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DISEASES OF THE CERVICAL AND LUMBAR SPINE WHIPLASH INJURY OF THE CERVICAL SPINE (NECK): Whiplash is usually caused by the head being whipped backward as in a rear-end collision. The major problems are pain and loss of motion. This is treated with non-surgical treatment and usually gets well in a few days or up to 3 months. Please be as active as you can. DEGENERATIVE DISEASE OF THE SPINE: DISC DEGENERATION: Begins early in life and slowly progresses. The center part of the disc loses water and collapses. The outer part of the disc bulges and may rupture allowing disc material to escape. RUPTURED DISC: A ruptured disc can press on a spinal nerve and cause leg pain or pain in the neck or arm. Continued collapse leads to joint arthritis with spurring, bulging of the disc, folding of ligaments and instability. These combine to produce spinal stenosis (narrowing of the spinal cord). Lumbar spinal stenosis can cause back pain and leg pain that is worse with standing and walking and relieved by sitting or lying down. Cervical spinal stenosis can cause neck pain, arm pain and even cause balance problems. 
PAINFUL DEGENERATIVE DISC DISEASE: As the spine continues to degenerate, they may cause chronic, disabling back pain which may radiate to the hips and upper thighs. This is treated nonsurgically at first. If relief is not adequate, surgical treatment may be an option. Diagnosis- x-ray, MRI, sometimes a discogram. Treatment is anterior fusion. At L5-S1 (lowest disc) an anterior lumbar interbody fusion is done through an abdominal approach (done by a vascular surgeon). The disc is removed, the disc space is enlarged and an implant is inserted to cause fusion. At L4-5 and above, a minimally invasive procedure can be done through the flank (XLIF). The patient is up immediately after surgery and goes home the next day. LUMBAR SPRAIN: This can occur from activity or with no obvious pain. You are not alone. 50% of working people will miss work sometime in their life because of back pain. It will usually get well with non-surgical treatmeant. Do not go to bed to rest, instead continue your regular activities, including work. RUPTURED DISC, CERVICAL (NECK): When your disc degenerates, it can bulge against a nerve in your neck causing neck pain, upper back pain, arm pain or even headaches. There may be numbness in the shoulders or arms and there can be weakness. The patient is diagnosed by history, exam and an MRI. If the symptoms fail to improve, surgical repair may be necessary. OPTIONS The usual treatment is removal of the disc thru a small incision on the front of your neck. The disc is replaced with a cadaver bone graft held in place with a plate. The patient stays overnight in the hospital. Disc replacementSometimes disc replacement is considered. This allows motion at the diseased level. The patient stays overnight in the hospital. 
RUPTURED DISC, LUMBAR: When a disc degenerates in your lower back, it may bulge and press against a nerve. This can cause back, hip and leg pain. It is diagnosed by symptoms, exam and an MRI. It is treated non surgically since 3 out of 4 patients will get better without surgery. An epidural steroid injection may be tried. Surgery is done through a 1 inch incision. The bulging fragment is removed. This is done as an outpatient. SPINAL STENOSIS, CERVICAL: As disc degeneration worsens, the disc collapses and spurs are formed. The spurs may cause chronic neck, shoulder, upper back pain, or headaches. They may cause nerve pain into the arms. Diagnosis is by exam, x-ray and MRI. This is treated with anterior cervical discectomy and fusion. More than one level may be involved. Surgery is done through a small incision on the front of the neck. The diseased disc(s) is removed along with the spurs and replaced with a cadaver bone graft that is held in place with a plate. SPINAL STENOSIS, LUMBAR: As the spine continues to degenerate , the discs narrow and bulge. The joints become arthritic with spurs and the ligaments fold. This causes narrowing of the spinal canal or spinal stenosis. This can cause hip and leg pain often worse with standing and walking, but relieved by sitting and lying down. SURGICAL OPTIONS X-Stop: This is an outpatient procedure in which a small implant is put in to bend the affective level, but allow extension above and below. It does not interfere with a second more extensive procedure if needed. Open Decompression: The spurs are removed and the nerves surgically decompressed. It does not stabilize the spine. XLIF: Is a minimally invasive procedure done thru the flank. It restores disc height and indirectly relieves the stenosis. DEGENERATIVE SPONDYLOLISTHESIS: Further spine degeneration causes the facet joints (small joints between the vertebrae) to become unstable. This allows the vertebrae above to shift forward on the vertebrae below- most often at L4-L5 and in women. Back pain and/or leg pain may result. It is diagnosed by a standing x-ray. Treatment may require fusion- through the back, flank, or abdomen or a combination of procedures. LYTIC SPONDYLOLISTHESIS: At age 6 - 8 a defect develops in the lower spine in about 5% of the population. This defect allows the vertebra to slip forward on the vertebra below. Some of these people develop low back pain and may eventually require fusion. Fusion can be performed thru the back or the front and back. VERTEBRAL COMPRESSION FRACTURES: As we age our bones become less dense and more susceptible to compression fractures, women more than men. These can be treated with rest, or they can be treated with a minimally invasive surgical procedure call kyphoplasty. This provides good and immediate pain relief.
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