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Disc and Vertebrae Problems

Pain and function problems related to discs or vertebrae of the back are the most common type of neurologic problem.   Backs, of course, take a lifetime of impact and stress, and often loose their proper structure, compromising the nerves that run in and out and through them.

Care of these conditions is a dedicated focus of the neurosurgical team, which maintains a subspecialist in back and spinal conditions.   Neurosurgeons may care for spinal problems resulting in neck or back pain——the pinching of nerves with resultant pain, as well as related numbness or weakness in the arms or legs.  These conditions can stem from ruptured or bulging disks, excessive overgrowth of arthritic bone, slippage of the vertebra, infections or fractures.   If the spinal cord becomes compressed patients may have difficulty with gait, balance issues or sensory feeling in the extremities.

The neurosurgical team takes advantage of high-quality radiology to understand the exact anatomic nature of the problem with a disc or vertebra in each individual patient, before using a prudent approach to different forms of care. The team may also use imaging during operations to better position implants and assess and access repairs.


Bulging, herniation or rupture of the flexible discs between vertebrae can cause pressure to nerve roots or the spinal cord, bringing significant pain and/or functional problems.   Disc conditions are widespread and virtually everyone develops some amount of disc compression with age.   Significant weight-bearing or impact activities are contributors.   Physical therapy (including at-home techniques for reducing pressure on discs), anti-inflammatory medications (including by injection at the site of the disc protrusion) and, in severe cases, surgery can help to alleviate these abnormalities.   These types of interventions can relieve the significant discomfort, numbness, functional problems and other symptoms of disc problems.

Procedures such as discectomy (removal of all or part of a disc, sometimes with a bone or prosthetic implant to maintain disc spacing), laminectomy (removal of a portion of the interior roof of the spinal canal to create more space for the spinal cord), and artificial disc replacement are common treatments, and the neurosurgical team uses highly exacting microsurgical approaches for these procedures.   Fusion of the vertebrae above and below the site of a discectomy, with a metal plate that bridges the area, is a common component of surgery for restoring stability in the back, especially in the cervical region of the spine.


X-ray image of spinal fusion, showing screw placement.

X-ray image of spinal fusion, showing screw placement.

Fractures to vertebrae of the back can be the result of a traumatic injury or bone weakened by age and osteoporosis.   A fracture that compresses the spinal cord or spinal nerve roots can cause pain, numbness, reflex changes and problems in sensation and movement.   In more severe cases, they can injure the spinal cord, causing paralysis.

Neurosurgical specialists approach these conditions on an individual basis with a range of care, from conservative, noninvasive treatment of symptoms to open surgery that serves to brace or fuse vertebrae.  Many fractures will not require surgery, but significant ones can result in major long-term problems unless treated correctly.

Sometimes external bracing will be adequate in the case of a broken vertebra.   But fractures that cannot heal adequately with external treatments such as these may require surgery to realign the spine, especially if the break is causing significant symptoms.  Surgical fixation fuses two vertebrae with a bone graft, through use of metal hardware such as plates and screws.

Today, the neurosurgical team also has significant success with a minimally invasive type of intervention (kyphoplasty or vertebroplasty) that uses a needle to inject bonding substances that repair breaks in vertebrae.    Learn more about nonsurgical treatment to repair fractured vertebra.

The staff provides knowledgeable management of other back and spine conditions, such as spondylolisthesis (forward shift of a vertebra), scoliosis and sciatic nerve problems.

The neurosurgical team participates in a full set of options for resolving or minimizing back and spinal conditions, using minimally invasive approaches whenever possible.  Virtua orthopedic surgeons also offer these procedures.

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