Degenerative conditions of the spine occur as part of the normal aging process. However, in some individuals, these changes are more advanced than would be expected for their given age. Nearly everyone experiences some degeneration of the intervertebral discs or spinal joints by the age of 40. Non-surgical treatments often are highly effective as an initial approach. If non-surgical treatment fails, surgical options are offered to eligible candidates.
Experts within the Johns Hopkins Bayview Neurosurgical Spine Program specialize in correlating the patient's symptoms to what can be seen on X-rays and MRI scans--a critical step in determining which patients will benefit from surgery and what type of surgery should be performed.
Spinal stenosis refers to narrowing of the spinal canal that can be congenital (present at birth), acquired/degenerative or a combination of both. If the stenosis is significant, it may result in neck, back, arm or leg pain, especially with increased activity. In severe circumstances, spinal stenosis results in the dysfunction of the spinal cord or nerve roots.
When non-surgical treatments fail, decompression or surgical widening of the spinal canal can be performed.
Cervical and Lumbar Disc Herniation
Intervertebral disc herniation is the displacement of the cushion or disc that is situated between the vertebral bones. These intervertebral discs normally act as “shock absorbers” for the spine. When displacement or herniation of the disc occurs, the disc can impinge upon the spinal cord or nerve roots causing pain and dysfunction of the nervous system.
In many circumstances, disc herniation can be successfully treated with medications, physical therapy and steroid injections. If these treatments are not effective, surgery is optional.
Some disc herniations may be treated with minimally-invasive surgery, while others require a traditional open-surgery approach. Minimally-invasive options include lumbar microdiscectomy, endoscope-assisted discectomy or cervical "keyhole" forminotomy with discectomy. Open procedures include anterior cervical discectomy with microscope assistance and fusion.
Degenerative Disc Disease
Degenerative disc disease is a common problem of the aging spine that can lead to severe, intractable low-back and neck pain.
When the location of the pain can be attributed to the degenerated disc, surgical treatment may be effective. Traditional open-surgery techniques are an old standard of treatment. Newer options include minimally-invasive surgery, dynamic stabilization and motion preservation with disc replacement/arthroplasty.
Spinal deformity (or scoliosis) is becoming more common in this country as our population grows older. Scoliosis and kyphosis are curvatures of the spine that develop in the aging spine.
When these deformities lead to pain or dysfunction of the spinal cord and nerve roots, non-surgical or surgical treatment options may be necessary. If surgery is indicated, minimally-invasive approaches and open deformity correction procedures are available.