For adults and children with complex spine deformities, find more help, more hope and more options here at the Ohio State University Wexner Medical Center.

If you hope to become more active, more functional and more mobile, The Ohio State University Wexner Medical Center can help. From spinal stenosis to scoliosis to tumors and infections, our team of orthopedic physicians, clinicians, anesthesiologists and occupational therapists are experts in treating very complex spine diseases, conditions and deformities.

With leading diagnostic tools, cutting-edge treatments and breakthrough research, our Comprehensive Spine Center offers the most extensive care for adults and children with complex spinal conditions and deformities than any other facility in central Ohio.


Conditions We Treat

Cervical Disc Degeneration

Cervical disc degeneration occurs when a healthy disc in the cervical or neck region begins to deteriorate rapidly, usually as a result of aging.

As a result, the discs in the spine become dehydrated, affecting both the flexibility and height of the disc. The disc or discs can cause pain, limit range of motion and lead to compression of the nerve.

Symptoms may include:

  • Burning
  • Headache
  • Numbness
  • Pain
  • Tingling

Nonoperative treatment may be helpful in relieving symptoms. However, depending on the diagnosis, surgery, such as fusion, may be necessary to relieve pressure and pain.

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Cervical, Lumbar and Thoracic Spinal Stenosis

Spinal stenosis causes narrowing in your spine. The narrowing puts pressure on your nerves and spinal cord and can cause pain.

Spinal stenosis occurs mostly in people older than 50. Younger people with a spine injury or a narrow spinal canal are also at risk. Diseases such as arthritis and scoliosis can cause spinal stenosis, too. Symptoms might appear gradually or not at all. They include:

  • Pain in your neck or back
  • Numbness, weakness, cramping, or pain in your arms or legs
  • Pain going down the leg
  • Foot problems

Doctors diagnose spinal stenosis with a physical exam and imaging tests. Treatments include medications, physical therapy, braces and surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

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Cervical Myelopathy

One of the most common neck conditions that occurs with age is cervical spondylotic myelopathy (CSM). Over time, the normal wear-and-tear effects of aging can lead to a narrowing of the spinal canal. This compresses the spinal cord. CSM can cause a variety of symptoms, including pain, numbness and weakness.

Spinal cord compression is a very common neck condition affecting older people in the United States. Symptoms usually begin after the age of 50, but can occur earlier if there was an injury to the spine at a younger age.

Many people with CSM will have steady progression of their disease. Once symptoms start, they tend to continue. Typically, the disease progresses slowly over several years. In about five to 20 percent of people, CSM worsens more rapidly.

Neck pain may result from abnormalities in the soft tissues—the muscles, ligaments and nerves—as well as in bones and joints of the spine. The most common causes of neck pain are soft-tissue abnormalities due to injury or prolonged wear and tear. In rare instances, infection or tumors may cause neck pain. In some people, neck problems may be the source of pain in the upper back, shoulders, or arms.

When the spinal cord is slowly compressed, people may develop symptoms such as:

  • Difficulty walking: loss of balance and/or a wide-based gait characterized by clumsy, staggering, tottering movements
  • Neck pain and stiffness
  • Tingling and numbness
  • Weakness and coordination problems: trouble lifting objects or dropping things

Source: American Academy of Orthopaedic Surgeons

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Failed Spinal Surgery

Generally used to describe an unsuccessful surgery for back pain, the cause of failed spinal surgery may include:

  • Post-surgical complications
  • Recurrence of original cause
  • Nerve root compression or irritation
  • Scar tissue
  • Nerve damage or abnormal regeneration
  • Improper, inadequate or incomplete rehabilitation

Pain is the most obvious sign of this condition. While treatment may be difficult, new treatment options are available and should be discussed with your surgeon.


Herniated Disc

A herniated, or slipped, disc occurs when all or part of a disc is forced through a weakened part of the disc. This may place pressure on nearby nerves or the spinal cord.

With herniated disc:

  • The disc may move out of place (herniate) or break open (rupture) from injury or strain. When this happens, there may be pressure on the spinal nerves. This can lead to pain, numbness or weakness.
  • The lower back (lumbar area) of the spine is the most common area for a slipped disc.
  • The neck (cervical) discs are sometimes affected. The upper-to-mid-back (thoracic) discs are rarely involved.
  • A herniated disc is one cause of radiculopathy, any disease that affects the spinal nerve roots.
  • Slipped discs occur more often in middle-aged and older men, usually after strenuous activity. Other risk factors include conditions present at birth that affect the size of the lumbar spinal canal.

The pain most often occurs on one side of the body.

With a slipped disc in your lower back, you may have sharp pain in one part of the leg, hip or buttocks and numbness in other parts. You may also feel pain or numbness on the back of the calf or sole of the foot. The same leg may also feel weak.

With a slipped disc in your neck, you may have pain when moving your neck, deep pain near or over the shoulder blade or pain that moves to the upper arm, forearm and fingers. You can also have numbness along your shoulder, elbow, forearm and fingers.

The pain often starts slowly. It may get worse:

  • After standing or sitting
  • At night
  • When sneezing, coughing or laughing
  • When bending backward or walking more than a few yards

You may also have weakness in certain muscles. Sometimes, you may not notice it until your doctor examines you. In other cases, you will notice that you have a hard time lifting your leg or arm, standing on your toes on one side, squeezing tightly with one of your hands or other problems.

The pain, numbness or weakness often goes away or improves over weeks or months. Surgery may be an option if your symptoms do not go away with other treatments and time.

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Kyphosis

Kyphosis is a curving of the spine that causes a bowing or rounding of the back, which leads to a hunchback or slouching posture.

Kyphosis can occur at any age, although it is rare at birth.

Adolescent kyphosis, also known as Scheuermann’s disease, is caused by the wedging together of several bones of the spine (vertebrae) in a row. The cause of Scheuermann’s disease is unknown.

In adults, kyphosis can be caused by:

  • Degenerative diseases of the spine (such as arthritis or disc degeneration)
  • Fractures caused by osteoporosis (osteoporotic compression fractures)
  • Injury (trauma)
  • Slipping of one vertebra forward on another (spondylolisthesis)
  • Certain endocrine diseases
  • Connective tissue disorders
  • Infection (such as tuberculosis)
  • Muscular dystrophy
  • Neurofibromatosis
  • Paget’s disease
  • Polio 
  • Spina bifida
  • Tumors

Kyphosis can also be seen with scoliosis. Each cause has its own risk factors.

Symptoms include:

  • Difficulty breathing (in severe cases)
  • Fatigue
  • Mild back pain
  • Round back appearance
  • Tenderness and stiffness in the spine

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Lumbar and Thoracic Instability

Instability in the spine is a general term for abnormal movement between vertebrae, often caused by disc degeneration. As a result, nerves become irritated and the patient experiences such symptoms as pain, a sensation that the back is “catching,” spasms or loss of motion when extending or flexing.

Pinched Nerve

Some people have neck pain that may radiate into the shoulder and arm. This type of pain is often caused by an injury near the root of a spinal nerve. A nerve root injury is sometimes referred to as a “pinched” nerve. The medical term for this condition is cervical radiculopathy.

Cervical radiculopathy pain travels down the arm in the area of the involved nerve. Pain is usually described as sharp. There can also be a “pins and needles” sensation or even complete numbness. In addition, there may be a feeling of weakness with certain activities.

Symptoms can be worsened with certain movements, like extending or straining the neck or turning the head. These symptoms are often made better by placing the hand on the head and stretching the shoulder.

The majority of patients with cervical radiculopathy get better with time and never need surgery, or even any treatment at all.

Some patients will have the pain go away quickly over days to weeks, while others take longer. It is also not uncommon for cervical radiculopathy to come back at some time in the future. Some patients do develop persistent symptoms and require evaluation and treatment for the arm pain or weakness.

There are several surgical procedures for radiculopathy. The procedure that is right for you will depend on many factors, most importantly the type of problem you have.

Source: American Academy of Orthopaedic Surgeons


Scoliosis

Scoliosis causes a sideways curve of your backbone, or spine. These curves are often S- or C-shaped. Scoliosis is most common in late childhood and the early teens, when children grow fast. Girls are more likely to have it than boys. It can run in families. Symptoms include leaning to one side and having uneven shoulders and hips.

Doctors use your medical and family history, a physical exam, and imaging tests to diagnose scoliosis. Treatment depends on your age, how much more you're like to grow, how much curving there is, and whether the curve is temporary or permanent. People with mild scoliosis might only need checkups to see if the curve is getting worse. Others might need to wear a brace or have surgery.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases

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Spina Bifida

Spina bifida is a neural tube defect—a type of birth defect of the brain, spine or spinal cord. It happens if the spinal column of the fetus doesn’t close completely during the first month of pregnancy. This can damage the nerves and spinal cord. Screening tests during pregnancy can check for spina bifida. Sometimes it is discovered only after the baby is born.

The symptoms of spina bifida vary from person to person. Most people with spina bifida are of normal intelligence. Some people need assistive devices such as braces, crutches or wheelchairs. They may have learning difficulties, urinary and bowel problems or a buildup of fluid in the brain.

The exact cause of spina bifida is unknown. It seems to run in families. Taking folic acid can reduce the risk of having a baby with spina bifida. Women who could become pregnant should take it daily.

Source: NIH: National Institute of Neurological Disorders and Stroke


Spine Disorders and Fractures

A number of problems can change the structure of the spine or damage the vertebrae and surrounding tissue. They include:

  • Infections
  • Injuries
  • Tumors
  • Conditions, such as ankylosing spondylitis and scoliosis
  • Bone changes that come with age, such as spinal stenosis and herniated discs

Spinal diseases often cause pain when bone changes put pressure on the spinal cord or nerves. They can also limit movement. Treatments differ by disease, but sometimes they include back braces and surgery.

Source: National Institute of Arthritis and Musculoskeletal and Skin Diseases

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Spondylolisthesis

Spondylolisthesis is a condition in which a bone in the spine slips out of the proper position onto the bone below it.

In children, spondylolisthesis usually occurs between the fifth bone in the lower back and the first bone in the pelvis area. It is often due to a birth defect in that area of the spine or sudden injury.

In adults, the most common cause is abnormal wear on the cartilage and bones (such as arthritis).

Bone disease and fractures can also cause spondylolisthesis. Certain sports—such as gymnastics, weight lifting and football—put a great deal of stress on the bones in the lower back. They also require that the athlete constantly overstretch the spine. This can lead to a stress fracture on one or both sides of the vertebra. A stress fracture can cause a spinal bone to become weak and shift out of place.

Spondylolisthesis may vary from mild to severe. A person with spondylolisthesis may have no symptoms.

The condition can produce increased lordosis (also called swayback), but in later stages may result in kyphosis (roundback) as the upper spine falls off the lower spine.

Symptoms may include:

  • Lower back pain
  • Muscle tightness (tight hamstring muscle)
  • Pain, numbness, or tingling in the thighs and buttocks
  • Stiffness
  • Tenderness in the area of the slipped disc
  • Weakness in the legs

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Diagnosis

Before we can determine a course of treatment for your spinal condition or complex spine deformity, our orthopedic surgeons need to evaluate your condition. Our diagnostic process includes a physical examination and neurologic exam, which may include the use of lights or reflex hammers to assess motor, sensory and reflex skills.

During your visit, you and your doctor will discuss your current condition, limitations and medical history. Your physician also reviews any prior imaging or operative reports including X-rays, MRI (magnetic resonance imaging) or CT (computed tomography) scans. These imaging reports give your physician detailed images of any deterioration or abnormality in your bones or soft tissues.

Your doctor may order further testing, if necessary, including additional X-rays, MRI, CT scan, EMG, myelogram and/or bone density. An EMG uses tiny electrodes to send signals to your muscles, and records their response. This test helps your doctor evaluate the health of your muscles and nerve cells. A myelogram involves the use of a contrast dye to further highlight areas of concern. A bone density test is a painless scan that measures calcium and minerals in your bone to detect for osteoporosis.

Treatments

Our Comprehensive Spine Center physicians specialize in both nonsurgical and surgical treatments. We provide advanced concepts of reconstruction for spinal deformity, as well as leading-edge treatments.

Nonsurgical treatments include:

  • Pain management through appropriate pharmaceutical therapy to relieve, reduce or eliminate pain

  • Physical therapy rehabilitation to build strength and speed recovery time

Surgical treatments include:

  • Fusion surgery to create stability in the spine by joining or fusing together two or more of the vertebrae

  • Lumbar discectomy, which is the surgical removal of low back herniated disc, to relieve pressure and pain

  • Minimally invasive spine surgery using special instruments and small incisions to surgically reduce pain and speed recovery

  • Osteotomy (including triplane osteotomy), which is a surgical realignment procedure, to correct spinal deformity and curvature

  • Spinal stenosis surgery to relieve pressure on spinal cord or nerve roots as an option for patients who do not respond to nonoperative treatments

  • Total disc arthroplasty of the cervical spine, which involves the replacement of a degenerated disc with an artificial disc, to provide an alternative to traditional fusion surgery

Patient Education

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Why Choose Ohio State?

Why choose Ohio State for spine care?

Comprehensive Care: The Ohio State University Wexner Medical Center’s Comprehensive Spine Center offers multiple options – nonsurgical and surgical – for the treatment of complex spinal conditions and deformities.

Physical Therapy Expertise: Our physical therapists specialize in spine conditions and work with you one-on-one to alleviate pain while improving balance, strength and coordination.

Surgical Expertise: If your condition requires surgery, our surgeons are fellowship-trained in complex spine surgeries. We perform more complex spine surgeries than any other medical center in central Ohio.

Research: The discoveries that come from bench-top research, including stem cell research, are being translated into clinical medicine that directly benefits complex spine patients.

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