SPINE ANATOMY AND PROCEDURES

Tulsa Spine & Specialty Hospital 6901 S. Olympia Avenue Tulsa, Oklahoma 74132

SPINE ANATOMY

• The spine consists of 33 bones called vertebrae.

• The top 7 are cervical, or neck bones.

• The upper back has 12 thoracic bones, and each has an attached rib.

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SPINE ANATOMY

• The lumbar spine, or low back, has 5 bones.

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• Next are the 5 fused vertebrae of the sacrum, and 4 fused bones of the coccyx (tailbone).

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SPINE ANATOMY

• The vertebrae surround and protect the spinal cord.

• Spinal cord is a column of nerves that run from brain to sacrum.

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SPINE ANATOMY

• Pair of nerve roots branch off spinal cord at each disc level.

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SPINE ANATOMY

• Nerve roots pass

through opening in vertebra called foramen.

• Branch further into peripheral nerves of the body.

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SPINE ANATOMY

• Between each vertebra is a flat intervertebral disc.

• Under constant pressure.

• It is the “shock absorber” of the spine.

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Spine Anatomy

• It consists of a fibrous outer layer (Annulus) and a jelly-like inner layer (Nucleus).

• Often described as a “jelly doughnut”.

• First to show signs of wear and tear from aging.

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SPINE ANATOMY

• There are joints between the vertebrae called facet joints.

• They function like hinges and guide spine movement.

• They also help stabilize the vertebral column.

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SPINE ANATOMY

• Muscles and ligaments attach to the bones of the spine

• Provide support and stability as well as flexibility and movement.

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BACK AND NECK PAIN

• Back pain results not from one single incident, but rather from gradual deterioration from years of wear and tear.

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CAUSES OF BACK INJURY

• SPRAINS AND STRAINS – From repeated

lifting, twisting, or bending.

– Scar tissue forms after healing occurs

– Scar tissue is weaker and less flexible

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CAUSES OF BACK PAIN

• HERNIATED DISC – A tear occurs in the

fibrous outer layer of the disc allowing protrusion of the nucleus.

– Causes compression of the nerve root or spinal cord.

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CAUSES OF BACK PAIN

• SPINAL STENOSIS – Narrowing of the

spinal canal from degeneration of the spine.

– Causes inflammation of nerves, and/or the spinal cord.

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CAUSES OF BACK PAIN

• TRAUMATIC NJURIES – Car accident – Falls – Stress fractures.

• INFECTIONS • TUMORS • SCOLIOSIS • OSTEOARTHRITIS

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DIAGNOSTIC PROCEDURES

• 1. X-RAYS • 2. CT or CAT SCAN- combines x-rays with

computer technology. Can give a cross-sectional look at the spine.

• 3. MRI SCANS-unlike plain x-rays, able to show

soft tissues as well as bones. Uses magnetic waves instead of radiation.

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DIAGNOSTIC PROCEDURES

• 4. MYELOGRAM – dye is injected into the

sub-arachnoid space. – Determines if flow of CSF

is blocked – Stenosis or decreased

flow could indicate pressure on the nerves of the spine

– Caused by bone spur, herniated disc, tumor, etc.

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DISCOGRAM

• Dye is injected into the vertebral disc.

• Dye should remain in the disc. • Leakage of dye could indicate

a bulge or tear. • Pain assessment done during

procedure helps determine location of painful discs.

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DIAGNOSTIC PROCEDURES

• 6. EMG (ELECTRO-MYOGRAM) – Studies the

condition of the nerve roots leaving the spine by examining the electrical activity in the muscles which these nerve roots control.

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NON-INVASIVE TREATMENTS

• 1. Rest • 2. Heat and cold • 3. Medication • 4. Physical and occupational therapy • 5. Bracing or stabilizing

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INVASIVE TREATMENTS

INJECTIONS • use local anesthetic

and/or steroid drugs injected to reduce inflammation. – Cervical, thoracic, or

lumbar, – Facet and sacroiliac

joints – Selective and

sympathetic nerve block

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INVASIVE TREATMENTS

• DISCECTOMY – Removal of part of the

herniated disc – Done through open

and minimally invasive surgery

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INVASIVE TREATMENTS

• LAMINECTOMY – to relieve spinal

stenosis (spinal canal narrowing).

– The lamina (bony portion over the spinal canal is removed)

spinal cord

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INVASIVE PROCEDURES

• SPINAL FUSION – A bone graft is

placed between two vertebrae.

– Done for instability of the spine

– Over time fuses together to form one bone

– Held together with instrumentation, and/or bracing

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INVASIVE PROCEDURES

• VERTEBROPLASTY – Cement (glue) is placed in a fractured

vertebral body to provide stability – Can be done under conscious sedation in

radiology

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INVASIVE PROCEDURES

• KYPHOPLASTY – Similar to vertebroplasty – Vertebral body is first

expanded then cement is injected to provide expansion and support

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INVASIVE PROCEDURES

• SPINAL CORD STIMULATOR, INDWELLING PAIN PUMP, RADIO FREQUENCY ABLATION.

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THE END

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