Wear and tear or so-called degenerative changes
of the spine can occur in a variety of locations, most commonly in the neck and low back regions.
They can cause a variety of symptoms ranging from back or neck pain to arm and leg pain
and sometimes even be associated with neurologic deficits such as numbness and or weakness.
Initial management of such conditions involves initial trials of nonoperative care. These
can include anything from physical therapy, traction to a trial of injections. It’s only
when these nonoperative measures fail that surgery can at times become a reasonable option
for patients. In the neck degenerative changes such as a disk herniation can occur over a
single level or over several levels. They can also vary in severity and also in location.
If a disk herniation occurs centrally in the neck or cervical region it can cause pressure
on the spinal cord. This in turn can cause either arm or leg symptoms ranging from weakness
to incoordination to gate and balance. If a disk herniation occurs on the side either
on the right or the left it can cause arm symptoms on that particular side. This can
also range in nature from pain to numbness to weakness. Treatment is tailored to the
specific scenario depending on the duration of symptoms, the severity of symptoms and
the imaging findings. Wear and tear related changes occur most commonly in the low back
area involving the lumbar spine. These changes can include wear on the disks, the joints
and the ligaments supporting the integrity of the spine. A disk herniation as is shown
here can occur, for instance, on one side. In this situation we would often see back
pain with associated leg pain. In more severe cases there can also be associated numbness
and or weakness involving that side. At Ohio State we particularly specialize in treating
complex spinal disorders. These can involve a variety of deformities of the spine. Broadly
speaking a deformity involves a abnormal curvature of the spine either in the neck, thoracic
or lumbar areas. Depending on the nature and severity of the symptoms and the imaging findings,
a tailored treatment program is initiated often initially involving nonoperative measures
such as physical therapy and injections. In cases that do not respond to such measures
surgical intervention is offered as an option.