What Is Segmental Spinal Instability?
Category: Spine | Author: Stefano Sinicropi
Segmental spinal instability is a condition characterized by an excessive range of motion between two vertebral segments in the spinal column. This increased range of motion is known as hypermobility, and it often develops when a spinal disc or facet joint erodes to the point where it can no longer support the weight of the body through that spine segment. Below, we take a closer look at the condition, and explain how it is treated.
Understanding Spinal Instability
If you care to understand how segmental spinal instability occurs, a quick anatomy lesson is in order. Each level of your spine functions as a three-joint mechanism, with the two facet joints in the back and a larger disc that acts as a joint in the front. This mechanism creates stability in the spine by supporting the weight above each level, and it aids in movement. As long as the joints remain healthy, they’ll easily be able to support the stress we put on our spines.
If one of these joints becomes damaged or degenerates to a point where it can’t support the weight being put upon it, the spinal disc segment can shift. The segment can shift forward, backward or sideways, and the movement can be documented by an x-ray exam with a spine specialist.
Causes and Treatment Options For Spinal Instability
Segmental disc slippage is usually caused by one of two causes:
- Stress fracture of the vertebra or joint
- Degenerative changes in the facet joint
As we noted above, a diagnosis of segmental spinal instability can be confirmed with the assistance of a physical exam and x-ray imaging. Oftentimes the condition is found in the lumbar portion of the spine, as this section bears the most stress.
The goal of treatment is to reestablish stability in an area where it has been lost. Specific treatment will be prescribed based on your specific case, but common conservative treatment techniques include moderate-intensity exercise, aqua therapy, core strengthening routines and pain relievers or pain injections. Your doctor will usually request that you give conservative treatment a go for at least six weeks before moving to operative methods, but again this may change based on the specific shift of your vertebral segments.
Spinal Fusion Surgery
If surgery is needed, your spine specialist may perform a 1- or 2-level spinal fusion to help anchor the vertebrae in place. This can typically be performed with a laparoscopic or minimally invasive technique, which is less taxing on the patient and reduces the risk of complications. We talk more about the specific procedure on this page.
For more information on how to treat and prevent segmental spinal stability, contact Dr. Sinicropi’s office today.
