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Category: Surgery

Carl Spivak, MD - Executive Spine SurgeryNewsSurgery
By Staff Writer Discectomy, Relief, Sciatica, Surgery, Treatment Options for Back Pain

How successful is a discectomy at relieving back pain?

Discectomy best relieves sciatica leg pain.  Back pain may be relieved after discectomy but it is not as consistent as leg pain. Patients with degenerate disk disease and primarily back pain may undergo a discogram (pain mapping of the disks) to confirm the symptomatic disk.   Discogram helps determine if surgery will work.

Discogram is an injection into disks.  If the injection produces your typical back pain (concordant pain) then this disk is most likely culprit of the back pain.  In addition to pain the discogram often shows leakage of dye out of the disk through a rip called an annular tear.  If the injection only causes mild pain or not typical pain then that disk is not causing the pain.   In this circumstance the patient would require additional pain mapping to identify the pain source.

The treatment options to fix painful disk include endoscopic discectomy and annuloplasty (the annular tear is isolated and burned with radiofrequency coagulation) or endoscopic fusion surgery (ELIF).  Often endoscopic discectomy is considered first to try to avoid fusion surgery.  Unfortunately surgery does not always relieve back pain from degenerated herniated disks.  Surgery should be considered the last option or not an option is some cases.  Please call and set up an appointment with Dr. Carl Spivak to discuss your back. Good Luck!

By Staff Writer Discectomy, Neck pain, Pain, Surgery

Does the donor bone graft in bone transplants come from living donors?

There are two types of bone graft commonly used autograft and allograft.  Autograft is taken from the patient during surgery, this is usually from iliac crest or bone that is removed the spine.  This is the best graft material but unfortunately can lead to new pain, deformity or complications.  Allograft is bone taken from bone bank from deceased donor.   This is almost as good as your own bone and saves you second surgical site. Recently bone substitutes made up of calcium have become available and may replace bone in the future.  For more information please contact Executive Spine Surgery today.  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!

 

By Staff Writer Pain, Surgery, Treatment problems

Is it common for the rod in a spinal fusion to break after 3 months?

It is not common for a rod to break at all, especially 3 months after surgery.  The rod is just a solid metal rod.  It is unlikely for the rod to be defective.  Factors that may lead to breakage of the rod include multi-level fusion (greater stress on the rod), very weak spine (often broken back places large forces across the rod), deformed spine requiring surgical correction (again places large forces across the rod), bent rod (may weaken the rod but is usually necessary to align the spine), smaller diameter rod (less strong but necessary at certain areas of the spine), large patient, too active patient or someone who falls or involved in an accident (increased forces across the rod).  Good Luck!

By Staff Writer Pain, Scoliosis, Surgery, Treatment Options for Back Pain

Does scoliosis cause other health problems?

If scoliosis is severe it can affect your heart, lungs, gut, spinal cord and nerves producing a large range of problems from difficulty breathing to difficulty walking.  Fortunately this is not common.  Many cases of scoliosis respond to conservative treatment (such as bracing) and do not require surgery.  Please see my blog posting Does scoliosis cause pain? For more information please contact Dr. Carl Spivak at Executive Spine Surgery.  Good Luck!

By Staff Writer Pain, Relief, Sciatica, Surgery, Treatment Options for Back Pain

Sciatica – see a General Practitioner (GP) or a Chiropractor?

I would recommend seeing your primary care doctor to orchestrate the workup and treatment of your pain.  You may require anti-inflammatory medicine, physical therapy, chiropractic manipulation and MRI scan of the spine .  Depending on the results of these tests and treatment you may need to see an interventional pain doctor or spine surgeon to determine the benefit of steroid injections or spine surgery.  Today many spine surgeries can be done minimally invasively through a spinal endoscope decreasing tissue damage, pain and recovery time from surgery.  Please contact us for more information.  Good Luck!

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