Spinal conditions cont...//

At the West Wales Spinal Centre we offer a full range of surgical and non-surgical procedures for the treatment and management of your spine condition in our state-of-the-art private hospital and private clinics in Swansea and West Wales. Listed below are some of the surgical treatments available, including the things to consider if you are undergoing spinal surgery.

treatment of neck pain in south wales
SCOLIOSIS



WHAT IS SCOLIOSIS?

Scoliosis is defined as an abnormal curvature curve in the spine, of more than 10 degrees. The spine may be a C-shape or S-shape, and may also be rotated (twisted).Curvature of the spine can occur at any point, from the top to the bottom. However, the most common regions affected are:

  • The chest area (thoracic scoliosis)

  • The lower back (lumbar scoliosis)

  • If scoliosis is left untreated, the curvature of the spine can get worse and cause damage to the spine, chest, pelvis, heart, and lungs.

  • There are two types of scoliosis:

  • Non-structural (mobile) scoliosis. Often caused by a condition outside the spine, which disappears when that is corrected. For example, if one of your legs is longer than the other, the curvature in your spine will disappear when you sit down.

  • Structural (true) scoliosis: A fixed curvature in your spine. Usually the underlying cause of structural scoliosis can't be treated.

 

CAUSES OF SCOLIOSIS

 

There are several causes of scoliosis…

Idiopathic
Idiopathic scoliosis is fairly common (affecting 2-3 out of every 100 people), with the condition usually developing between 10-15 years of age (known as ‘late onset’ / ‘adolescent idiopathic scoliosis’). The condition is not present at birth and the cause is unknown. Idiopathic scoliosis almost always results in curvature to the right, and is more common in girls.

Less commonly idiopathic scoliosis occurs in younger children, known as ‘early onset scoliosis. The curvature is usually to the left, and is slightly more common in boys. There seems to be a family link with idiopathic scoliosis, with approximately 3 in 10 people with scoliosis having one or more family members with the curvature of the spine..

Idiopathic scoliosis is a type of structural scoliosis or true scoliosis. This means that the underlying cause of the scoliosis cannot be reversed.

Congenital
Congenital scoliosis is where you are born with an abnormally curved spine. This is caused by development of the vertebrae that is not symmetrical. Sometimes two of the vertebrae are joined together on one side, and a person’s spine becomes curved as the individual grows. This is usually quite apparent before adolescence.

Neuromuscular
This type of scoliosis is caused by conditions affecting the nerves / muscles of the back, such as cerebral palsy or muscular dystrophy. Neuromuscular scoliosis can be structural or non-structural, depending if there is rotation of the spine (in addition to any curvature). Non-structural scoliosis can be caused by several problems including:

  • poor posture

  • muscle spasm eg caused by a compressed or 'slipped' disc

  • having one leg shorter than the other

  • By correcting the underlying problem, it is usually possible to reverse this type of scoliosis. Additional causes of scoliosis can include trauma and/or infection, which then result in damage / uneven growth of the spine.

 

SYMPTOMS OF SCOLIOSIS

  • Scoliosis can usually be seen in patients between 8-10 years of age. As the condition progresses, the symptoms may include…

  • Rotation of the bones in the spine, making it look as if the child’s waist or shoulders are uneven.

  • One or both shoulder blades may stick out.

  • One hip looking higher than the other

  • The child may lean to one side

 

If you notice any of the symptoms above then you should see your GP. Scoliosis can develop over a prolonged period of time and cause little on no pain initially, so it can be easily missed.

 

DIAGNOSIS OF SCOLIOSIS

Scoliosis is usually initially diagnosed by a GP, who will then refer the patient on to an orthopaedic / spinal specialist. The patient will then require a physical examination of the spine, ribs, hips, and shoulders.

At West Wales Spine, we use the latest diagnostic equipment and techniques to identify scoliosis. The clinical examination will be accompanied by some diagnostic imaging, usually included an X-ray or MRI. This will also aid in diagnosing the direction and angle of the curve. An MRI scan will also show any underlying neurological conditions (that affect the nerves and muscles), although this type of scan will usually only be performed on children experiencing back pain / a child that appear to have severe curvature.

If you would like more information about our scoliosis treatment or would like to arrange an appointment in any of our private clinics, please complete the form on the right of this page.

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SPINAL INJURIES/ TRAUMA



WHAT CAUSES SPINAL CAUSE TRAUMA?

 

Spinal trauma can be caused by a number of injuries to the spine, including:

 

  • Assault

  • Falls

  • Gunshot wounds

  • Industrial accidents

  • Motor vehicle accidents

  • Sports injuries (particularly diving into shallow water)

 

A minor injury can cause spinal injury if the spine is weakened (such as from rheumatoid arthritis or osteoporosis) 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:

 

  • Participating in risky physical activities

  • Not wearing protective gear during work or play

  • Diving into shallow water

 

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

 

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:

 

  • Increased muscle tone (spasticity)

  • Loss of normal bowel and bladder control (may include constipation, incontinence, bladder spasms)

  • Numbness

  • Sensory changes

  • Pain

  • Weakness, paralysis

 

CERVICAL (NECK) INJURIES

 

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. 

treatment of neck pain in south wales
treatment of neck pain in south wales
SPINAL MALIGNANCY



SYMPTOMS

 

Depending on the location and type of spinal tumor, various signs and symptoms can develop, especially as a tumor grows and affects your spinal cord or on the nerve roots, blood vessels or bones of your spine. Spinal tumor symptoms may include:

 

  • Back pain, often radiating to other parts of your body

  • Loss of sensation or muscle weakness, especially in your arms or legs

  • Difficulty walking, sometimes leading to falls

  • Decreased sensitivity to pain, heat and cold

  • Loss of bowel or bladder function

  • Paralysis that may occur in varying degrees and in different parts of your body, depending on which nerves are compressed

 

Back pain is a common symptom of both noncancerous and cancerous spinal tumors. Pain may also spread beyond your back to your hips, legs, feet or arms and may become more severe over time in spite of treatment.

 

Spinal tumors progress at different rates. In general, cancerous spinal tumors grow more quickly, whereas noncancerous spinal tumors tend to develop very slowly.

 

TREATMENTS & DRUGS

 

Ideally, the goal of spinal tumor treatment is to eliminate the tumor completely, but this goal may be complicated by the risk of permanent damage to the surrounding nerves. Doctors also must take into account your age, overall health, the type of tumor, and whether it is primary or has spread to your spine from elsewhere in your body.

Treatment options for most spinal tumors include:

 

  • Monitoring. Some spinal tumors may be discovered before they cause symptoms — often when you're being evaluated for another condition. If small tumors are noncancerous and aren't growing or pressing on surrounding tissues, watching them carefully may be all that's needed. This is especially true in older adults for whom surgery or radiation therapy may pose special risks. If you decide not to receive treatment for a spinal tumor, your doctor will likely recommend periodic scans to monitor the tumor.

  • Surgery. This is often the treatment of choice for tumors that can be removed with an acceptable risk of nerve damage. Newer techniques and instruments allow spinal surgeons to reach tumors that were once considered inaccessible. The high-powered microscopes used in microsurgery make it easier to distinguish tumor from healthy tissue. Doctors also can test different nerves during surgery with electrodes, thus minimizing nerve damage. In some instances, they may use sound waves to break up tumors and remove the fragments. However, even with advances in treatment, not all tumors can be removed completely.

    When the tumor can't be removed completely, surgery may be combined with chemotherapy or radiation therapy.

    Recovery from spinal surgery may take weeks or longer, depending on the procedure, and you may experience a temporary loss of sensation or other complications, including bleeding and damage to nerve tissue.

  • Standard radiation therapy. This may be used following an operation to eliminate the remnants of tumors that can't be completely removed or to treat inoperable tumors. It also may be the first line therapy for metastatic tumors. Radiation may also be used to relieve pain or when surgery poses too great a risk.

    Medications can help some of the side effects of radiation, such as nausea and vomiting. And depending on the type of tumor, your doctor may be able to modify your therapy to help prevent damage to surrounding tissue and improve the treatment's effectiveness. Modifications may range from simply changing the dosage of radiation you receive to using sophisticated techniques that offer better protection to healthy tissue, such as 3-D conformal radiation therapy.

  • Chemotherapy. A standard treatment for many types of cancer, chemotherapy uses medications to destroy cancer cells or stop them from growing. Your doctor can determine whether chemotherapy might be beneficial for you, either alone or in combination with radiation therapy. Side effects may include fatigue, nausea, vomiting, increased risk of infection and hair loss.

  • Other drugs. Because surgery and radiation therapy as well as tumors themselves can cause inflammation inside the spinal cord, doctors sometimes prescribe corticosteroids to reduce the swelling, either following surgery or during radiation treatments. Although corticosteroids reduce inflammation, they are usually used only for short periods to avoid such serious side effects as osteoporosis, high blood pressure, diabetes and an increased susceptibility to infection.