Back Clinic Spinal Hygiene. The spine is the protective housing for the nervous system, a system so powerful that it controls every function in the human body. The nervous system tells your body to breath, tells your heart to beat, tells your arms and legs to move, tells your body when and how to produce new cells and it even has the power to control healing. A damaged or misaligned spine can dramatically interfere with the signals constantly being sent through the nervous system, eventually resulting in bodily pain, internal deterioration and loss of many of the everyday functions we take for granted.
Spinal hygiene is extremely important, yet 89 percent of the world’s population does not realize the importance of maintaining proper alignment of the vertebrae through chiropractic adjustment, as well as protecting the spine from injury through healthy living practices. Instead we neglect our spines. As children we start our lives with tumbles and trips that jar our spines, we grow into adults with poor posture, we lift things that are too heavy, carry overloaded back packs, and we suffer injury through car accidents, sports impacts and stress.
Get in on the health trend of the future-today. Join the growing percentage of the population that enjoys greater health and wellness through regular care of their spines. Talk to your chiropractor today about ways you can improve your spinal hygiene.
The spinal/vertebral column extends from the skull to the pelvis and consists of individual bones known as vertebrae. It is what holds the body upright, allows the body to bend, twist, and is the conduit for major nerves running from the brain to the rest of the body. The vertebrae are grouped into four regions. They are the:
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SpinalTerminology
Number of Vertebrae
Area of Body
Abbreviation
Cervical
7
Neck
C1-C7
Thoracic
12
Chest
T1-T12
Lumbar
5-6
Low back
L1-L5
Sacrum
5 fused vertebrae
Pelvis
S1-S5
Coccyx
3
Tailbone
None
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Cervical Vertebrae
The cervical spine breaks down into two parts. The upper cervical C1 and C2, and the lower cervical C3 through C7. The C1 vertebrae are known as the Atlas and the C2 the Axis. The Occipital Bone is a flat bone that forms the back of the head.
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Atlas
The Atlas is the first cervical vertebra and is abbreviated as C1. This vertebra supports the skull. It appears different from the other spinal vertebrae, as it resembles a ring and is made up of two masses joined at the front and back by the anterior and posterior arches. �
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Axis
The Axis is the second cervical vertebra and is abbreviated C2. It is a tooth-like process that projects upward. It is referred to as the odontoid process or dens, which is Latin for tooth. It provides a kind of pivot and collar that allows the head along with the atlas to rotate.
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Thoracic Vertebrae
The thoracic vertebrae become larger from T1 through T12. What makes the thoracic spine unique is that it is the only vertebrae that support the ribs and is made up of pedicles, spinous processes, and large neural passageways that help reduce nerve compression. Unfortunately, not everyone has a large intervertebral foramen, which can cause compression. �
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Vertebral Body
Spinous Process
Transverse Facet
Pedicle
Foramen
Lamina
Superior Facet
The thoracic vertebrae are attached to the ribs. However, at T11 and T12, the ribs are not attached and are called floating ribs. The region of the spine’s range of motion is limited because of the rib/vertebrae attachments and the long spinous processes. �
Lumbar Vertebrae
The lumbar vertebrae increase in size from L1 through L5. These are the vertebrae that take the body’s weight along with any loading force that can create biomechanical stress. The pedicles are longer and wider than the thoracic spine pedicles, and the spinous processes are horizontal and more square. The neural passageway is large but nerve root compression is very common due to disc herniation from poor posture, prolonged sitting, improper lifting, etc. �
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Vertebrae’s Purpose
The vertebrae range in size with the cervical region being the smallest. The lumbar low back region is the largest. The vertebral bodies of the spinal column are what bear the weight. The body’s upper weight is dispersed through the spine to the sacrum and pelvis. Thee natural curves in the spine provide resistance, flexibility by distributing the body’s weight, and axial loads/forces sustained when in motion. Vertebrae are made up of many elements critical to the overall function of the spine. This includes the intervertebral discs and facet joints. Functions of the spinal/vertebral column include: �
Protection
Spinal Cord Internal Organs
Attachment
Ligaments Muscles Tendons
Support Structure
Head Shoulders Chest Connect Upper and Lower body Balance
The sacrum is located behind the pelvis. It consists of five bones that are abbreviated S1 through S5. They are fused together in a triangular shape. The sacrum fits between the hipbones and connects the spine to the pelvis. The last vertebra L5 moves with the sacrum. Right below are five more bones that are also fused together and they form the Coccyx or tailbone.
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Intervertebral Discs
The intervertebral discs make up a quarter of the spinal/vertebral column’s length. There are no discs between the Atlas, Axis, and Coccyx. Discs are not connected to the body’s vascular system and so depend on the endplates to disperse essential minerals and nutrients. The cartilaginous layers keep the discs in place. They are fibrocartilaginous cushions that function as the spine/body’s shock absorbers. They protect the vertebrae, brain, nerves, etc. There is some vertebral motion that the discs allow but individual disc movement is limited. Significant motion is possible when the discs work together. �
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Annulus Fibrosus and Nucleus Pulposus
Intervertebral discs are made up of an annulus fibrosus and a nucleus pulposus. The annulus fibrosus is a strong radial structure made up of lamellae. Concentric sheets of collagen fibers connect to the endplates. These sheets are positioned at various angles. The annulus fibrosus encapsulates the nucleus pulposus. �
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Both are made up of water, collagen, and proteoglycans. However, the larger amount of water and proteoglycans are in the nucleus pulposus. Proteoglycan molecules are essential because they attract and retain water. The nucleus pulposus consists of a hydrated gel-like substance that resists compression. The amount of water in the nucleus changes throughout the day. This depends on the activity or non-activity. All in all proper care and maintenance of the spinal/vertebral column is vital to general health and overall well-being.
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Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
The thoracic spine known as the middle back starts below the cervical or neck spine at around the level of the shoulders. It continues down to the first level of the low back or lumbar spine. There are twelve vertebrae, numbered T1-T12 top to bottom, and it is these vertebrae that make up the thoracic spine. When seen from the side, a normal forward curve can be seen.
The ribs are attached to the thoracic spine�s vertebrae making this region of the spine strong and stable. However, this area has less range-of-motion than the neck region. Because of its location, the thoracic spine deals less with injury/s than other areas of the spine. But it is the most common area for fractures from osteoporosis. Scoliosis and abnormal kyphosis are also thoracic spine disorders.
Getting to know the body’s spine and how it functions can help individuals have a better and thorough understanding of possible causes to upper and middle back pain, a doctor�s diagnosis, and the reasons for how simple lifestyle changes/choices can keep the middle back, as well as, the rest of the spine healthy.
Thoracic Support
The thoracic spine gives support to the torso, chest and provides an attachment point for each of the rib bones, minus the two at the bottom. The vertebral bodies are rounded with bony arches that project from the back of each and form a hollow protective space for the spinal cord. Facet joints are paired at the back of each and allow for limited movement.
Intervertebral Discs
There is a fibrous pad called an intervertebral disc that is held in place by the endplates between each level�s upper and lower vertebral bodies. Each disc acts like a spacer creating disc height/space between the upper and lower vertebrae. This space opens nerve passageways called a foramen or neural foramina at both sides. Nerve roots branch off the spinal cord and exit the canal through the neural foramina.
Soft Support Structures Limited Movement/s
The entire spinal column consists of:
Ligaments
Tendons
Muscles
These soft tissues attach to the bones, the discs, and work together to stabilize the midback when resting and when in motion. Ligaments are the strong bands of tissue that connect/protect the vertebrae, discs, provide stability, and help with excessive movement. Muscles hold the body upright and allow spinal flexion which is bending forward, extension bending backward, and rotation twisting from side to side. And the tendons are fibrous tissues that attach the muscle/s to the bone.
Nerves Role
The twelve pairs of nerve rootlets that branch off the cord through the neural foramen are to supply and generate sensation/feeling along with function/movement to the body. These nerves provide nutrients to the midback and chest area and relay signals between the brain and major organs, including:
Lungs
Heart
Liver
Small intestine
Spinal Disorders
Osteoporosis raises the chances of a thoracic fracture. A vertebral compression fracture can cause one or more bodies of bone to flatten or become wedge-shaped creating spinal cord/nerve compression. Sudden and severe back pain can be associated with vertebral compression fractures.
Scoliosis is an abnormal side to side curvature of the spine and is well known to develop in the thoracic spine causing deformity.
Abnormal kyphosis means the forward curvature has become extreme. The appearance of a kyphotic deformity can be seen as a hump.
Metastatic cancer where it travels from the chest, or lung causing spinal tumor/s that can develop and potentially lead to structural deterioration
Thoracic disc herniations are not common because of the middle back’s strength and stability created by the ribcage.
Spine Maintenance
Talk with your doctor, chiropractor, spine specialist about stretches and exercises that will work for your specific situation to strengthen the core, and middle back musculature. This will help significantly with injury prevention during flexion, extension, and rotation.
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
Different spinal surgical procedures use various types of spinal hardware to stabilize the spine. When this hardware breaks or gets infected sometimes it could have to be removed. The reason for this spinal hardware, whether from injury, disease, or a condition, that area of the spine needs added support other than the bone, collagen, ligaments, and other tissues. Surgeons utilize this hardware to:
Stabilize the spine
Correct deformities
Regain motion
Height restoration
Pain relief
Help heal another area of the spine
The hardware ranges from rods, plates, cages, wires, spacers, etc. There are many types and are employed in various operations. Many spine procedures involve some type of hardware. A surgeon relies on this spinal hardware to complete procedures involving realignment of the spine or spinal fusion.
Many patients undergo spine surgery without complications, however, some have problems with the hardware. The most common issues are the hardware loosening, breaking, or the development of an infection. Unfortunately, when this happens it can mean that another surgical procedure may be necessary to remove the hardware/device. �
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Spinal Instrumentation
All of these pieces of equipment are designed to remain in the body permanently. The hardware can be made from stainless steel, titanium, and titanium alloy. Spinal fusion is common, involves hardware, and could be necessary to help/correct:
Spinal deformity/s
Degenerative condition/s
Heal fractures
Other issues causing back pain
The procedure involves the surgeon grafting bone between two vertebrae. Then the hardware is used to hold those vertebrae together. This eliminates motion between them. This is how the vertebrae fuse into a single bone, which reduces or eliminates the pain. Like with any surgical procedure complications can include hardware failure. �
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Spinal Hardware Removal Reasons
If the hardware loosens, gets infected, or the patient can feel some of the hardware under the skin a surgeon will likely recommend removal. Intense, excessive pain is often a symptom of a loose screw and other hardware complications. If the hardware is protruding under the skin the patient could feel a bump that could cause pain when touched.
Loose hardware could irritate the surrounding tissues and nerves, resulting in the patient feeling pain or hearing a grating, crackling, or popping sound. Loosened instrumentation can be caused by the bones of the spine not healing or fusing correctly. The hardware can also shift and break from the bones not healing properly. Other reasons for hardware failure shortly after surgery.
Lifting heavy objects
Participation in high-impact activities
Trauma from accident, slip, fall, etc.
Health conditions especially osteoporosis and osteopenia can increase the risk of the instrumentation loosening, breaking, and shifting.
Quite uncommon but some patients develop infections right after or weeks following the surgery. When the hardware gets infected the patient could feel pain along with the site of the incision draining, and fever. Key indicators around the incision site are:
Chills
Redness
Swelling
Tenderness
Sometimes there are allergic reactions to the hardware itself. However, this has decreased significantly in recent years. This was common with stainless steel before the use of titanium. �
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How The Removal Is Done
This type of removal surgery is typically not considered an emergency unless the nerves or spinal cord are at risk of being injured/damaged. The exact procedure depends on the individual’s specific situation and case. However, it will be easier than the first surgery. Removal is typically nowhere near the extensiveness of the initial instrumentation placement.
Before the procedure, the surgeon will advise preparation tips, just as with the original surgery. To optimize recovery, patients should ensure they are in the best possible health that they can be. This means no smoking, light exercise, and even breathing exercises for optimal lung function.
Patients should not begin any new medication regimen prior to the surgery and should ensure all medications are known to the surgical team. The procedure will go in through the original incision and remove any scar tissue around the hardware. Depending on the situation the hardware could be reinserted or left out entirely.
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Post Removal
Hospital stay depends on the individual situation. Some patients go home the same day and some have to wait. If there was an infection it more than likely means an extended hospital stay to make sure the infection is gone and has not spread elsewhere. The healthcare team will give directions just as with the original surgery which can include detailed instructions on:
Sitting
Sleeping
Showering
Taking meds
Sex
Recovery from hardware removal depends on the extent of the surgery. Contact the surgical team if experience new or unusual symptoms after the procedure, including fever, pain beyond the surgical soreness, numbness, weakness, tingling, and for problems/issues around the incision area, like bleeding, redness, swelling, and draining.
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Bottom Line
Spinal hardware helps the spine heal, and ultimately reduces or eliminates the back pain improving quality of life. Instrumentation and devices can be defective, causing them to break, loosen, etc and need to be replaced. It’s just in this case the replacement has to take place in and around the spine. A doctor will assess the damage and decide if removal surgery is necessary, which will prevent further problems.
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Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
PODCAST: Dr. Alex Jimenez, Kenna Vaughn, Lizette Ortiz, and Daniel “Danny” Alvarado discuss nutrition and fitness during these times. During quarantine, people have become more interested in improving their overall health and wellness by following a proper diet and participating in exercise. The panel of experts in the following podcast offers a variety of tips and tricks on how you can improve your well-being. Moreover, Lizette Ortiz and Danny Alvarado discuss how they’ve been helping their clients achieve their optimal well-being during these COVID times. From eating fruits, vegetables, lean meats, good fats, and complex carbohydrates to avoiding sugars and simple carbohydrates like white pasta and bread, following a proper diet and participating in exercise and physical activity is a great way to continue to promote your overall health and wellness. – Podcast Insight
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Thank You & God Bless.
Dr. Alex Jimenez RN, DC, MSACP, CCST
PODCAST: Dr. Alex Jimenez and Dr. Marius Ruja discuss the importance of personalized medicine genetics and micronutrients for overall health and wellness. Following a proper diet and participating in exercise alone isn’t enough to make sure that the human body is functioning properly, especially in the case of athletes. Fortunately, there are a variety of tests available that can help people determine if they have any nutritional deficiencies that may be affecting their cells and tissues. Vitamin and mineral supplements can also ultimately help improve an individual’s overall health and wellness. While we may not be able to change certain aspects of our genes, Dr. Alex Jimenez and Dr. Marius Ruja discuss that following a proper diet and participating in exercise while taking the proper supplements, can benefit our genes and promote well-being. – Podcast Insight
If you have enjoyed this video and/or we have helped you in any way
please feel free to subscribe and share us.
Thank You & God Bless.
Dr. Alex Jimenez RN, DC, MSACP, CCST
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