Massage & Bodywork

SEPTEMBER | OCTOBER 2016

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facets. Additional synovial joints connect each thoracic vertebra to a pair of ribs. Many ligaments help to stabilize the vertebrae to allow a wide range of motion without danger of nerve damage. Most of the spinal ligaments are short, running from spinous to spinous process, or from transverse to transverse process. However, three long ligaments help stabilize the spine on its vertical axis. They are the anterior longitudinal ligament, which runs up the anterior side of the vertebral bodies; the posterior longitudinal ligament, which runs along the posterior aspect of the vertebral bodies, on the anterior side of the vertebral canal; and the ligamentum flavum, which also runs inside the vertebral canal, on the posterior aspect. Together, the bones, discs, and connecting ligaments give our spine tremendous adaptability: we can jump, twist, flex, extend, torque, and roll without damaging our spinal cord. However, it is possible for things to go wrong. When that happens, some of the consequences include the following conditions. SPONDYLOSIS Spondylosis is a form of degenerative arthritis. It involves age-related changes in the vertebrae, as well as the discs, joints, and ligaments of the spine. Unlike many other spinal conditions, spondylosis tends to impact the neck more than the low back. Neck pain is common, but while the majority of people over 60 years old have some indication of spondylosis, this condition is not always associated with pain. Spondylosis has two features that distinguish it from other forms of degenerative arthritis: bone spurs and ossification of the longitudinal spinal ligaments. • Bone spurs or osteophytes are common signs of spondylosis. These protrusions usually grow on the anterior or lateral aspects of the cervical vertebral bodies (where they may never produce symptoms), but they can also grow on facets or near enough to the transverse foramina to put pressure on nerve roots where they exit the spine. • Diffuse idiopathic skeletal hyperostosis (DISH) is a situation in which the anterior longitudinal ligament, the posterior longitudinal ligament, and the ligamentum flavum can become thickened, calcified, or even buckled with age. When these ligaments degenerate, two problems can develop: progressive, painless loss of range of motion and impingement of the nerves, spinal cord, and/or blood supply to the central nervous system. Spondylosis may not have major symptoms outside of a progressive loss of range of motion. When symptoms are present, they are related to bone spurs or DISH putting mechanical pressure on the spinal cord or nerve roots. Nerve root irritation leads to numbness, tingling, pins and needles, and muscle weakness on the affected side. Spondylitic myelopathy—spinal cord damage from spondylosis—is an especially alarming possibility; this may be marked by bilateral nerve symptoms, loss of balance, trouble with walking, and loss of bowel or bladder control. Left untreated, it could lead to paralysis. SPONDYLITIS Spondylitis is technically "inflammation of the spine," but this term is usually reserved for a group of autoimmune conditions, the most common of which is called ankylosing spondylitis (AS). Ankylosing means "stiffening." Ankylosing spondylitis usually starts with an acute inflammatory episode at one or both sacroiliac joints, and then moves upward with episodes of flare and remission. In its wake, the vertebrae, cartilage, ligaments, and even nearby tendons ossify and fuse together. Further, the spine may fuse in a flexed position. The ribs may fuse with the vertebrae, resulting in a locked rib cage and a high risk of fractures, pneumonia, and heart failure. In rare cases, this process may also affect joints of the axial skeleton. AS usually starts as an experience of low-back pain. It is often confused for disc injuries or spondylosis in early stages. Each episode leaves permanent damage behind as the disease progresses up the spine. SPONDYLOLISTHESIS Spondylolisthesis (say that three times fast!) is a condition in which the pars interarticularis, which is the anterior portion of the lamina, degrades. This allows the vertebral body to slip forward, while the posterior part of the vertebral arch stays in place. Spondylolisthesis usually happens in the lumbar spine, where the intervertebral facet joints are on a coronal plane. C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 39

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