Let's Break it Down

Week 2

Hi all, 

It's all about the basics, right? Here is some background information for you guys to help you better understand my research.

The Spine Anatomy 

The spine can be broken down to into three parts—the cervical spine, the thoracic spine, and the lumbar spine—all of which are comprised of vertebrae. The cervical spine has seven vertebrae, the thoracic spine has twelve vertebrae, and the lumbar spine has five vertebrae. Below the lumbar spine is the sacrum, which has five vertebrae that are joined together. The purpose of the sacrum is to connect the lower spine to the pelvis and sacroiliac joints Lastly, below the sacral spine is the coccyx, which is also known as the tailbone. Click here to view a really cool video that illustrates the anatomy of the spine.

In between the vertebrae are intervertebral discs, structures that cushion, support, and allow the spine to move. The disc anatomy can be broken down into two parts: the annulus fibrosis and the nucleus pulposus. The annulus fibrosis, which is the outer part of the disc, is made of strong collagen fibers. If you use your latin, can you guess what the nucleus pulposus refers to? Just like it sounds, the nucleus pulposus refers to the gelatinous center of the disc, which is comprised of a loose network of fibers. 

A healthy disc is a disc that is hydrated. When humans are born, the fluid inside the intervertebral discs is 80% water. As humans age, the discs are unable to hold as much fluid as they used to. As a result, the disc loses its robust shape and compresses, shortening the spine. This is why humans shrink as they age. 

Remember Degenerative Disc Disease? For a reminder here is a video that illustrates the specifics: 

Lordosis, Kyphosis, and Sagittal Balance

A healthy spine has two curves: kyphosis, the outward curve of the spine, and lordosis, the inward curve of the spine. Both the kyphotic and lordotic curves serve to balance one another and this is known as sagittal balance. A healthy spine has normal lordosis and normal kyphosis. According to a study called Sagittal Plane deformity: an overview of interpretation and management published by The National Center for Biotechnology Information (NCBI), there is a healthy relationship between the kyphotic and lordotic curves of the spine. However, if one curve is pronounced more than the other curve, this creates sagittal imbalance, sometimes other spinal deformities, and back pain. An over-pronounced lordotic curve is known as swayback and an over-pronounced kyphotic curve is known as hunchback or hyperkyphosis. 

So how does this all relate to my research? Unfortunately, that is for next week's post. 

Don't forget to try out this week's yoga pose: Triangle. Comment down below and share your thoughts! 

Ciao, 

Hannah 

Shoulda, Coulda, Woulda

Week 1

Do you ever have those self-scrutinizing moments where you reflect and try to pin-point at what time in your life you messed up? If so, yay I am glad I am not alone. If you need more "inspiration", I highly recommend conducting research as a seventeen year-old. Because the material is so unfamiliar and difficult, research really makes you analyze everything...including your life choices. So the other day, I figured out where I went wrong in my life. I didn't go to medical school.

Since this blog is supposed to explain my research experiences, I thought I'd take the time to chronicle my newest challenge: understanding medical literature. This was me when I first started reading articles for my research. Yes. I was a bit overwhelmed.

WHY DO I NOT UNDERSTAND??! I SHOULD HAVE GONE TO MED SCHOOL!!

When the literature is peppered with words like "osteotomies", "percutaneous screw fixation", and "cauda equina compression", how am I supposed to react? More importantly, how am I going to be able to write a five thousand word paper about all of this material I currently don't understand? Key-word currently. In another less scrutinizing self-reflecting moment, I realized that while I currently don't understand the material, it doesn't mean that I won't be able to eventually (even though it feels like I never will). 

I realized that in order to understand more complex articles that are related to my research, I needed to have a basic understanding of the spine anatomy. So like a true BASIS student, I went looking for resources. Fortunately, the Flagstaff medical community is so supportive and willing to help high school students like me. I reached out to a local neurosurgeon, Dr. Bradley Nicol, M.D., and he loaned me two of his medical school text books! So over the next few weeks, these guys will be my best friends!

Receiving help has restored my optimism and enthusiasm for this new, challenging adventure.  I actually really enjoy perusing the text books and learning about the spine. I feel like an actual medical student, which makes me feel super cool! I am excited that I have been given this opportunity as a senior in high school to explore and apply my skills to a foreign field of study.

This week's yoga pose: Sphinx Pose. According to the Yoga Journal, this pose helps mitigate stress and strengthen the spine. Click here for step-by-step instructions on how to do the pose. Comment down below if you tried this at home!


See you next week,

Hannah

P.S.  I am sorry for the pedestrian moral!

Introduction

What do school, car rides, studying, cuddling with your dog, and watching The Bachelor all have in common?

Did you say nothing, Mr. Lamb? If so, you’re wrong.

The correct answer is… sitting!

Like most of you, I spend the majority of my days sitting. I sit when I go to school, I sit on the way to and from school, I sit when I eat, I sit when study, and even when I workout whether it be sit-ups or spin class, I sit. In summation, I sit a lot and you all sit a lot too! So why is this bad?

It is kind of obvious but sitting compresses the discs in the spine, creating pain and discomfort. (We’ve all been there.) Twisting in your chair and circling your neck are good solutions to help relieve the pain in the short-term, but unfortunately these exercises won’t be enough to maintain a healthy spine in the long run. Over time, the discs that cushion the vertebrae in your spine will  (most likely) degenerate. This condition is known as Degenerative Disc Disease. The compressed disc causes persistent nerve pain otherwise known as radiculopathy. Sometimes this nerve pain can radiate down your arms and legs and this is called radiculitis. The moral of the story is that sitting has bad consequences if you don’t modify your lifestyle. In some cases this disease is associated with the normal process of aging. Either way, you are at risk!

Degenerative Disc Disease cannot be treated, but radiculopathy and radiculitis can be treated by a Minimally Invasive Transforaminal Lumbar Interbody Fusion (MIS TLIF). While MIS TLIF is known to have many short-term, postoperative benefits, the long-term effects of MIS TLIF, specifically on lordosis, are largely unknown among the neurological community. (Don’t worry. I will be writing another blog post delineating what all this medical jargon means and why the preservation of lordosis is important for long-term spine health.) My research will be looking to see if MIS TLIF has a positive, negative, or neutral effect on lordosis by comparing patient preoperative and postoperative spinal parameter measurements.

My external advisor for my project is Dr. Jeffrey J. Larson, M.D., a neurosurgeon in Coeur d’Alene, Idaho, and my internal advisor is my fabulous Statistics teacher, Chris Lamb. I will be interning at CDA Spine in March. Click here to visit the website.

Lastly, I hope to incorporate some Yoga poses that will help relieve your spine into my weekly posts. Might as well be proactive right?

No matter how boring my research may sound, it applies to all of you! So, I suggest you join me on my journey and pay close attention:)

Until next time,

Hannah