Dr. Fred Geisler

Board Certified Neurosurgeon

Tel: 650.631.4515

To understand Spinal Conditions, it is important to appreciate the basics of the human spine anatomy. The human spine consists of 3 major regions with 2 smaller sections at the lower end:

  • Cervical
  • Thoracic
  • Lumbar
  • Sacrum
  • Coccyx

The spinal column is made up of five sections and consists of 33 bones known as vertebrae. Cushion-like discs separate the first 24 vertebrae bones, giving the spine the ability to bend and flex.


The cervical, or neck section of the spine, consists of seven vertebrae known as C1 to C7. The top cervical vertebra C1 connects the spinal column to the base of the skull.


The thoracic section of the spine is located at chest level, between the cervical and lumbar vertebrae, known as T1 to T12.  They also serve as the attachment points for the ribs that form the rib cage. Because of the bony numerous muscles surround the thoracic spine that strengthen and support that area, thoracic spinal problems are less frequent.


The lumbar section of the spine is located between the thoracic section and the pelvis that has the sacrum portion of the spine as a part of the pelvis bony ring. The five lumbar vertebrae, known as levels L1 to L5, are the main weight bearing section of the spinal column. Below the lumbar region are two other sections of the spine: the sacrum and the coccyx bones, which are within the pelvis area.  The sacro-iliac joints link the sacral spine to the iliac bones of the pelvis to form the pelvic ring.


The spinal nerve roots transmit information between the spinal cord and other parts of the body, such as arms, legs and organs.  The spinal cord which runs in the spinal column contains all the nerve pathways to the arms and legs.   The spinal cord and spinal nerves have specific regions for both the motor and sensory signals.  The motor function refers to signals from the brain to the extremities to cause movement and the sensory function includes the various sensations as well as pain transmitted to the brain.


Between 75-85% of all people are afflicted with back pain at some point in their lives and seek medical attention or loose days at work as a direct result. It is one of the most common reasons for people to visit a physician following heart disease and cancer.  Back pain is categorized as Acute or Chronic as well as specific or non-specific. The word “acute” is a term meaning pain that it has had a relatively recent onset in the proceeding days or week and is usually caused by the straining of muscles or ligaments. The pain can be severe immediately following the injury and last for several days/weeks, but individuals usually resolve the acute episode within 6-8 weeks on a non-operative treatment course of NSAID’s (Motrin or Aleve), exercise (Physical Therapy) and avoiding strenuous activities for several weeks.  The specific or non-specific refers to either having a discrete area of anatomy causing the low back pain versus a diffuse muscle injury over a region of the low back area respectively.


Unfortunately, many acute back pain sufferers tend to continue their normal activities before they are fully healed, causing the initial injury to not only perpetuate itself but also to increase in severity, resulting in Chronic Back Pain. Chronic Back Pain can also result from the progression of naturally occurring degenerative disease with is part of the aging process.  Without proper diagnosis and treatment, people are forced to suffer from chronic back pain for months, years or even decades.


Dr. Fred GeislerBoard Certified Neurosurgeon
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