The fellowship-trained spine specialists at the Spine Center at MedStar Georgetown University Hospital diagnose and treat a wide variety of complex conditions related to the spine, including:
- Adjacent Segment Degeneration
- Burst Fractures
- Chronic Pain
- Compression Fractures
- Degenerative Disc Disease
- Herniated Discs
- Metastatic Cancer
- Post-Laminectomy Syndrome
- Spinal Stenosis
- Spinal Tumors
- Synovial Cysts
- Traumatic Spinal Cord Injury
Adjacent segment degeneration is a condition that results from a prior spinal fusion surgery. It affects the intervertebral joints and disc located above or below the area that was operated on, causing spinal stenosis, degenerative disc disease or spondylolisthesis.
A burst fracture occurs when a vertebra collapses due to severe compression often caused by an immediate traumatic injury such as a car accident or fall. A burst fracture can lead to severe compression of the spinal cord or spinal nerves and possibly paralysis.
Chronic back pain describes pain that persists in the back for six months or more. Pain can range from a dull, constant ache to sudden, sharp pain that makes it hard to move. The pain is often progressive.
Chronic back pain is due to a variety of causes and conditions:
- Disc degeneration at one or multiple levels
- Herniated disc at one or multiple levels
- Spinal stenosis
- Deconditioning of the supporting muscles of the spine
- Injuries from sprains, fractures, accidents and falls
- Other causes not related to the spine such as pregnancy, kidney stones or abdominal diseases
The symptoms of chronic back pain can often be alleviated by:
- Exercising often
- Maintaining a healthy weight
- Proper posture
- Smoking cessation
- Avoiding certain risky physical activities
A compression fracture most commonly occurs when the vertebra collapses due to osteoporosis, or when bones become weak and brittle. Compression fractures can also be a result of trauma.
Degenerative disc disease results from a wearing and tearing of the intervertebral disc. The disc itself loses its shock absorbing properties and diminishes in height and strength. This can cause bone spur formation and stenosis with radiculopathy, or radiating pain through the limbs. The typical symptoms are neck or back pain.
Resting between the vertebrae of your spine are discs (strong, pliable cushions) that act as shock absorbers and facilitate spinal movement. A herniated disc occurs when the outer wall of the disc ruptures and the gel-like substance from inside the disc leaks out and compresses the spinal cord or nerve roots. Ruptured discs are caused by:
- Degeneration or aging of the spine
- Unhealthy lifestyle choices (obesity, smoking, excessive alcohol consumption)
- A genetic predisposition
Symptoms of a herniated disc include:
- Neck and lower back pain
- Radiating or “shooting pain” in the limbs on one side of the body
- Muscle weakness and spasms
- Numbness of the limbs
- Difficulty walking
We treat all types of herniated discs in the cervical (neck), thoracic (upper back) and lumbar (lower back) areas. We also treat re-occurring herniated discs from previous surgery.
Learn more about herniated disc treatment.
Metastatic cancer is when cancer cells from one part of the body spread to another part of the body and grow. Cancer of the spine can destroy the bony architecture of the vertebrae leading to fractures and spread to the spinal cord and spinal nerves causing compression.
Learn more about cancer care at MedStar Georgetown.
Myelopathy results from spinal cord compression, which is commonly caused by degenerative changes or a herniated disc in the cervical (neck) or thoracic spine (mid-back). Myelopathy can occur at any age, but most often occurs in older patients and causes the following, potentially devastating, symptoms:
- Weakness in the arms or legs where the limbs feel heavy
- Pain in the neck or mid-back with radiations in the arms or legs
- Difficulty performing fine motor skills (like writing and grasping small objects)
- Spasticity (stiffness) in upper or lower extremities
- Numbness or tingling
- Difficulty walking or feeling unsteady
- Loss of bowel or bladder function
Vertebral (spine) osteomyelitis is an infection in the spine caused by bacteria, fungi or other infectious agents. An infection of the spine can destroy the bony architecture and spread to the spinal cord and spinal nerves in the form of a spinal abscess.
Signs and symptoms of osteomyelitis include:
- Neck and back pain
- Bone pain
- Fever, chills or sweats
- Tenderness of the tissue overlying the infected bone
- Swelling, warmth and redness over the area of infection
- Weight loss
Post-Laminectomy Syndrome (also known as Failed Back Surgery Syndrome) is a condition that describes patients who have had back surgery, but continue to suffer severe symptoms.
Causes of this syndrome include:
- Scar tissue formation
- Nerve damage
- Failure of fusion (the fused vertebrae have not healed properly)
- Hardware related pain
- Failure to adequately diagnose the condition(s)
- Failure to adequately treat the condition(s)
- Surgery performed at the wrong level of the spine
- Missed fragment of a herniated disc or residual bone spur
- Inadequate decompression of nerve root or spinal cord
- Creation of new spine conditions at another level after spine fusion
Symptoms of Post-Laminectomy Syndrome include:
- Continued/chronic pain
- New spine conditions
- Pain above or below the treated level of the spine
- Inability to recuperate
- Limited mobility
- Sharp/stabbing pain in extremities
- Dull/aching pain in neck, back or legs
- Dependence on prescription drugs
Scoliosis is a spinal deformity where the spine is curved unnaturally toward the right and/or left side of the body, often in the shape of an “S” or a “C.” There is no clear cause of this condition, although genetics are believed to be a factor. Scoliosis can develop at birth, later in life or as a result of degenerative conditions.
Spinal stenosis is a narrowing of spinal canal that leads to compression of the spinal cord or nerve roots. Spinal stenosis can be caused by:
- Osteoarthritis/bone spurs
- Degenerated or herniated discs
- Synovial cysts
Spinal stenosis results in the following symptoms:
- Burning or cramping pain that runs down the lower back and into the legs and feet that is worsened with standing or walking
- Weakness or numbness in the limbs or extremities
- Radiculopathy, or radiating/shooting pain caused by compression of the nerves that originate from the spine (nerve root) due to disc herniation, degenerative disc disease, spondylolisthesis, bone spurs or trauma
A spinal tumor is a growth that develops within or near the spinal cord or spinal column. These growths can be cancerous (malignant) or noncancerous (benign). Whether cancerous or not, a spinal tumor can cause pain and compression of the spinal cord or nerve roots.
Depending on the location and type of spinal tumor, various signs and symptoms can develop, including:
- Neck or back pain, often radiating to other parts of the body
- Loss of sensation or muscle weakness, especially in the arms or legs
- Difficulty walking
- Decreased sensitivity to pain, heat and cold
- Loss of bowel or bladder function
Spondylolisthesis is the slippage of one vertebra over another. This condition most often occurs from degenerative changes. Spondylolysis is one of several other causes
The severity of spondylolisthesis is categorized by the following grades:
- Grade 1: Less than 25 percent slippage
- Grade 2: 25-50 percent slippage
- Grade 3: 50-75 percent slippage
- Grade 4: Greater than 75 percent slippage
- Grade 5: 100 percent slippage of the vertebra over the other
Symptoms of spondylolisthesis depend on the level of slippage. The slippage of one vertebra over another can cause nerve compression, leading to symptoms such as, localized pain, radiating pain, tingling, numbness or muscle weakness.
Spondylolysis is a fracture (crack) in the pars interarticularis, a small bony portion of a single vertebra that protects the nerve roots. It happens most often in the lumbar (lower back) region.
People can be born with this condition and it becomes symptomatic with aging.
Trauma is another cause. This situation occurs most frequently in athletes who play sports that require repeated hyperextension of the lower back, such as rowing and gymnastics.
Symptoms of spondylolysis vary depending on the severity of the crack or fracture. Some may experience mild back pain while others experience debilitating back pain. In extreme cases, one vertebra may slip over another (known as isthmic spondylolisthesis) and cause nerve compression, leading to pain, tingling, numbness or muscle weakness.
A synovial cyst is a fluid-filled sac from the lining of the joints (facets) of the spine that develops due to degeneration. These cysts are benign and can cause spinal stenosis and radiculopathy in the lower back.
Learn more about synovial cyst resection.
A traumatic spinal cord injury refers to any damage to the spinal cord that is caused by trauma instead of a disease.