Degenerative spine conditions involve the gradual loss of normal structure and function of the spine over time. They are usually caused by aging, but may also be the result of tumors, infections or arthritis. Pressure on the spinal cord and nerve roots caused by degeneration can be caused by:

• Slipped or herniated discs 

• Spinal stenosis, or narrowing of the spinal canal

• Osteoarthritis, or breakdown of the cartilage at the spinal joints

Although rare, several types of tumour can affect the spine. Spinal tumours that originate from the vertebra (bone), spinal cord or nerves are known as primary tumours. There are also tumours that spread to the spine from cancer starting elsewhere in the body; these are called secondary tumours or metastases. Spinal tumours can cause pressure on the spinal cord and/or nerves and depending on where the tumour is in your spine, different areas of your body can be affected.

Symptoms may include pain in the neck, upper or lower back and in your arms or legs. You can also experience numbness, tingling or weakness in the arms, legs, on your body or around your bottom. You can have difficulty with balance and/or difficulty in walking. Occasionally people can have problems with going to the toilet (controlling your bladder and/or bowel function).

Spinal infections are rare infections that can involve the intervertebral disc space, the vertebral bones, the spinal canal, or adjacent soft tissues. Discitis refers to an infection of the intervertebral disc in the spine. Osteomyelitis refers to an infection of the vertebral bones in the spine. Infection may be caused by bacteria or fungal organisms, viruses, or can occur after a spinal procedure or surgery.

Generally, infections are bacterial and spread to the spine through the bloodstream. Bacteria may spread through the bloodstream into the vertebral discs and affect this area causing discitis. As the infection progresses, the disc space degenerates. As the disc decays, the infection may spread into the vertebral bodies above and below the disc called osteomyelitis. The bone, weakened by infection may also begin to collapse or crumble causing spinal deformity. In some cases the infection or crumbling bones may push into the area for the nerves or spinal cord which may cause neurologic symptoms including numbness, weakness, tingling, pain, or bowel or bladder dysfunction.

Spinal cord trauma is damage to the spinal cord. It may result from direct injury to the cord itself or indirectly from disease of the nearby bones, tissues, or blood vessels.

Symptoms vary, depending on the location of the injury. SCI causes weakness and loss of feeling at, and below the injury. How severe the symptoms are depends on whether the entire cord is severely injured (complete) or only partially injured (incomplete).

An injury at and below the first lumbar vertebra does not cause SCI. But, it may cause cauda equina syndrome. This is an injury to the nerve roots in this area. This is a medical emergency and needs surgery right away. Injuries of the spinal cord at any level can cause:

Increased muscle tone (spasticity)
Loss of normal bowel and bladder control (may include constipation, incontinence, bladder spasms)
Numbness
Sensory changes
Pain
Weakness, paralysis

Complex spinal deformities can are often serious conditions within the cervical, thoracic and/or lumbar spine, in which patients are debilitated by their suffering. This often ranges from chronic pain and a generally lowered quality of life to loss of bladder and/or bowel control and the inability to stand or walk.

Some of the most common conditions that can develop into complex spinal deformities include:

Kyphosis

Defined as a severe curve in the spine leading to a hunched or rounded back, kyphosis can be the result of poor posture or a structural abnormality. This can lead to chronic back pain and difficulty standing upright. This condition can also affect intervertebral discs, nerves, bones and muscles within the back.

Spondylolisthesis

When one vertebra slips forward onto the bone below, it is usually defined as spondylolisthesis. This condition most frequently occurs in the lumbar (lower back) region, but can happen anywhere within the spine. This causes intense pressure on the spinal cord and surrounding nerves, in turn creating pain and discomfort that will likely become severe if left untreated. Treatment will be recommended on an individual basis, with factors such as the severity of the complex spinal deformity and the patient’s surgical and health history all carefully considered.

Several inflammatory and auto-immune conditions can affect the spine. The two most frequent ones encountered are:

Spinal rheumatoid arthritis- a type of arthritis that affects the joints of the spine, more specifically sliding joints called facet joints. Two facet joints are located posteriorly on each vertebra behind the central spinal canal. Facet joints allow flexion and extension of the spine while inhibiting spinal rotation. Rheumatoid arthritis is an autoimmune disorder. The body’s defense system attacks its own health joint lining (synovium) as though it were a foreign invader such as a bacteria or virus. Synovium under attack ceases production of synovial fluid, the natural lubricant which keeps joints moving smoothly.

In cases of spinal rheumatoid arthritis, the body’s immune system attacks the synovium in the facet joints, causing the membrane to become inflamed and thick. As the facet joints swell and stop lubricant production, damage of cartilage on the joints occurs. Without the lubrication and protection of synovial fluid and cartilage, facet joints become stiff, swollen, painful and damaged. Spinal muscles and ligaments also might weaken as the arthritis progresses. Bone spurs often form as joints become deformed.

As spinal rheumatoid arthritis progresses, joints enlarge. This leads to spinal stenosis, meaning the open spaces in the spinal column that allow nerves to travel to other parts of the body become constricted, exerting painful amounts of pressure on the nerves.

Ankylosing spondylitis (AS) is an inflammatory condition that affects the joints in your spine. Spondylitis simply means inflammation of the spine.

As part of the body’s reaction to inflammation, calcium is laid down where the ligaments attach to the bones that make up the spine (vertebrae). This reduces the flexibility of your back and causes new bone to grow at the sides of the vertebrae. Eventually the individual bones of the spine may link up (fuse). This is called ankylosis and can be seen on x-rays.

The brain and spinal cord are surrounded by cerebrospinal fluid (CSF), a clear liquid that cushions and protects the nervous system while delivering essential nutrients and removing waste. In some people, problems can arise with how this fluid circulates, leaks, or collects, leading to a group of conditions known as spinal CSF disorders. These conditions can be spontaneous — occurring without any obvious cause — or related to trauma, surgery, or underlying structural abnormalities. They may cause a wide range of symptoms including severe positional headaches, neck or back pain, dizziness, visual disturbances, cognitive changes, or problems with balance and coordination. Because these symptoms can overlap with more common disorders, diagnosis is often delayed or missed, and expert assessment with advanced imaging techniques is usually required.

Spinal dysraphism refers to a spectrum of conditions present from birth where the spine or spinal cord does not form normally. These can range from minor structural anomalies with little or no symptoms to more complex forms, such as tethered cord syndrome, where the spinal cord is abnormally anchored and stretched. Depending on the type and severity, patients may experience progressive neurological symptoms such as pain, leg weakness, gait changes, bladder or bowel difficulties, or spinal deformities.

Both spinal CSF disorders and dysraphism require careful, specialist evaluation to identify the underlying cause and determine the most effective treatment. Management may involve targeted imaging, minimally invasive procedures to seal leaks, or advanced surgical techniques to repair structural abnormalities and prevent further neurological damage. With timely diagnosis and expert care, many patients experience significant improvement in their quality of life and long-term outcomes.

Not every spinal problem fits neatly into a single diagnosis. The spine is a complex structure, closely linked to the nervous system, muscles, joints, and surrounding tissues — and as a result, the symptoms patients experience can be just as varied and unique as they are. Some people struggle with persistent pain, numbness, weakness, or unusual sensations that remain unexplained despite multiple consultations or scans. Others develop changes in balance, posture, or bladder and bowel function without a clear cause. In many cases, these symptoms are due to less common or overlapping spinal conditions that require a deeper level of investigation to diagnose accurately.

This “miscellaneous” category reflects the reality that spinal health is not always straightforward. Conditions such as benign nerve sheath tumours, spinal vascular malformations, inflammatory or autoimmune disorders affecting the spinal cord, subtle instability, or rare degenerative changes can all mimic more common problems and are frequently overlooked. Sometimes the challenge lies not in the treatment itself, but in reaching the correct diagnosis — and that’s where specialist expertise becomes vital.

Every patient’s story is different, and your symptoms deserve careful attention even if they don’t seem to follow a typical pattern. My role is to listen to your concerns, investigate thoroughly using advanced diagnostic tools, and help you make sense of what’s happening to your body. Whether you are seeking answers after months of uncertainty, or simply want reassurance that nothing serious is being missed, my consultation is designed to bring clarity, guide you through the next steps, and provide a clear plan towards managing your condition and improving your quality of life.