In addition to its supportive role, the spine also performs other equally important tasks, such as protecting the spinal cord (contained within it) and enabling motor support. Thanks to its joints, it allows head movement in space, bending the body forward, extending it backward, flexing, and rotating. It is a system that must be carefully protected and maintained to prevent highly disabling pathological conditions.

Spinal diseases often cause pain, particularly when pathological conditions compress the spinal cord or nerves. Pain is often accompanied by limited movement. Treatment depends on the specific pathology and may include physiotherapy, pharmacological therapy, or, as a last resort, surgery. The aim is to reduce painful symptoms and alleviate stress. The conditions that may alter the structure of the spine or damage the vertebrae and surrounding tissue include the following:

Scoliosis: This refers to a complex spinal deformity that can affect individuals from childhood to adulthood. Contrary to common misconceptions, it is not caused by poor posture but usually results from a malformation of the vertebral bodies. Mild scoliosis typically does not require active treatment, but in severe or rapidly worsening cases, surgery may become the only viable solution.

Stenosis: This is the narrowing of the space housing the spinal cord and nerve roots, which can result in compression, often with severe or dangerous consequences. It is a relatively common condition with both congenital and acquired causes. Initially asymptomatic, it may progress to cause debilitating pain. Conservative and/or pharmacological therapy may suffice in milder cases, while surgery might be necessary in more severe cases.

Herniated disc: This condition occurs when the soft inner material of a disc protrudes through a rupture in its fibrous outer ring. The primary cause is aging, leading to a gradual loss of water content in the intervertebral discs. Other contributing factors include prolonged or sudden strain, smoking, and obesity. Symptoms vary greatly depending on the affected area, as compressed nerves transmit electrical impulses to different parts of the body. Symptoms often include pain, numbness, or weakness. As with stenosis, mild cases may be treated conservatively or pharmacologically, while surgery might be required for more severe cases.

Fractures: Vertebral fractures can result from traumatic events (such as accidents), sometimes with neurological repercussions, or from degenerative conditions (such as osteoporosis). Treatments vary significantly, ranging from rest in mild cases to surgical intervention in more severe ones.

Infections: Vertebral infections, such as spondylodiscitis or vertebral osteomyelitis, involve the spine and may affect only the vertebrae (spondylitis), the discs (discitis), or both (spondylodiscitis). These infections are caused by pathogenic microorganisms, which vary depending on the mode of contamination, age, and predisposing factors such as prior surgeries or immunosuppressive states. Treatment typically involves targeted antibiotic therapy for mild cases or surgery for more complex ones.

Spondylolisthesis: This is a condition in which one vertebra slips relative to the one directly below it. It may result from trauma or overload, while degenerative spondylolisthesis is linked to aging. Common treatments include rehabilitation, physical therapy, and pharmacological therapies. In severe cases, surgery may be required to relieve nerve pressure and stabilize the affected spinal segment.

Osteoporosis: This is a clinical condition where bone density decreases, primarily with age. It typically presents no symptoms unless fractures occur (see above). Recent advancements in early diagnosis (bone densitometry), pharmacological treatments, and surgical techniques (vertebroplasty/kyphoplasty) have significantly improved management.

Tumors: Tumors can affect various spinal structures and exhibit a wide range of symptoms and severities. Thanks to modern chemotherapy and radiotherapy techniques, increasingly effective clinical protocols have been developed, allowing for the radical removal of spinal tumors. Surgical treatment is often the only option when medical therapies fail and the goal is to improve quality of life and pain relief, even temporarily.

A specialist in Neurosurgery or Orthopedics is the primary point of reference for diagnosing and treating spinal pathologies. A thorough clinical evaluation and radiological imaging guide the specialist in proposing the best treatment plan (in line with national and international guidelines). The patient’s overall condition and expectations are also carefully considered, particularly for potentially disabling issues. Over the past 10–15 years, spinal surgery techniques have undergone a revolutionary transformation. Pedicle screws, cervical screws, cervical and lumbar cages, bone substitutes, spinal navigation, and, more recently, spinal robotics have enabled surgeons to perform procedures with reduced patient impact and increasingly positive outcomes, as supported by extensive literature.