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Month: May 2013

Carl Spivak, MD - Executive Spine SurgeryNews2013May
By Staff Writer Spinal fusion, Treatment problems

Does the body ever reject the materials used in spinal fusion?

Spinal fusion is the connecting of one vertebrae to another vertebrae to strengthen the spine and decrease pain.  This is usually done with screws and rod or sometimes a metal clamp.  Bone is placed between the vertebrae to cause the vertebrae to grow together to make a solid continuous bone.  This is the fusion part of spinal fusion.

It is uncommon for the body to reject spinal fusion materials. Spinal fusion is usually done with bone, plastic (PEEK) or titanium cages and titanium screws and rods.   Spinal clamps are becoming more popular and  sometimes are used as an alternative to pedicle screws.   Bone or bone alternatives are packed into the disk space, facet joints or beside the spine for fusion to happen.  It is very rare to have a reaction to bone, PEEK or titanium.     Very rarely patients develop an allergic reaction to donor bone. If they use your own bone your body should not react to it.   Bone alternatives like calcium phosphate may cause reaction but again this is unlikely.

Rest assured most people go through a spinal fusion without rejection to the fusion materials.  To learn more information on spinal fusions please click Spinal Fusion and Options.

To book an appointment please contact Executive Spine Surgery at  908-452-5612 or click schedule-an-appointment.

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

What is the sciatic nerve?

The sciatic nerve is made up of the spinal nerve roots exiting the lower spine. The sciatic nerve travels through the pelvis and down the leg. When disk or bone spur pinches the sciatic nerve in the back it causes back and leg pain called sciatica. This pain tends to be in the back of the thigh and calf.  This may be associated with numbness in the little toes and difficulty walking on your toes.  Bending forward or lifting your leg may aggravate the pain.  People with sciatica benefit from rest, anti-inflammatories, pain medicine, physical therapy, steroid injections and spine surgery.

Today spine surgery is not like how it used to be.  Most spine surgeries can be done with laser or spinal endoscope.  The arthroscopic procedure is done through a small incision the size of your finer nail through a tube the size of a pen.  The herniated disk is found and removed under direct visualization un-pinching the nerve relieving pain and suffering.  Patients are discharged home the same day after one to two hours.  Many people have little post-operative pain and need for pain medication after surgery and can return to most activities within a few weeks after surgery.

To learn more about sciatica and endoscopic spine surgery please see What is Sciatica? and Laser Spine Surgery.

Click to schedule-an-appointment or call 908-452-5612.

By Staff Writer Treatment problems

My foot continues to flop after surgery. Should I have another surgery?

Herniated disk at the L4-5 level is a common cause of foot drop.  Foot drop is weakness bending your foot upwards towards your nose.  This may range from mild to severe.  As the weakness increases the foot tends to slap down when walking or must be lifted up high to prevent it from snagging on the floor.  The weakness may be from dysfunction of the nerve from compression or from nerve damage.   The damage may increase the longer the foot drop is present. Usually early surgery is recommended to prevent damage.

The purpose of surgery is to remove the disk and “un-pinch” the nerve.   Normal back surgery mainly decompresses the L5 nerve root, but endoscopic transforaminal surgery (such as JOIMAX) enters through the foramen and opens up the foramen taking pressure off the L4 nerve in the foramen and L5 nerve in the spinal canal. Therefore second surgery or surgical approach is not needed.  Other advantages include pen sized scope, very small skin incision, minimal muscle damage, same day surgery  and quick recovery.

If the foot drop continues after surgery then there may be continued compression at that level or maybe unrecognized compression at the L5-S1 foramen or more likely nerve damage.  Nerve damage may improve over months or years or may be permanent.

Sometimes scar tissue is found on post-operative MRI in people who are not improving.  Removal of the scar tissue will unlikely help your nerve improve.  Continued foot drop after surgery is likely due to preoperative nerve damage.

For more information please contact Executive Spine Surgery at 908-452-5612.

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