, or standing for long periods of time; problems with balance; and unremitting back or neck pain. The causes of stenosis include normal wear-and-tear, bony overgrowths, and vertebral deterioration due to osteoporosis. People at higher risk for stenosis are over age 50 and have osteoporosis or other conditions that affect the bones of the spine. Treatment for mild or moderate symptoms include over-the-counter medications to reduce pain and inflammation, physical therapy, acupuncture, life style changes, steroid injections, and weight loss. If these less invasive therapies are not effective, a minimally invasive decompression procedure may be recommended. If symptoms are severe, disabling, and persistent, surgery such as a laminectomy, laminotomy, or laminoplasty may be necessary, and minimally invasive techniques may be available.

A condition in which tissues become attached to the spinal cord and restrict its movement–tethered cord syndrome can compress or stretch the spinal cord. Most commonly diagnosed in children with spina bifida or other congenital conditions that affect spine development, there are rare cases of tethered cord syndrome that are not detected until adulthood. For many children, symptoms get progressively worse as they grow, because the spinal cord remains tethered or “tied” to one area while surrounding structures enlarge and shift position. This can lead to poor blood supply and intense stretching forces that damage the tethered section. In addition to the processes of spina bifida, other causes of this condition include prior spine surgery, traumatic injury to the spine or back, and tumors or other growths such as lipomas. Symptoms of a tethered spinal cord include loss of sensation, muscle movement problems, bowel or bladder incontinence, back or leg pain, visible lesions on the back, a tender area along the spine, numbness or tingling in the legs, loss of walking ability, muscle spasms, and spinal curvature (scoliosis). Surgery to decompress the spinal cord may be recommended, particularly in cases where there is noticeable loss of function or increased pain. Children with spinal tethering may require more than one decompression procedure over the course of their development to relieve symptoms as they grow.

Acute damage to the spinal bones or cord–traumatic spinal injury is an urgent medical emergency that requires appropriate immediate medical care and long-term follow-up. The most common causes of traumatic spinal injuries are accidental falls, motor vehicle accidents, diving into shallow water, gunshot and knife wounds, and high-impact sports. If one or more spinal bones (vertebrae) are fractured, the area must be stabilized quickly to limit irreparable damage and loss of function. If any part of the spinal cord or nerves at the base of the spine are injured, permanent loss of strength, sensation, or bodily functioning below the injury site often occurs. How much function remains or can be regained depends on the severity and location of the injury. The most severe type, a “complete injury” destroys nearly all function and sensation below the injury site. All other types are classified as “incomplete injuries” and cause a wide range of sensation and functional loss below the injury site. Typically, high spinal injuries that occur in the neck (cervical spine) produce the most severe functional limitations and complications, and require complex, life-long follow-up care. Because function, sensation, and mobility are generally preserved above the injury site, spinal trauma to the low back (lumbar spine) often produces less severe functional limitations. Risk factors for having a traumatic spinal injury include: being over age 65 or between 16 and 30 years of age; being male; using alcohol and/or street drugs; engaging in aggressive or violent behavior; and taking risks such as playing sports without appropriate safety equipment, drunk driving, or diving into shallow water. Traumatic spinal injuries almost always require surgery to stabilize the injured area which is followed by multiple rehabilitative therapies that may be lifelong. While initial treatment focuses on limiting the physical impacts of the injury, the psychological, social, and emotional effects are equally important. Multifaceted therapies are recommended to help people with these injuries manage their lives and psycho-social well-being over the long term. While it is not currently possible to repair the spinal cord, surgical techniques, devices, and rehabilitative modalities have made tremendous advancements. Today, more people than ever before are enjoying full, productive, and independent lives after experiencing a traumatic spinal injury.

If you witness someone experience a spinal trauma, it is safest to assume that they have a spinal cord injury until proven otherwise, because symptoms are not always immediately apparent. Numbness or paralysis may not occur right away, and can come on gradually, even hours or days after the injury.

• Dial 911.
• Do not move the person or allow them to move.
• Brace their head, neck, and torso with rolled up clothing, towels, or blankets until medical help arrives.

It is critical to shorten the time between their injury and getting treatment to reduce permanent damage and support their fullest possible recovery.

Abnormal growths on the spine–spinal tumors can be benign or cancerous and may develop within the spinal cord itself (intradural tumors) or on the outer bones (vertebral tumors). Spinal tumors can either originate on the spine or metastasize to the spine from another part of the body. Both benign (non-cancerous) and cancerous spinal tumors, require thorough, timely treatment to avoid potentially life-threatening complications and disability. All types of spinal tumors can cause: back pain or pain that radiates to other body parts; loss of sensation; impaired movement, vision, or speech; bowel or bladder incontinence; muscle weakness and/or paralysis. Symptoms may change as the tumor grows and begins to press on different structures inside and around the spinal column. Risk factors for developing spinal tumors include having a history of cancer, certain genetic markers, and either of two inherited conditions (neurofibromatosis-2 or von Hippel-Lindau disease). In many cases, however, the exact cause is unknown. Spinal tumors are usually treated with a combination of surgery, chemotherapy, and radiation depending on the tumor type, size, and location. Initial treatments are followed by rehabilitation therapy to restore lost function and regain the highest quality of life possible.