endoscopic discectomy

Is Endoscopic Discectomy Right for You? 5 Things You Need to Know

Do you suffer from chronic back pain?

If so, you’re not alone. The American Chiropractic Association reveals that back pain plagues approximately 31 million Americans. Back pain ruins the quality of life, as many sufferers miss work, stop engaging in physical activities, and turn to pain medications that can make them sleepy.

Back pain can be caused by a number of ailments, which all require different routes of treatment. If you suffer from chronic back pain caused by a herniated disc, then you may want to consider undergoing an endoscopic discectomy.

What Is an Endoscopic Discectomy?

This procedure removes herniated disc material through a minimally invasive surgical procedure. The surgeon makes a small incision to insert a camera and microsurgical tools. This avoids the need to make large, damaging incisions.

Why Choose this Procedure?

Herniated discs cause extreme pain. When an injury ruptures them, a jelly-like inside spills out and press on nerves. This results in serious pain that this surgery eliminates. Also, this surgery offers a much quicker recovery time than the traditional herniated disc surgery. It does not damage the neck muscles as the alternative does.

5 Things You Should Know

Before choosing any treatments, you should know exactly what you are signing on for. Read on for 5 facts you should know about an endoscopic discectomy.

1. You Reap Recovery Perks

Typically, the surgery ends in about a half hour, as opposed to hours on the operating table. The patient can go recover at home after a couple of hours and expect to resume normal activities within a couple of weeks.

This sounds especially amazing when you compare it to traditional herniated disc surgery. In comparison with an artificial disk replacement or spinal fusion, patients face up to a three month recovery time.

Furthermore, you will not need the cervical immobilization collar, if your herniated disc is in the cervical region. Patients who receive the spinal fusion require this uncomfortable device for anywhere from 4-6 weeks, to support their neck and allow for proper healing.

2. You Can Stay Conscious

Some people simply do not like the thought of going under anesthesia and therefore avoid surgery. Other people simply cannot go under due to life-threatening allergies or underlying conditions. If you’re one of those people, then you may want to think about choosing this procedure.

Though some surgeons do use anesthesia for this surgery, they often give the option to perform it under a local anesthesia. This means that they blocking nerve signals from reaching the pain, so the patient does not feel anything in that area.

This eliminates the groggy feeling along with the risks involved with going under. Patients may find this a better option since the surgery only lasts about 30 minutes.

3. You Can Choose Alternatives to Pain Medicine for Recovery

Following herniated disc surgery, many people take opiate-based pain pills and strong noninflammatory medications. This can lead to a serious addiction. You should know that after your surgery, you can choose from other options.

Acupuncture

Nearly every culture has used acupuncture for medicinal purposes throughout history. The acupuncturist strategically places thin needles into the skin in order to stimulate natural healing properties and block pain signals.

Because of our learned dependency on pharmaceuticals, some people view this as a type of pseudoscience, however, research says otherwise. An extensive study reveals that acupuncture worked just as well as traditional pain medications for the first few weeks of treatment, but proved superior for pain management in the long term.

Like the minimally invasive microdiscectomy, acupuncture comes with far fewer risks than the traditional alternative. Moreover, the treatment often involves a whole body healing in addition to minimizing the pain.

Therapy

Though you will feel real pain following surgery, underlying stressors and/or mental conditions can exacerbate your perception of it. Even if you typically do not suffer from anxiety or depression, surgery can sometimes trigger these conditions in some people, especially if they enjoy being on the go.

Consider seeing a therapist before and following your arthroscopic back surgery to help you cope with your emotional pain. This will help keep your physical pain under control.

Celery Seed Extract

This natural supplement continues to gain popularity, as the Arthritis Foundation reveres celery seed extract for its ability to reduce pain and inflammation. Its volatile components contain a number of healing properties that can help you eliminate the need for pain medications and NSAID’s following your surgery.

Though anything medicinal comes with some side effects, the mild side effects of celery seed do not compare those of prescription medications. Ask your surgeon if taking this supplement after your procedure can replace the medications.

4. You Need Physical Therapy Afterwards

Unfortunately, this surgery is not magic. You do not undergo it and effortlessly feel healed.

Though this procedure minimizes your risks of muscle damage your muscles do atrophy as you rest them for recovery. Weakened neck and back muscles leave your spine unsupported and can lead to pain and risk of further injury.

Seeing a physical therapist decreases your time to complete recovery. Strategically and safely working your muscles in a controlled setting will improve your overall quality of life following surgery. Your efforts will optimize your strength, flexibility, and mobility for the long run.

5. This Surgery Fixes Other Back Problems Too

Though surgeons often use this procedure to repair herniated discs, cervical, mid, and/or lumbar discectomy may also be used to fix:

  • brachial neuritis
  • disc bulges
  • disc tears
  • radiculitis
  • radiculopathy

If you suffer from chronic pain, ask your doctor if this minimally invasive surgery can help you. Regardless of what you need repaired, this procedure offers similar benefits to the ones discussed above.

Talk To Your Doctor Today!

Pain reduces the quality of life. If you do not want to suffer from chronic neck or back pain any longer, and open spinal surgery always sounded too risky, talk with your doctor about undergoing an endoscopic discectomy.

This minimally invasive procedure offers a faster and more complete recovery and safer surgery. You deserve your life back! Visit our website to learn the advantages of choosing us for your spinal surgery.

The Top 5 Questions About Recovery After Minimally Invasive Lumbar Fusion

1. How long will I have to stay in the hospital after minimally invasive lumbar fusion?
It is generally a rule of thumb to say that minimally invasive spine surgery usually will decrease the patient’s hospital stay by half. For a typical endoscopic discectomy and lumbar fusion surgery, the surgeries are performed in the same day, and the patients is usually able to go home in two to three days, compared to a hospital stay of five to seven days with traditional open lumbar surgery.

2. When can I go back to work after minimally invasive lumbar fusion?
This decision varies for each patient, depending on the type of work the individual does. If the patient has a sedentary job, he or she could likely return to part-time work a month or six weeks after lumbar fusion surgery. For more physical occupations, the patient must seek the advice of his or her surgeon on when it would be safe to return to work. Patients generally return to work much more quickly after minimally invasive surgery than after traditional open surgery.

3. What is the recovery time for endoscopic lumbar fusion?
The recovery time for each surgery is different. While some patients are able to return to full activity within only six weeks, others can require more time. Your surgeon will be able to give you a good estimate of what your recovery time will be like based on your individual needs and circumstances. I definitely encourage all of my patients to participate in a physical therapy program so that they can safely begin to return to the normal activities of their lives.

4. How long after minimally invasive lumbar fusion surgery will my pain last?
Pain generally follows that same rule of thumb as hospital stays with endoscopic spinal fusion: the patient usually experiences pain for half the time he or she would with traditional surgery. Patients typically experience the most pain in the first week with a gradual lessening of pain over the next six or so weeks. Each patient recovers differently.

5. Will I need physical therapy after endoscopic spinal fusion surgery?
I highly recommend physical therapy to all of my patients. It is an important part of a quick and easy recovery and return to full function and range of motion. While it varies from patient to patient, most patients who undergo endoscopic lumbar fusion will start physical therapy four to six weeks after the surgery.

6 Signs of Herniated Disk or Slipped Disk

 

  1. Leg pain – this may be pain radiating down the back or the side of the leg to the knee or foot.   Sometimes this pain is felt in the front or inner thigh or even the groin.  The pain may worsen with straightening the leg or siting up.   Arthritis pain is different from slipped disk.  arthritis pain  is usually only found in the hip, knees or ankle and does not radiate down the whole leg.
  2. Numbness and tingling – this may be felt as pins and needles, burning or decreased or absent feeling in the area of the pain or beyond it.  Sometimes numbness may appear without pain.
  3. Weakness – the leg may give out or drag.  You may have problems getting up from sitting, stepping onto a stool or moving your foot.
  4. Reflex loss – patients may loose reflexes at their knee or ankle or from the bottom of their foot.  Usually this is picked up from your doctor.
  5. Walking – the leg may drag or catch on the floor, you may have to lift the leg high to avoid this
  6. Bowel and bladder – if the disk compresses the cauda equina (the nerves to the bowel and bladder)  the bowel and bladder may stop working.  You may retention of pee or bowel movements or become incontinent of them.  If this happens you should seek medical attention immediately.

About Dr. Carl Spivak

Dr. Spivak is the president of Executive Spine Surgery and has offices in New York and New Jersey.  He is well known for his cutting-edge, minimally invasive endoscopic spine surgeries and regularly teaches courses throughout the USA.  For more information please call 908-452-5612 or click on schedule-an-appointment.

6 Best Treatments for Back Pain

1. Physical therapy focusing on core strength and flexibility.

2. Weight loss.  Weight loss alleviates back pain by reducing stress and strain on your back and decreases damage to disks and joints.

3. Steroid injections may relieve back pain.  Steroids and local anesthetics work to decrease inflammation, washout chemicals that cause pain and directly reduce pain often breaking the destructive pain cycle.  Steroid injections are an effective treatment for conditions that cause back pain such as arthritis of the spine (called facet arthropathy) and disk disease.

4. Stem Cell Therapy.  Disk regeneration is a new therapy where stem cells taken from your hip are injected  into your damaged disk to regenerate the disk.  The stem cells make new disk cells increasing the fluid and size of the disk reducing back pain and suffering.

5. Endoscopic Laser Discectomy.  As the disk wears out, or degenerates, it turns black on MRI, collapses, bulges and may tear causing back pain.  Removal of the degenerated disk and treatment of the annular tear has been found to reduce back pain and suffering.   The discectomy and annuloplasty can be done with the spinal endoscope.  A scope the size of a pencil can be placed through an incision the size of your finger nail.  The disk is found and repaired under direct visualization.

6. Endoscopic Fusion. Painful degenerated disks, spinal instability, spondylolithesis may lead to severe back and/or leg pain.  This pain can be disabling.  Patients that have failed other treatments may be a candidate for fusion surgery.  Today fusion surgery can be done through a very small incision with the aid of an spinal endoscopic to reduce soft tissue and bone damage and quicken recovery.

ABOUT US:

Dr. Spivak is the President of Executive Spine Surgery and is a leader in Endoscopic Laser Spine Surgery.  He see patients in New York and New Jersey and teaches doctors his advanced surgical techniques throughout the United States.  For more information please call 908-452-5612 or click schedule-an-appointment.

Can spinal epidural steroid injection hurt my brain?

Spinal epidural injections are very common treatments for back pain and sciatica.  Sciatica is leg pain running down the back of your leg caused by a slipped disk pinching a nerve.  Imagine the disk is a marshmallow (even though it really isn’t).  The disk like a marshmallow may expand out if you squeeze it.

HOMEWORK:

You can try this at home – take a marshmallow and squeeze it from the top and bottom.  See how the marshmallow expands out as you flatten it.  This is similar to a herniated disk .  The bulging disk may pinch a nerve causing the nerve to swell up and get “hot” called inflammation causing back and leg pain.

Spinal epidural steroid injections are the placement of steroid medicine into the spine onto the hot and swollen nerve to cool down the inflammation and relieve the pain and suffering.  Think of it like putting an aspirin on the nerve.

Even though spinal injections are generally safe there are risks and side effects to all medical procedures. These include bleeding, infection, dural puncture or “wet tap” causing headaches and nerve damage.  Patients may also experience increased pain, headaches, red face, anxiety, problems sleeping, fever, high blood sugar, decreased immunity, stomach ulcers, severe arthritis, cataracts and menstrual irregularities.

TO ANSWER YOUR QUESTION the most common way spinal epidural steroid injections affect your brain is through headaches.  Usually these headaches will resolve with time.  If they are related to “wet tap” you may require bed rest, caffeine, fluids and rarely blood patch.  Blood patch is the injection of blood into the spine to stop spinal fluid leak and “plug” the hole from the “wet tap”.

ABOUT DR CARL SPIVAK

Dr. Spivak is a neurosurgeon fellowship trained in minimally invasive spine surgery and spinal epidural steroid injections.  He has practices in New York and New Jersey.  For more information on spinal epidural injections or laser endoscopic spine surgery please call Executive Spine Surgery at 908-452-5612 or click schedule-an-appointment.

How can I get relief from my bad back pain?

Sorry to hear about your back and sciatica. The L5-S1 disk is probably pinching your sciatic nerve causing leg pain called sciatica. Lumbar disk surgery may be considered if steroid injections have not relieved the pain. Traditionally lumbar disk surgery was done through a large incision with significant muscle retraction, damage and bone removal to get to the disk. Today most lumbar disk herniations can be removed minimally invasively with the spine endoscope. This outpatient surgery is done with a small camera the size of a pen through an incision the size of your finger nail. Most people have quick relief from their pain and decreased recovery.

Patients are admitted to the hospital or surgery center for same day surgery.  They change into a gown and IV and EKG stickers are placed by the nurse and taken to the preoperative area.  The patient is seen by the surgeon, anesthesia and nursing.  The risks and benefits of surgery are explained to the patient if not already done.  The patient then signs an informed consent sheet verifying they understand the risks and benefits of surgery and want to go ahead with surgery. The patient is then taken into the operating room.  The patient is sedated (called conscious sedation) or put to sleep (general anesthesia) by the anesthesiologist and then position face down onto the operating room bed. The back is cleaned with a disinfectant and then a drape is placed over the patient.  X-ray machine and endoscopic equipment are brought to the bed.  After the surgery is completed the patient is transferred back onto their bed and taken to the recovery room.

For more information on minimally invasive spine surgery (MISS), endoscopic spine surgery or laser spine surgery please call Executive Spine Surgery at 908-452-5612 or click on schedule-an-appointment.

Can scoliosis cause chronic back pain?

The spine is made up of a stacked alternating vertebral bodies and disks.  The spine is usually straight on anterior posterior x-ray.  Scoliosis is an abnormal curvature of the spine.  The spine may look like a C or S on X-ray. Scoliosis may arise from birth abnormalities where the spine was formed wrong, such as missing half of a vertebrae or from changes resulting from arthritis.  The cause of scoliosis in young people is unknown and is called idopathic even though certain genetic traits have been defined.

Children are commonly screened at school for scoliosis, especially at the time of the growth spurt when the development and progression is most common.  Patients suspected of having scoliosis undergo a history and physical and relevant laboratory investigations.  This may include x-rays, serial x-rays, CT and MRI.  Patients found to have a spinal curvature of greater than 10 degrees are diagnosed as scoliosis.

Scoliosis alters the mechanics of the back and puts significant strain on the vertebral bodies, disks, muscles and even the nerves leading to chronic pain and suffering.

Treatment is complex and requires individualization.  Smaller curvatures are watched while larger curvatures greater then 20 to 30 degrees may require bracing. Surgery is usually reserved for very large curvatures greater then 45 to 50 degrees which have high likelihood to progress even more.  Other indications for surgery include pain, weakness, difficult mobilizing and breathing.  Surgery usually involves spinal fusion surgery, this may be done through the front (anterior), side (lateral) or back (posterior) combined with spinal instrumentation (screws and rods).

Overall prognosis of scoliosis depends on the likelihood to progress.  Patients with larger curvatures, thoracic curves, double curves and immature spines (such as adolescents) have higher chance or progressing.

ABOUT DR CARL SPIVAK.

Dr Spivak is a neurosurgeon who specialized in minimally invasive endoscopic spine surgery.  He is a well known teacher and speaker in laser spine surgery.  For more information on scoliosis, other spinal disorders or laser spine surgery please call 908-452-5612 or click schedule-an-appointment.

Where do you get the bone for spinal fusion?

People often ask 2 questions about spinal fusion:

1) Why do you need bone?

Bone is a key ingredient in spinal fusion.  Spinal fusion is done when the spine is weak and needs to be made stronger.  One vertebral body is connected to another vertebral body with metal screws and rods.  Bone is placed in-between the vertebrae so the vertebrae will grow together and form one solid bone.  If bone isn’t placed  and a solid spinal fusion is not obtained the screws and rods will eventually loosen and fall out or break.

2) Where do you get the bone from?

In the old days the bone was taken from your body.  Usually a piece of your hip would be cut out and then used as graft for the fusion.  Sometimes only the inside of the hip bone would be scraped out.  Today  donor bone or synthetic bone alternatives like hydroxyapatite are usually used.. Bone removed during the operation is rarely used.  This may still be done if the person last fusion surgery failed to fuse and now the surgery was been redone or if they are very high risk for the fusion failing such as smoker, sick or on chronic anti-inflammatory medications.

About Dr. Carl Spivak and Executive Spine Surgery

Dr Spivak is a neurosurgeon with expertise in minimally invasive spine surgery and is a pioneer in endoscopic spine surgery.  He routinely teaches workshops and courses for doctors throughout the United States for JOIMAX USA.  For more information on how Dr. Spivak can help you, please call 908-452-5612 or click schedule-an-appointment.

Will a back brace help alleviate my lower back pain?

Back braces are commonly used for back pain.  They provide support for the back and may relieve pain.  They are best used to help brace the back to prevent injury (such as a work belt) rather to treat pain.  They may be useful during flareups, but wearing a back brace all the time can lead to weakening of the back muscles and increased ironically more back pain.

A properly fitted back brace will limits spinal movement. It may affect participation in sports, especially if a lot of back movements are involved.

Back braces are commonly used after spinal surgery, especially fusion surgery.  They limit movement, support and most importantly remind patients to not over do it.

Back surgery today is not like 10 or even 5 years ago.  Most back surgeries can be done using a small spinal endoscope through an incision the size of your fingernail (index.php).  Since the surgery is minimally invasive their is less tissue damage and as a result pain.  Patients may forget they just had surgery and over do it.  Heavy lifting, strenuous activity or running may re-injure their back.  Wearing  back brace may remind the patient to take it easy.

About US:  Dr. Spivak is president of Executive Spine Surgery.  He specializes in extremely minimally invasive spine surgery utilizing new endoscopic technology recently introduced from Germany. Dr. Spivak has offices in Manhattan, NY, West Orange, NJ and Hackettstown, NJ.  Please call 908-452-5623 or click on schedule-an-appointment.