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Month: April 2013

Carl Spivak, MD - Executive Spine SurgeryNews2013April
By Staff Writer Neck pain, neck stretch, Pain, Relief

Neck Stretch Exercises for Stiff Painful Neck.

Does your neck get stiff?  Do you ever feel like you need to “crack it”?  Do you get severe neck pain?

If you answered yes to any of these questions then Neck Stretching may be the answer for you.

Neck pain causes a viscous cycle of stiffness, weakness and pain.  For example you twist your neck and develop neck pain.  Every movement worsens the pain.  You respond by  not moving your neck or putting on a neck collar.  Unfortunately  this weakens your neck muscles and weak tight neck muscles hurt more.  You are making the pain worse.

Stretching is the best way to break the pain, stiffness and weakness cycle!  Neck stretching stretches the muscles, improves neck mobility and decreases pain.

NECK STRETCH ROUTINE

I recommend a hot shower before stretching to relax and loosen the neck.  You need 5 to 10 minutes to properly stretch the neck.  You must flex neck forward and hold the neck in that position with your hand on the back of your head.  You must simultaneously relax your neck.   Hold this stretch for 30 seconds.  Repeat this exercise for the rest of the neck stretch positions.   After the whole set is complete repeat the set 2 more times.  You need to do exercise 3 times in total.

EXERCISE SEQUENCE

Flex head forward x 30 seconds

Extend head backwards x 30 seconds

Turn head right x 30 seconds

Turn head left x 30 seconds

Bend head right x 30 seconds

Bend head left x 30 seconds

Repeat whole sequence for a total of 3 times.

For more information please contact Executive Spine Surgery at 908-452-5612 or email at appt@executivespinesurgey.com

By Staff Writer Discectomy, endoscopic spine surgery, laser surgery, Lower back pain, Pain, Relief, Sciatica, Surgery, Treatment Options for Back Pain

Can I have surgery for an old ruptured disk?

The spine or back bone is composed of vertebrae separated by disks. The disks support and cushion the spine.  Over time the disks may become damaged and wear out causing back pain.  If the outer disk lining (annulus fibrosis) tears the inner jelly nucleus  (nucleus pulposus) may herniate out of the disk and “pinch” a leg nerve causing sciatica.  This usually is felt as back pain shooting down the back or side of the leg.

The disk pushing on the nerve causes inflammation around and in the nerve leading to irritation, swelling and pain.  The pain and inflammation may settle quickly over a few weeks in some people, but other people the pain may continue for years.   Unfortunately long term nerve pinching may cause breakdown of the nerve myelin covering and loss of nerve fibers causing nerve damage.  Nerve damage may or may not improve even after the nerve is “un-pinched”.

People with a pinched nerve and pain, numbness and weakness usually require removal of the disk “pinching” the nerve.  Sometimes recovery will be longer if the nerve has been “pinched” for a long time.

Yes it is recommended to have surgery for an old ruptured disk if:

1) The disk is still pinching nerve on recent MRI (usually 6-12 months old)

2) The disk causes the type of pain the patient has

3) The disk causes the type of weakness or numbness the patient has

Today Endoscopic Spine Surgery is a new answer to disk surgery.  The disk can be found with a small high definition video camera that is inserted into the spine through a skin incision the size of a finger nail.  The nerve is then “unpinched” relieving pain and suffering.  For more information on minimally invasive endoscopic laser spine surgery please contact Executive Spine Surgery 908-452-5612 or email appt@executivespinesurgery.com Good Luck!

 

By Staff Writer endoscopic spine surgery, laser surgery, Lower back pain, Spinal fusion

Will I be able to play sports after spinal fusion?

Spinal fusion is the connection of one spinal vertebrae to another spinal vertebrae though a bony bridge. Eventually the vertebrae and bone bridge join together forming a strong “solid bone”.  During the healing the bones are “braced” or held in position by titanium screws and rods.  The rods and screws prevent the bones from falling apart.   Excessive forces placed across  spinal instrumentations (screws and rods) may break them preventing the spinal fusion from healing. It may take a year or so for the spine to fuse.

You can return to light activity right away.   Most people can return to sports before the spinal fusion heals.

Return to sports depends upon the type of sports, professional or amateur, contact or non-contact, reasons the spinal fusion was needed in the first place, patient’s age, patient’s health, location of the fusion, how many levels were fused and other patient , disease and bio-mechanical factors.

People returning to strenuous, contact and /or professional sports may need to wait 1 year or until the fusion has completely healed.

For more information please see Spinal Fusion and Options.  Please call 908-452-5612 to schedule an appointment or click schedule-an-appointment to discus your problem and see if you are a candidate for endoscopic spinal fusion surgery.

By Staff Writer News

Study Finds Endoscopic Spinal Surgery Early Discharge

New Jersey-based Executive Spine Surgery alerts spine surgery patients to a recent academic study that showed patients treated with endoscopic spine surgery were discharged quicker then after open traditional spine surgery or minimally invasive microscopic spine surgery.

Back pain suffers who need spine surgery now have evidence that patients who undergo endoscopic spine surgery have quicker recovery and discharge home, say physicians at West Orange-based Executive Spine Surgery. They point to a recently presented academic study that showed patients treated with endoscopic discectomy recovered and were discharged home 94% earlier then open surgery.

Presented at International Society of Advancement of Spine Surgery (ISASS) meeting in Vancouver, BC on April 3, 2013, the study led by the University of Columbia’s Reginald Knight, MD examined the results of almost 300 lumbar decompression patients from Prospective Spine Registry at Bassett Healthcare, a rural multispecialty employed physician-hospital.

Drs. Knight and Spivak and their colleagues used the database to review 283 consecutive elective lumbar degenerative spine cases from years 2010 to 2012, looking at outcomes after traditional-open surgery, minimally invasive tubular microscopic surgery and endoscopic surgery.

The results: All three treatment groups showed remarkable improvements in back pain, leg pain and disabilities scores over the course of the study, but there was significant differences in the length of stay after these surgeries. Patients who underwent open-traditional surgery, minimally invasive surgery and endoscopic surgery had average stays of 1.8, 1.0 and 0.1 days respectively.

“This study emphasizes that endoscopic spine surgery is extremely minimally invasive even for minimally invasive surgery. The exact reason for early discharge is unknown, it is likely due to less tissue damage and pain from the surgery” comments Dr. Carl Spivak. “This is why I make every effort to provide the least invasive, cutting-edge surgical techniques available.”

By Staff Writer Case report, Discectomy, endoscopic spine surgery, laser surgery, Sciatica, Treatment Options for Back Pain

Case Report: 61 Year Old Man Felt Like He was Kicked in the Groin!

Patient History

The patient is a 61-year-old man who presented to emergency room with severe back pain and right testicular groin pain.  He said “It felt like I was kicked in the groin”.  The medical workup identified additional right leg weakness, numbness and pain.  MRI diagnosed right L3-4 slipped disk pinching the right L4 nerve.

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Treatment

Patient underwent Endoscopic Laser Spine Surgery for complete removal of the herniated disk.  The procedure was done comfortably under twilight sedation and patient had instant, complete pain relief after removal of the large disk fragment.  Patient was discharged home pain free one hour after surgery.

Case Discussion

Testicular pain is an unusual presentation of a slipped disk herniation.  If the disk becomes injured or weakens it may rupture and leak out of the disk and compress or “pinch” a nerve causing back and leg pain called sciatica.

Endoscopic Laser Spine Surgery is an advanced minimally invasive option to cure back pain.  A pen-sized video camera is inserted into the spine to identify and remove the herniated disk and un-pinch the nerve.  There is minimal skin or muscle damage or blood loss.  Patients are discharged home the same day and benefit from shorter recovery, decreased post-operative pain and quicker return to work.

By Staff Writer Lower back pain, Pain, Spinal fusion

How does spinal fusion help low back pain?

There are many causes of low back pain.  Back pain may arise from the muscles, tendons, joints, disks, bones, nerves and spinal cord.  Rarely back pain may arise from other organs in the abdomen or chest.

Black disks called degenerative disk disease (DDD) may produce back pain.  This may be caused by  injury to the disk called an annular tear.  Scientists believe annular tears cause pain from ingrowth of pain nerves into the disk.  As the disk disease progresses this can lead to weakness in the spine called instability.  Instability produces pain from abnormal movements in the spine.

Facet joint damage can also cause back pain.  The facet joints hold the back of the spine together.  If the joints are injured they can be a source of pain.  This is called facet arthropathy  and is common when people have severe arthritis in there spine.  If the facet joints wears out or break and can no longer hold the spine together then the spine may slip apart.  This is called a spondylolithesis.

If the back pain arises from the torn disk then pain is relieved by removing the painful disk and replacing it with cage and bone. If the problem is instability (that is weakness and abnormal movement) the fusion and instrumentation holds the spine together preventing these abnormal movements.

Today spinal fusion can be done minimally invasively with the spinal endoscope (endoscopic lumbar interbody fusion or ELIF).  This decreases skin and muscle damage, pain and suffering after surgery and allows you to get gong quicker.

Please see Spinal Fusion and Options for more information about spinal fusion or schedule-an-appointment.

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