Relief Archives - Page 3 of 4 - Carl Spivak, MD

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, 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 Lower back pain, Neck pain, Pain, Relief, Spondylosis, Treatment Options for Back Pain

How can I ease upper back pain?

There are many causes of upper back pain. The pain may originate from your bones, disks, muscles, joints, nerves and spinal cord, neck, shoulders, lungs and heart. Most causes of upper back pain I see is from spine fractures, pulled muscles or arthritis. Initially you may be treated with rest, anti-inflammatory medicine, muscle relaxant and sometimes pain medicine. If the pain is severe your doctor may take you out of work. If the pain does not improve or you have neurological problems (weakness, numbness, etc) then you would need a full workup which may include X-rays, MRI and sometimes blood tests. Further treatment would depends on what is found.

Click Read More for information on treatment options. Please contact Executive Spine Surgery for more information. 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 Lower back pain, Relief, Surgery, Treatment Options for Back Pain

What is the difference between vertebroplasty and kyphoplasty?

Vertebroplasty and Kyphoplasty are very similar procedures. Kyphoplasty is a slight variation of vertebroplasty.

In both vertebroplasty and Kyphoplasty a large needle is placed into the broken vertebrae under x-ray guidance. Next plastic is injected into the fractured vertebrae in vertebroplasty, but in Kyphoplasty a ballon is blown up. The balloon may push the bone back into its original position (that is reduce the fracture). The balloon is then removed and plastic is injected into the cavity. Overall they are very similar procedures and have similar outcomes. Please click on Kyphoplasty for more information. Good Luck!

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 Relief

I started yoga again after a long break. What stretch is safe for my body?

Great! Yoga is good for improving flexibility and core strength. Unfortunately I am not an expert at yoga. I recommend discussing your workout routine with your yoga instructor. As in with any exercise it is safest to start slow and slowly increase over time. You should try to increase your stretch over many days or weeks as you recondition your body. You want to avoid very painful stretches to decrease the chance of tearing soft tissues and injuring yourself. Good luck!

By Staff Writer Relief, Treatment Options for Back Pain

Is it better to go to a pain clinic or spine surgeon?

I would recommend seeing a doctor who specializes in interventional pain management and spine surgery to best determine what treatment will benefit you. I usually recommend spinal injections first and surgery to people who have failed injections. Unfortunately few doctors do shots and surgery and you will need to see 2 doctors. Click to read more about Treatment Options. 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, Pain, Relief, Sciatica, Surgery, Treatment Options for Back Pain

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

Sciatica is characterized by pain starting in the back and radiating down the back of the leg to the foot. It is associated with numbness in the little toes of the foot and plantar flexion weakness (that is weakness when standing and walking on your tip toes). The sciatic nerve is made up of spinal nerves exiting the lower spine. After exiting the spine it travels though the pelvis and down the leg. Sciatica is commonly caused by a slipped herniated disk in the back between the L5 and S1 vertebrae. Other causes of sciatica include stenosis, bone spurs, slippage of the spine (called spondylolithesis), fracture, tumor and infection.

Sciatica is initially treated conservatively without surgery. Common treatments includes rest, anti-inflmmatory medicine, steroid medicine, pain medicine, physical therapy, steroid injections and spine surgery. Traditional surgery involved a large incision, significant muscle dissection, retraction and injury and removal of a lot of bone called a laminotomy. All these destructive changes may lead to scar tissue, spinal weakness (called instability) and chronic pain. Today lumbar disk herniations may be removed minimally invasively with the spinal endoscope. The spinal endoscope is a very small tube (7 mm) with a camera at the end of it. Using x-ray guidance it can be placed directly to the herniated disk in the spine. The disk can then be removed with tiny instruments under direct visualization.

The procedure takes 1 hour and patient is discharged home after 1 to 2 hours. There is less blood loss, tissue damage and pain compared to traditional open surgery. Most patients have a quicker recovery and return to work. For more information please contact Executive Spine Surgery at 908-452-5612.

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Category: Relief