These drawings represent the appearance of a herniated or ruptured disc. Both drawings show the disruption of the annulus fibrosus, the outer ring-like portion of an intervertebral disc. We are often asked the difference between a herniated disc and a bulging disc. A bulging disc is a slight protrusion of the center of the disc (nucleus pulposus) into the spinal canal. In a bulging disc, the annulus fibrosus (outer ring) has not been ruptured. A disc herniation is a large protrusion of the nucleus pulposus (center of the disc), which has burst through the annulus fiborsus (outer ring of the disc) into the spinal canal, invading the surrounding nerves and causing pain in the extremities. The tissue located in the center of the intervertebral disc, the nucleus pulposus, is partially extruded from the intervertebral disc. The extruded nucleus pulposus material can exert pressure on nerves thus causing pain, numbness, and muscle weakness due to nerve damage.
An abnormal spinal condition known as scoliosis is shown in this drawing. Scoliosis is a lateral (sideways) curvature of the spine. In the United States, children are screened for scoliosis with a bending test in the 7th and 8th grades. The etiology of Scoliosis is unknown. There are four classifications of scoliosis: Adolescent Idiopathic Scoliosis, Adult Idiopathic Scoliosis, Congenital Scoliosis, and Neuromuscular Scoliosis. Review Adult Scoliosis Cases and Adolescent Scoliosis cases performed by Dr. Robert Pashman.
Spondylolisthesis is an abnormal spinal condition in which one vertebra slips or is displaced over another vertebra. The drawing shows spondylolisthesis as a result of a lumbar vertebra (L5) slipping over the sacrum (S1). There are two classifications of Spondylolisthesis: Isthimic Spondylolisthesis and Degenerative Spondylolisthesis. Additionally, Spondylolistheis is classified by the grade of the slip. The grades are I, II, IIII, IV. Grade I is the least amount of slippage, while Grade IV is the greatest amount of slippage. Review Spondylolisthesis surgeries performed by Dr. Pashman.
This picture depicts the spinal deformity Kyphosis. Kyphosis is an abnormal increase in normal kyphotic (posterior) curvature of the thoracic spine which can result in a noticeable round back deformity. Many times patients report that they “can’t stand up straight” or are always slouching. Review Kyphosis surgical cases Dr. Pashman has performed.
Lordosis is the abnormal increase in normal lordotic (anterior) curvature of the lumbar spine. This can also lead to noticeable “sway back”.
This drawing illustrates degenerative and hypertrophic arthritis between the 3rd, 4th, and 5th lumbar vertebrae, as well as the lumbosacral joint (L5-S1 disc space). The degeneration of the intervertebral discs has reduced the height of the discs. There are bone spurs or hypertrophic bone adjacent to the discs and hypertrophic arthritis of the facet joints. This results in reduced range of motion of the spine. Also, the hypertrophic bone and narrowing of the intervertebral foramen can produce nerve root impingement thereby causing back and leg pain, as well as numbness and weakness of leg muscles.