Tag Archive for: back pain

Chordoma

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Cancer is always frightening, no matter where it occurs. One type of cancer that is particularly distressing is chordoma, a rare malignant bone tumor that forms in the spine or the base of the skull. More specifically, it’s a type of sarcoma, which is a broad group of cancers that begin in the bones and your soft (connective) tissues. A chordoma tumor usually grows slowly, often without symptoms at first, and then might cause symptoms for years before doctors find it. Chordoma can be fatal, but with early diagnosis and appropriate treatment, many chordoma patients can live for a decade or more and some can be cured. That’s why it is so crucial to find skilled surgeons with extensive experience treating chordomas like the first-class experts you’ll find at Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado.

OVERVIEW

Chordomas account for about 3 percent of all bone tumors and about 20 percent of primary spinal tumors. They are diagnosed in just 1 in 1 million people every year. There’s nothing that can be done to prevent developing chordoma. Most cases happen randomly. They develop in anyone at any age, but they are most likely to occur in adults aged 40 to 80. Men and people assigned male at birth are approximately 1.5 times as likely to have a chordoma as women and people assigned female at birth. However, chordomas, especially the types that appear at the bottom of the spine, affect more women than men. Skull base chordomas are more common in younger patients; spinal chordomas are more likely after age 50. It is possible to develop more than one chordoma tumor at a time, in different places along the spine.

WHAT IS A CHORDOMA?

Chordomas are complicated tumors to treat due to the involvement of critical structures such as the brainstem, spinal cord, and important nerves and arteries. They can also come back or recur after treatment — usually in the same place as the first tumor. This is called a local recurrence. In about 30 to 40 percent of patients, the tumor eventually spreads or metastasizes to other parts of the body, usually to the lungs. After it has recurred, it can cause death, typically due to tissue destruction in the spinal cord, or brainstem. Different segments of the spine correlate with different parts of the body, and so a chordoma’s effects depend on where along the spine it occurs:

  • The skull base includes a bone called the clivus, where about a third of all chordomas develop. Tumors there affect cranial and facial nerves and can affect vision.
  • The cervical spine starts just below the skull and ends just above the thoracic spine. Its nerves branch off to the arms and upper chest.
  • The thoracic spine is the mid-back. Its nerves branch off to the abdomen and chest.
  • The lumbar spine is the lower back. Its nerves branch off to the hips, knees, ankles, and toes.
  • The sacrum is the base of the spine and below that is the coccyx. A chordoma in this area can affect the function of the legs, pelvis, bowel, and bladder.

TYPES OF CHORDOMA

The World Health Organization (WHO) recognizes three distinct types of chordoma based on what the cells look like under a microscope (their histology):

  • Classic/conventional chordoma. This is the most common type (80-90% of all cases). It’s made up of a unique type of cell that looks “bubbly”.
  • Chrondoid is a variant of this type. Under a microscope, it has certain features of a conventional chordoma and a chondrosarcoma, which is another type of cancer, but one that derives from cells that produce cartilage.
  • Differentiated chordoma is the rarest (less than 5% of cases). It’s more aggressive, faster growing, and more likely to metastasize.

Read more about Chordoma on our new Colorado Springs Orthopedic News Site – Colorado Springs Orthopedic News. Schedule an appointment with a spine specialist today.

Thoracic Fracture

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Thoracic fractures can be extremely painful, particularly if there is displacement of bone fragments or injury to surrounding soft tissues. Delayed treatment of thoracic fractures can increase the risk of complications such as spinal instability, deformity, nerve damage, and paralysis. All of which may be permanent and irreversible. In the case of thoracic fracture, you need a surgeon at the top of their field. Someone whose experience and skill you can trust. At OCC – Colorado Center of Orthopedic Excellence in Colorado Springs, Colorado, their highly accomplished surgeons are known and respected for their diagnosis and treatment of thoracic fractures. When it comes to thoracic fracture, you can count on getting not just the best treatment but the best results.

OVERVIEW

People sometimes refer to a spinal fracture as a broken back. When a bone in the spine collapses, it is called a vertebral compression fracture (VCF). Vertebral compression fractures are the most common injury to the thoracic spine.  Osteoporosis causes more than 1.5 million vertebral compression fractures each year. They are almost twice as common as other fractures typically linked to osteoporosis, such as broken hips and wrists. Forty percent of all women will have at least one vertebral compression fracture by the time they are 80 years old. More than 150,000 thoracic fractures each year are caused by traumas. Men are 4 times more likely to have a traumatic spinal fracture than women. Once someone has had a vertebral compression fracture, they are five times more likely to develop another compared to someone who’s never experienced one. Prognosis and recovery from a thoracic fracture may differ from patient to patient. The difference is due to the type of injury and the level of severity.

ABOUT THE THORACIC SPINE

The spine is made up of three segments. When viewed from the side, these segments form three natural curves. The “c-shaped” curves of the neck (cervical spine) and lower back (lumbar spine) and the “reverse c-shaped” curve of the chest (thoracic spine). 33 vertebrae make up the spine. Vertebrae are the individual bones that interlock with each other to form the spinal column. The thoracic spine consists of 12 vertebrae numbered T1 to T12. Each number corresponds with the nerves in that section of the spinal cord. These nerves branch off, transmitting signals between the brain and major organs, including the lungs, heart, liver, and small intestine. Thoracic vertebrae are unique in that they have the additional role of providing attachments for the ribs. This makes the thoracic spine more rigid and stable than the cervical or lumbar regions, making it the least common area of injury along the spine. While it’s primarily designed for stability, force absorption, and keeping the body upright, the thoracic spine is capable of a wide range of movement and its mobility is vital to overall health and function.

WHAT IS THORACIC FRACTURE?

There are several types of thoracic fractures, which can vary based on the mechanism of injury, severity, and location within the thoracic spine. These include compression fractures (wedge), burst fractures, flexion-distraction (seat belt injury/Chance fracture), and fracture-dislocation. A stable versus an unstable fracture is another way a provider will classify a thoracic fracture. With a stable fracture, the injury that broke the vertebrae didn’t push or pull them out of their usual place in the spine. One is less likely to need surgery with a stable fracture. Unstable fractures happen when the injury moves the vertebrae out of their usual alignment. There’s a much higher chance of the need for surgery to repair the broken vertebrae and a higher risk for dangerous complications that can affect the spinal cord.

Read more about Thoracic Fractures on our new Colorado Springs Orthopedic News Site – Colorado Springs Orthopedic News. Schedule an appointment with a spine specialist today.

5 Facts You Should Know About Low Back Pain

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If you’re suffering from low back pain, you’re not alone. More than 80 percent of adults in the US will experience some kind of lower back pain in their life and it is the most common job-related disability. But knowing that misery loves company doesn’t relieve your pain. Only getting a proper diagnosis and treatment can do that. If you’re trying to figure out where to start with your lower back pain, these 4 facts can point you in the right direction:

#1 There are many causes of low back pain, from injury to disease

The majority of low back pain is caused by an injury, many from sports or occupational situations. But it can also be caused by disease. Arthritis, certain infections, cancers or diseases of the discs are all known to cause low back pain.

If you have low back pain and it does not resolve in a couple of weeks with home care remedies such as rest and ice, seek out an orthopedic specialist who can evaluate you and determine if tests such as x-rays, are needed to look for disc damage or indication of other diseases.

#2: Everyday changes can make a big difference

If your pain is caused by injury or overuse, pausing intense activities or swapping them for some strategic exercises (or both) can be key to recovery. Even those of us who are committed to a consistent fitness routine or have done the same activities for years still overdo it occasionally. Taking a short break or adjusting your form can work wonders for healing and reducing the chance or reinjury.

If your pain is aggravated by certain work activities, there may be small changes you can make to minimize further strain. If you’re on your feet all day or your job entails heavy lifting or other strenuous activities, you might benefit from better equipment (even changing to more study, supportive shoes can make an impact!), form or technique.

#3 Physical therapy and exercise can be a game changer

When homecare and lifestyle adjustments are not helping, your doctor may prescribe therapy under the guidance of a physical or occupational therapist. These experts can recommend exercises that are specifically designed for your situation. They may include stabilization or core strengthening exercises that help you regain strength and control over your abdominal muscles which are key in properly aligning and stabilizing the back and spine.

#4 Surgery for low back pain is typically only recommended when all other options have been exhausted

Even chronic pain can often be addressed with non-surgical, or minimally invasive treatments such as injections or physical therapy. But some problems, left untreated, can lead to significant and even permanent nerve damage and must be addressed. When surgery is recommended, it’s after non-surgical options are exhausted, and an orthopedic specialist feels that surgery gives a patient the best opportunity for a full and pain fee life.

#5 Many causes of low back pain can be prevented!

You’ve probably heard the phrase “an ounce of prevention is worth a pound of cure” and if you’ve endured low back pain, you know this is no exaggeration! Your lower back and spine are balanced by your core, which means your ab muscles are essential to keeping things in proper alignment. Strengthening those muscles and maintaining a healthy weight are two key ways to put less burden on your low back, and prevent injury.

Maintaining good posture at all times is also important. Make it easier on yourself and be mindful of how you sit, work and even stand – align your chair, desk, and computer so that you’re less likely to hunch over and put strain on your low back. If you stand for long periods of time during the day, wear comfortable, supportive and flat shoes to minimize or avoid low back pain.

If you have low back pain and haven’t been able to find relief, talk to an orthopedic spine specialist. They can diagnose the cause of your pain and outline a custom treatment plan that addresses your symptoms and related medical history.

Learn more about Dr. Crowther, our spine specialist, or make an appointment today.

When Is an Orthopedic Injury an Emergency?

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Orthopedic physicians deal with injuries to the bones and their related structures. Orthopedic treatments and procedures cover fractures, torn ligaments and tendons, strained muscles, and similar injuries. They also deal with acquired and congenital skeletal deformities and degenerative diseases like osteoarthritis.

With new knowledge and technology in orthopedic medicine, older procedures have been replaced by bone grafts, joint replacements, prostheses, and special footwear. Orthopedic treatment frequently combines rehabilitation with traditional medicine and surgery.

When Does an Orthopedic Issue Become Urgent?

Orthopedic emergencies are conditions that should be seen by a physician the same day the injury occurs, to help prevent harm and long-lasting negative impact to the patient. Major trauma with complex fractures, deep and/or wide cuts, and loss of consciousness definitely demand immediate care at the hospital emergency room (ER).

Other orthopedic emergency conditions can develop slowly, with little or no apparent trauma. They often occur at home with no obvious injury. It can be difficult to judge whether they qualify as emergencies and need immediate attention, or whether such attention can be deferred, or whether a physician should at least be consulted about the condition.

So if you do have an emergency orthopedic issue, where is the best place to get the care you need? Knowing when and where to go can save you future problems and significant time and money.

Common Emergency Orthopedic Conditions

There are many serious and painful orthopedic conditions. When these occur or are discovered, an immediate call to the orthopedic physician is needed.

The most common orthopedic injuries – which usually occur in the aftermath of surgery or an accident – that require urgent and emergency attention are:

Severe back pain along with weakness in the legs and difficulty in urinating, especially after lumbar spine surgery or epidural spinal injection, could be caused by bleeding in the area around the spinal cord.

Severe pain and swelling in a joint, accompanied by fever and chills, could be due to a joint infection.

Calf pain and swelling shortly after being injured or having surgery in the legs could indicate a blood clot deep in the veins. This can become a life-threatening embolism.

Dislocations are joint injuries that force the bones out of their normal position.

Falls or twists in a post-operative limb, along with significant pain, could mean a positional change in the setting of the fracture, another new fracture, or a dislocation of the new joint.

Increasing pain, swelling, and numb fingers or toes in a patient with a solid cast could indicate cast-compression syndrome.

Neurovascular injury in an injured extremity can compromise neurovascular function. Signs of this type of injury can be pain, numbness, or tingling. Delays in treating the condition can affect nerve function and blood flow to the limb. This can result in the need for amputation of the extremity, or even death.

Exposed fractures or joints, such as open injuries to the knee, sprained ankle, or other broken bones, are severe health concerns requiring immediate attention.

Osteoporosis accompanied by pain in the thigh or groin, and difficulty walking, could mean an osteoporotic fracture of the hip due to insufficient bone matter.

Septic joints can occur when a bacterial infection invades a joint – in the knee, hip, shoulder, or spine. Any joint is vulnerable to infection, so never hesitate to have it evaluated by a physician.

Chest pain, shortness of breath, and cough manifesting a few weeks after total hip, knee, or shoulder replacement, or any surgery for fractures, could indicate a blood clot to the lungs (pulmonary embolism).

Spontaneous draining of body fluid oozing out of a wound in a post-operative patient requires treatment by a physician. 

Orthopedic Injuries that Are Treatable at Urgent Care Centers

Most orthopedic injuries can be safely treated at an urgent care center. While life-threatening conditions require true emergency-room treatment, orthopedic urgent care is the better option for treatment of conditions that are not life-threatening, as these specialized facilities are less crowded and pressured. 

Orthopedic urgent care centers can address injuries and problems that include:

  • Cast or splint issues
  • Cuts and lacerations
  • Fractures
  • Ligament tears
  • Painful, swollen joints
  • Pediatric injuries
  • Sports injuries
  • Sprains, strains, and discolorations

Injuries that Should Be Treated at Hospital Emergency Rooms

Any injury or condition that may be life-threatening should always be directed to a hospital emergency department for expert care and management. The emergency room is open 24 hours a day, offers top-of-the-line resources, and is the best choice for severe orthopedic injuries if:

  • Arm or leg is severely fractured and/or out of alignment
  • Bone is fractured and exposed through the skin
  • Significant blood loss has occurred
  • Other injuries from falls or accidents are present

Pediatric Emergency Care 

For severely injured children, the emergency room offers the most appropriate environment for handling their injuries immediately. Emergency rooms also feature the widest range of services and access to medical specialists.

Cases that require pediatric care at a hospital emergency room include:

  • A child with a fractured bone remains in pain and is irritable, despite treatment and medication. This could indicate dangerous swelling at the site of the fracture.
  • A child who has no obvious symptoms of an injury but is crying, restless, feverish, and unable to walk. This could indicate a serious hip joint infection.
  • Children with large, deep cuts or wounds.
  • A child who has positional deformities of the limbs.

Family Orthopedic Care in Colorado Springs

The Colorado Center of Orthopaedic Excellence (CCOE) offers expertise spanning the entire spectrum of orthopedic specialties. We can diagnose and treat your orthopedic issues with state-of-the-art treatment options and the personalized care and attention you deserve.

Contact us today and make an appointment with one of our orthopedic doctors for award-winning orthopedic and sports medicine treatment. Fill out our online appointment request form, or call (719) 623-1050 today. We look forward to helping you live a more pain-free and active lifestyle.

Can Scoliosis Occur Later in Life?

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Scoliosis is a condition where the spine curves to the left or right. It can be slight or severe, and there may or may not be a defined reason for developing the condition. Most of the time, scoliosis develops around the time of puberty. Adolescent girls get scoliosis more than boys, and children more than adults. In rare cases, scoliosis can also develop during adulthood.

Your spine has natural curves, like an S, that gently support your body and its movement. When a person has scoliosis, a sideways curvature is present. Some of the symptoms of scoliosis include pain, tingling in the extremities, and noticeable abnormalities in posture (like uneven shoulders or stooping). Nobody knows why people develop scoliosis, but there is some evidence of hereditary factors. 

There are two types of scoliosis, idiopathic and degenerative. Idiopathic scoliosis usually develops in and is diagnosed in young adolescents. Idiopathic scoliosis may not be diagnosed until adulthood, either because there may have been no symptoms for many years, or the curvature has become more pronounced.

Degenerative scoliosis is more likely to occur in adults. Just like many orthopedic conditions faced by older adults, degenerative scoliosis is preceded by wearing down of the cartilage between the bones of the spine. The spinal bones collapse against each other and can deviate to the side. Osteoarthritis of the spine results in scoliosis for some people. Some patients will also have osteoporosis also add the possible complication of a fracture due to the pressure on the spinal curvature. But just as idiopathic scoliosis may not cause any symptoms or discomfort, the same is true for degenerative scoliosis. There is no need for treatment if it is not causing the patient any issues with pain or mobility. Of course, a patient is unlikely to seek treatment and be diagnosed if there are no troubling symptoms.

Some possible reasons for the increase in cases of adult scoliosis are that people are living longer, and more active lives. Wear and tear of the cartilage in the back happens more quickly when there is more movement, such as from running, playing sports, or just walking. People also are more likely to seek out help for back pain than they may have been in the past. As the field of orthopedic medicine develops and specialists are more widely available, people increasingly know where to go with their back pain and they have more trust in orthopedic physicians who can help.

The severity of scoliosis is measured in degrees that the spine moves away from the center. If the curve is less than 40 degrees, most of the time conservative methods of treatment are effective in reducing or eliminating symptoms and preventing further curvature. Conservative treatments may include medication, physical therapy, or braces to provide stability and decrease pain. Surgical correction is a possible treatment for severe cases of scoliosis. Spinal surgery carries a significant risk of complications, so it is not normally considered unless there is severe pain or deformity. Each case is unique, so the surgery is performed with the goal of preventing further pain and damage in addition to correcting the abnormalities. 

Patients in the Colorado Springs area who have sports injuries or any orthopedic injury trust the Colorado Center for Orthopaedic Excellence to provide the best care. If you have an orthopedic injury or condition, call (719) 623-1050 for an appointment today.