Spinal Conditions Explained

The spinal cord connects the brain with the rest of the body. It carries motor impulses from brain to the muscles and carry sensory impulses from the body to the brain. The cervical part of the spinal cord passes through the neck. The canal through which the cervical spinal cord and nerves pass can get narrowed and produce pressure on the nerves leading to symptoms in the arms and legs. One of the common cause is cervical spondylitis or wear and tear changes in spine which can lead to pressure on the spinal cord. It can lead to a combination of some of these symptoms like weakness in arms and grip, numbness in limbs, lack of dexterity in hands, tightness in arms and legs, difficulty in balance and walking, stumbling easily, and / or abnormal jerks in limbs. This condition is called cervical myelopathy. MRI of the cervical spine is the investigation of choice to diagnose the condition. It not only shows the level where spinal cord is compressed but also the exact nature of the compressive pathology. The compressive force can be a disc prolapse in the neck or because of hypertrophy or thickening of the ligaments of the spine. The symptoms may remain static for prolonged period of time and in that case surgical intervention may not be required. Sometimes these symptoms are progressive and surgery may be required to halt these progressive symptoms. Early evaluation and appropriate intervention is recommended to reduce chance of long term neurological deficits

This condition predominantly affects our lumbar or lower back spine as we get older. In this condition the spinal canal becomes narrow due to the wear and tear changes in spine. This can result in pressure on the nerves especially while standing and while walking and can result in pain in legs or weakness or numbness in legs. People with this condition struggle to stand for any length of time or walk any distance. One has to sit or lean to improve these symptoms. This condition is termed ‘neurogenic claudication’. This can be very disabling especially for people who love to walk. Correct and judicious surgery can be very effective in improving these leg symptoms

This is a condition where there is pain shooting down the leg/s. There are various causes of sciatica. One of the common cause is disc prolapse pressing on a lumbar (lower back) nerve. It can be associated with back pain. Pressure on the nerve can lead to weakness in the muscles supplied by that nerve or numbness in the distribution of the nerve. MRI of the lumbar spine is the investigation of choice to diagnose the cause of sciatica. It can show the level where the nerve root is compressed. It can also show the exact cause of the compression like a disc prolapse or narrowing of lumbar canal or any other pathology. If it is the disc prolapse causing the sciatic pain, there is a very good chance that the pain would improve with time. This can be treated nonoperatively with pain management and physiotherapy input. Surgical intervention is necessary in patients who have progressive worsening of neurology in the legs or if the pain is excruciating not controlled with medication or persisting for few months in spite of full conservative management. When there is a large prolapse of disc in the spinal canal, it can affect multiple nerves leading to a condition called as cauda equina syndrome. It involves bilateral sciatica and / or bilateral weakness or numbness in legs and / or numbness in saddle region and / or any bowel or bladder or erectile dysfunction. This is an neurosurgical emergency and those having these symptoms should seek medical attention immediately.