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Conditions
Procedures
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Spinal stenosis
Spinal stenosis usually develops as a person ages and the discs become drier and begin to shrink while the bones and ligaments of the spine swell or grow larger due to arthritis or chronic inflammation.
Causes includes arthritis, herniated or slipped disc, injury that causes pressure on the nerve roots or the spinal cord itself, defect in the spine that was present from birth (congenital defect), tumours in the spine and bone diseases (e.g. Paget’s disease of bone & achondroplasia). Symptoms includes numbness, cramping, or pain in the neck, shoulder, back, arms, buttocks, thighs, or calves. Other serious symptoms include difficulty or imbalance when walking, problems controlling urine or bowel movements and problems urinating or having a bowel movement. These symptoms often worsen over time hence limiting one’s quality of life.
Generally, conservative management is encouraged (e.g. medications, physical therapy, steroid injections and lifestyle changes). However, spine surgery will be necessary if these conservative measures do not work. Our spine specialists at Island Orthopaedic Consultants are skilled to perform minimally invasive surgeries with a wound of only a 2-3cm which allows for faster healing and return to work and activities. The surgery will often provide full or partial relief of symptoms.
Call 6737 5683 if you have symptoms of spinal stenosis. Our Orthopaedic Specialists at Island Spine & Scoliosis will help you manage your pain and improve your quality of life.
Neck pain
There are many structures in the neck that can result in neck ache and pain. Common causes include postural causes, wear and tear (Spondylosis), disc herniation, inflammation, traumatic injuries and other rare causes like infection, tumours and congenital abnormalities. This becomes serious when you have the following symptoms: weakness, numbness or tingling, loss of bladder and bowel control, persistent pain or neck movement or/and pain that radiates down the arms.
X-rays, CT scans or MRI is usually done to examine the condition of the nerve roots and spinal cord. Treatment is always conservative first before resorting to surgery. Surgery is only required when conservative methods fail to provide relief of pain or when there is danger of permanent nerve or spinal cord damage. Surgical options include fusion, arthroplasty (artificial disc replacement) , laminectomy/laminoplasty, facet Blocks and radio frequency neurotomy and disc nucleoplasty.
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Scoliosis
Among the children with scoliosis, majority do not progress to a severe degree. However some do. It is important to pick out those with potential to become severe and institute appropriate treatment. Timely institution of bracing may prevent further curve progression. When surgery is indicated, it is necessary to consider the appropriate surgical approach, the levels to be fused, and the appropriate instrumentation.
Metastatic Spine Disease
Spinal metastasis is common in patients with cancer. Primary sources for spinal metastatic disease include the following: Lung, Breast, GI tract, Prostate, Lymphoma, Melanoma, Kidney and others including multiple myeloma.
The spine is the most common site for metastatic disease. Spinal metastases are slightly more common in men than in women and adults aged 40-65 years than in others.
The morbidity of spinal metastatic disease is important, especially in patients with paralysis and/or bowel and bladder involvement.
No treatment has been proven to increase the life expectancy of patients with spinal metastasis. The goals of therapy are pain control and functional preservation.
The advancement of minimally invasive surgery and of new forms of robotic radiation therapy has radically changed the management paradigm of metastasis disease to the spine. The traditional treatment for spinal metastasis is radiation and steroids. Surgery is advocated only as a last resort. Surgical approaches include Laminectomy, Kyphoplasty and others depending on the condition.
Fusion
A procedure where the damaged disc is removed and bone is inserted between the vertebrae to fuse the level. This relieves the pressure on the nerve and spinal cord but it also increases the stress to the disc above and below the operated level.
Laminectomy/Laminoplasty
This is a time tested way to reduce pressure on the spinal cord over a large area by removing part of the bone. This surgery is performed from the back of the neck.
Facet Blocks and radiofrequency neurotomy
This is a minimally invasive technique to reduce neck pain. A fine needle is inserted from the side of the neck and local anaesthesia and a very small dose of steroids is injected to give relief to neck pain.
Vertebroplasty/ Kyphoplasty for osteoporotic spine fracture
This procedure involves injection of bone cement into the vertebral body via the trochars introduced percutaneously through the pedicles into the vertebral body. This is often done under local anaesthesia with sedation under the guidance of image intensifier. Main indications are severe and persistent pain from osteoporotic fractures and spinal metastasis. Patient usually experiences almost instant pain relief. Complication rate has been low.
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Arthroplasty (Artificial Disc Replacement)
This is the newer approach where after disc removal, an artificial disc is inserted. This performs the same function as the disc by allowing motion at the operated level and reduces the damage to the adjacent discs.
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Nucleoplasty for Slipped Disc
Nucleoplasty is one of the latest minimally invasive methods to treat mild prolapsed disc and neck pain caused by disc degeneration. It involves using coblation technology to remove disc material. This procedure allows the patient to go home the day of the surgery with only a small bandage on their back. The procedure is performed by our Orthopaedic Specialists at Island Spine & Scoliosis using x-ray guidance to accurately place a needle in the disc, much like an epidural steroid injection. A patented plasma device is then inserted through the needle into the disc, where excess tissue is removed. Similar to letting sir out of a bicycle tire, removing some of the tissue from the center of a disc causes a reduction in disc pressure. This eases symptoms and reduces pain.
If your spinal problem is causing you discomfort, call us at 6737 5683 to see our Orthopaedic Specialists at Island Spine & Scoliosis. We are committed to helping you manage your pain and keep you as active as possible.
