The majority of spine-related problems result from normal degeneration of the bones, ligaments and disks of the spine.  For some people, laying low and allowing for time to recuperate is all that is needed. For others, medication and/or physical therapy may do the trick. If the pain does not respond to one of these therapies, surgical intervention may be in order. 
 
The spinal column and vertebrae serve to protect the delicate nerves of the spinal column.   Figure 1 illustrates the four major areas of the spine: cervical (C1 – C7) neck area; thoracic (T1 – T12) chest area; lumbar (L1 – L5) lower back; and the sacral (S1 – S5) or area of the buttocks.  The type and intensity of the pain depends in large part on the location of the vertebrae involved.

Herniated or slipped disks, spinal stenosis (narrowing of the canal through which the spinal cord travels), scoliosis and kyphotic deformities (abnormal curvature or bending of the spine) and spondylolisthesis (slipping of the bones of the spine) are common problems.

Congenital defects are problems that result from abnormal growth and/or development of the spine and spinal cord include spina bifida (incomplete closure of the spinal cord or myelomeningocele), scoliosis (bending or twisting of bony spine), tethered spinal cord and diastematomyelia (abnormal division of the spinal cord associated with a bony spur).

Trauma to the spinal and spinal cord result in approximately 10,000 new spinal cord injuries per year in the US. Most injuries result from motor vehicle crashes, violent acts and falls, with over 80% of injuries occurring in males. A spinal cord injury happens as a result of damage to the nerves in the spinal cord. For this to occur, usually the bones protecting the spinal cord have also been injured (either broken or dislocated).

Just as tumors, infections, and vascular lesions can occur in the brain, they occur in the spine and spinal cord.

Tumors of the spinal cord may be benign or malignant and are generally primary tumors, not metastatic lesions (please see tumor sections for more details). Examples of spinal cord tumors are astrocytomas, ependymomas, meningiomas, schwannomas, and epidermoids.

Vascular lesions, such as AVM's, may also be found in the spinal cord. They too can cause symptoms that are similar to tumors and may even cause spinal cord strokes. Surgery may be warranted for removal or tumors, vascular lesions, and infection. In some cases, radiation and chemotherapy may be required.


Content provided by UW Medicine Neurological Surgery, Seattle, Washington

Spine and spinal cord injuries generally result in devastating loss of neurological function, although occasionally injuries affect only the bone and spare the spinal cord.

While surgery may be required to repair fractures, stabilize the bony spine, stop bleeding or repair torn membranes, it usually cannot repair or restore function to the spinal cord itself. Thus, the goal of surgery is to prevent further injury from occurring and maximize the opportunities for patients to participate in rehabilitation and physical therapy. 

Congenital defects - Some congenital defects are recognized at or before birth and must be surgically treated within a few days of their diagnosis. Other problems may not be obvious until a patient experiences a growth spurt or develops symptoms or signs related to that problem.

Spinal cord injuries -  For the first few days after an injury it is usually hard to tell how much of the damage may be temporary and how much may be permanent. One reason is that sometimes the injury causes swelling in the spinal cord that may last for days or weeks. Also, right after the injury the spinal cord may go into shock.  Terms you may hear used to describe the injury are complete or incomplete. Incomplete means the signals between the body and brain are partially interrupted. Complete means all signals between the body and brain are cut off at the level of the injury.

Spinal shock is a period of time when all of the functions of the spinal cord below the injury are stunned and do not work. This does not happen to everyone, but if it does, it too may last from a few days up to a week or so.

The long-term result of a Spinal Cord Injury (SCI) depends on a lot of different factors including the location and severity of the injury.

Participation in rehabilitation will play a big role for almost everyone with SCI. This starts in the hospital, even in the intensive care unit, and continues in other settings as well. The health-care team will work together with the person with SCI to achieve as much independence as possible.

As you and your health-care team find out more about how this injury has affected you, you will continue to learn about how to reach your goals.