Lumbar Spondylosis

Lumbar Spondylosis

Spondylosis is a deterioration that affect the lumbar spine but can also affect the cervical and thoracic spine. As the body goes through changes, normally from old age, the spine degenerates. The margin between discs in the lumbar vertebrae becomes constricted which can bring about tingling, numbness, and pain that appear to emit out from the area. These indicators are the reaction of force on the nerves as they leave the spinal cord.

If the degeneration is permitted to advance, it can cause insufficient space of the spinal canal. With this limited space, it can produce impingement of the spinal canal which can create an unsteady walk, deficient bladder control and other serious nerve problems. With Lumbar Spondylosis, osteophytes form which is excess bone growth that is mainly seen around the anterior, lateral, and less often at the posterior side of the superior and inferior borders of the vertebral bodies.

Generally Spondylosis is identified with a manual exam and x-rays of the spine. Sometimes a neurological exam is performed to establish if there are problems in the spinal canal that might be caused by spondylosis.

Treatment can be determined once the doctor evaluates how seriousness of the spondylosis and the patients age. There are several treatments that can be used to control the pain such as nonsteroidal anti-inflammatory drugs, acupuncture, osteopathic manipulative medicine, trigger-point therapy, massage, chiropractic and osteopathic care. Surgery can be performed to take out the osteophytes or occasionally sections of the intervertebral disc are routinely removed to try and ease the compression on the adjoining nerve roots and possibly the spinal cord. If a patients age is in question it may not be worth it the risk of surgery.

Schmorl's Node in the Throacic Spine

Schmorl's Node

Schmorl's node is described as a herniation of the spinal disc's soft tissue into the bony tissue of the adjoining vertebrae. Schmorl's node is a lesion considered to be linked with trauma, frequently located in the thoracic and lumbar vertebrae, however there is a chance that the node can be a congenital defect of the vertebral end-plate. Schmorl's nodes are usually the start of degenerative-disc disease. X-rays are used to diagnose this spinal defect.

A physical exam will show soreness directly over the concerned vertebrae. Schmorl's nodes typically cause no symptoms nevertheless an inflammatory response can take place producing severe pain. Generally the patient cannot remember what they did to cause the pain. Not requiring substantial medical care, rest and spinal manipulation are usually required to alleviate the pain. Oral supplements can assist elasticity and non-steroidal anti-inflammatory drugs can relieve pain and swelling. If the discs need repaired, advanced Arthroscopic surgery can be performed to relieve nerves that are crushed.

(Image shows Schmorl's node at T11 and T12)

Clay Shoveler's Fracture

Clay Shoveler's Fracture
Clay Shoveler's fracture is an uncommon but stable fracture customarily seen at the level of C7 succeeded by C6 and T1. This fracture usually happens in people who work lifting some type of weights quickly with arms lengthened causing the muscles to forcefully tighten. The force from the muscle pulling on the spinous process results in the base of its neck to break.

With Clay Shoveler's fracture, a person will feel a "knife-like" burning pain between the shoulder blades. Usually the fracture is so painful that the person can not continue with the activity they were performing.

A radiography is used to diagnose a Clay Shoveler's fracture. However if there is nerve loss, an MRI should be performed.

The majority of patients do not need medical care. Massage, physical therapy, pain medication or a cervical collar can be used to aid in the patients treatment.

Carotid Body Tumor

Carotid Body Tumor

Carotid body tumors develop in the upper region of the neck where the carotid artery bifurcate. These tumors can also be called chemodectoma or paraganglioma.

Carotid body tumors often show up as a slow-growing asymptomatic touchable mass on the anterior aspect of the neck. Symptoms will appear, such as pain, tongue paresis, Horner Syndrome, hoarseness, and dysphagia as the tumor grows and constricts the carotid artery and the encompassing nerves.

Usually removal of a carotid body tumor is proposed and occasionally radiation therapy is used in conjunction with surgery. Embolization is done to lower or cease the blood supply to the tumor and then a resection is performed on the carotid artery.

Treatment for carotid body tumors is typically very safe, and the end result is extremely good. However, there is always risk with any surgical procedure.

A very rare complication of the resection of carotid tumors is stroke. Carotid body tumors with nerves connected will need accompanying resection of the vagus nerve which might result in the dysfunction of the nerve. Facial nerves and hypoglossal nerves can also be involved depending on the size of the tumor. Less than 5 percent of patients progress to metastasis.

Ranula

Ranula
A ranula is a mucus filled cyst from an obstruction in the salivary gland. Ranula can be found in the mouth known as oral ranula or in the neck known as cervical ranula. The oral ranula usually can be found under the tongue which produces a sublingual ranula.

Ranula vary in size and in color hinging on how deep-rooted the cyst is. Depending on the size of the cyst, it can may make it unbearable to eat or talk. Periodically, the cyst will subside on its own but if that is not the case then a marsupialization may have to be performed by an oral surgeon. A marsupialization is when the oral surgeon creates a pocket by opening the cyst to enable the cyst to fill with liquid again. If this doesn't repair the cyst then the it will have to be removed along with the gland that is blocked to keep it from coming back.

Vein of Galen Malformation

Vein of Galen Malformation

Vein of Galen malformation is a very rare disorder known as cerebral vascular malformation which affect the blood vessels in the brain. The irregularity occurs during embryonic development when there is flaw in the connection between arteries and the deep draining veins. Capillaries which allows the blood to send oxygen and nutrients slowly to the brain is lacking in the connection which makes the blood run too fast which prompts the heart to work to hard. Too much blood accumulates in a deep draining vein causing it to expand which can cause heart failure. Heart failure is the most standard concern in newborns.

Sometimes a Vein of Galen malformation may be diagnosed by an ultrasound before a baby is born, yet it may not be found until after the baby is born and it undergoes heart failure. Every so often, children with Vein of Galen malformation never develop heart failure but because of the miscommunication between the arteries and veins, the water inside the brain cannot be completely consumed. The baby's head expands but over time the baby will grow into it.

To determine if the baby symptoms or heart failure is caused by Vein of Galen malformation, some test may be performed such as an Angiogram, CT or MRI. Embolization may be required as treatment which decreases blood flow by cutting off encompassing blood vessels.

Chronic Sinusitis

Chronic Sinusitis

Chronic sinusitis is one of the most frequently diagnosed chronic conditions. Chronic sinusitis is a common recurring inflammation of the air filled cavities in and around the nose that makes it difficult to breathe through the nose, which obstructs drainage and causes mucus to build up.

Some of the symptoms of chronic sinusitis may involve trouble breathing through the nose, tenderness in the cheeks, headaches, eyes and face may feel swollen and painful, nasal discharge, or sinus congestion.

Chronic sinusitis is a long-term infection that can last longer than 12 weeks. Most occurrences start with the common cold causes by a viral or bacterial infection and some originate from allergies, upper respiratory tract infection or deviated septum.

To diagnose chronic sinusitis, the healthcare provider will need to do an in-depth medical history and physical examination focusing on the sinuses and nose. If the physician suspects that the chronic sinusitis is causes by allergies, a person should be referred to an allergy specialist. Imaging of the sinuses may involve an X-ray or CT to decide the severity of the infection.

Treatment of chronic sinusitis depends on the patients medical history, whether there are complications and the severity of the symptoms. Non-medical treatments include using a humidifier to dampen and release nasal discharge and to keep the head elevated while sleeping to reduce pressure. Medical treatments include medications such as decongestants, saline nasal spray or non-steroidal anti-inflammatory drugs. If these treatments do not work, surgery may be an option to enlarge the nasal passage of the infected sinus.