Overview:

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Spinal instability occurs when there is excessive movement between two or more vertebrae (bones that make up the spine). This ultimately limits the spine’s ability to hold an individual's body weight and can result in significant disability. 

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Causes:

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• Disc degeneration - Each of the discs in your spine act as shock absorbers between each vertebrae helping to limit damage to the spinal tissues and bones. These discs are made of two parts. The nucleus pulposus is a gelatinous liquid-like center and the annulus fibrosus is a tough elastic band that circles the soft center. Degenerative disc disease can occur in any part of the spine; however, it most frequently develops in the lower back. With age, the liquid-like center of the disc can begin to dry out, putting more pressure and friction on the disc. Disc degeneration can affect the structure of the vertebrae. 

• Trauma - Spinal fractures or damage to ligaments that hold the vertebrae together

• Congenital Defects - Scoliosis and Spina Bifida 

• Pathological - Rare tumors can involve the vertebrae and surrounding structures.

 

Symptoms:

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• Leg weakness and/or tingling 

• Back and/or leg pain that may get better with rest

• Severe back pain when lifting objects

• Muscle spasms

 

Diagnosing: 

 

To diagnose, your doctor will perform a clinical exam and ask you a number of questions regarding your symptoms.  Your doctor may look for abnormalities via a physical examination, X-rays, computed tomography (CT) scans, and magnetic resonance imaging (MRI).

 

Treatment: 

 

Leg pain and weakness secondary to instability may be self-limiting and go away on its own over time.  When appropriate, non-surgical intervention is the first choice and may include:

1. Medications (anti-inflammatories, muscle relaxants, steroids)

2. Physical Therapy (core strengthening, stretching, soft tissue release)

3. Steroid Injections (epidural, facet blocks)

 

If non-surgical treatment fails, surgical intervention may be warranted to treat the underlying structural issue, including a Spinal Fusion.  This is a procedure where the doctor will fuse two or more vertebrae together. This is done to prevent movement and stabilize the spine.