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Category: endoscopic spine surgery

Carl Spivak, MD - Executive Spine SurgeryNewsendoscopic spine surgery
By Staff Writer endoscopic spine surgery, laser surgery, Pain, Relief, Spinal fusion, Surgery, Treatment Options for Back Pain, Treatment problems

How painful is recovery from lumbar spinal fusion surgery?

Spinal Fusion is the joining of one vertebrae to another vertebrae by a bone graft.  This bone graft acts as a bridge between the two vertebrae.  Spinal fusion is held together with metal screws and rods. It is done for symptomatic degenerative disk disease, spine fractures, cancer, spinal instability and spondylolithesis.  Large open spinal fusions may have incisions many inches long while single level minimally invasive spinal fusion can done through 1 inch incisions.

Recovery from lumbar spinal fusion depends on the patient’s health, pathology being treated  [what is actually wrong with your spine,  the number of levels affected (single vs multilevel disease) and prior surgery and complications] and the lumbar fusion technique.  Minimally invasive surgery tends to be less destructive, painful and have a quicker recovery. Most people will be on pain medication for a week to months as they recover from there surgery.

For more information please Schedule an Appointment! Good Luck!

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

Do I have to wear my back brace at night?

Back brace is used to stabilize your spine after spinal fusion surgery.   These braces are used to hold the spine together until fusion occurs.  Spinal Fusion is the joining of one vertebrae to another vertebrae by bone bridge.  The two vertebrae and the bone graft eventually become one solid bone.  Spinal instrumentation acts as a internal brace to hold the fusion together.  This may consist of rods, screws, plates, clamps or wires.

The rate of spinal fusion depends on many factors including age, activity, size, location.  Spinal fusion is decreased by smoking and usage of non-steroidal anti-inflammatory medications.

Spine braces can be in the form of a neck collar after anterior cervical discectomy and fusion (ACDF), thoracic lumbar sacral orthosis (TLSO) after treatment of a thoraco-lumbar burst fracture or lumbar sacral orthosis (LSO) after lumbar fusion.

For more information on back braces please see the following blog posts:

Is it bad to use a back brace?

Should I be wearing a back brace if I have a disc injury?

Back braces are not usually worn in bed because there are less forces being applied across the surgical site and less chance of damaging the fusion and instrumentation holding the spine together.

For more information please Schedule an Appointment.   Good Luck!

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

What is the recovery time for lumbar fusion?

Spinal Fusion is the joining together of the spinal vertebrae with bone.  This is usually done through the disk space [called anterior lumbar interbody fusion (ALIF), direct lateral interbody fusion (DLIF) / extreme lateral interbody fusion (XLIF), posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF) or endoscopic lumbar interbody fusion (ELIF)] but can be done posteriorly over the lamina (posterior fusion), in the facet joints (facet fusion) or transverse processes [posterolateral fusion (PLF)].

The Endoscopic Lumbar Interbody Fusion is the newest development in fusion techniques and many believe will cause the least damage and pain and have the quickest recovery.   Endoscopic fusion is done through a small tube with the aid of an endoscope.   This endoscopic area of spine surgery is generally called Laser spine surgery, even though lasers are rarely used today.

Recovery time varies from person to person and from procedure to procedure. The larger the procedure (that is more exposure and therefore tissue damage and the greater number of levels fused) the longer the recovery. People recover quicker from minimally invasive procedures.  Recovery can take from a couple weeks to many months.  Most people can return to light activity (no strenuous lifting or exertion) in few weeks.

Schedule an Appointment to learn more about endoscopic lumbar interbody fusion (ELIF).

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

I am 39 year-old woman with left leg pain and numbness. What can I do?

Your left leg pain and numbness is probably from a “pinched” nerve in your back.  This is called Sciatica.  Sciatica in a 39 year old is most commonly caused by a disk herniation.  Treatment for sciatica varies from rest, physical therapy, anti-inflammatories, steroid injections and surgery.   Pain that is not improving, very severe or associated with neurological deficits (weakness, foot drop, numbness or bowel and bladder incontinence or retention) may require spinal surgery.

In the past spinal surgery was a big deal.  You were admitted to the hospital, put to sleep under a general anesthetic and had your back half opened up to expose the spine.  The muscles were retracted and damaged and the bone was removed.  This bone removal is called a laminectomy or laminotomy, depending on how much lamina was removed.  Then the traversing nerve and thecal were retracted and the disk was found and removed.

Today disk surgery is much simpler.  Disk surgery can be done through a spinal endoscope (such as JOIMAX), this is often called Laser spine surgery, even though the laser is not necessary today.  The big advancement of “Laser spine surgery” is the used of an endoscope.  An endoscope is a pen-sized micro-video camera that is placed inside the spine to the herniated disk pinching the sciatic nerve.  Tiny instruments are inserted through the endoscope to remove the disk.   The sciatica leg pain often improves very quickly often before surgery is over.

Schedule an Appointment to learn more about endoscopic spine surgery and how it can help you!

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

Does everyone eventually suffer from degenerative disc disease?

Degenerative disk disease is the wearing out of your disks in your back.  This is a slow process resulting from drying out of the nucleus pulposus changing how the disk manage forces. Over time the disk may darkens, collapse, bulge, tear and rupture producing leg pain called Sciatica.

Everyone or at least most people develop radiologic evidence of degenerative disk disease if they live long enough, but not everyone will have pain and suffering as a result of it.  There are many new treatments for degenerative disk disease including artificial disk replacement, endoscopic discectomy and annuloplasty,  Endoscopic Spinal Fusion (that is Endoscopic Lumbar Interbody Fusion or ELIF). 

Schedule an Appointment to learn more how Executive Spine Surgery can help.  Good Luck!

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

What causes neck and shoulder blade pain and arm tingling?

The neck and shoulder pain and arm tingling may be from a disk pinching a nerve in your neck. This often will cause spasms in the shoulder and lower neck.   You may benefit from rest, physical therapy and/or anti-inflammatory medicine.  If the pain does not improve with conservative treatment you may benefit from steroid injections or surgery depending on the cause of the pain.  There is new endoscopic spine surgery options for treatment of symptomatic disks in the neck.  Good Luck!

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

Will my pain go away after L4-L5 spinal fusion surgery?

Pain may improve, stay the same or worsen after fusion surgery.  The majority of people will see improvement in there pain, but few people will have complete pain relief.  Unfortunately spine surgery does not give you a new uninjured back.   I would discuss what the likelihood of you improving with your surgeon.

Spinal fusion surgery  is usually done through an open traditional technique causing significant skin, muscle and bone damage.  Recently open traditional fusion surgery is being replaced by percutaneous endoscopic fusion techniques I call Endoscopic Lumbar Interbody Fusion (ELIF).  These surgeries appear to have less bleeding, soft tissue and bone damage compared to open traditional fusion surgery.  Due to less soft tissue and bone damage these endoscopic surgeries appear to have less post-operative pain and a quicker recovery.

For more information on percutaneous endoscopic fusion surgery please contact Executive Spine Surgery.   Good Luck!

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

I have a large disc protrusion compressing my L5 nerve and causing spinal stenosis. Do I need surgery?

Disc protrusion is when the disk slips out of it’s normal position in between the spinal vertebrae and extends into the spinal canal.   Other commonly used names are bulging disk, slipped disk or herniated disk, etc.  Spinal stenosis is tightness or loss of volume of the spinal canal.

Right L4-5 disk protrusion initially is treated with conservative treatment which may include rest, physical therapy, medications and steroid injections.  Surgery is considered when a patient fails conservative treatment and/or has severe pain, numbness, weakness or neurological dysfunction (such as urinary incontinence).

Today most disk surgery can be done by using extremely minimally invasive surgical techniques called endoscopic spine surgery or laser spine surgery.  This revolutionary same day surgery is done through a tiny tube the size of a pen which is placed into the spine under X-ray guidance.  The disk is found and visualized through the high definition video camera found inside the spine endoscope.   The disk is then removed with tiny little instruments taking pressure off of the nerve.  This usual provides quick relief of pain and suffering.  Often patients feel much better right after surgery.

For more information on sciatica and lumbar disk herniations click on the following link Sciatica.  Good Luck!

By Staff Writer Discectomy, endoscopic spine surgery, laser surgery, Pain, Sciatica

What does degenerative disc disease and no signal abnormality within the cord or enhancement mean?

Degenerative disc disease = “worn out” degenerated disks in your spine

No signal abnormality = spinal cord looks normal, no abnormal signal suggesting disease or damage

No enhancement = the spinal cord is not taking up contrast die.  This would suggest inflammation, infection or cancer

For more information on sciatica please click the blog below.  Please contact Executive Spine Surgery for more information on degenerative disk disease, disk herniations, sciatica and endoscopic spine surgery. Good Luck!

I have a pain in my left butt that goes all the way down my leg. What could that be?

By Staff Writer Discectomy, endoscopic spine surgery, laser surgery, Pain, Relief, Sciatica, Surgery

I have a knife pain on right side of mid back that radiates around ribs but I never experience severe abdominal pain.

You may have a thoracic disk herniation with a pinched nerve. You will need an MRI scan of your thoracic spine.  Thoracic disk herniations are uncommon but they can be dangerous especially if they pinch and damage the spinal cord.  Thoracic disk herniations can cause shooting pain around your rib cage and weakness, paralysis or bowel and bladder incontinence.   They are usually treated surgically if there is neurological deficits.  In the past open traditional surgery was the only option to treat thoracic disk herniations.  This was a large operation with significant risk.  Today there are new minimally invasive spine surgery (MISS) options for thoracic disk disease including laser discectomy or endoscopic discectomy.

Endoscopic discectomy involves placement of needle into the herniated disk, followed by serial dilation of the soft tissue and placement of an endoscopic port.  The endoscope is then placed through the port to the herniated disk.  The disk is then removed with small cutting and grabbing instruments under direct visualization.  After the disk is removed and the nerve is unpinched the endoscope and tube are removed allowing the soft tissues to fall back together.  Single suture  and dressing is used to close the incision.  The patient is discharged home the same day.

Click Read More to learn about treatment options.  Good Luck!

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