Instability of the spine

What is spine instability?

Lifting, Carrying, Running, Sitting, Jumping, Turning around, Bending, Stretching ... all these are movements that affect our body and thus our spine for a lifetime. We defy gravity every day. When we are young our spine is flexible and stable. Bones, discs, tendons, joints, and ligaments stabilize the spine; a perfect system. However, weakness, gradual deterioration or acute injury to these components can cause instability. For example, if ligaments and tendons lose their elasticity or "stretch out", they no longer hold the vertebrae firmly in its natural position and as a consequence individual vertebrae move too much. The same happens when the intervertebral discs lose height or the muscles are too weak. In the worst case, so-called spondylolisthesis one vertebrae moves mostly forwards from the other vertebrae. In fact, instability of the spine is causally responsible for many spinal disorders.

Frequency of instability

The painful spine instability has become so common in the civilized world. Back pain is one of the most common reasons why a doctor is consulted. Low back pain (50%) is the most common pain. The total cost of care for chronic back pain is € 20 billion a year. The bulk of the costs are caused by sick leave periods. Back pain is responsible for 15% of sick leave periods and 18% of early retirement every year. About 60% of adults reported back pain in the last 12 months.

Causes of the instability of the spine

Whenever a serious problem we call illness arises in our body, we wonder why! What is the cause! Have we overtaxed our body? Is the disease fatal? Is it genetic? Have we smoked too much, drank too much alcohol, moved too little? Patients are always almost clueless that is why the search for the cause. The diagnosis and of course the therapy lays in the hands of a specialist. In terms of instability of the spine, there are many causes that lead to back pain, although, despite the state-of-the-art diagnostic options, we do not always get clear information. For the development of back pain and the tendency to chronicity, apart from physical factors, many circumstances are important - for example workload, social factors, evaluation of pain, depressive moods. The fact is: as you age, the spine becomes more susceptible to wear. This initiates a chain reaction that almost always causes instability. The most common consequence of the degenerative changes is a narrowing of the spinal canal (spinal canal stenosis) and the causes include vertebral gliding, scoliosis, herniated discs, and spondylosis. Instability can be caused not only by wear but also by trauma, surgery, inflammation, tumors, and others.

Symptoms of the instability of the spine

From instability of the cervical spine patients have neck pain. However, when nerves are pinched by shifts, the pain can radiate to other parts of the body as well. In instability of the lumbar spine patients often complain of back pain that radiates into the leg. This causes discomfort and loss of strength. The back pain increases when getting up, with distortion and after exercise.

More specifically, try to pay attention to these symptoms:

  • If you have pain in the morning after getting up and feel stiffness,
  • If you feel pain after prolonged weight-bearing (for example shopping bags),
  • If you have pain after sitting for a long time - for example when driving a car or in an office chair. 
  • If you feel your back is breaking down or your head is not being carried off from your neck.If you have pain in the lumbar or cervical spine when you bend yourself down or turn your head quickly from side to side.

Diagnosis of spine instability

No doctor in the world will/can make a competent diagnosis without having had a detailed conversation with the patient. This conversation has a name: anamnesis. That is, in seeking the answer to your pain you need to tell the doctor all your symptoms - when do they occur, where do they occur, how often are you affected by pain, how severe is the pain, etc.? Then it begins the clinical examination as an initiation of further and ideally final diagnosis. In this case, MRI, CT, and X-ray are available upon request of the doctor. Afterward, the doctor will choose with you; after a detailed explanation of pros and cons an optimal therapy. At the Avicenna Clinic you can count on it: YOUR NEEDS ARE OUR COMMANDS!

Instability of the spine - treatment with different methods

The spine is complicated to treat. On one side, it is exposed to high mechanical strain, on the other side, it has great flexibility. Whenever you rely on a specialist make sure he has a lot of experience. Spine care requires a lot of skill and meticulousness. The main goal of any treatment, to reduce instability and prevent further sequelae (such as subsequent arthritis / spinal cord damage), is to find a treatment that does not require surgery. In fact, conservative methods are ideal. Other measures depend on the cause of the instability.
So, in case of degenerated discs, we offer you the disc cultivation with which we restore the buffer function of the intervertebral disc. In case of osteoporosis of the vertebral body, we would perform the kyphoplasty and when no other methods can help us, we will stabilize the spinal segments with a spinal fusion
Sometimes it is necessary to replace the damaged discs or the damaged vertebrae with bone blocks, titanium structures or plastics one. A few months after the procedure, the vertebral joints fuse with the blocks or chips used. 

As a result, the loosening is eliminated; pain is significantly alleviated and given the opportunity to physiotherapy to strengthen the back muscles. After such an operation, you can continue to perform back movements - even better than before.


The prognosis of instability depends on the severity of anatomical changes and duration of the symptoms and the age of the patient. It goes from a complete cure in case of timely recognized cause to the development of paraplegia. And because very very rarely - thank God! - consequences can be fatal, we recommend you: Please do not wait so long to visit a specialist and make an appointment as soon as possible. Painkillers intake usually delay not only the diagnosis but also the therapy.

Dr. med. Munther Sabarini

Dr. med. Munther Sabarini
Specialist in Neurosurgery

The Avicenna Clinic in Berlin is always willing to help you

Since the year 2001, the Avicenna Clinic is based in Berlin. Our doctors have at least 25 years of international experience in their respective fields (neurosurgery, spinal surgery, anesthesia, and orthopedics).

If you have severe back pain, a herniated disc or a suspected herniation, please contact us using the following information:

Avicenna Clinic
Paulsborner Str. 2
10709 Berlin

Telephone: +49 30 236 08 30
Fax: +49 30 236 08 33 11