Genetic disorders, age, illness, sports or traumatic injuries often leave otherwise healthy individuals with limited range of motion, mild to severe pain, even permanent paralysis. Through advanced technology and experience, Goodman Campbell specialists are finding effective new surgical and non-surgical ways to care for the spine. Only neurosurgeons have the advanced medical training to understand how the brain, spine and nervous system (your nerves) are all connected together and function as a whole. Working on the spine is more than just working on the bones of the spine. Trust a neurosurgeon to provide care for your back and neck pain.
Various Conditions For Which Treatment Options Are Available With Us Include :
SPINAL CORD TRAUMA
Spinal cord trauma is damage to the spinal cord. It may result from direct injury to the cord itself or indirectly from disease of the surrounding bones, tissues, or blood vessels.
Spinal cord trauma can be caused by a number of injuries to the spine, including :
A minor injury can cause spinal cord injury if the spine is weakened (such as from rheumatoid arthritis orosteoporosis) or if the spinal canal protecting the spinal cord has become too narrow (spinal stenosis) due to the normal aging process. Direct injury, such as cuts, can occur to the spinal cord, especially if the bones or the disks have been weakened. Fragments of bone (for example, from broken vertebrae, which are the spine bones) or fragments of metal (such as from a traffic accident or gunshot) can cut or damage the spinal cord. Direct damage can also occur if the spinal cord is pulled, pressed sideways, or compressed. This may occur if the head, neck, or back are twisted abnormally during an accident or intense chiropractic manipulation. Bleeding, fluid buildup, and swelling can occur inside or outside the spinal cord (but within the spinal canal). The buildup of blood or fluid can press on the spinal cord and damage it. Most spinal cord trauma happens to young, healthy individuals. Men ages 15 - 35 are most commonly affected. The death rate tends to be higher in young children with spinal injuries.
Risk factors include:
Older people with weakened spines (from osteoporosis) may be more likely to have a spinal cord injury. Patients who have other medical problems (stroke or prostate cancer, for example) that make them more likely to fall may also be more susceptible.
Symptoms vary depending on the location of the injury. Spinal cord injury causes weakness and loss of feeling at, and below the injury. How severe symptoms are depends on whether the entire cord is severely injured (complete) or only partially injured (incomplete). Injuries at and below the first lumbar vertebra do not cause spinal cord injury. However, they may cause "cauda equina syndrome" -- injury to the nerve roots in this area. This type of spinal cord injury is a medical emergency and needs immediate surgery.
Injuries at any level can cause :
When spinal cord injuries occur in the neck area, symptoms can affect the arms, legs, and middle of the body. The symptoms may occur on one or both sides of the body. Symptoms can also include breathing difficulties from paralysis of the breathing muscles, if the injury is high up in the neck.
THORACIC (CHEST LEVEL) INJURIES
When spinal injuries occur at chest level, symptoms can affect the legs. Injuries to the cervical or high thoracic spinal cord may also result in blood pressure problems, abnormal sweating, and trouble maintaining normal body temperature.
LUMBAR SACRAL (LOWER BACK) INJURIES
When spinal injuries occur at the lower back level, symptoms can affect one or both legs, as well as the muscles that control the bowels and bladder.
Spinal cord injury is a medical emergency that needs immediate medical attention. The health care provider will perform a physical exam, including a brain and nervous system (neurological) exam. This will help identify the exact location of the injury, if it is not already known. Some of the reflexes may be abnormal or missing. Once swelling goes down, some reflexes may slowly recover.
The following tests may be ordered:
A spinal cord injury is a medical emergency that needs to be treated right away. The time between the injury and treatment can affect the outcome. Corticosteroids, such as dexamethasone or methylprednisolone, are used to reduce swelling that may damage the spinal cord. If spinal cord pressure is caused by a growth that can be removed or reduced before your spinal nerves are completely destroyed, paralysis may improve. Ideally, corticosteroids should begin as soon as possible after the injury.
Surgery may be needed to:
Spinal traction may be recommended. This can help keep the spine from moving. The skull may be held in place with tongs (metal braces placed in the skull and attached to traction weights or to a harness on the body). You may need to wear the spine braces for a long time. The health care team will also provide information on muscle spasms, care of the skin, and bowel and bladder dysfunction. Your skin will be protected against pressure sores. You will probably need physical therapy, occupational therapy, and other rehabilitation therapies after the injury has healed. Rehabilitation will help you cope with the disability from your spinal cord injury. Muscle spasticity can be relieved with medications taken by mouth or injected into the spinal canal. Botox injections into the muscles may also be helpful. Painkillers (analgesics), muscle relaxers, and physical therapy are used to help control pain.
Any type of tumor may occur in the spine, including:
A small number of spinal tumors occur in the nerves of the spinal cord itself. Most often these are ependymomas and other gliomas. Tumors that start in spinal tissue are called primary spinal tumors. Tumors that spread to the spine from some other place (metastasis) are called secondary spinal tumors. Tumors may spread to the spine from the breast, prostate, lung, and other areas. The cause of primary spinal tumors is unknown. Some primary spinal tumors occur with genetic defects.
Spinal tumors can occur:
Or, tumors may extend from other locations. Most spinal tumors are extradural.
As it grows, the tumor can affect the:
The tumor may press on the spinal cord or nerve roots, causing damage. With time, the damage may become permanent.
The symptoms depend on the location, type of tumor, and your general health. Tumors that have spread to the spine from another site (metastatic tumors) often progress quickly. Primary tumors often progress slowly over weeks to years. The symptoms depend on the location, type of tumor, and your general health. Tumors that have spread to the spine from another site (metastatic tumors) often progress quickly. Primary tumors often progress slowly over weeks to years.
Symptoms may include:
Abnormal sensations or loss of sensation:
Exams and Tests
A neurological examination may help pinpoint the location of the tumor. The health care provider may also find the following during an exam:
These tests may confirm spinal tumor:
The goal of treatment is to reduce or prevent nerve damage from pressure on (compression of) the spinal cord. Treatment should be given quickly. The more quickly symptoms develop, the sooner treatment is needed to prevent permanent injury. Any new or unexplained back pain in a patient with cancer should be thoroughly investigated.
Sciatica is pain in the lower extremity resulting from irritation of the sciatic nerve. The pain of sciatica is typically felt from the low back (lumbar area) to behind the thigh and radiating down below the knee. The sciatic nerve is the largest nerve in the body and begins from nerve roots in the lumbar spinal cord in the low back and extends through the buttock area to send nerve endings down the lower limb. The pain of sciatica is sometimes referred to as sciatic nerve pain.
While sciatica is most commonly a result of a lumbardisc herniation directly pressing on the nerve, any cause of irritation or inflammation of the sciatic nerve can reproduce the symptoms of sciatica. This irritation of nerves as a result of an abnormal intervertebral disc is referred to as radiculopathy. Aside from a pinched nerve from a disc, other causes of sciatica include irritation of the nerve from adjacent bone, tumors, muscle,internal bleeding, infections, injury, and other causes. Sometimes sciatica can occur because of irritation of the sciatic nerve during pregnancy.
What are sciatica symptoms?
Sciatica causes pain, a burning sensation, numbness, or tingling radiating from the lower back and upper buttock down the back of the thigh to the back of the leg. The result is lumbar pain, buttock pain, hip pain, and leg pain. Sometimes the pain radiates around the hip or buttock to feel like hip pain. While sciatica is often associated withlower back pain (lumbago), it can be present without low back pain. Severe sciatica can make walking difficult if not impossible. Sometimes the symptoms of sciatica are aggravated by walking or bending at the waist and relieved by lying down. The pain relief by changing positions can be partial or complete.
How is sciatica diagnosed?
Sciatica is diagnosed with a physical exam and medical history. The typical symptoms and certain examination maneuvers help the health care professional to diagnose sciatica. Sometimes, X-rays and other tests, such as CT scan, MRI scan, and electromyogram, are used to further define the exact causes of sciatica.
If the sciatica pain is severe and has not gotten better within six to twelve weeks, it is generally reasonable to consider lower back surgery. Depending on the cause and the duration of the sciatica pain, one of two surgical procedures will typically be considered:
In some situations, concussion-type symptoms can be missed. Patients may experience difficulty concentrating, increased mood swings, lethargy or aggression, and altered sleep habits among other symptoms. Medical evaluation is always wise even well after the injury has occured.
Microdiscectomy for Sciatica
In cases where the sciatica pain is due to a lumbar disc herniation, a microdiscectomy or small open surgery with magnification may be considered. In this surgery, the portion of the herniated disc that is pinching the nerve is removed. This surgery is generally considered after 4 to 6 weeks if the severe pain is not relieved by non-surgical means. If the patient’s pain and disability is severe, surgery may be considered sooner than 4 to 6 weeks. As a general rule, approximately 90% to 95% of patients will experience relief from their sciatica pain after this type of surgery.
Lumbar Laminectomy for Sciatica
In cases where the sciatica pain is due to lumbar spinal stenosis, a lumbar laminectomy may be recommended. In this surgery, the small portion of the bone and/or disc material that is pinching the nerve root is removed. Laminectomy surgery may be offered as an option if the spinal stenosis causes the patient’s activity tolerance to fall to an unacceptable level. The patient’s general health may also be a consideration in whether or not to have surgery. After a lumbar laminectomy (also called an open decompression), approximately 70% to 80% of patients typically experience relief from their