Alterations to the spine generate a series of problems in everyday life that prevent many patients from leading their lives at their normal pace.

Some conditions entail surgical procedures, implants, infiltrations and/or injections and other milder conditions can be treated with rest or exercise.

Some solutions require the help of orthopaedics and ergonomics is always taken into account.

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dolor crónicodolor crónicoTypes of conditions

Types of conditions

Within spinal conditions, there is a wide range of disorders and problems to treat.

Degenerative conditions

The most common degenerative conditions of the spine are:

    • Osteoporosis: Osteoporosis is a condition characterised mostly by low bone mass as a result of the deterioration of bone tissue.

    • Arthritis: Arthritis is inflammation of the joints. Articular cartilage absorbs pressures that are applied between the bones acting as a shock absorber. When these "shock absorbers" are inflamed or if the amount of cartilage is reduced (as a result of friction and over time), pain and stiffness will occur.

Vertebral fractures

Spinal fractures can be classified into three types:

    • Wedge fracture: Due to the way in which they are formed, vertebrae are more fragile in their anterior region. This means that fractures occur on this face losing bone mass only in that anterior region and being left in the shape of a wedge. They usually occur in elderly people, although they can happen in young people due to trauma.

    • Fracture-burst: In this type of fracture, the vertebral body breaks into multiple fragments. This fracture is usually the result of very severe trauma.

    • Fracture-dislocation: This type of condition occurs as a consequence of a very high-energy trauma resulting in a breakage of the ligaments that join the vertebrae together, causing two adjacent vertebrae to lose their physiological relationship. It can cause a spinal cord injury.

Spinal deformities

    • Scoliosis: Scoliosis is the sideways curvature of the spine. It can result in cases in which the curvature is especially severe, leading to a reduction of the space within the chest, triggering difficulty in the normal functioning of the lungs. Some of the symptoms of scoliosis are: uneven shoulders, one shoulder blade that seems to stick out more compared to the other, uneven waist or that one hip is higher than the other.

    • Kyphosis: Kyphosis is an exaggerated forward curvature of the back. This condition happens when the vertebrae of the upper part of the back are shaped like a wedge (due to wedge fractures). There can be mild cases of kyphosis and severe cases, which cause severe pain and even deformity.

Spinal infections

These are rare. Spinal infections can be divided into:

    • Osteomyelitis: This is the inflammation of the bone marrow and of the bone.

    • Discitis: This is an infection of the disc space which leads to an inflammatory injury of the intervertebral discs.

    • Epidural abscess: This is an infection that develops in the space around the tissue surrounding the spinal cord and the nerve roots.

Spinal tumours

A vertebral tumour is a type of tumour that affects the vertebrae or the spinal cord:

    • Spinal cord tumours: These are tumours which begin within the spinal cord or in its covering. Metastasis can occur on many occasions.

    • Bone tumours: These types of tumours begin within the bones of the spine. There are several tumours that can affect the vertebrae:
      • Chordoma
      • Chondrosarcoma
      • Osteosarcoma
      • Plasmacytoma
      • Ewing's sarcoma.

dolor crónicodolor crónicoTreatments

Treatments

Non-invasive conservative treatments

There are conditions which can be corrected without having to resort to surgery. The most used methods are:

    • Sport: With the objective of developing muscles, and that the vertebrae suffer from the efforts as little as possible. Exercise has to be as gentle as possible. That is why sports such as swimming, cycling and yoga are recommended.

    • Immobilisation: In the case of fractures and, depending on the affected area, it will be necessary to immobilise the individual with cervical collars, braces, etc. It may even be advisable that the patient rests in bed with minimum possible movement for the necessary period of time.

    • Infiltrations: Infiltrations of different substances are used in order to relive pain and to reduce inflammation. In general, infiltrations of corticosteroids will be given. In addition, infiltrations of ozone (ozone therapy) can be performed, which in some cases give very good results.

    • Other.- Acupuncture and painkillers for the elimination of pain.

Minimally invasive conservative treatments

To treat compression fractures (often as a result of osteoporosis) which tend to be very painful, there are two techniques that require a minimally invasive surgery:

    • Vertebroplasty.- Consists of filling in with a type of biocompatible cement the space that the fracture of a vertebra has left using X-ray images.

    • Kyphoplasty.- The technique is similar to that of vertebroplasty with the difference being that a "balloon" is inserted to create a space and then the cement is injected.

Surgical treatments without instruments

These are surgical procedures in which items to stabilise the treated area are not inserted. This is the case in herniated discs or the removal of tumours.

    • Surgical treatments with stabilisation using mobile prostheses: Mobile disc prostheses enable a damaged intervertebral disc to be completely replaced, maintaining the mobility functions of the back.

    • Surgical treatments with stabilisation by means of spinal fusion: Sometimes the solution involves vertebral fixation. Two or more vertebrae may be fixed, with some fittings that will be fixed using screws. The resulting supportive structure will mean that this area cannot move.

    • Surgery with intraoperative neurophysiological monitoring (IONM): There is a risk of damaging the nerve function during spinal surgery. Therefore, techniques can be used to monitor this function. This involves emitting some electrical impulses through the nerves at risk and collecting the result at the other end. In this way, it is possible to see if the corresponding nerve has been damaged.