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Spine Care

Bare back with potruding spineSpinal disorders are one of the most common reasons for seeking healthcare. They can be annoying, disabling or even life-threating. Tulane Health System is a leader in treating spinal disorders using both neurological and orthopedic solutions. We provide access to the services and expertise you need — all under one roof.

We offer advanced care, including minimally invasive surgery and the latest proven treatment options for disc disease, tumors, spinal stenosis or fracture. As part of Tulane Medical Center, we can connect you with the follow-up care and other services you might need, and we’ll make sure you understand your options and know what to expect.

What are spinal disorders?

Spinal disorders are problems with the spinal column (the line of bones and nerves that runs from the neck down the back). These include numerous conditions that can cause a wide range of symptoms and complications. Some examples of spinal disorders include:

  • Ankylosing spondylitis. This inflammatory disease can cause some of the vertebrae in your spine to fuse (join) together. It can make the spine less flexible, resulting in a hunched-over posture, and can even affect breathing.
  • Basilar invagination (cranial settling). This condition occurs when the upper bone in the neck protrudes into the hole in the base of the skull, called the foramen magnum. It can cause pain in the lower part of the skull and upper neck, and can compress the spinal cord, causing weakness and numbness.
  • Herniated (ruptured) disc. This condition occurs when the inner core of a disc in the neck or back leaks out. The resulting bulge can press on nearby nerves or the spinal cord, causing pain and numbness.
  • Cervical fractures. If one of the seven vertebrae in the neck are fractured (broken), paralysis or even death can result.
  • Chordoma. This rare type of cancerous tumor can occur anywhere along the spine. These tumors grow slowly, gradually extending into the bone and surrounding soft tissue.
  • Degenerative disc disease and other degenerative conditions. Degenerative disc disease means that your discs have lost some of their cushioning and water content, bringing them closer together. They may press on nerves and cause pain or numbness in the back, hips and legs.
  • Facet joint osteoarthritis. Arthritis can cause cartilage between the facet joints, located in the back of the spine, to break down. It can cause pain and stiffness.
  • Kyphosis. Also called roundback or hunchback, this means that the upper part of your back is overly curved. It can cause a hunched-over posture, as well as back pain and difficulty breathing.
  • Lower back pain. One of the most common health problems, lower back pain can have many causes. It usually involves damage to the muscles and ligaments in the back.
  • Myelopathy. This means there is something wrong with the spinal cord itself. It could be from spinal cord injury or from a disease or other condition. Symptoms can vary depending on the extent and nature of the condition.
  • Neck pain. Nearly two-thirds of Americans will have neck pain at some point in their lives. It can have many causes, and though the pain is felt in the neck, the cause may be in the back or somewhere else in the body.
  • Spinal column (bone) tumors. These tumors grow from the bone or discs in the spine. They are more common in young adults and usually spread from somewhere else in the body.
  • Scoliosis. This sideways curve of the spine usually begins due to a growth spurt that occurs right before puberty. Scoliosis is more common in girls. The curve can be shaped like a C or an S. Scoliosis can cause serious problems if the curve is severe enough to crowd internal organs or cause disability.
  • Spinal cord trauma. Spinal cord trauma is damage to the spinal cord. It can result from injury or disease in the bones, tissues or blood vessels around the spinal cord. If the trauma is severe, spinal cord trauma can cause paralysis or even death.
  • Spinal cord tumors. These abnormal growths inside the spinal column can be benign (noncancerous) or malignant (cancerous). Even if a growth is not cancerous, it can put pressure on sensitive tissue in the brain, threatening your health and life.
  • Spinal dysraphism. This means that the spinal cord itself is malformed. An example is a tethered spinal cord, where the spinal cord is attached to surrounding tissue. Such malformations can lead to severe injuries and disability.
  • Spinal fractures. These are cracks or breaks in bones or vertebrae of the spine. Some small fractures may not cause symptoms, while others can cause paralysis and other disabling problems. The most serious fractures usually happen due to an accident or other trauma. Often other injuries occur at the same time, so doctors must work together quickly and precisely.
  • Spinal stenosis. This condition is a narrowing of the open spaces within your spine. It can put pressure on your spinal cord and the nerves that go to your arms and legs. It can cause pain, numbness, and can interfere with bowel and bladder control.
  • Spondylolisthesis. This means that a bone (vertebra) in the spine has shifted forward out of the proper position onto the bone below it. It can happen as a result of arthritis, in an accident or as a result of spondylolysis, a defect in a small piece of bone joining the facet joints in the back of the spine. Spondylolisthesis can cause pain in the back and leg, and in rare and severe cases, paralysis.
  • Spondylosis. This term refers to pain from degeneration in the spine. The pain could be caused by arthritis, stenosis or another condition.

How are spinal disorders diagnosed and treated?

When you come to the Tulane Neuroscience Center with a spinal disorder, our team will perform a full evaluation. We’ll talk to you about your medical history, family history, physical activity and other factors that could contribute to your condition. You may need tests or imaging that might include:

  • Magnetic resonance imaging (MRI) or computed tomography (CT). These imaging techniques can show problems in the back that don’t show up on X-rays.
  • Discography. This test involves injecting dye into a disc, and it can help doctors find out if an identified problem with a disc in your spine is causing your pain. It can also make cracks on the surface of the disc show up in an X-ray or CT scan.
  • Electromyography (EMG). This test checks the health of the muscles and the nerves that control the muscles.

Depending on your condition, you may need additional tests. We work with respected specialists throughout Tulane Medical Center to provide the diagnostics and other services you need as conveniently as possible.

Treatment for spinal disorders depends your specific problem, health, preferences and other factors. We offer advanced nonsurgical and surgical treatment options, and if surgery is necessary, we use techniques and technology that can help reduce tissue damage to speed recovery and healing.

Nonsurgical treatments may include:

  • Physical therapy. Often used along with other treatment, physical therapy can help you regain strength and move more easily. Our physical therapy team can also help you learn how to move without doing more damage or increasing pain and other symptoms.
  • Epidural steroid injections (ESI). These are injections of powerful anti-inflammatory medicine directly into the epidural space (the space outside of the sac of fluid surrounding your spinal cord). ESI is not the same type of epidural given just before childbirth or some types of surgery.
  • Facet injections. Facet joints are located between the vertebrae, allowing them to move against each other. Injections of medication directly into the facet joints (guided by X-ray imaging) can reduce swelling and pain in and around the facet joints.
  • Nerve blocks. Nerve blocks are injections of pain-numbing medicine into nerves that cause pain in the back or other areas of the body.

New robotic spine surgery technology

Tulane Health System is the first in the New Orleans region to offer physicians and patients the benefits of a new robotic guidance and navigation system that provides minimally invasive surgical options for several complex spinal, orthopedic and neurological conditions. The ExcelsiusGPS™ system provides surgeons enhanced, real-time visualizations of a patient’s anatomy to help improve the accuracy of procedures.

Learn more About Robotic Spine Surgery

Surgical treatments may include:

If surgery is needed, our specialists are skilled and experienced in minimally invasive procedures with smaller incisions, as well as open surgery techniques minimize damage to surrounding tissue. Surgical treatment might include:

  • Minimally invasive spine surgery. In minimally invasive procedures, doctors use specialized instruments to access the spine through small incisions. These small incisions cause less damage to the muscles surrounding the spine. In most cases, this results in less pain after surgery and a faster recovery. Many spinal surgeries can now be done this way, thanks to innovations in technology and technique.
  • Disc replacement. This surgery removes a damaged disc in the neck or back and replaces it with an artificial disc implant. It can relieve pressure on nerves or the spinal cord.
  • Cervical discectomy. This is surgery to remove one or more discs in the neck. It can relieve neck and other pain when a herniated (ruptured or burst) disc is pressing on the spinal cord or a nerve root.
  • Lumbar microdiscectomy. This surgery removes a disc in your back to relieve pressure on a nerve root. The surgeon moves muscles out of the way instead of cutting them, and uses a microscope to see the nerve root so it can be gently moved aside to remove the disc underneath. This surgery often relieves leg or back pain.
  • Lumbar interbody fusion. This open surgery can remove the source of pressure on nerves in the spine. It also immobilizes a section of the back to prevent pain triggered by movement.
  • Cervical foraminotomy. This surgical procedure widens the area of a damaged disc in the neck where the spinal nerves pass through. It can relieve pressure on the spinal nerve, preventing neck and arm pain.
  • Deformity correction. Our surgeons are skilled and experienced in surgery to treat scoliosis or other deformities of the spine. In some cases, complex spinal reconstruction may be necessary. Surgeons will correct the deformity and stabilize the spine with rods and pins. Some vertebrae in your spine may need to be fused together.
  • Kyphoplasty and vertebroplasty. These surgeries are done to try to relieve pain from compression fractures, which are often the result of osteoporosis. Surgeons stabilize the broken bone by injecting a substance that works like cement into the fracture.
  • Pain pumps. These small devices can be implanted to continuously deliver a precise dose of pain medicine to a targeted area in the spine. It can often provide better pain control than medicines taken orally. You may be able to stop taking oral medicines or take less of them.
  • Revision surgery. This is surgery to remove and replace a disc implant or other implant that has failed.
  • Spinal cord stimulators. Also called a dorsal column stimulator, this device is implanted under your skin to send a mild electric current to your spinal cord through a small wire. It can often help decrease pain so that you can take less pain medicine or stop taking it
  • Spinal fusion. This surgery joins, or fuses, two or more vertebrae in the low back. Bone from your own pelvic bone or from a donor is used to make a bridge between vertebrae in your spine. The piece of bone helps new bone grow. Metal implants hold the vertebrae together until new bone grows between them.

Helpful resources

Many organizations and agencies offer information and resources for people with all kinds of spinal disorders. Here are a few places to start.