SPINE ANATOMY AND PROCEDURES. Tulsa Spine & Specialty Hospital 6901 S. Olympia Avenue Tulsa, Oklahoma 74132

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1 SPINE ANATOMY AND PROCEDURES Tulsa Spine & Specialty Hospital 6901 S. Olympia Avenue Tulsa, Oklahoma 74132

2 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. LB2013 2

3 SPINE ANATOMY The lumbar spine, or low back, has 5 bones. LB2013 3

4 Next are the 5 fused vertebrae of the sacrum, and 4 fused bones of the coccyx (tailbone). LB2013 4

5 SPINE ANATOMY The vertebrae surround and protect the spinal cord. Spinal cord is a column of nerves that run from brain to sacrum. LB2013 5

6 SPINE ANATOMY Pair of nerve roots branch off spinal cord at each disc level. LB2013 6

7 SPINE ANATOMY Nerve roots pass through opening in vertebra called foramen. Branch further into peripheral nerves of the body. LB2013 7

8 SPINE ANATOMY Between each vertebra is a flat intervertebral disc. Under constant pressure. It is the shock absorber of the spine. LB2013 8

9 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. LB2013 9

10 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. LB

11 SPINE ANATOMY Muscles and ligaments attach to the bones of the spine Provide support and stability as well as flexibility and movement. LB

12 BACK AND NECK PAIN Back pain results not from one single incident, but rather from gradual deterioration from years of wear and tear. LB

13 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 LB

14 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. LB

15 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. LB

16 CAUSES OF BACK PAIN TRAUMATIC NJURIES Car accident Falls Stress fractures. INFECTIONS TUMORS SCOLIOSIS OSTEOARTHRITIS LB

17 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. LB

18 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. LB

19 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. LB

20 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. LB

21 NON-INVASIVE TREATMENTS 1. Rest 2. Heat and cold 3. Medication 4. Physical and occupational therapy 5. Bracing or stabilizing LB

22 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 LB

23 INVASIVE TREATMENTS DISCECTOMY Removal of part of the herniated disc Done through open and minimally invasive surgery LB

24 INVASIVE TREATMENTS LAMINECTOMY to relieve spinal stenosis (spinal canal narrowing). The lamina (bony portion over the spinal canal is removed) spinal cord LB

25 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 LB

26 INVASIVE PROCEDURES VERTEBROPLASTY Cement (glue) is placed in a fractured vertebral body to provide stability Can be done under conscious sedation in radiology LB

27 INVASIVE PROCEDURES KYPHOPLASTY Similar to vertebroplasty Vertebral body is first expanded then cement is injected to provide expansion and support LB

28 INVASIVE PROCEDURES SPINAL CORD STIMULATOR, INDWELLING PAIN PUMP, RADIO FREQUENCY ABLATION. LB

29 THE END LB2013 LB