"Spinal instability is routinely given as a diagnosis to these patients with chronic lower-back pain," Wheeler said.

Predicting spinal instability of vertebral thoracic lumbar fractures is based on several radiologic and clinical parameters.

Malformed bones are unable to withstand the normal mechanical stresses placed on them in day-to-day activity, leading to fractures, spinal compression, and spinal instability.

Expedient wide decompression with concurrent instrumented fusion is recommended to prevent late development of spinal instability and recurrent spinal stenosis.

It can result from whiplash and be overlooked for years by doctors who are not looking for it, despite the chronic pain that accompanies the resultant spinal instability.

In spinal TB, surgery is indicated for spinal instability (when there is extensive bony destriction) or when the spinal cord is threatened.

Bone metastases are a major clinical concern that can cause severe pain, bone fractures, spinal cord compression, hypercalcemia, anemia, spinal instability, decreased mobility, and rapid degradation in the quality of life for patients.

If Trisha had explored the medical literature, however, she would have discovered that every aspect of her case-the interpretation of her MRI scan, the diagnosis of spinal instability, the rationale for fusing vertebrae, the impending discography-was controversial among spine specialists.

IDET is used to treat a select subgroup of people who have had chronic disc-related low back pain (usually for at least 3 to 6 months) despite nonsurgical treatment.3, 4 IDET is not recommended for people with severe disc degeneration, spinal stenosis, or spinal instability (such as spondylolisthesis).