SAN­DRA L BLOOD

When Trinida­di­an so­ca star Denise “Saucy Wow” Bel­fon, one of this year’s (2026) New York City Coun­cil Procla­ma­tion Hon­orees for cul­ture, per­forms and in­structs her au­di­ences: “Put your back in it” and “wine,” she isn’t aware that she’s lit­er­al­ly en­cour­ag­ing/pro­mot­ing spine well­ness. Win­ing is said to re­lieve stiff­ness, im­prove range of mo­tion and pro­mote pelvic aware­ness, while gen­er­al ex­er­cise pre­vents back in­juries and pain.

Many peo­ple are born with spinal dis­or­ders, and many spinal dis­or­ders are in­vol­un­tar­i­ly caused, but by and large, the spine is usu­al­ly tak­en for grant­ed un­til we be­gin to ex­pe­ri­ence dis­com­fort.

Doc­tors say the spine talks via nerve sig­nals and pain as a mes­sage, and they lis­ten to those bi­o­log­i­cal sig­nals.

Says In­di­anapo­lis Neu­ro­log­i­cal Group’s Good­man Camp­bell Brain and Spine (GCBS): “The spine is a very com­plex me­chan­i­cal struc­ture that is high­ly flex­i­ble yet very strong and sta­ble, and there’s al­ways some type of phys­i­cal de­mand be­ing placed on it. It con­sti­tutes 33 stacked bones that run from the base of the skull to the tail­bone. Al­so called the back­bone or ver­te­bral col­umn, its main parts en­tail ver­te­brae, discs, spinal cord and soft tis­sues, and if the in­tegri­ty of the spine and its cord to­tal­ly col­lapse, there will be cat­a­stroph­ic, im­me­di­ate loss of move­ment, sen­sa­tion, and vi­tal body func­tions.”

The spine and its re­gions

“Cer­vi­cal, Tho­racic, Lum­bar, Sacrum, and Coc­cyx. Cer­vi­cal (neck), sev­en small bones (C1-C7) at the top which sup­port the head. Tho­racic (up­per or mid-back), 12 bones (T1-T12) that con­nect to our ribs and pro­tect the chest cav­i­ty. Lum­bar (low­er back), five large bones (L1-L5), which car­ry most of our up­per body weight. Sacrum (base of the spine), five bones (S1-S5) con­nect­ing the ver­te­bral col­umn to the pelvis. And Coc­cyx (tail­bone), four fused bones (C01-C04) at the end of the col­umn.”

• The spine’s func­tions: “Sup­port, Move­ment, and Pro­tec­tion.”

• Spinal curves (lor­do­sis and/or kypho­sis): “When the spine is viewed from the side, a nor­mal spine has three grad­ual curves.

Cer­vi­cal Ver­te­bra of the first sev­en bones, Tho­racic Ver­te­bra, the fol­low­ing 12, and the Lum­bar Ver­te­bra, the fol­low­ing five. The neck has a lor­do­sis (curves to­wards the back). The tho­racic spine has a kypho­sis (curves to­wards the front) and the lum­bar spine al­so has a lor­do­sis. How­ev­er, when the spine is viewed from the front or back, a nor­mal spine is in a straight line, with each ver­te­bra sit­ting di­rect­ly on top of each oth­er, but a side-to-side curve is sco­l­io­sis.”

Ben­e­fits of the three grad­ual curves

“To help the spine sup­port the load of the head and up­per body, and main­tain in the up­right po­si­tion.”

Ver­te­brae bones

“The first ver­te­bra bone, the At­las (A1) holds up the skull. The sec­ond, the Ax­is (C2), al­lows the head to turn from left to right. While both are struc­tural­ly dif­fer­ent from the oth­er ver­te­brae, each ver­te­bra has an an­te­ri­or arch and a pos­te­ri­or arch, which form a hole called a fora­men through which the spinal cord pass­es.”

Spinal cord

“The spinal cord is lo­cat­ed im­me­di­ate­ly be­low the brain stem and ex­tends through the fora­men mag­num—a hole at the base of the skull. This cord car­ries in­for­ma­tion from the out­er el­e­ments of the body (skin, joints, lig­a­ments, mus­cles) through the sen­so­ry tracts to the cen­tral ‘com­put­er’—the brain.”

There are two con­cern­ing con­di­tions of the spine: sci­at­i­ca and sco­l­io­sis.

Sci­at­i­ca

Ex­plained Trinida­di­an med­ical prac­ti­tion­er, chi­ro­prac­tor and con­sul­tant based in Trinidad, Dr Ravi Sinanan of Pro­gres­sive Health Ser­vices, “Sci­at­i­ca is a sharp-shoot­ing pain down the leg caused by a pinched nerve of the low­er back. In rare cas­es it can se­ri­ous­ly progress in­to a med­ical emer­gency called Cau­da Equina Syn­drome.”

Cau­da Equina Syn­drome (CES) &

Signs of Red Flags

“CES oc­curs when a large disk or her­ni­a­tion or oth­er prob­lems com­press­es the bun­dle of nerves at the base of the spine. Those nerves con­trol our legs, bow­el, blad­der, and sex­u­al func­tion, and un­like reg­u­lar sci­at­i­ca, this con­di­tion is a true emer­gency. Signs of red flags are Sad­dle Anes­the­sia: numb­ness in the sad­dle area (groin, in­ner thigh, or but­tocks), spinal in­fec­tions, tu­mours or frac­tions.”

Com­pli­ca­tions of sci­at­i­ca

“If left un­treat­ed and al­lowed to progress, be­cause the nerve sup­plies legs, any in­sult to the nerve can lead to symp­toms in the legs as well, such as the clas­sic pain, tin­gling, tight ham­string, and numb­ness, and if not treat­ed, cer­tain com­pli­ca­tions can oc­cur.”

Main com­pli­ca­tions

“Chron­ic pain, mus­cle weak­ness, mus­cle-loss, and cau­da equina syn­drome.”

Chron­ic pain

“If the nerve com­pres­sion is al­lowed to con­tin­ue and or wors­en, this can re­sult in a per­ma­nent­ly-dam­aged nerve. The nerve may not be com­plete­ly cut, but rather, a sec­tion that is per­ma­nent­ly crushed and nev­er ful­ly heals, which di­rects im­prop­er sig­nals to the brain that may be in­ter­pret­ed as pain.

“Nerves are re­spon­si­ble for sen­sa­tion as well as mus­cu­lar con­trac­tion. If the con­di­tion pro­gress­es, it goes from mild to se­vere pain with tin­gling and numb­ness in the leg, and pro­gress­ing fur­ther, we may ex­pe­ri­ence weak­ness in the leg and foot to the ex­tent where crutch­es may have to be con­sid­ered. Ad­di­tion­al­ly, a con­di­tion known as drop foot—un­able to dor­si­flex the foot or pull it up­ward.”

Mus­cle loss in legs

“Both mus­cle strength and size can be lost, and size is lost when the nerves that in­ner­vate it are in­ter­rupt­ed or in­jured in some way.”

Cau­da Equina Syn­drome

“A med­ical or neu­ro­sur­gi­cal emer­gency. It means horse­tail—a bun­dle of nerves that come off the end of the spinal cord. The spinal cord ends at the L1, L2, and the bun­dle of nerves that ex­tend from be­yond that point is the cau­da equina, or if a disc bulges in­to the spinal canal and com­press­es the cau­da equina, it can lead to sci­at­i­ca in one or both legs.”

Symp­toms and treat­ments

“Dif­fi­cul­ty walk­ing, low­er body paral­y­sis, sud­den pain or weak­ness in both legs, numb­ness be­tween legs and in the gen­i­tal, sex­u­al dys­func­tion, and con­trol can be loss of our bow­el and blad­der, and treat­ments in­clude mas­sage ther­a­py, phys­io­ther­a­py, shock­wave ther­a­py, acupunc­ture, elec­troacupunc­ture, or surgery.”

Sco­l­io­sis

Stat­ed GCBS, “Sco­l­io­sis is an ab­nor­mal spine cur­va­ture that does not fol­low the nor­mal spine curves and re­sults in a loss of the body’s align­ment and cen­tre of grav­i­ty.”

Cause

“The cause varies, and it can af­fect any part of the spine. Many peo­ple are born with the con­di­tion, but it can al­so de­vel­op. It’s an ab­nor­mal side-to-side cur­va­ture of the spine, which should nat­u­ral­ly have a slight for­ward and back­ward curve, but with sco­l­io­sis, the spine curves to the left and right in­to a C or S shape. Most cas­es are mild, don’t cause symp­toms and don’t need treat­ment, but se­vere cas­es can cause un­even pos­ture and pain, and treat­ment may in­clude wear­ing a brace or un­der­go­ing surgery.”

Three types of sco­l­io­sis

“Id­io­path­ic, with cause un­known, con­gen­i­tal iden­ti­fied at birth, and neu­ro­mus­cu­lar, ab­nor­mal­i­ties in mus­cles and nerves that show up as cere­bral pal­sy, spina bi­fi­da or mus­cu­lar dy­s­tro­phy.”

Mea­sur­ing sco­l­io­sis

“Sco­l­io­sis is mea­sured in de­grees us­ing a sco­l­iome­ter. Less than 10 de­grees in­di­cates no sco­l­io­sis di­ag­no­sis. 10-24: mild, 25-39: mod­er­ate and 40-plus: se­vere.”

Com­pli­ca­tions of sco­l­io­sis

“Long-last­ing pain, phys­i­cal de­for­mi­ty, or­gan dam­age, nerve dam­age, arthri­tis, spinal flu­id leak­age, and dif­fi­cul­ty breath­ing which is ad­vised to prompt­ly con­tact emer­gency.”

Spinal de­gen­er­a­tion

With more than a decade as a Com­plex Spinal Sur­geon, the very first Con­sul­tant Com­plex Spine & Sco­l­io­sis Sur­geon in Trinidad and first Trinida­di­an to do the surgery in Trinidad, Dy­lan Keir Thomas, MBBS, DM, FICS (Ed, Glasg), FACS, MBTT and RCS-ap­proved Com­plex Spine Fel­low­ship (UK) of Caribbean Spine and Sco­l­io­sis Clin­ic as­serts, “Spinal de­gen­er­a­tion, par­tic­u­lar­ly de­gen­er­a­tive disc dis­ease, is pri­mar­i­ly caused by the nat­ur­al ag­ing process. As peo­ple age, spinal discs lose wa­ter and flex­i­bil­i­ty, be­com­ing less ef­fec­tive as shock ab­sorbers. How­ev­er, oth­er fac­tors like in­jury, obe­si­ty and cer­tain lifestyle choic­es can ac­cel­er­ate this de­gen­er­a­tion or con­tribute to its de­vel­op­ment.”

Re­gard­ing sco­l­io­sis and kypho­sis (S&K) and spinal re­vi­sion surg­eries, Thomas ad­vised, “Surgery is usu­al­ly rec­om­mend­ed for pa­tients with se­vere spinal cur­va­ture, that con­tin­ues to wors­en, or cause sig­nif­i­cant pain that af­fects day-to-day liv­ing, if the sco­l­io­sis be­gins to af­fect mo­bil­i­ty or im­pact on in­ter­nal or­gans.”

Spinal re­vi­sion surgery

Thomas said it’s a pro­ce­dure per­formed to cor­rect prob­lems or com­pli­ca­tions aris­ing from a pre­vi­ous spinal surgery, aimed at ad­dress­ing is­sues such as per­sis­tent pain, hard­ware and mal­func­tions, or failed fu­sion, and can in­volve tech­niques re­mov­ing hard­ware, ex­tend­ing fu­sions, or cor­rect­ing mis­align­ments.”