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A congenital disorder is a medical condition that is present at or before birth. These conditions, also referred to as birth defects, can be acquired during the fetal stage of development or from the genetic make up of the parents.

Congenital disorders are not necessarily hereditary, since they may be caused by infections during pregnancy or injury to the fetus at birth.

If the lamina (bony arch) to the spine does not fully develop, this is known as spina bifida and is the most common congenital disorder.

Osteoarthritis of the Spine

OArthritis is a general term that describes many different diseases causing tenderness, pain, swelling, and stiffness of joints as well as abnormalities of various soft tissues of the body. The term comes from "arthros," meaning a joint and its attachments, and "-itis," meaning inflammation.

Definition of Osteoarthritis

Of the several varieties of arthritis, the most common, the most frequently disabling, and often the most painful is osteo- (meaning bone) arthritis, mostly affecting the weight bearing joints (hips and knees) plus the hands, feet and spine.

Normal joints are hinges at the ends of bones usually covered by cartilage and lubricated inside a closed sack by synovial fluid.

Normally, joints have remarkably little friction and move easily. With degeneration of the joint, the cartilage becomes rough and worn out, causing the joint halves to rub against each other, creating inflammation with pain and the formation of bone spurs. The fluid lubricant may become thin and the joint lining swollen and inflamed.

Spinal Abnormalities Rarely Cause Back Problems

Spine surgeons and radiologists (who both may read and interpret MRI scans) sometimes differ in their method of labeling a particular spinal segment. This creates confusion - among both patients and insurance companies - triggering the question: "Where is the problem?"

    Radiologists commonly count down from the last rib when numbering the lumbar vertebral bodies.
    Surgeons on the other hand, count up from the sacrum when numbering the lumbar vertebrae.
    Neither method of labeling lumbar vertebrae is incorrect, but obviously it can create confusion.

For an individual with 5 vertebral bodies, they would be in agreement when labeling the L4-L5 level. If the individual has 6 lumbar vertebrae, however, the radiologist would typically refer to the lowest level as L6-S1 and the level above that L5-L6, which in the surgeon's mind, would be correctly labeled L4-L5.

Bone Spurs (Osteophytes) and Back Pain

Many patients are told that they have bone spurs in their back or neck, with the implication that the bone spurs are the cause of their back pain. However, bone spurs in and of themselves are simply an indication that there is degeneration of the spine; the presence of bone spurs does not necessarily mean that they are the actual cause of the patient's back pain.

The medical term for bone spurs is osteophytes, and they represent an enlargement of the normal bony structure. Basically, osteophytes are a radiographic marker of spinal degeneration (aging), which means that they show up on X-rays or MRI scans and are by and large a normal finding as we age. Over the age of 60, bone spurs on the spine are actually quite common.

Bone Spurs (Osteophytes) and Spinal Anatomy

The human spine is made of thirty-two separate vertebral segments that are separated by intervertebral discs made of collagen and ligaments. These discs are shock absorbers and allow a limited degree of flexibility and motion at each spinal segment. The cumulative effect allows a full range of movement around the axis of the spine, especially the neck (cervical spine) and lower back (lumbar spine).

Spina Bifida Definitions

Spina Bifida is congenital disorder involving the failure of the vertebral canal to close before birth. The condition results in malformation of the spinal cord, severely impairing spinal alignment and the nerves in the lumbar and sacral areas. Babies born with spina bifida may be paralyzed and lack sensory perception, and experience problems with bladder and bowel function and limb control. To prevent further nerve damage and infection, doctors operate on babies with spina bifida to close the opening of the back, which leaves the baby with a tethered spinal cord and scar tissue. Patients with spina bifida typically need braces and other equipment to walk.

Lamina Definition

The lamina is the flattened or arched part of the vertebral arch, forming the roof of the spinal canal; the posterior part of the spinal ring that covers the spinal cord or nerves.

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NEUROLOGIC REHABILITATION

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