You sustain this position for 10 seconds and then lower the buttocks back down to the couch with ten repetitions. RandallWrightMD,Steven B.InbodyMD, inNeurology Secrets (Fifth Edition), 2010. While you can achieve massed practice with a written sheet of exercises, it can be tough to stick with it consistently and consistency is key to recovery. Patients with a lumbar spinal cord injury can be independent and care for their own mobility and hygienic needs. Peripheral neuropathy is the damage of the peripheral nervous system, such as carpal tunnel syndrome that involves trapped nerves in the wrist. Likewise, a pinched nerve in your wrist can lead to pain and numbness in your hand and fingers (carpal tunnel syndrome). The test is based on stretching of the nerves in the spine. Accessed Sept. 21, 2021. Additionally, bowel and/or bladder function may be affected. Heres a quick explanation of how the lumbar spinal cord fits in with your lower back anatomy, as well as potential symptoms of injuries do different parts of the lumbar spine. Spinal cord compression can often be helped with medicines, physical therapy, or other treatments. If you liked this post, youll LOVE our emails and ebook. Radiculopathy describes a range of symptoms produced by the pinching of a nerve root in the spinal column. Compressed nerves may also stop sending signals from the brain to the muscles . Radicular pain and nerve root pain can be defined as a single symptom (pain) that can arise from one or more spinal nerve roots. Also, write down any new instructions your provider gives you. The division of the sciatic nerve in the popliteal fossa: anatomical implications for popliteal nerve blockade. Rutkove SB. Nerve roots split from the cord and travel between the vertebrae into various areas of your body. A nerve root in the back or neck may become trapped due to any of the following reasons: Arthritis of the spine. 1. Tips to help you get the most from a visit to your healthcare provider: Know the reason for your visit and what you want to happen. These cysts are most often caused by repetitive motion stress injuries (i.e. However, until now, evidential value for this is lacking.[9][10]. This may cause pain that radiates down the back of your leg. As a result, the compression in this nerve can cause numbness in these muscles and hinder movement. https://www.uptodate.com/contents/search. Massed practice like this helps stimulate and rewire the nervous system. Back pain, often radiating to other parts of your body. On average, survivors complete hundreds of repetitions per half hour session. Click here for an email preview. This may involve removing all or parts of a disc and/or vertebrae. Diffuse posterior disc bulge with right forminal disc herniation at C5-6 level indenting the anterior thecal sac and compromising the right neural foramen with moderate impingement of C6 nerve root. That is usually the journal article where the information was first stated. As a fetus, vertebral segments directly relate to spinal cord segments. Courtesy of Barton Branstetter, MD. Radicular symptoms are often treated with neuroleptic agents. Phys Med Rehabil Clin N Am. 2. mild disc bulging at L4-5 3. Train lumbar multifidus muscle activation in an upright sitting position. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Exercise therapy is often the first line treatment. The complication rate of simple discectomy is reported at less than 1%. You can help prevent symptoms of spinal cord compression caused by gradual wear and tear by keeping your back as strong and healthy as possible. G54.4 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Accuracy of physical examination for chronic lumbar radiculopathy, https://www.ncbi.nlm.nih.gov/books/NBK430837/, Radiculopathy and Degenerative Spine Disease, https://www.sciencedirect.com/topics/neuroscience/lumbar-nerves, http://www.youtube.com/watch?v=JmvGHszR_X4, http://www.youtube.com/watch?v=cN0uou-nZH8. When the vertebrae protecting the spinal cord and spinal nerves are fractured or dislocated, bone shards can damage or pinch the spinal nerves/cord. The medial branches of L1-L4 dorsal rami run across the top of transverse processes one level below the named spinal nerve. Except in cases of emergency, such as cauda equina syndrome or a broken back, surgery is usually the last resort. Your doctor will ask you to stop any activities that cause or aggravate the compression. Asymmetric right sided facet degeneration is seen at this level. . http://orthoinfo.aaos.org/topic.cfm?topic=a00332. With an L5-S1 degenerative disc, these sensations are generally felt on the outside of the ankle, heel or foot. In the case of carpal tunnel syndrome, a variety of tissues may be responsible for compression of the carpal tunnel's median nerve, including swollen tendon sheaths within the tunnel, enlarged bone that narrows the tunnel, or a thickened and degenerated ligament. Iliohypogastric nerve entrapment. Numbness, Tingling and Weakness. Other conditions that may cause spinal cord compression can develop more quickly, even very suddenly, and can occur at any age: Symptoms of spinal cord compression can develop quickly or slowly, depending on the cause. Anesthesia & Analgesia. When radiculopathy occurs in the lower back, it is known as lumbar radiculopathy, also referred to as sciatica because nerve roots that make up the sciatic nerve are often involved. The need for a manual wheelchair for part-time or full-time use, Ability to ambulate using braces or other walking devices. Pain is a common symptom associated with L5-S1 pinched nerves 3. Injuries may cause immediate symptoms. (79% versus 56% Global PerceivedEffect, respectively). Thanks to the Americans with Disabilities Act, most restaurants, stores, and other public places are wheelchair accessible. [8], Femoral Nerve Stretch Test:For the Femoral Nerve Stretch Test, the patient lies prone with the knee passively flexed to the thigh. https://www.uptodate.com/contents/search. Each exercise features pictures of a licensed therapist to help guide you. A pinched nerve occurs when too much pressure is applied to a nerve by surrounding tissues, such as bones, cartilage, muscles or tendons. A single copy of these materials may be reprinted for noncommercial personal use only. Therefore, most individuals who have sustained a lumbar spinal cord injury experience sensory and/or motor deficits in their lower body, but can use their upper body and trunk normally. 1973 Nov 1;52(6):989-96. This content does not have an English version. This pain can range from mild to severe and may be constant or intermittent. It emerges near the lateral border of the psoas major muscle and goes inferior through the anterior abdominal wall, being sub-peritoneal and anterior . Damage or interference with the conduction (transfer of information) of these nerves can cause neurological problems such as pain, weakness, abnormal sensations, numbness and changes in spinal reflexes. All six patients with L1-L2 disc herniation showed severe thigh pain and sensory disturbance at the anterior aspect or lateral aspect of the thigh. Masks are required inside all of our care facilities. When these nerve roots become pinched or damaged, the resulting symptoms are called radiculopathy. Symptoms of iliohypogastric nerve entrapment include burning or lancinating pain immediately following an abdominal operation. But at the same time, a substantial group (30%) continues to have pain for one year or longer. Next to simple discectomy and spinal fusion, there are 3 other surgical treatments which can be applied in patients with disc herniation: 1) chemonucleolysis 2) percutaneous discectomy 3) microdiscectomy. Journal of neurology. Overview of upper extremity peripheral nerve syndromes. These typically occur unilaterally, only on one side of the body, and the specific location of the symptom will vary based on the nerve being compressed. Radiculopathy is typically caused by changes in the tissues surrounding the nerve roots. Perform co-contraction of the two muscles while sitting on a balance board. This is the middle vertebra of the lumbar spine, and the first vertebra to not contain a section of the spinal cord. urinary tract infections Symptoms of neurogenic bowel include: constipation bowel frequency bowel incontinence Neuropathy Neuropathy is nerve damage or dysfunction. Conservative management of symptoms is generally considered the first line. This problem is most likely to occur in your lower back, but it can also affect your neck. privacy practices. Symptoms may also include neurogenic claudication, a nerve-related pain that increases with walking and improves with rest. A common cause of radiculopathy is narrowing of the space where nerve roots exit the spine, which can be a result of stenosis, bone spurs, disc herniation or other conditions. Numbness or decreased sensation in the area supplied by the nerve, Sharp, aching or burning pain, which may radiate outward, Tingling, pins and needles sensations (paresthesia), Frequent feeling that a foot or hand has "fallen asleep". Systemic steroids are often prescribed for acute low back pain, although there is limited evidence to support its use. Find more COVID-19 testing locations on Maryland.gov. Ilioinguinal neuralgia is a frequent cause of pain in the lower abdomen and the upper thigh. Spinal discs act as cushions between your vertebrae. should reproduce the symptoms if there is nervous entrapment at that level. In some cases, this tissue might be bone or cartilage, such as in the case of a herniated spinal disk that compresses a nerve root. All rights reserved. The lumbar nerve roots and spinal cord. Clinical Examination Videos. Vertebral tumors can cause different signs and symptoms, especially as tumors grow. Cauda Equina Syndrome (CES), which is often difficult to distinguish from the similarly-located conus medullaris syndrome, affects the lumbar spine and is considered a medical emergency. This eliminates all pathways for communication between the brain and areas below the level of injury. The yellow and blue pucks track your movement and provide feedback. [2]. Vertebral tumor signs and symptoms may include: Pain at the site of the tumor due to tumor growth. The C6 and C7 cervical vertebrae (and the C8 spinal nerve) form the lowest levels of the cervical spine and directly impact the arm and hand muscles. This is called lumbarization. So, a disc protrusion at L4/L5 will compress the L5 root, and a protrusion at L5/S1 will compress the S1 root. You may opt-out of email communications at any time by clicking on Hopefully this article helped you understand what to expect following a lumbar spinal cord injury and how to promote recovery. In fact, people can live their whole lives without realizing that they have sacralization of their L5 vertebra. Reported prevalence is 83 people per 100,000 people [8]. Causes of nerve root pain may include: Arthritis Bone spurs You may learn how to do activities more safely. L2 Spinal Cord Injury Masks are required inside all of our care facilities. Maintain good posture and learn how to safely lift heavy objects. With effective management strategies, individuals with lumbar spinal cord injuries can maximize their functional abilities and lead fulfilling lives. Pain radiating into one or both thighs and legs, similar to the lay term "sciatica". Merck Manual Professional Version. These sections are labelled as the L1-L5 vertebrae. Spinal cord compression can cause cauda equina syndrome, which needs medical attention right away. Integrated transversus abdominis and lumbar multifidus training light activities2. In some instances, spinal nerve impingement can result in a radiating burning sensation. Many patients are able to maneuver around in their manual wheelchair and may even be able to walk for short distances. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education. Sciatica S1 is a specific diagnosis describing symptoms which originate from nerve root impingement of the sacral 1 spinal nerve. The Questionnaire is widely used for health status. Exercise strengthens the muscles that support your back and helps keep your spine flexible. Other causes of nerve root impingement often present with a unique constellation of symptoms ( Table 3). The vast majority of cases are benign and will resolve spontaneously, and thus, conservative management is the most appropriate first step in the absence of clinical red flag symptoms. Traveling pain. information is beneficial, we may combine your email and website usage information with The 2023 edition of ICD-10-CM G54.4 became effective on October 1, 2022. Left foraminal and far lateral disc bulging at L3-4. It can also help you better predict your bladder and bowel movements. Then you slide a single leg down until the knee is straight, maintain it for 10-second holds and then slide it back up to the starting position. Dermatomes can be helpful in evaluating and diagnosing conditions affecting the spine or nerve roots. Correlate clinically for left L3 radiculopathy. Maintain good positioning don't cross your legs or lie in any one position for a long time. Isolated transversus abdominis and lumbar multifidus training1. You sustain this pose for 10 seconds and then return to the starting position with ten repetitions. Vloka JD, Hadic A, April E, Thys DM. Injuries only sometimes occur in isolation, so trauma to the surrounding lumbar and sacral spinal nerves may accompany an injury to the L4 nerves. [5], While the literature lacks concise epidemiologic data, most reports estimate about a 3% to 5% prevalence rate of lumbosacral radiculopathy in patient populations. The lower back is the area most frequently affected by radiculopathy. other information we have about you. Accessed Sept. 21, 2021. When you have nerve root encroachment, abnormal tissue moves in on the spinal nerve root. [1], Overall, lumbosacral radiculopathy is an extraordinarily common complaint seen in clinical practice and comprises a large proportion of annual doctor visits. Click here to download our free SCI Rehab Exercise ebook now (link opens a pop up for uninterrupted reading). How to test the Femoral Nerve (Lumbar Plexus L2,3,4) or reverse Lasegue's. 2007 May 1;25(2):387-405. How many vertebrae are in the spine? You flex the hip and knee of one leg to 90 degrees. A pinched nerve occurs when too much pressure (compression) is applied to a nerve by surrounding tissues. Typically, a dull ache or sharp pain may be felt in the lower back. Sometimes the MPPT is positive at the popliteal fossa, other times only at . Lumbosacral radiculopathy. Advertising revenue supports our not-for-profit mission. Overview and evaluation of hand disorders. In refractory cases, surgical decompression and spinal fusion can be performed. [7] The prevalence of lumbosacral radiculopathy has been situated from 9.9% to 25%.[8]. Lesions of the intervertebral discs and degenerative disease of the spine, most common causes of lumbosacral radiculopathy. Physical therapy, acupuncture, chiropractic manipulation, and traction are all commonly used in the treatment of lumbosacral radiculopathy. Because one of the nerve roots is irritated, this could impair the nerve's capacity to function. If youd like to learn more about FitMi, click the button below: Do you have this 15 pages PDF of SCI rehab exercises? Even individuals with the same level of injury may experience different secondary effects depending on the severity of injury. Surgery should be offered only if complaints remain present for at least 6 weeks after a conservative treatment. The disc often presses on a nerve root which can cause pain and other symptoms in a leg. Symptoms and Signs Stemming from L3-L4 The L3-L4 motion segment may cause muscle pain, discogenic pain, radicular (nerve root) pain, and/or radiculopathy (neurologic deficit) that typically affects the lower back and/or the legs. A related, but usually more severe, diagnostic conclusion . L1 spinal nerve provides sensation to the groin and genital regions and may contribute to the movement of the hip muscles. Pain and stiffness in the neck, back, or lower back, Burning pain that spreads to the arms, buttocks, or down into the legs (sciatica), Numbness, cramping, or weakness in the arms, hands, or legs, "Foot drop," weakness in a foot that causes a limp. 3. [4] L1. Spinal cord compression can occur anywhere from your neck (cervical spine) down to your lower back (lumbar spine). Lumbar spinal cord injuries (SCIs) may be complete or incomplete and may affect one or both sides of the body. Flint Rehab is the leading global provider of gamified neurorehab tools. Roland Morris Disability Questionnaire (RMDQ) - The Roland Morris Disability Questionnaire assess changes in functional status after treatment in patients with low back pain. Common patient complaints include pain, numbness, tingling and weakness L5-S1 nerve impingement symptoms For example, a herniated disk in the lower spine may put pressure on a nerve root. The ilioinguinal nerve is a mixed nerve originating from the anterior rami of T12 and L1 nerve roots. Babinski's test. information highlighted below and resubmit the form. A crossed straight-leg raising test may . The international consensus says that in the first 6-8 weeks, conservative treatment is indicated.[4]. In cases where symptoms fail to resolve, imaging studies, electromyography, and nerve conduction studies can assist in making a diagnosis. Wear and tear of the spine may take years to cause symptoms. Radiculopathy can be defined as the whole complex of symptoms that can arise from nerve root pathology, including anesthesia, paresthesia, hypoesthesia, motor loss and pain. My occupational therapist recommended to give this a try. Symptoms such as pain, numbness, or weakness in the arms, hands, legs, or feet can come on gradually or more suddenly, depending on the cause. In this case, the person would likely have full use of the arms and breathing ability, but may have weakness, numbness, and other problems in the abdominal area and below, such as paralysis of both legs and bowel/bladder dysfunction. The following factors may increase your risk of experiencing a pinched nerve: The following measures may help you prevent a pinched nerve: Mayo Clinic does not endorse companies or products. Since damaged neurons (nerve cells) in the spinal cord are not capable of regeneration, only spared neural pathways can be adapted and rewired through a process called neuroplasticity. https://www.ninds.nih.gov/Disorders/All-Disorders/Pinched-Nerve-Information-Page. Ask if your condition can be treated in other ways. 3% (188/5895) 3. S1 is one of the nerve structures which eventually create the sciatic nerve lower in the pelvic anatomy. Common symptoms of an L3 lumbar spinal injury include weakness, numbness, and loss of flexibility in the legs, hips, and/or groin. The pain extends from the surgical incision laterally into the inguinal and suprapubic regions. A 'slipped' (prolapsed) disc often causes sudden, severe lower back pain. L5 Nerve Root - Everything You Need To Know - Dr. Nabil Ebraheim nabil ebraheim 1.08M subscribers Subscribe 2.8K 198K views 3 years ago Dr. Ebraheim's educational animated video describes the. Radiculopathy and radicular pain commonly occur together, but radiculopathy can occur in the absence of pain and radicular pain can occur in the absence of radiculopathy.[3]. I feel more at ease in flexing.. This content does not have an Arabic version. The Maine-Seattle Back Questionnaire - A 12-item disability questionnaire for evaluating patients with lumbar sciatica or stenosis. This involves testing sensation and motor functions in various areas of the body. In other cases, muscle or tendons may cause the condition. A 2016 study revealed that appropriate use of EI (= epidural injections) to treat sciatica could significantly improve the pain score and functional disability score leading to a decrease in surgical rate.. A study evaluating the effect of non-steroidal anti-inflammatory drugs, or Cox-2 inhibitors reported that the drugs have a significant effect on acute radicular pain compared with placebo. . Facing pain in neck, shoulders and the upper back from last 10 months. information submitted for this request. The sacral spine consists of five segments, S1 - S5, that together affect nerve communication to the lower portion of the body. Risk factors for radiculopathy are activities that place an excessive or repetitive load on the spine. Pain. When the spinal cord is involved, the symptoms can be more severe, including poor coordination, trouble walking and paralysis. Lumbar vertebrae anatomy is generally classified by dividing the lumbar spine into five distinct sections. At Another Johns Hopkins Member Hospital: Your thoughts matter to us. Sharp pain in the back, arms, legs or shoulders that may worsen with certain activities, even something as simple as coughing or sneezing Weakness or loss of reflexes in the arms or legs Numbness of the skin, "pins and needles," or other abnormal sensations (paresthesia) in the arms or legs information and will only use or disclose that information as set forth in our notice of Additionally, surgerymay be recommended for some individuals to decompress the spinal cord, stabilize the spinal column, manually lengthen spastic tendons and muscles, and minimize the hyperactivity of spastic muscles. Each nerve demonstrates slightly different symptoms in terms of specific areas of the leg that are involved. As such, all fractures should be handled with extreme caution to prevent worsening a lumbar SCI. Some spinal injuries can cause cysts to develop inside the spinal column. Train transversus abdominis muscle activation in a prone lying position without spinal and pelvic movements for 10 seconds with ten repetitions. L3/4 central disc herniation with impingement on the bilateral descending nerve roots. If you have carpal tunnel syndrome, your doctor may . They also hold your body upright. Treatment depends on the cause and your symptoms and may involve medication, physical therapy, injections, and surgery. What is the L4 Vertebra? Generally, more severe spinal cord injuries carry a greater risk of complications. 2009 Dec 1;147(1):17-9. Therefore, connections between areas below the level of injury and the brain still exist. causing nerve root impingement, this maneuver may elicit a positive response. The lumbar spine is located in the lower back below the cervical and thoracic sections of the spine. Since mostdisc herniationsoccur posterolaterally, the root that gets compressed is actually the root that exits the foramenbelowtheherniated disc. Cervical radiculopathy is a dysfunction of a nerve root in the cervical spine, is a broad disorder with several mechanisms of pathology and it can affect people of any age, [6] with peak prominence between the ages of 40-50 [2] [7] [8] . Nerve compression syndrome . Radiculopathy symptoms may overlap with those of peripheral neuropathy, making it difficult to pinpoint the source of the problem. Undergoing medication and physiotherapy from last 9 months. Early treatment is important to the prognosis of lumbar spinal cord damage. [2], Radiculopathy is not the same as radicular pain or nerve root pain. In a complete spinal cord injury, the spinal cord is completely severed, leaving no spared neural pathways. With rest and other conservative treatments, most people recover from a pinched nerve within a few days or weeks. Perform co-contraction of the two muscles in a standing position while a mini ball is behind your upper back and against the wall. Bone spurs can form in the spine due to inflammation from osteoarthritis, trauma or other degenerative conditions. If not present, this is not radiculopathy. It may also harm the tip of the spinal cord known as the cauda equina, which is a bundle of spinal nerves and nerve roots that innervate the lower lumbar spine to the sacrum. A frequently overlooked cause of testicular and buttock pain is irritation of the T10-L1 sensory nerve roots, the genitofemoral nerve, and the ilioinguinal nerve. Pressure on nerve roots may produce numbness, tingling or pins and needles sensations in the areas supplied by the nerve. Bring someone with you to help you ask questions and remember what your provider tells you. Perform ankle movement in the forward-backward direction while keeping your lumbar spine in a neutral position. The inguinal paravascular technic of lumbar plexus anesthesia: the 3-in-1 block. We will never sell your email address, and we never spam. Symptoms of nerve root impingement vary depending on the location and severity of the condition. [6] Motor, sensory, and reflex functions should be assessed to determine the affected nerve root level. Your spine is made of many bones called vertebrae, and your spinal cord runs through a canal in the center of these bones. or loss of reflexes. You use the index and middle fingers to palpate the contraction of the transversus abdominis muscle and the opposite two fingers to palpate the contraction of lumbar multifidus muscle. Consistent at-home therapy is key to making this happen. The pinched nerve in the L5: the nerve located in the L5 supplies impulses to the muscles responsible for lifting the foot and the big toe. The pain will be concentrated in the neck, upper arm, shoulders . Many causes of spinal cord compression cant be prevented. The lower extremity symptoms are almost always described as burning, cramping, numbness, tingling or dull fatigue in the thighs and legs. As is the case with other spinal cord injuries, the completeness of the spinal cord damage will determine how severe the injury and symptoms will be for the patient. But it can also be a result of a spinal injury. Spinal cord injuries are traumatic for patients and their families. CES affects the nerves of the lumbar spine, which may cause incontinence and potentially permanent paralysis of the legs. Nerve conduction studies, along with electromyography, can also be used to help pinpoint whether the problem is neurological or muscular. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Iliac crest and groin. For S1 radiculopathy the clinician emphasised the straight leg raise test, the ankle reflex, sensory loss in the S1 dermatome, and the muscle power for hip extension, knee flexion, ankle plantarflexion, and ankle eversion.[6]. Clinical evaluation of lumbosacral radiculopathy begins with: Medical history (type, location, and duration of symptoms, presence of subjective weakness and dysesthesia, current therapy, dermatomal radiation, absence of work) and physical examination: dermatomal sensory loss, myotomal weakness, straight leg raise[12][6], Crossed Straight Leg Raise Test, Femoral Nerve Stretch Test and reflexes.If the patients report the typical unilateral radiating pain in the leg and there is one or more positive neurological test result, the diagnosis of sciatica seems justified. Such symptoms may include: Pain, weakness or numbness in the legs, calves or buttocks. In addition, choose two aggravating activities or tasks that you anticipate would cause pain or instability and perform muscle co-contraction while doing these activities or tasks without having pain. As an adult, the spinal column grows longer than the spinal cord and they no longer relate to one another. The role of core stabilization in lumbosacral radiculopathy. Know what to expect if you do not take the medicine or have the test or procedure. The L2 vertebra contains the end of the spinal cord properall other spinal vertebrae below this point only have spinal nerves, not the spinal cord. Spinal cord compression is caused by a condition that puts pressure on your spinal cord. [6]If the patient reports the typical unilateral radiating pain in the leg and there is one or more positive neurological test result the diagnosis of sciatica seems justified.[6]. Make a donation. With proper treatment and management techniques, many individuals are able to participate in most of their day-to-day activities with minimal or no difficulty. The test is positive if the patient experiences anterior thigh pain. Keep your back as healthy as possible by maintaining a healthy weight, practicing good body mechanics, and getting regular exercise. Accessed Sept. 21, 2021. Herniations of the nucleus pulposus are noted at L4/5 and L5/S1. Integrated transversus abdominis and lumbar multifidus training in pain aggravating activities810. L2, L3, and L4 spinal nerves provide sensation to the front part of the thigh and inner side of the lower leg. Iversen T, Solberg TK, Romner B, Wilsgaard T, Nygaard , Brox JI, Ingebrigtsen T. Bogduk N. On the definitions and physiology of back pain, referred pain, and radicular pain. The L1 vertebra is the topmost section of the lumbar spinal column. As your spinal cord travels down your back, it is protected by a stack of backbones called vertebrae. Thats why Flint Rehab created FitMi, a motion-sensing, gamified home recovery tool designed for neurological injury like SCI. Other procedures may be done to relieve pressure on the spine or repair fractured vertebrae.