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Category: Treatment problems

Carl Spivak, MD - Executive Spine SurgeryNewsTreatment problems
By Staff Writer Treatment problems

Degenerative Cervical Spine Disorders: Causes and Best Treatments

Degenerative Disk Disease SurgeryDegenerative Cervical Spine Disorders will affect up to two-thirds of the population in their lifetime.

If this term has come up in conversations with your doctor, you aren’t alone. That doesn’t make it any less serious.

If you have been diagnosed with Degenerative Cervical Spine Disorder, or consider yourself at risk for it, then you’re in the right place. In this article, we’ll be covering the causes and treatments for it.

Let’s get into it!

What is a Degenerative Cervical Spine Disorder?

Most people will experience some form of neck pain in their lives. For some people, this pain is an isolated incident or directly related to a neck injury sustained.

However, in the case of individuals with Degenerative Cervical Spine Disorder, their neck pain is ongoing and caused by a disorder of the spine. The difference lies in the frequency and intensity of the pain the person feels.

Additionally, the neck pain associated with this disorder is felt mostly when the patient is upright, or attempting to move their head. Other symptoms associated with Degenerative Cervical Spine Disorder are numbness, tingling, and other strange sensations in the neck area. Headaches can also be a symptom.

Complications of Degenerative Cervical Spine Disorder include bone spurs. These can occur when the discs in your cervical spine have begun to deteriorate, and a growth on your spine occurs to relieve the stress on your spine.

Degenerative Cervical Spine Disorder is a complex issue. Now that we’ve considered what this disorder is, let’s take a look at its causes.

What Causes a Degenerative Cervical Spine Disorder?

As the term degenerative suggests, a Degenerative Cervical Spine Disorder is caused by the breakdown of one or multiple cushioning discs in the cervical spine. This breakdown is often attributed to the “wear and tear” associated with aging.

Degenerative Cervical Spine Disorder has been known to affect people as they age. Studies done by the US National Library of Medicine on degenerative spinal discs show the average age of participants to be 53.7. It’s true that people diagnosed with this disorder are often over the age of 40.

However, that doesn’t mean young people aren’t susceptible – individuals as young as 18 have been diagnosed with this disorder, too. In reality, there are a few key causes of Degenerative Cervical Spine Disorder, some of which aren’t age-specific:

  • • Genetics – some individuals’ genes cause the discs in their cervical spine to degenerate faster than normal, causing this disorder.
  • • Age – the older you get, the more wear and tear your cervical spine discs have to endure. Additionally, as you age, your spinal discs dry out. This means that there is less fluid present to absorb the shock of movement, so it becomes painful.
  • • Sports – rigorous sports and other strenuous activity can cause the outer core of the disc to deteriorate, causing degenerative cervical spine disorder as well.

One of the main reasons why Degenerative Cervical Spine Disorder is such a debilitating condition is because of how permanent it is. Unlike other parts of the body, there is very little blood flow to the discs; therefore, discs can do very little to fix or regenerate themselves.

Even though this is true, rest assured that they are ways to treat this condition. Here are a few ways to do so.

How can Degenerative Cervical Spine Disorder be treated?

There is no “one size fits all” solution to Degenerative Cervical Spine Disorder. But, there are a few things you can do at the advice of your doctor that can alleviate the symptoms.

One way that this can be done is by doing exercises to strengthen the muscles in the affected area, which will help to lower the pain you’ll feel when doing daily physical activities. Also, improving your diet and eating more healthy and nutritious food can help to alleviate the effects of this musculoskeletal disorder.

Additionally, once you consult with your doctor, there are a few things that he or she may prescribe based on how far along your Degenerative Cervical Spine Disorder is.

These include:

  • • Physical therapy – at times, physical therapy under the guidance of a trained specialist may be enough to improve the symptoms associated with this disorder.
  • • Hot and cold therapy – depending on the situation, your doctor may also prescribe therapy involving the use of alternating hot and cold compresses to improve discomfort.
  • • Medication – if the pain is the biggest problem in your situation, your doctor may prescribe different medications to help alleviate pain and/or swelling. These medications range from acetaminophen for pain relief to ibuprofen for swelling of the area.
  • • Surgery – surgery is also a viable option in some cases. The two kinds of surgery that can be done to treat Degenerative Cervical Spine Disorder are spinal fusion and an artificial disk replacement.

There are a variety of other ways that Degenerative Cervical Spine Disorder can be treated, such as wearing a neck brace. A brace will prevent your neck from assuming painful positions.

Additionally, most doctors agree that strengthening the muscles around the affected area can do a world of good in combating this painful musculoskeletal disorder.

I think I have Degenerative Cervical Spine Disorder

Do you think you are currently suffering from Degenerative Cervical Spine Disorder? If so, a visit to a doctor is in order. You’ll be able to identify if you indeed have this condition, and the steps that you can take to start alleviating the discomfort associated with it.

If surgery is the route prescribed by your doctor and you’re in the Whiting, Cedar Knolls or Hackettstown, New Jersey area, then Executive Spine Surgery run by Dr. Carl Spivak might be the solution you need. We even offer free MRI reviews and Benefits screening upon request!

Visit our Contact Us page for more information, including our locations and telephone numbers.

Degenerative Cervical Spine Disorder is a condition that doesn’t get better without treatment, so the longer you wait, the more detrimental it could be to your chances of recovery. Get in contact with us today. We’re here for you.

By Staff Writer Treatment problems

Transforaminal Lumbar Interbody Fusion: Are You a Good Candidate?

Lower back pain – the kind that you might get from lifting something wrong or sleeping in a weird position – is all too familiar.

Sometimes it shows up as just a lingering dull ache. Other times, it’s a sharp stabbing sensation that shows up only when you bend or twist a certain way.

If you’re lucky, it’s only temporary. If you’re like almost 80% of Americans, it can turn into a chronic condition.

Chronic lower back pain has more than doubled in the U.S. since 1992, regardless of gender or ethnicity.

There are the usual culprits of lower back pain – an old mattress, sitting in a chair all day long, doing heavy lifting or strenuous physical labor – but there are a few things you might not realize are causing your lower back pain.

Your genetics can influence how much pain you feel. They play a part in determining how fast your bones deteriorate over time or if you have more nerves than average.

Whatever the case may be, you’re not alone in experiencing this all-too-common condition. But there is a solution – Transforaminal Lumbar Interbody Fusion.

What’s Going On With Lower Back Pain?

Transforaminal Lumbar Interbody Fusion is a mouthful for sure, but it’s an effective way to end your lower back pain for good.

Let’s talk about the spine itself for a moment before we get into what TLIF can do for you.

The spine is made out of individual bones called vertebrae. They form a canal through the center that allows your spinal column to travel from your brain to the base of your spine, completely protected by the hard bones.

The spinal column supplies nerves to your entire body. Two nerves branch off from the main bundle at each vertebrae and go where they’re needed. The holes where they exit are called the foramen.

Between each of the vertebrae is a disc – a jelly-like shock absorber for the body bones.

This interbody space can be damaged, causing bones to grind against each other, nerves to pull, or discs to slip out of alignment. As you can imagine, that really hurts!

Here’s where TLIF comes in. By fusing the vertebrae of the lumbar area, it reduces pain by stabilizing the spine and aiding the shock-absorbing discs.

The main goals of this minimally invasive surgery are to improve spinal stability, correct any kind of spinal deformities, and, ultimately, reduce pain.

No doubt you’re wondering if it’s painful or if there’s a long recovery process. Keep reading to find out what exactly is involved with this procedure.

How Does TLIF Work?

Spinal surgery can be scary. The good news is that TLIF is minimally invasive and you’ll even be up and walking the day after surgery.

So what happens during this procedure?

You’ll be under general anesthesia which means you’ll be asleep during the entire process.

The surgeon will first make a small incision above the vertebrae to be fused.

The surgeon then moves the muscles and skin apart from the operation site and removes the damaged disc.

The surgeon clears out most of the disc from between the vertebrae and prepares to insert the object the bone will graft to in order to stabilize the bones. This object can be a bio-compatible polymer implant or even a piece of the patient’s pelvic bone.

Once fused, the nerves are no longer impeded as they exit through the foramen, greatly reducing chronic back pain.

The procedure is fairly simple, but who qualifies to receive it? Are you a good candidate for TLIF?

Who Is A Candidate For This Procedure?

Of course, those who have back pain from just sleeping in a weird position or from a long day of moving house aren’t going to qualify. There are certain chronic indicators and diseases that a TLIF patient has.

Beyond back pain, there’s weakness or pain in the legs, meaning the nerves in the lumbar region are being affected.

Those who haven’t responded well to therapy or medicine also qualify.

There are also many degenerative spinal diseases that can be alleviated by having a Transforaminal Lumbar Interbody Fusion procedure.

One of the most common ones is Degenerative Disc Disease, where the vertebral disc is damaged and wears away.

A disc that wears down can bulge against the nerves exiting the foramen, pressing them against the hard bone and causing pain.

Sometimes, arthritic overgrowth takes over the bone. The extra bone pinches the nerve, resulting in a condition called Lateral Stenosis.

Your back pain could be a result of a condition called Spondylolisthesis, where the disc is weak and allows the vertebral bones to shift and slide out of alignment.

If your back pain stems from these or any other serious condition, TLIF is an option you should consider. But is it a long-term and successful solution?

Why Transforaminal Lumbar Interbody Fusion Works

Not only is TLIF a convenient surgery, it’s one with an extremely high success rate, too.

The surgery itself has been perfected to cause minimal issues for both patients and the surgeon performing it.

Although it’s a relatively small incision, there’s a larger surface area available to facilitate fusion. Fusion can be achieved in both the front and the back with one simple surgery.

By working with the foramen, pain, injury, and scarring to the nerve roots are reduced because the surgeon doesn’t have to forcefully retract them.

Once the procedure is complete, patients will be expected to stay in the hospital for up to five days and will be given narcotics to deal with the pain, but a walking program is started the very next day.

The success rate is incredible! Patients report a 60-70% reduction in pain after the surgery and about 80% of them are satisfied with the results post-op.

They quickly return to work and get back to enjoying their now-pain-free lives.

If you’re ready to work, move, and live without pain, contact Dr. Spivak and have a discussion about whether TLIF is your best option.

By Staff Writer Discectomy, endoscopic spine surgery, laser surgery, Lower back pain, Nerve damage, Pain, Sciatica, Surgery, Treatment Options for Back Pain, Treatment problems

Can spinal epidural steroid injection hurt my brain?

Spinal epidural injections are very common treatments for back pain and sciatica.  Sciatica is leg pain running down the back of your leg caused by a slipped disk pinching a nerve.  Imagine the disk is a marshmallow (even though it really isn’t).  The disk like a marshmallow may expand out if you squeeze it.

HOMEWORK:

You can try this at home – take a marshmallow and squeeze it from the top and bottom.  See how the marshmallow expands out as you flatten it.  This is similar to a herniated disk .  The bulging disk may pinch a nerve causing the nerve to swell up and get “hot” called inflammation causing back and leg pain.

Spinal epidural steroid injections are the placement of steroid medicine into the spine onto the hot and swollen nerve to cool down the inflammation and relieve the pain and suffering.  Think of it like putting an aspirin on the nerve.

Even though spinal injections are generally safe there are risks and side effects to all medical procedures. These include bleeding, infection, dural puncture or “wet tap” causing headaches and nerve damage.  Patients may also experience increased pain, headaches, red face, anxiety, problems sleeping, fever, high blood sugar, decreased immunity, stomach ulcers, severe arthritis, cataracts and menstrual irregularities.

TO ANSWER YOUR QUESTION the most common way spinal epidural steroid injections affect your brain is through headaches.  Usually these headaches will resolve with time.  If they are related to “wet tap” you may require bed rest, caffeine, fluids and rarely blood patch.  Blood patch is the injection of blood into the spine to stop spinal fluid leak and “plug” the hole from the “wet tap”.

ABOUT DR CARL SPIVAK

Dr. Spivak is a neurosurgeon fellowship trained in minimally invasive spine surgery and spinal epidural steroid injections.  He has practices in New York and New Jersey.  For more information on spinal epidural injections or laser endoscopic spine surgery please call Executive Spine Surgery at 908-452-5612 or click schedule-an-appointment.

By Staff Writer Spinal fusion, Treatment problems

Does the body ever reject the materials used in spinal fusion?

Spinal fusion is the connecting of one vertebrae to another vertebrae to strengthen the spine and decrease pain.  This is usually done with screws and rod or sometimes a metal clamp.  Bone is placed between the vertebrae to cause the vertebrae to grow together to make a solid continuous bone.  This is the fusion part of spinal fusion.

It is uncommon for the body to reject spinal fusion materials. Spinal fusion is usually done with bone, plastic (PEEK) or titanium cages and titanium screws and rods.   Spinal clamps are becoming more popular and  sometimes are used as an alternative to pedicle screws.   Bone or bone alternatives are packed into the disk space, facet joints or beside the spine for fusion to happen.  It is very rare to have a reaction to bone, PEEK or titanium.     Very rarely patients develop an allergic reaction to donor bone. If they use your own bone your body should not react to it.   Bone alternatives like calcium phosphate may cause reaction but again this is unlikely.

Rest assured most people go through a spinal fusion without rejection to the fusion materials.  To learn more information on spinal fusions please click Spinal Fusion and Options.

To book an appointment please contact Executive Spine Surgery at  908-452-5612 or click schedule-an-appointment.

By Staff Writer Treatment problems

My foot continues to flop after surgery. Should I have another surgery?

Herniated disk at the L4-5 level is a common cause of foot drop.  Foot drop is weakness bending your foot upwards towards your nose.  This may range from mild to severe.  As the weakness increases the foot tends to slap down when walking or must be lifted up high to prevent it from snagging on the floor.  The weakness may be from dysfunction of the nerve from compression or from nerve damage.   The damage may increase the longer the foot drop is present. Usually early surgery is recommended to prevent damage.

The purpose of surgery is to remove the disk and “un-pinch” the nerve.   Normal back surgery mainly decompresses the L5 nerve root, but endoscopic transforaminal surgery (such as JOIMAX) enters through the foramen and opens up the foramen taking pressure off the L4 nerve in the foramen and L5 nerve in the spinal canal. Therefore second surgery or surgical approach is not needed.  Other advantages include pen sized scope, very small skin incision, minimal muscle damage, same day surgery  and quick recovery.

If the foot drop continues after surgery then there may be continued compression at that level or maybe unrecognized compression at the L5-S1 foramen or more likely nerve damage.  Nerve damage may improve over months or years or may be permanent.

Sometimes scar tissue is found on post-operative MRI in people who are not improving.  Removal of the scar tissue will unlikely help your nerve improve.  Continued foot drop after surgery is likely due to preoperative nerve damage.

For more information please contact Executive Spine Surgery at 908-452-5612.

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, 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 Neck pain, Pain, Surgery, Treatment problems

I had a cervical fusion done at C4-C7 4 years ago, but I am still in pain. Do I need it redone?

This is difficult question without seeing you and your films.  Most cervical fusions heal 1 year after surgery.  If the X-rays and/or CT scan showed healed fusion of C4-C7 (that is C4-5, C5-6 and C6-7) revision will unlikely help your neck pain.  Your neck pain maybe from breakdown of another level of your spine such as C3-4 or C7-T1.  This is called adjacent level disease.  After fusion surgery, the disks beside the fusion must take up the extra movement lost by the fused levels.  This may increase  “wear and tear” on these disks, increasing the chance of developing future problems.  It is possible one of your other disks have now become painful.  You may also have neck pain from stiff weak neck muscles.  You may benefit from daily neck stretches.

Please see the following blog posting for instructions on neck stretches.   Please contact Executive Spine Surgery to schedule an appointment.  Good Luck!

I smashed my shoulder into the pool wall 5 days ago and now I can’t move my neck or shoulder without a lot of pain.

By Staff Writer Sciatica, Surgery, Treatment problems

Is it common to develop sciatica after back surgery?

Sciatica is back and leg pain produced by a pinched nerve in the back.  Unfortunately sciatica may recur after back surgery, but it is not very common.  The cause of it depends on your original back problem and what type of back surgery you had.  For example after:

Lumbar discectomy – The disc is not as strong after back surgery and it is possible for new piece of disc to break off, herniate and pinch the sciatic nerve.  This is called recurrent disk herniation.  Other times the sciatica may be caused by scar tissue.  This is less common with endoscopic surgery.

Lumbar laminectomy – Stenosis (tightness) may develop from new bone or ligament formation or the development of instability and slip of the spine called spondylolithesis.

Lumbar fusion – the instrumentation may break or fusion fail producing instability, slip and sciatica.  Alternatively the spinal disease may worsen at the level above or below the fusion (that is at L3-4 or L5-S1 level after L4-5 fusion) due to increased strain to the surrounding spine due to the immobile fused segment or just from worsening degenerative spine disease.  This is called adjacent segment disease.

I would recommend you see a spine surgeon. You will likely require new X-rays and MRI of the lumbar spine. Make sure you have the MRI with and without contrast to rule out scar tissue.  For more information please 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!

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