Are there any age limits to a vertebroplasty and kyphoplasty procedure?

There are no specific age limits for vertebroplasty and kyphoplasty.  Many surgeons do not recommend these procedures for young people (under 40) due to the unknown risk of living with plastic in the body for decades. Most of these procedures are done on elderly people with osteoporosis.   People with significant medical diseases and the very elderly are at higher risk of complications, there has even been reports of death during or after these procedures.  The majority of people will have very good results (that is 50-90% reduction in pain).  Please click Kyphoplasty for more information on vertebral compression fractures.

What are the alternative treatments to vertebroplasty or kyphoplasty?

The alternative treatments to vertebroplasty or kyphoplasty are living with the pain, rest, wearing a back brace, physical therapy for core muscle strengthening and pain medicine.  Please click on Kyphoplasty for more information on vertebral body compression fractures.

I broke my back. Who do I see for vertebroplasty and kyphoplasty?

I would recommend seeing a spine surgeon if you are considering vertebroplasty or kyphoplasty.    You should bring your x-rays, CT and MRI to be reviewed and interpreted to determine the best treatment for you.  For more information about spinal compression fractures, vertebroplasty and kyphoplasty, please click Kyphoplasty.

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

What are the Risks of Vertebroplasty and Kyphoplasty?

Vertebroplasty and kyphoplasty are common, safe, and helpful procedures, but like any other procedure or medication, there are many risks.  Some of the risks are related to fracture, a person’s health, anesthesia, and procedure.  Fortunately, the risk of these procedures are generally low, but risks include death, stroke, heart attack, pneumonia, blood clots in lungs and legs, fat embolus, plastic spreading to the lungs, lung collapse, spinal cord or nerve injury causing pain, numbness, weakness, bowel and bladder incontinence or paralysis, infection, bleeding, but not limited to these complications. People with one fracture are at increased risk of future fractures.

For more information on vertebroplasty and kyphoplasty please click on Kyphoplasty.

What are the Results I should Expect from a Vertebroplasty or Kyphoplasty?

The results from some clinical studies have been controversial. I have found very good results with vertebroplasty and kyphoplasty if you have a recent fracture, back tenderness, and acute to subacute (recent) swelling of your fracture on MRI and do not have back nerve or spinal cord compression or instability in the spine. Most patients’ pain improves.  Even though uncommon these procedures may have risks.  Please contact Executive Spine Surgery if you have a vertebral body compression fracture.

For more information please click Kyphoplasty.

spinal arthritis

5 Signs Your Back Pain May Be Spinal Arthritis

50% of all working Americans deal with back pain symptoms every single year. This doesn’t include the number of young adults who may have scoliosis or a back-related sports injury, or retired or unemployed personnel who also struggle with back pain.

When you think of everyone around you who understands how serious back pain can be, it’s nice to know you’re not alone. But, this doesn’t make the pain go away. You still need to get treatment for the pain you’re dealing with, especially if you think you have a condition like spinal arthritis.

Spinal arthritis causes the protective cartilage of the spine to wear down. This can lead to even more pain in the spine and lack of spinal mobility.

Keep reading to see if you have any of the common signs of spinal arthritis.

1. You Back Pain Is Getting Worse and Worse

The thing about spinal arthritis is that the pain doesn’t just come and go. It’s a constant pain that lingers throughout your day, every day.

The pain may increase and decrease depending on your level of activity or lack thereof. But, it’s still there as you do everything from making breakfast to driving to work, to completing your work out.

More importantly, spinal arthritis in the back causes the pain to get worse.

You may have first experienced pain in the lower back that spread up the spine. Or, you could have noticed a bit of pain in your mid-back at first which has now spread up or down. However it began, if your back pain is spreading on the spine and/or increasing in intensity, you’re likely dealing with spinal arthritis.

2. You Have a Stiff Back

Another sign of spinal arthritis is immobility in the back. If you have trouble bending over or moving your spine side to side, you have a stiff back. This means you feel pain when performing simple tasks – like tying your shoes or lifting a load of laundry.

The stiffness stays with you throughout the day. Even if your back pain goes away when you sit, stand, or lay down for an extended period of time, you feel the stiffness when you try to move and shift positions.

This isn’t something to brush off or feel like you have to live with. It’s a spinal condition worth getting medical attention for as soon as possible.

3. Your Back Pain Causes Trouble Sleeping

Does the back pain you feel throughout the day follow you to bed at night? Is it hard for you to find a comfortable position to sleep in because your spine hurts?

This is another sign of spinal arthritis worth paying attention to. As common as back pain can be, it’s not normal for it to affect your quality of sleep.

Not to mention, a low level of sleep quality can make your back pain even worse. When you sleep poorly, you don’t have as much energy to take on your day. This can result in lower levels of activity and spending more time with your back in a fixed position. It can also lead you to hunch over at work from being groggy, which doesn’t do any good for the spine, either.

4. You Wake up with Back Pain

Maybe it’s not that you have trouble falling asleep because of your back pain but that you feel it the moment you wake up. Maybe you feel it in your sleep and the next morning, too.

Either way, you’re likely dealing with spinal arthritis. Remember, this affects the cartilage of the spine, not the bones themselves (at least, not right away). Lack of cartilage means lack of cushion for the bones.

This could result in a herniated disc or a pinch in the nerves. Cartilage is essential for healthy bone functions and placement. When it starts to degenerate, the surrounding area may inflame and cause more discomfort than the body is already experiencing.

As such, the pain you feel when waking up in the morning is a lowering of the inflammation that occurred during sleep. If the pain lasts throughout the day at a more intense level than normal, it could be that your spinal arthritis has caused a herniated disc, which should be taken care of right away.

5. Other Parts of Your Body Also Hurt

As if all the pain and discomfort caused by spinal arthritis isn’t enough, keep in mind this condition can spread. Pain in the spine may lead to discomfort in the neck or a tingling in the legs.

This tingling can reach as far as your toes if you’re not careful and you go too long without treatment. The tingling may end up as more of a numb sensation throughout your whole leg or it can concentrate in a certain area such as the knee.

Still, there’s no sense in putting yourself through this when help is available.

Get the Help Your Spinal Arthritis Needs

It’s one thing to recognize the symptoms of spinal arthritis and understand you have it, and another to actually get the treatment your spine needs.

Don’t go another day without taking care of your back. Make an appointment with an experienced spinal professional right now to get the treatment you deserve.

Before you know it, your back will feel as good as new and your pain will feel practically nonexistent! Click here to discover more about spinal arthritis and what Dr. Carl Spivak, MD, and his team can do for you.

bulging disc treatment

The Best Bulging Disc Treatment for Pain Relief

Lower back pain is one of the most common health complaints worldwide. Approximately 31 million Americans are struggling with this issue at any given time. In some cases, the pain can worsen and become chronic.

This condition can have a variety of cases, from poor posture to arthritis and injuries. Sometimes, it results from a bulging disc.

Also known as a disc protrusion, bulging discs typically occur in the lower back between vertebrae L5 and S1 or L4 and L5. Their symptoms vary from one individual to another.

Some people may experience no symptoms at all, while others report excruciating pain.

Bulging disc treatment involves medications, physiotherapy, massage, or spinal manipulation. In severe cases, surgery is the only option.

Before discussing these options, let’s see what a bulging disc is in the first place.

What Is a Bulging Disc?

Spinal discs are cartilaginous joints that hold the vertebrae of your spine together. Their role is to absorb shock and allow movement at each spinal level. The spine has a total of 23 discs.

These anatomical structures are subject to wear and tear. At birth, about 80 percent of their content is water. As we age, our discs dehydrate and their cartilage becomes stiff, which may cause them to bulge out.

While aging is the most common cause of bulging discs, there are other factors that may contribute to this condition. These include:

  • A family history of spinal problems
  • Direct trauma
  • Sports injuries
  • Poor lifting technique
  • Muscle and posture imbalances
  • Cigarette smoking
  • Obesity
  • Lack of exercise
  • Slips and falls

Sometimes, it takes just one wrong move to develop a bulging disc. That’s why people who participate in contact sports, as well as those whose jobs involve prolonged standing, driving, and repetitive lifting, are at higher risk.

Common mistakes, such as slouching in your chair and sitting with poor posture, can affect your discs too.

This problem is more common in middle-aged individuals. However, anyone can develop a bulging disc. Cigarette smoking, weight gain, and too much sitting can all increase your risk.

Bulging Disc Treatment Options

Unless your condition is severe, you may able to treat a bulging disc with rest and physiotherapy. Pain relievers and anti-inflammatory drugs can help.

Bulging disc treatment options depend largely on your symptoms. Doctors often recommend acupuncture, electrotherapy, ice packs, or soft tissue massage for minor and moderately bulging disc injuries. You might also want to consider chiropractic treatment.

Another option is stem cell disc regeneration. This procedure stimulates the formation of new disc cells, which helps restore and rebuild damaged discs. Patients experience a reduction in pain and discomfort – and improved quality of life.

Surgery is only recommended in severe cases. If your back pain doesn’t settle with a conservative approach, this may your only option.

Let’s take a look at the best ways to treat a bulging disc and what to expect.


A bulging disc can place extra pressure on the muscles and nerves around it, causing pain. Medications only provide temporary relief. Plus, they fail to address the root cause of your problem.

Physiotherapy has emerged as a safe, effective way to treat bulging discs. Certain techniques, such as electrical stimulation, ultrasound therapy, traction, joint mobilization, and soft tissue massage, can relieve pain and improve your range of motion.

Electrical stimulation, for instance, helps reduce muscle spasms. Joint mobilization can increase your flexibility and normalize joint function.

Your physiotherapist may also recommend stretching and strengthening exercises that reduce back pain and improve your posture. He will create a workout plan that can be safely done at home with little or no equipment. The end goal is to improve your body mechanics and restore your mobility.

Furthermore, a physical therapist can show you how to exercise safely and what movements to avoid. The wrong kind of exercises can worsen your symptoms. Leg lifts, sit-ups, overhead weightlifting, and running are just a few to mention.

In general, it’s recommended to avoid high-impact workouts, heavy lifting, and contact sports.

Steer clear of any movements that involve repetitive forward-bending at the waist. Instead, opt for low-impact aerobic activities and stretching.

Ice and Heat Therapy

Unless you have excruciating pain, ice and heat therapy can help.

Ice packs reduce inflammation and swelling around the compressed spinal nerve. All you need to do is to apply ice on the affected areas for about 10 minutes; repeat several times a day.

Heat therapy may relieve muscle spasms and ease your pain. It also helps increase oxygen and blood flow to your tissues, leading to faster healing.

Depending on your symptoms, you may alternate ice and heat. However, be aware that heat isn’t effective against inflammation; in this case, it’s better to use ice.

Stem Cell Disc Regeneration

This quick, minimally invasive procedure may offer complete relief from back pain and other symptoms associated with bulging discs. In clinical trials, it has been shown to slow or stop the degenerative process and increase disc hydration.

As its name suggests, stem cell disc regeneration aims to restore damaged discs to their normal, healthy state. It has been proven effective in the treatment of bulging discs, herniated discs, degenerative disc disease, and other similar conditions.

Since this procedure uses your body’s own stem cells, it’s well tolerated and unlikely to cause adverse reactions. After you receive the treatment, you’re free to go home and resume you

Don’t Let Pain Take Over Your Life

As you see, there are various options for bulging disc treatment. Choosing one over another depends on your symptoms and the severity of your condition.

The sooner you receive treatment, the better. Early intervention can lower your risk of developing complications.

You deserve a pain-free life. Don’t wait until it’s too late. Book an appointment and find out how we can help!

Sacroiliac Joint Fusion with The iFuse Implant


The Sacroiliac (SI) joint may be a pain generator in 15-30% of patients with chronic lower back pain and even higher (up to 43%) for patients with continued or new onset low back pain after a previous lumbar fusion.* Learn about SI joint dysfunction and treatment options from Dr. Carl Spivak, MD, a Neurosurgeon at Executive Spine Surgery.
*Rashbaum – Clin Spine Surg 2016
This event is co-sponsored by SI-BONE, Inc.
Important Safety Information:

stem cells

Can Stem Cells Fix a Discogenic Back Pain?

Discogenic low back pain is a disabling condition. It is the third largest healthcare expense in the U.S. It is also second only to the common cold as a cause of missed work.

Many people who live with discogenic back pain have limited treatment options. Non-surgical treatments, such as physical therapy and opioid pain medication, aren’t always effective.

The injection of stem cells into the disc is being pursued as an alternative to both non-surgical and surgical treatments.

Read further to learn more about this exciting, new technique that offers long-term pain relief.

Discogenic Back Pain

Discogenic pain begins from one or more damaged spinal discs. It is usually due to degenerative disc disease and happens naturally with age. Sometimes, a ruptured or herniated disc is the cause of pain. It is rarely seen after 60 years of age.

Symptoms of this disorder include:

  • Increased pain when sitting, coughing and sneezing, and leaning forward
  • Leg pain, called radiculopathy, when sitting, standing, and walking
  • Usually chronic in nature

Discogenic pain is most often diagnosed by MRI. When standard treatments fail, the physician orders a discography (or discogram). This is a special x-ray where the radiologist injects dye into the discs and takes x-rays. It helps determine if the patient has more than one disc causing the pain.

The most common treatment for this disorder is surgery, which has many risks. Other treatments include physical therapy, medications, and spinal injections. Alternative therapies such as acupuncture and yoga may also be helpful.

Doctors are now turning to stem cell therapy to treat patients with uncontrolled back pain.

Stem Cells and Pain Management

Stem cells are cells that have not transformed into their specific function in the body. They include bone marrow, skin cells, and embryonic cells. Their main function is to replace damaged cells and promote tissue regeneration.

The doctor aspirates bone marrow from the hip bone of the patient. The bone marrow has many different types of cells including stem cells. Then, the lab spins the aspirated sample in a centrifuge to separate the different types of cells.

Stem cell disc regeneration is the process where the physician injects the cells into a patient’s spine. He/she uses x-ray imaging as guidance to locate the correct location. With time, the cells begin to differentiate with the growth of new disc tissue. Complete disc regeneration occurs from a couple months to a year. Many patients experience total relief of their pain within a few months.

Researchers reviewed many studies using different types of stem cells. They found improvement in discogenic pain in all but one study.

Researchers think stem cells work to decrease the pain and inflammation in the spine. They also function to repair the damaged tissue. These studies show that stem cells can increase the new growth of the disc tissue.

The exact mechanisms of this novel treatment are still unknown. Yet, it creates a less invasive choice for people suffering from back pain.

Patient Criteria

Because this is such a new therapy, there are no official guidelines in place. Some physicians recommend it for younger patients with mild disc damage. Others make the decision on a case-by-case basis. The patient also needs to know that health insurance doesn’t cover it. Most facilities require cash payments.

Risks and Benefits

Stem cell therapy is so new that the long-term risks and benefits are still unknown.

Benefits include:

  • Reduction of pain
  • Decreased inflammation
  • Replace bone, cartilage, and disc cells
  • Less invasive and shorter recovery time than surgery
  • Minimal pain with the procedure
  • Little to no adverse effects

Risks involved include:

  • The best stem cell type and the best way to administer it is unknown
  • The potential for infection at aspiration and injection sites
  • Pain and swelling
  • Rash and redness at the site

There are no serious adverse effects reported to date. But, there are also no long-term studies to compare results. Doctors suggest weighing the pros and cons to determine if this is a good fit for each patient.

Questions for Your Doctor

Write down your questions before coming to the appointment. You won’t forget to ask about important concerns. You will leave informed and confident about your decision.

  1. How do you calculate the number of cells needed per injection?
  2. Is there a difference between stem cell therapy for disc regeneration and cancer therapy?
  3. What is the risk of contamination?
  4. Do other conditions like diabetes or smoking affect the regeneration?
  5. What is your success/fail rate?
  6. Have you seen any adverse side effects from this treatment?

Future Implications

There are still unknown aspects of stem cell therapy. Future research should include long-term studies to rule out complications not already known.

In the future, the use of stem cells can decrease or end the pain. It can help avoid thousands of unnecessary surgeries. The disc causes unbearable back pain when they deteriorate. There is no cushion from the discs creating unrelenting pain.

Researchers expect to slow down the breakdown of aging discs. Initial data from current research shows this is a promising therapy for discogenic back pain.

How We Can Help

Stem cell therapy often gives welcomed relief from this painful condition. It also creates the regeneration of tissue to heal the damaged discs. Patients who have exhausted all available treatments now have an alternative to surgery.

There are no guarantees with any medical procedure. Alternatives for these patients include surgery and narcotic pain medications.

Understanding the use of stem cell therapies is crucial for patients to weigh all their options. Sometimes this is the only treatment option left. It provides a better solution while decreasing the time for recovery and the costs seen with surgery.

Disk regeneration helps patients suffering from long-term, disabling pain. It allows them to return to a life without pain. They can begin to take part in activities that their pain prevented them from doing.

If you’re dealing with disabling back pain, contact us to find out if stem cell therapy is for you. We will direct you to the next steps to take to find out if you are a good candidate for the procedure.

spinal injections

Are You a Candidate for Spinal Injections?

Every time you move, you wonder if more pain will follow. That’s what life looks like when you’re suffering from chronic pain such as back or neck pain. Fortunately, spinal injections may give you the relief you desperately need from this type of pain.

Getting spinal injections involves having anti-inflammatory steroidal compounds — for example, cortisone — injected into your body so that you can experience temporary relief from your chronic pain.

These injections decrease swelling around your nerve, thus easing the irritation there.

Steroid injections may provide more relief than over-the-counter medications. Here’s a rundown of what makes you a candidate for these injections.

Let’s get started!

Candidates for Spinal Injections

You are a candidate for steroid injections if you are struggling with an irritated or compressed nerve.

You may also be eligible for injections if you have a spinal joint that is degenerating, leading to localized pain, tingling, muscle weakness, radiating pain or numbness.

The following conditions can produce such symptoms.


With osteoarthritis, or degenerative joint disease, the cartilage that provides cushion at the top of your bones wears down, thus causing pain and swelling. This condition might also cause bone spurs to develop.


Spondylolisthesis refers to the condition where a vertebra — a bone in your spine — slips, usually at your spine’s base.

Vertebrae can easily slip over a bone, backward or forward as a result of spondylolysis, a fracture or defect of part of a vertebra.


Sciatica is typically characterized by several symptoms, including chronic pain in one leg or buttock, pain that worsens when you’re sitting, or a searing, burning or tingling sensation in your leg.

Other signs you have sciatica include trouble moving your toes, leg, and foot, or even radiating pain that impacts your leg and even your toes and foot.

Herniated Disc

If you have a herniated disc problem, this means one of your discs, or rubbery cushions, between your vertebrae has a problem.

Specifically, the softer part inside the disc pushes out via a tear present in the disc’s tougher exterior.

Herniated discs can easily irritate the surrounding nerves, thus leading to weakness, pain, and numbness.

Failed Back Surgery Syndrome

Also known as FBSS, this condition generally refers to the condition you face if you’ve undergone an unsuccessful spine surgery or back surgery.

Unfortunately, this is not an uncommon issue, as even with the best surgeon, having a 100% successful result is not always guaranteed.

Spinal Stenosis

This condition refers to the narrowing of your spine’s spaces, which can place pressure on your spine’s nerves. Stenosis usually occurs in the neck and lower back areas.

Although some spinal stenosis sufferers might not have symptoms, others experience muscle weakness, tingling, pain and numbness. And these symptoms could become worse over time.

Before You Get Injections

Before you can receive spinal injections, you typically have to try more conservative, less invasive treatment options first. These include chiropractic manipulation, hot/cold therapy, exercise, and stretching.

Of course, every individual responds to these treatments differently. If they prove not to be effective for you, then you may be eligible to receive injections to manage your back or neck pain.

The injections work by decreasing the inflammation causing you discomfort around the spinal nerve that has become irritated.

Injection Treatment

Steroid injections can be given in multiple areas of the body. One of these areas is your epidural space — the area of the spinal canal that the nerve roots and spinal cord pass through.

Yet another area subjected to these injections is your facet joints — the bones responsible for connecting your vertebrae and allowing them to move.

Finally, the sacroiliac joints — the areas where the pelvis and sacrum meet — also receive injections.

However, getting these injections too often may disrupt your body’s natural hormone balance. That’s because the effects of steroids mirror those of certain hormones that the body produces.

Note that the effects of cortisone do wear off after a while. For this reason, if your doctor determines that you need more than one shot, you’ll likely be limited to three injections over the course of a year.

Also, if you decide to go with injections, it’s recommended that you get them about a month and a half apart.

If a shot is successful, you should be able to tell this within a couple days to five days.

Of course, any relief you experience will be temporary — in other words, the positive effects will last maybe several weeks to a year. But at least you’ll be able to function more normally during this time.

While you’re feeling better, you may want to take part in physical therapy, as this may help you in resolving the underlying problem.

What Happens When Injections Don’t Work?

Unfortunately, sometimes spinal injections aren’t quite enough to manage your debilitating back or neck pain. But don’t worry — there is hope.

In this situation, you may quickly become a candidate for spine surgery that is minimally invasive.

For instance, you may be directed to undergo decompression surgery. This is perfect for anyone with a compressed nerve along his or her spinal cord, which leads to both radiating and local pain.

Another surgery option is stabilization surgery. This procedure is more precise and less invasive than conventional open back fusion surgery.

This procedure involves making a tiny incision in your side or back. Through the incision, your surgeon can remove a diseased vertebra or disc. Then, he or she will insert bone and an implant to give your body immediate pain relief and stability.

Your medical history and MRI results will help your doctor to determine if you’re a candidate for these types of surgeries.

How We Can Help

We offer high-quality spine surgery for patients dealing with severe chronic pain.

We can typically perform surgical procedures in an outpatient setting, so you don’t have to worry about an overnight stay.

In addition, most of our patients are able to go back to work or resume their daily activities in three months.

If spinal injections just aren’t working for you, contact us to find out more about how spine surgery may help you to get your quality of life back.