Spine Conditions

The Saskatchewan Spine Pathway is a truly innovative program for low back pain:  it is the first Provincial spine pathway in Canada, and in fact, it is the first clinical spine pathway implemented in a geopolitical region in the world!  It is designed to improve the assessment of low back pain by family physicians and other health providers, so that patients can quickly receive care that is appropriate for their condition. 


The Division of Neurosurgery at Royal University Hospital was one of the first centers in Canada to offer minimally invasive microdiscectomy performed through a small tube as a day procedure.  Currently, minimally invasive options are a consideration for all types of spine conditions. If you are planning to have spine surgery, it is worth talking to your surgeon to see if minimally invasive techniques are an option.


We are Saskatchewan’s center for the Rick Hansen Spinal Cord Injury Registry which enables researchers and healthcare providers to answer critical questions about care including evaluating how their patients are being treated and helping identify how to improve spinal cord injury.  The Division of Neurosurgery has been active in basic science and clinical research top improve the outcomes for people who have suffered spine injuries. 


Division of Neurosurgery spine surgeons have helped develop innovative strategies to treat tumors of the spine and integrate minimally invasive options for spine tumors.


What Causes Back Pain?

Back pain is very common. Many factors can contribute, including:

  • Poor posture
  • Excess body weight
  • Lack of physical activity leading to muscle weakness and fatigue
  • Emotional stress/tension
  • Reaching / lifting beyond safe base of support
  • Poor repetitive lower back movement habits
  • Trauma (e.g. a fall or a car accident)

It may help you to realize that you have control of some (or most) of these factors contributing to back pain. Taking care of your back may help reduce your pain.  Other factors that may cause back pain are from age-related changes in your lumbar spine. These include:

  • Loss of intervertebral disc height. As a result, the bones in the spine become closer, causing the nerve openings in the spine to become narrower.
  • Joint inflammation (arthritis); causing stiffness and pain in the lower back
  • Intervertebral disc ruptures in the lumbar spine. The ruptured material can put pressure on one or more nerve roots or on the spinal cord, causing pain and other symptoms in the back and legs.
  • Degenerative Disc Disease: A medical term for wear and tear on the spinal intervertebral discs.
  • Degenerative Joint Disease: A medical term for wear and tear on the spinal joints.
  • Disc Herniation: Intervertebral discs are small cushions which separate each spinal vertebrae. They are made up of a tough outer shell (annulus) and a jelly-like centre (nucleus). Due to wear and tear, the outer shell can weaken, allowing the jelly centre to push through. This protruding material can put pressure on the spinal nerve root and may cause pain, numbness and/or weakness.
  • Stenosis: A narrowing of the spinal canal where the spinal cord runs, and of the spaces in the bone where the nerve roots exit from the spinal cord. The narrowing can be caused by poor postural positioning, arthritic changes, inflammation or swelling, and loss of height of the vertebrae and the intervertebral discs due to aging or injury.

Non-Surgical Treatments

Many people with age-related changes in their lumbar spine can respond to a non-surgical approach that includes:

  • Physical therapy and exercises to strengthen back and abdominal muscles;
  • Improved work/home/leisure ergonomics;
  • Discussions with a mental health therapist to assist in addressing emotional stress;
  • Anti-inflammatory medication;
  • Avoidance of repetitive activities;
  • Ice; and
  • Control of weight

Surgical Treatments

When is surgery needed?  Back surgery may be considered to alleviate pain and prevent nerve damage when conservative measures have failed with the following conditions:

  • Compression on the spinal nerves
  • If the spine is unstable due to injury (spinal fracture)
  • If the spine is unstable due to slippage of one spine bone on another (spondylolisthesis

Learn More

Our Team


Daryl Fourney, MD, FRCSC, FACS - Professor, Director of Research, Departement of Surgery, Neurosurgery
Luke Hnenny, MD, FRCSC, FAANS - Assitant Professor, Neurosurgery
Adam Wu, MD, MSC, FRCSC - Assistant Professor, Neurosurgery



Joseph Buwembo, MB. ChB, FCS(SA), MMeD, FRCSC
Turker Dalkilic, MD, FRCSC
Ritesh Kumar, MD, FRCSC
Jean Mark Ouattara, MD, FRCSC
Akram Zwai, MD-CHB, FRCSC


Dr. Daryl Fourney

(306) 844-1107
(306) 655-2354
Professor, Director of Research,
Departement of Surgery, Department of Neurosurgery

Royal University Hospital
103 Hospital Drive
Saskatoon SK S7N 0W8

Dr. Luke Hnenny

(306) 655-2499
(306) 655-2354
Assistant Professor, Neurosurgery
Royal University Hospital
103 Hospital Drive
Saskatoon SK S7N 0W8

Dr. Adam Wu

(306) 844-1100
(306) 655-2354
Assistant Professor, Neurosurgery

Royal University Hospital
103 Hospital Drive
Saskatoon SK S7N 0W8