Spine Archive: Spondylosis

Robotic Spine Surgery Saves This Rancher

Watch this New Mexico rancher regain his life after fifteen years of back pain. To learn more search Dr. Anthony Leone’s Knowledge Center.

Capitan, New Mexico is the home to career-rancher Floyd Goodloe. Thanks to doctors in El Paso and the Mazor Robotics Renaissance system, Floyd was able to regain his life after spondylolisthesis claimed fifteen years of his life. Robotic spine surgery has allowed Floyd to take back his life and enjoy pain-free days on the ranch.

Video courtesy Mazor Robotics

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Central Cord Syndrome, Buffalo NY

Syndromes like Central Cord Syndrome can be found here, in Dr. Anthony Leone’s Knowledge Center.

The most common of the incomplete syndromes is central cord syndrome, which is characterized by motor weakness of the upper extremities greater than the lower extremities, in association with spinal sparing. Central cord syndrome most frequently occurs in older patients with cervical spondylosis and a hyperextension injury, but can occur in any age group or with any mechanism. The mechanism of injury involves compression of the cord during hyperextension, caused by an inward bulging of the ligamentum flavum on an already narrowed canal.¹

¹R. Vaccaro MD, Alexander. Orthopaedic Knowledge Update. Rosemont: American Academy of Orthopaedic Surgeons, 2005.

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Degenerative Disorders of the Lumbar Spine in the Elderly, WNY

Find out more regarding degenerative spinal complications here in Dr. Anthony Leone’s Knowledge Center.

Lumbar spondylosis is ubiquitous in the elderly population. Most patients will become symptomatic at some point in their adult lives. Degenerative disc disease, facet arthrosis, and muscle deconditioning may all be sources of pain. Low back and radiating proximal leg pain (pseudoradicular pain) may result from disc disease of facet hypertrophy and inflammation. This pain typically responds to traditional conservative treatment.¹

¹Garfin MD, Steven. Orthopaedic Knowledge Update : Spine. Rosemont: American Academy of Orthopaedic Surgeons, 1997.

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Lumbar Spondylosis

Lumbar spondylosis including stenosis is also prevalent. This entity can be present with extremity pain and limitations in walking. Many types of lumbar stenosis exist, including congenital, iatrogenic, degenerative, and post- traumatic. MRI imaging of asymptomatic volunteers have shown up to 60% prevalence of lumbar stenosis in adults older than 60 years. About 80% of patients with symptomatic lumbar stenosis have back and leg pain and 62% have claudication.

¹Warner, William C. (2015). American Association of Orthopaedic Surgeons Annual Meeting Lecture.

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Natural History – Spondylolysis

Relatively few patients with spondylolysis will acquire spondylolisthesis. Those who do typically have some associated dsyplastic features such that the true incidence of acquired isthmic spondylolisthesis may be much less. Many patients who eventually acquire spondylolisthesis are asymptomatic. True acquired slips are almost always grade I or II and rarely progress beyond grade I or II severity unless there is dysplasia present.¹

¹R. Vaccaro MD, Alexander. Orthopaedic Knowledge Update. Rosemont: American Academy of Orthopaedic Surgeons, 2005.

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Spondylosis

Spondylosis is a generalized process that affects all levels of the spine. It encompasses a sequence of progressive degenerative changes in the intervertebral disks, vertebral bodies, facet joints, and ligamentous structures. Spondylosis occurs in a sequential fashion as the body and the spine age. In any individual, symptoms due to senescent versus pathologic processes can be very difficult to differentiate.¹

¹Garfin MD, Steven. Orthopaedic Knowledge Update : Spine. Rosemont: American Academy of Orthopaedic Surgeons, 1997.

For more on Spondylosis, please visit our patient resource page |
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Spondylolisthesis Non-surgical Management

Most patients with spondylolisthesis and the presenting symptoms of greater back pain than leg pain will improve with nonsurgical treatment. For the pediatric population, cessation of aggravating activities and a period of gradual mobilization with trunk strengthening may control symptoms. Often, a period of bracing may be beneficial in selected younger patients. For adult patients with any type of spondylolisthesis, nonsurgical management is the rule initially. Symptoms usually are controlled with a combination of exercises, anti-inflammatory medication, and aerobic activities. For patients with predominant back pain syndromes, it is difficult to localize the precise cause of the patient’s symptoms. Surgical management should be considered only after a period of nonsurgical care. Evaluation and management of coexisting osteopenia is important.¹

¹Garfin MD, Steven. Orthopaedic Knowledge Update : Spine. Rosemont: American Academy of Orthopaedic Surgeons, 1997.

For more on Spondylosis, please visit our patient resource page |