Spinal disk disease occurs when the nucleus pulposus, a gel-like material in the inner core of the vertebral disc, ruptures.Rupturing of the nucleus pulposus can lead to compression of nerve roots. Symptoms may be unilateral or bilateral, and correlate to the region of the spine affected. The most common region for spinal disk disease is at The risk for lumbar disc disease is increased in overweight individuals due to the increased compressive force on the nucleus pulposus.
Severe spinal cord compression is considered a surgical emergency and requires decompression to preserve motor and sensory function. Cauda equina syndrome refers to severe compression of the cauda equina and presents initially with pain followed by motor and sensory. Bladder incontinence is seen in later stages of the cauda equina syndrome.Spondylosis, or degenerative arthritis of the spine, occurs when the intervertebral disc undergoes degenerative changes, causing the disc to fail at cushioning the vertebrae. There is an association between intervertebral disc space narrowing and lumbar spine pain. The space between the vertebrae becomes more narrow, resulting in compression and irritation of the nerves.
Spondylolithesis is the anterior shift of one vertebra compared to the neighboring vertebra. It is associated with age-related degenerative changes as well as trauma and congenital anomalies.Spinal stenosis can occur in cases of severe spondylosis, spondylotheisis and age associated thickening of the ligamentum flavum. Spinal stenosis involves narrowing of the spinal canal and typically presents in patients greater than 60 years of age. Neurogenic claudication can occur in cases of severe lumbar spinal stenosis and presents with syptoms of pain in the lower back, buttock or leg that is worsened by standing and relieved by sitting.
Vertebral compression fractures occurs in 4 percent of patients presenting to primary care with low back pain. Risk factors include age, female gender, history of osteoporosis, and chronic glucocorticoid use. Fractures can occur due to trauma but in many cases can be asymptomatic.Osteomyelitis is the bacterial infection of the bone. Vertebral osteomyelitis is most commonly caused by staphylococci. Risk factors include skin infection, urinary tract infection, IV catheter use, IV drug use, previous endocarditis, and lung disease.
