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Category: laser surgery

Carl Spivak, MD - Executive Spine SurgeryNewslaser surgery
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!

By Staff Writer endoscopic spine surgery, laser surgery, Pain, Spinal Stenosis, Surgery

I’m 63 and now when I walk for a short distance the back of my right leg starts burning to the point I can hardly walk. What is this?

Leg pain from walking is called claudication.  Neurogenic claudication is leg pain from nerve compression in the spine.  This is called stenosis and results from thickened ligaments, bone spurs and disk herniations.  Some people are at increased risk of spinal stenosis because they were born with a smaller spinal canal then normal.   This is called congenital spinal stenosis.  Spinal stenosis and neurogenic claudication presents with back pain and diffuse leg pain and numbness from walking which is relieved by using a shopping cart or sitting down.  Some people describe it “like walking on a cloud”.  Vascular claudication is leg pain from narrowed arteries in your legs.  It is brought on by walking and is relieved by sitting or standing still.  People usually have absent pulses, skin and hair changes in there feet.

You probably have spinal stenosis compressing your spinal nerves and decreasing blood supply to the nerves.  If the nerves can not get enough blood and oxygen they “suffocate” developing pain and numbness in the legs.  Stopping and sitting down or bending forwards decreases pressure on the nerve, improving blood supply and decreasing pain.

Many people benefit from rest, physical therapy, anti-inflammatories, nerve medicine (such as neurontin), steroid injections and surgery.  Please click on Sciatica for more information on lumbar spinal stenosis.  Please contact Executive Spine Surgery for a consultation on spinal stenosis.   Good Luck!

By Staff Writer endoscopic spine surgery, laser surgery, Pain, Relief, Sciatica, Spinal Stenosis, Spondylosis, Treatment Options for Back Pain

What can be done? Can it be fixed easily? What are Schmorls nodes? What is an annular bulge?

These are 3 separate problems:

1. Schmorl’s nodes – Schmorl’s nodes are disk herniations into the vertebral body.  The disk squeezes out of the disk space into the bone.  This is usually not usually painful or treated.

2. L5-S1 degenerated, bulging and protruded disk – Over time disks wear out from injury, aging, wear and tear, genetics, work and sports.  Your L5-S1 disk is degenerating, wearing out and likely collapsing and bulging into the spinal canal pinching the L5 and S1 nerve root.  A protruded disk is larger then bulging disk.  This may be the source of the pain and is often fixed with discectomy or spinal fusion.  Click link to read more on sciatica and disk herniations I have a pain in my left butt that goes all the way down my leg. What could that be?

3. Spinal stenosis – is narrowing of the spinal canal.  The measurement varies but is in the range of 11 mm.  More important than the measured size of the canal is the appearance and the amount of nerve compression seen on MRI.  Spinal stenosis may be treated with pain injections or surgery.  Minimally invasive treatment options include MILD procedure and METRx tubular laminectomy.  JOIMAX is currently working on new endoscopic treatment for spinal stenosis.

I would recommend seeing a spine surgeon to determine the best treatment for your back.   Good Luck!

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

Does a pinched nerve (sciatica) always stay pinched unless surgery is given? Will it always show up on an MRI if surgery is given?

Disk herniations cause leg pain (sciatica) by pinching the sciatic nerve in the back.   Disk herniations may resolve on their own over a year or so, but they usually just get a little smaller as seen on multiple MRI .  Surgery is the best treatment to physically remove the disk.  Today this can be done endoscopically (endoscopic discectomy) though a very small incision the size of your finger nail. The endoscopic port is placed right onto the herniated disk and the disk is removed with tiny instruments.  This is a new minimally invasive treatment for back and leg pain.

Disk herniations may show up after surgery on MRI scan, but it usually is smaller.   Postoperatively the the disk that is seen is a combination of disk, bulging ligaments and scar tissue.

For more information on sciatica please contact Executive Spine Surgery. Good Luck!

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

L5S1 Hernation, S1 nerve compression.

You have a herniated disk in your spine pinching your left S1 leg nerve causing sciatica.  For more information please see my blog posting on sciatica.  Most of these disks can be removed by an extremely minimally invasive surgery called endoscopic spine surgery.  This surgery can be done awake through a small incision the size of your finger nail.  Pain relief is often immediate and you are usually discharged home 1 hour after surgery.  To schedule an appointment contact Executive Spine Surgery.  Good Luck!

 

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