Spinal Instability

Spinal Instability is the inability of the spinal column to maintain its normal configuration under normal usage conditions. The function of the spine is to provide structure, protection, and support for the body and its internal organs. In an unstable spine, the integrity of the spine is compromised such that it is no longer able to hold together the spinal ligaments, muscles, discs, and bones, in such a way as to provide these essential functions. In other words, An unstable spine means that the integrity of the spinal column has been compromised. It can be caused by congenital defects, injury or trauma, degenerative change, or neoplastic diseases affecting the spine (the vertebrae, intervertebral discs, or spinal ligaments).
Microinstability, or mild spinal instability, may be largely asymptomatic and may correct itself spontaneously, while macroinstability, or severe spinal instability, may lead to damage to the spinal cord or nerve roots or to painful spinal deformity.

Spinal macroinstability symptoms are often similar to sciatica – often a deep, severe pain that starts low on one side of the back and then shoots down the buttock and the leg with certain movements.  The pain can be most severe after prolonged sitting and standing, or on standing from a low seated position. Coughing, sneezing or laughing may exacerbate the pain. Pain may also be accompanied by weakness in the leg or foot. Abnormal movement can also trigger extremely painful muscle spasms.

Cases of spinal macroinstability may present with spine pain, or weakness/numbness of arms or legs.

As part of the normal aging process, many people experience the loss of some amount of spinal integrity due to conditions such as spinal arthritis or degenerative disc disease. Mild asymptomatic cases of instability may not require intervention, or may be relieved through physical therapy to build up surrounding spinal muscles to prevent pain and vertebral slippage.

Congenital instability or instability caused by trauma often require surgical treatment. Some form of surgical fusion of the spine can often repair the instability. Many procedures have been developed to address different aspects of instability, including microsurgical and minimally invasive techniques. As spinal instability is a generalized term, it includes many specific types of physical issues, and thus there are different approaches to their resolution. Good diagnosis of the underlying problem is a key factor in developing a treatment plan.