A spinal tumor is an abnormal mass of tissue either inside the spine or outside. It is also called a neoplasm meaning a new abnormal growth. They can develop in the bone, spread to other parts of the spine, or outside the spine, like the lungs and chest. Tumor cells can multiply slowly or very rapidly. Tumors are either cancerous or non-cancerous. They can develop anywhere in the spine:
Cervical – neck
Thoracic – mid-back
Lumbar – low-back
Sacral – sacrum
It is not uncommon for spinal tumors to develop out of a tumor from the individual’s breast, lung, kidney, prostate, or another area of the body that has spread out.
Whether cancerous or not, spinal tumors can cause a variety of symptoms, including:
Pain not related to an injury or physical activity.
Pain in the back or neck that presents suddenly, quickly worsens, especially at night. This can be an indicator of a spinal tumor.
Pain that radiates to other parts of the body, like the arms, hands, legs, and feet.
The pain continues even when resting.
Muscle weakness or loss of sensation, especially in the legs, arms, or chest.
Abnormal curvature of the spine not from poor posture
Loss of bladder or bowel control
Lowered sensitivity to heat and cold
An individual could have a dominating symptom/s or a combination.
As previously mentioned these tumors can originally develop in another part of the body and then metastasize to the spine. These types of tumors are secondary tumors. Research scientists are still trying to figure out what exactly causesprimary tumors that originate in the spine. One theory believes genetics plays a role.
The most common symptom of a spinal tumor is pain. Examinations and diagnostic tests will be conducted both physical and neurological. A doctor or specialist needs to see and evaluate the spine. This is essential in diagnosing a potential tumor. A doctor could also order:
PET scan – Positron Emission Tomography
Myelogram if there are symptoms of spinal cord compression
If the imaging reveals a tumor, a biopsy could be performed. A sample of tissue will be examined under a microscope to see if the tumor is cancerous or not. If the tumor is cancerous, the biopsy will show the type of cancer and determine the stage of the disease. Depending on the tumor type and location, other tests/procedures could be recommended.
There are many factors that go into creating an optimal treatment plan. This includes whether the tumor is cancerous or not, size, location, and symptoms. Types of treatment:
Observe and wait as small non-cancerous tumors that are not growing or impinging/pinching other spinal structures could only need to be monitored for changes.
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Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We 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; 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*
Smart supplementation along with proper nutrition is one of the biggest factors and plays a large role in an individual’s health. You are what you eat is true. Feeding the body with vital vitamins and minerals promotes growth and healing. Filling up on processed, fatty foods does the opposite. The bones in the spine and throughout the body need nutrients to continue to rebuild and maintain strength throughout life.
A balanced diet rich in:
This is the best way to nourish the body’s bones and ward off spinal problems, like spinal fractures, and osteoporosis. Inadequate diets or medical issues can create nutritional gaps. This is where vitamins or mineral supplements come in. Supplements are not a cure-all, but they can create a safetyhealth net when taken properly.
These supplements for bone health, fill in nutritional gaps. They are not necessary if the key nutrients the body needs from a proper diet are already there. However, individuals use supplements as a replacement for certain foods, this is not how they should be used. Actual food supplies multiple nutrients, along with minerals, and vitamins that are beneficial for health and are not found in supplements.
Taking a Supplement to Strengthen the Spine
The body’s dietary needs change throughout life, so adding supplements as you age or during pregnancy can help maintain health. Calcium and vitamin D requirements vary based on age and sex.When it comes to protecting spine bone health, certain individuals may need supplements to ensure their bodies are processing calcium and vitamin D properly.
Individuals who had intestinal bypass procedure
Those with food absorption conditions, like Celiac or Crohn�s disease
People who eat few or no dairy products, like vegans or those that are lactose intolerant
Is a calcium supplement right for you?
The only way to definitively know is by having a conversation with your doctor. Then you can supplement smart.
Because nutritional supplements can be purchased over the counter, individuals assume�incorrectly�that they are completely safe. Dietary supplements can interfere with absorption, other supplements, medications, and can be toxic if taken in high doses.
Calcium and iron supplements can prevent each other from being fully absorbed when taken together. This is true of many minerals, including magnesium, because they get into�absorption�competition with each other and so are best taken separately.
Supplements taken together can cause too much of either one to be absorbed. This is the case with high-dose vitamin D supplements, which can cause too much calcium absorption.
Too much calcium can increase raise the risk of having a heart attack or stroke. Taking more than 1,000-1,200 mg of calcium per day is pointless because the body cannot process that much calcium at once.
Are your supplements helping or hurting you? The best way to know is to talk to your doctor whenever you change medication or a supplement program, even when just adding a new vitamin to the mix. An underused resource for supplement advice is a pharmacist. They will know whether the mix of supplements and medicines being taken pose any risk of negative interaction. And a pharmacist can help recommend a trustworthy product.
Here are a few tips to get the most benefits if you and your doctor think a calcium supplement can help support spinal bone health.
Buy supplements with the USP symbol. This indicates that the supplement has been independently evaluated and certified.
Take your supplement as directed, ideally with a meal.
Take doses no higher than 500-600 mg, no more than 2-3 times a day, for a maximum of 1,000-1,200 mg.
Drink plenty of water as some supplements can cause constipation.
Do not take calcium supplements with a high-fiber meal or laxative. This can interfere with calcium absorption.
Supplements Support Spine Health
Remember that supplements are exactly that supplements. Eating foods rich in calcium, vitamin D, and magnesium is the best way to build/maintain strong healthy spinal bones and prevent debilitating health problems. If you are concerned about your diet, talk with your doctor or a health coach about a smart supplementation regimen to meet your nutritional needs.
Bone growth stimulation (BGS) is a therapy your surgeon may prescribe following a spinal fusion procedure. A bone growth stimulator is an auxiliary device worn following cervical (neck) or lumbar (low back) spine surgery. BGS may be used to assist spinal bone fuse after a fusion procedure or as a treatment for failed fusion. Naturally, you’ve questions about this technology.
Spinal column with implant, screw placement and fusion
The info provided in this patient guide can assist you to learn:
Risk factors for a poor or failed fusion
Role of bone growth stimulation in spine fusion aftercare
Questions to ask your back surgeon
“Bone growth stimulation to be used in both the cervical and lumbar spine has demonstrated to substantially help fusion results. Having been a study centre for this particular technology, I’ve used bone growth stimulation in most my post-operative cervical and lumbar patient instances. The patient assessment standards I use contains:
Multi-level fusions; more than one degree of the back is fused
Co-morbidities (risk factors) that could hinder bone healing and growing”
�Gerard J. Girasole, MD
Orthopaedic & Sports Medicine Center
About Spinal Fusion
Spinal fusion is done to stop motion of neurologic deficit and the spine. During the procedure two or more vertebral bodies are joined together using instrumentation and bone graft. Spinal instrumentation includes poles, screws, plates, and interbody devices (implants). Bone graft may comprise your own bone (autograft), donor bone (allograft), or alternative forms of graft.
Bone graft helps stimulate new bone to grow through three stages:
Inflammatory period: cells start to form new tissue
Repair period: small blood vessel ingrowth begins
Remodeling phase: bone structure becomes powerful
Spinal instrumentation creates an internal cast, allowing the inflammatory procedure to stimulate bone healing. With time, new bone grows into and about the implanted instrumentation healing into a construct that is sound.
Some patients are at risk for spinal fusion to fail. A failed fusion is called pseudarthrosis or nonunion. Pseudarthrosis and nonunion are medical terms your surgeon may utilize to identify a fusion dilemma.
Common Spinal Issues Treated Surgically With Fusion Include:
Degenerative disk disease
Adult degenerative scoliosis
How Does A Bone Growth Stimulator Help Spinal Fusion?
A BGS sends electric signals to the fusion site. The electrical signals activate the body’s natural bone healing process, which may be impaired in at-risk patients.
Bone Growth Stimulation Has Been Put To Use For Decades To Help Bone Heal
Over 50 years ago scientists found that low-level electrical fields arouse the entire body’s bone-healing process. Other improvements included finding several types of energy that stimulate bone development, electromagnetic coil technology and only better devices � supported by clinical and scientific research�have enhanced bone healing in patients who undergo spinal fusion.
Different Types Of Bone Growth Stimulators
All bone growth stimulators are different. Certain types are designed to be surgically implanted (internal BGS) and other stimulators are worn outside the body (external BGS). Other differences include how stimulation is transmitted to the back and the kind of magnetic field or electric current created by the apparatus.
Chiropractors who provide care for children � and families � can attest to the many benefits of a healthy spine to a growing child. However, this relatively new area of focus for chiropractic is susceptible to many misconceptions, among the public and the health-care community.
Many of the public perceptions about chiropractic care for children, however, are far from the truth. We explore these misconceptions and spoke to the experts to get the real facts about this thriving chiropractic focus area.
Myth #1 Chiropractic care of children is new.
When some individuals first learn that DCs treat children as well as adults, they may get the wrong idea that chiropractic for kids is new � which is to say untested, experimental and dangerous.
That isn�t the case. Sure, the modern era of this field dates only as far back as the 1980s. But the fact is, the practice actually has much older and stronger roots. �If you go back to 1910, [founder of chiropractic] D.D. Palmer indicated how important it is to check a child�s spine from birth and throughout life,� notes Jeanne Ohm, CEO of the International Chiropractic Pediatrics Association (ICPA), a non-profit organization in Philadelphia.�
By the 1980s, many DCs had developed their practices to treat adults specifically. In 1986, Dr. Larry Webster in the U.S. helped re-establish chiropractic care for children as a legitimate area of focus. He started teaching his child-friendly techniques, and he created the ICPA to further help chiropractors treat children.
Webster passed away in 1997, but his legacy continues. The ICPA now has more than 4,000 members and hundreds of DCs are studying to become chiropractors with a special focus on kids.
Myth #2 Children don�t need chiropractic care.
DCs who treat kids often hear questions along these lines: Why in the world would a child need to see a chiropractor? What good does chiropractic do for a toddler, or even a newborn?
Chiropractors have a few good answers.
�We may see a one-week-old child who is already showing signs of favoring, turning her head to one side versus the other,� says Dr. Judy Forrester, owner of Synergea Family Health Centre, a multidisciplinary clinic in Calgary, Alta. �That may seem minimal� but if we can determine any imbalances or asymmetry with the muscular function or the joint alignment, and we address it early, it�s better. Once those postural patterns and habits develop as they grow, they can be much more difficult to change.�
Dr. Liz Anderson-Peacock is a Barrie, Ont., chiropractor who focuses on care for children. She notes the link between the central nervous systems and various childhood afflictions.
�Children may have symptoms like ear infections, difficulty breathing, colic, attention deficit. We do not treat those things per se. We see those as expressions of the body not interpreting the world properly,� explains Anderson-Peacock, who also serves in the editorial board for the Journal of Maternal, Pediatric and Family Health.
�The organizing system for us to respond to the world is the nervous system. The questions we ask are: if there is something going on with the nervous system, what is it, and can chiropractic care help?�
Anderson-Peacock now spends most of her time travelling around the world doing lectures and other speaking engagements. She also conducts seminars for the ICPA about chiropractic care for children and families.
Ohm from the ICPA links chiropractic to the very moment a child emerges from the womb. �Birth can be traumatic,� she says. The event could cause physical damage that leads to difficulties later. So if a baby develops breathing trouble, �the real cause may simply be a misalignment to the spine from the birth process. Parents who get that will stop at the clinic on the way home from the birth centre to make sure everything is OK.�
Chiropractic & Children
Myth #3 Chiropractors use the same techniques on children as adults.
�That�s what terrifies a lot of chiropractors about adjusting children, as well as parents,� Anderson-Peacock says. �They think we�re going to adjust them like an adult.�
But DCs who treat children do not apply heavy pressure. �Often, it�s a matter of moving the child into a position of ease, holding that position and things will reset quite nicely on their own,� Anderson-Peacock says. Care, she points out, is nowhere near as forceful as it may be for adults.
�That�s why extra training is so crucial. These children are not like miniature adults. For example, spines are primarily cartilaginous until the age of six, and we know cartilage will deform when we have abnormal function. So we want to make sure that function is restored normally. And since the bones are immature, the alignment issues are different. We want to minimize rotations and traction, because children have different needs, due to the immaturity of their musculoskeletal and ligamentous structures.�
The ICPA aims to validate techniques for chiropractic care for children, particularly to help dispel the idea that DCs use the same pressure on kids as they do on adults, Ohm notes. The organization is working with Walter Herzog, co-director of the Human Performance Laboratory at the University of Calgary, to study the pressure required when caring for children. The report should be out by the end of 2015.
Chiropractic & Children with Chronic Conditions
Myth #4 There are no real experts in chiropractic care for children.
In Canada, chiropractic care for children is not a recognized area of specialty, which leads some people to think there are no genuine experts in the field. But that isn�t true.
Many DCs follow accredited courses to develop child-specific skills. Anderson-Peacock spent three years studying at the International Chiropractors Association�s Council on Chiropractic Education (CCE)-accredited program in pediatric chiropractic. She achieved her Diplomate in Clinical Chiropractic Pediatrics (DICCP) in 1996.
Dr. Stacey Hornick is owner of Market Mall Family Chiropractic in Saskatoon, Sask. She attended McTimoney College of Chiropractic, operated by BPP University � a post-secondary institution in London, England. Over three years, she took courses by correspondence and traveled to Thailand, Hong Kong and Australia to complete the residency portion of the program. Having succeeded in her studies last year, she was granted a master�s degree in Chiropractic Paediatrics.
Hundreds of DCs have taken the ICPA�s programs. The ICPA Diplomate Program involves a total of 400 hours of learning and achieved through the successful completion of two levels of study.
The first part � a 200-hour certification program � involves 14 classroom modules, participation in two ICPA Practice Based Research Network projects, and successful completion of the comprehensive certification� final exam.
The second part is a 200-hour advanced competency program. It requires 200 hours of work with more emphasis on research, including either a published research case study or a publishable thesis, as well as clinic work. Enrollment in the first level (200-hour certification program) is a prerequisite to enroll in part two.
Chiropractic care for kids may not be a recognized specialty in Canada, but chiropractic associations recognize it as a legitimate area of focus.
In a statement, the Alberta College and Association of Chiropractors (ACAC) has acknowledged, �chiropractic treatment is as beneficial to children as it is to adults and that the efficacy and benefits of the delivery of chiropractic care to individuals 18 years of age and under are well supported by a body of ongoing research and documented case histories.�
Chiropractic & Teens with Back Pain
Myth #5 Chiropractors don�t collaborate with pediatricians and medical doctors.
Hornick says this simply isn�t the case.
�I often refer pediatric patients to their medical doctors and to medical specialists, and we communicate clearly in the best interests of the child. I see our roles as complementary.�
Forrester also says she has good ties with medical doctors. �The majority of them are very much in favor of working together. Every once in a while you run into someone who thinks we�re all a bunch of quacks and they�re not up to date with the sorts of things we do. But by far the relationship with pediatricians is healthy and puts the patients� best interests first.�
Chiropractic care for kids is not new. Children benefit from chiropractic care. Techniques for children are safe and nowhere near as forceful as they may be for adults. Many DCs are qualified experts, and many child-focused chiropractors establish strong connections with medical doctors. The truth is, DCs can and do share the benefits of their profession with patients across the entire age spectrum.
Late last year, Dr. Stacey Hornick, a Saskatoon, Sask.-based DC focused on chiropractic care for children became one of the first Canadians to attain a Master�s of Science in Chiropractic Paediatrics.She studied at McTimoney College of Chiropractic, operated by BPP University, a post-secondary institution in London, England. The McTimoney program is the only pediatric chiropractic program that meets the academic requirements for entry into doctoral studies (PhD) in the specific content area of chiropractic pediatrics, an opportunity never before afforded the chiropractic profession, she says.
�For me, it was important to seek out a highly respected qualification in pediatric care,� Hornick says. �There were no university-accredited courses in pediatrics in North America that I was aware of at the time. I liked the idea of studying abroad and at the same time becoming an expert in pediatric-specific assessment, and adjusting techniques that were gentle yet neurologically precise.�
It takes stamina and smarts to get into and complete this tough three-year course. Read on for the requirements. Do you have what it takes?
To enter the program, a candidate must have: a professional qualification in chiropractic and registration with a relevant chiropractic governing body
In each of the first two years of the program, the student must complete:
Work at two residential schools � Hornick explains that usually, students complete their residencies at U.K. chiropractic facilities, but McTimoney also gives students the chance to practice outside of the U.K. For her part, Hornick completed her first-year residency in Thailand, which was memorable. �We stayed at the Children of the Golden Triangle Training Center. It�s a safe haven when kids can go to school and avoid the whole child-trafficking danger, which is a heart-wrenching reality in that part of the world. Many of the children at the facility were orphans � 450 of them. We got to stay with them, and between five chiropractors, we adjusted all of them in three days.�
Online course work � Subjects range from the fundamentals of chiropractic pediatrics to specific requisite topics. Hornick says first-year courses include substrates of chiropractic pediatrics, physical assessment in chiropractic skills and pediatric neurology. �The second year is more application of knowledge.� Courses include normal and variant radiology anatomy in pediatrics, clinical research methodology, and four clinical pediatrics programs.
Structured clinical education, directed and self-directed
Objective structured clinical exam
In the third year of the program, students must complete a research project, including project design, implementation and report at a publishable standard. Hornick�s dissertation: The Effect of Chiropractic on Cortisol Levels in Infants with Colic. The investigation aimed to help doctors understand why chiropractic adjustment has a positive influence on colicky infants. Hornick found that infants with colic who receive chiropractic care demonstrate salivary cortisol release patterns similar to those seen in infants with no colic.
Public�Perceptions about chiropractic care for children are far from the truth. Let’s�explore these misconceptions and speak to experts in order to get the real facts about chiropractic care for children.
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