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Bone Spur


As we age, some of us may have bone spurs form within the spinal canal. These bone spurs, or osteophyte, can in turn cause a narrowing of the spinal canal that houses the sensitive spinal cord. This narrowing can progress for years unnoticed, until something causes an inflammation of the spinal cord or nerve root, much like a ring stuck on a swollen finger. Bone spurs and overgrowth of the Ligamentum Flavum cause compression on the nerves and / or spinal cord.

The illustration shows the formation of bone spurs on both sides of the spinal cord. These bone spurs in turn have crimped the spinal cord and inflamed the nerve roots. A bone spur on its own is not the real problem; once the bone spur rubs against nerves and bones, pain and inflammation occur.

Possible Causes

Bone spurs usually occur as a result of a disease or condition - commonly with osteoarthritis. As osteoarthritis breaks down the cartilage in your joint, your body attempts to repair the loss. This may involve creating new areas of bone along the edges of your existing bones.

Bone spurs often signify other conditions, including:

Spondylosis

Osteoarthritis and bone spurs may cause degeneration of the bones in your neck (cervical spondylosis) or your lower back (lumbar spondylosis) in this condition.

Spinal stenosis

This condition can be described as a narrowing of the bones that make up the spine (spinal stenosis), adding pressure on your spinal cord. Bone spurs contribute to this.

Aging

Bone spurs may be a normal part of aging and have been found in older people who don't have osteoarthritis or other diseases. In an effort to increase stability to aging joints, the body may create bone spurs. To protect areas of cartilage that are beginning to break down, bone spurs may help redistribute your weight.

Diagnostic Methods

Evaluation of back and neck pain requires a physician experienced in diagnosing spinal conditions. The work-up begins with a detailed history and physical examination. Your medical history helps your doctor understand your back and neck pain, and the influence of your lifestyle in contributing to your pain. During your physical exam, your neurosurgeon examines your spine and neurological system to pinpoint the source of pain. Simple tests for flexibility and muscle strength may also be conducted. Diagnostic tests may be ordered to confirm the location and source of your pain.

X-rays

The first step is usually a set of X-rays. X-rays show the bones (vertebrae) of the spine.

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging (MRI) uses a magnetic field and radio waves to generate highly-detailed pictures of the inside of your body. The MRI depicts soft tissues of the muscle and discs as well as nerves. These images help your neurosurgeon provide a more accurate diagnosis. This type of imaging is very safe and usually pain free. In most cases, injections are not required. However, in some situations, a contrast agent may be needed to enhance the ability of the MRI to see into your body.

Myelogram Followed by CT

A myelogram determines any decreases or blockages in the flow of cerebral spinal fluid (CSF) around your spinal column. It is used to diagnose a bulging disc, tumor or changes in the bones surrounding the spinal cord or nerves. A local anesthetic is injected into your lower back to numb the area. A lumbar puncture (spinal tap) is then performed. A dye is injected and a series of X-rays taken. Once the myelogram is completed, you are sent for a CT scan.

Intrathecal CT

Intrathecal CT determines blockages or flow of cerebral spinal fluid around the spinal column. A local anesthetic is injected into the lower back to numb the area. A lumbar puncture (spinal tap) is then performed. A dye is injected. This procedure is followed by a CT scan, which takes a series of detailed pictures of the spinal area.

Electrodiagnostics

Electrical testing of the nerves and spinal cord may be performed before, during and after surgery. These tests, called Electromyography (EMG) or Somato Sensory Evoked Potentials (SSEP), assist your neurosurgeon in understanding how your nerves or spinal cord are affected by your condition.

Bone Scan with SPECT

Bone imaging is used to detect infection, malignancy, fractures and arthritis in any part of the skeleton. Bone scans are also accurate for finding lesions for biopsy or excision. The use of single-photon emission tomography (SPECT) techniques contribute significantly to the diagnostic accuracy of the scan. A small amount of radioactive material (tracer) is used to visualize all the bones in your body. Approximately three hours after the tracer has been injected into a vein, a scan takes place.

Discography

Discography is a procedure used to determine the internal structure of your disc. It is performed by using a local anesthetic and injecting a dye into your disc under X-ray guidance. An X-ray and CT scan are performed to view the appearance of the disc composition to determine if its structure is normal or abnormal. In addition to your disc appearance, your doctor will note if you have pain with this injection.

Treatment

Pain reduction and prevention of further joint damage remain common goals in treating bone spurs. Weight loss, stretching and physical therapy, rest and ice are just a few of the treatment methods. Medications such as ibuprofen or injections may be administered for pain. Injections may reduce inflammation long enough to relieve symptoms. In serious cases of damage and deformity, bone spurs can be surgically removed.

Book Resources

 

   
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Black Hills Neurosurgery & Spine is proud to welcome itís newest physician, Dr. Jonathan L. Wilson. He joined the practice on Aug 1st, 2013 after completing his residency in neurosurgery at Wake Forest University, Winston-Salem NC. Read more.

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Learn what causes your back or neck pain with medical illustrations and narrated animations. Click here.

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Numerous patients have shared their life-changing experiences with the physicians at Black Hills Neurosurgery & Spine. Read more.

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