artificial disk replacement

Are You a Good Candidate for Artificial Disk Replacement?

Chronic back pain will affect 80-90% of people at some point in their lives. Almost 2% of our country’s workforce deals with debilitating back pain. Many conditions can cause pain and require surgery.

When your pain becomes so severe that you cant control it with conservative treatments, you’ll need to be evaluated by a spine surgeon.

Spinal surgery has advanced a lot in the last few years, including FDA improved devices that can replace damaged spinal disks.

But the conditions that disk replacement surgery can treat are limited by a variety of factors. To learn more about artificial disk replacement and whether or not you would be a good candidate, read on.

What is Artificial Disk Replacement?

Before we talk about what makes a person a good candidate for this surgery, you should understand exactly what this surgery is.

Artificial disk replacement surgery is when worn or damaged disk material between the small bones in your spine are removed and replaced with synthetic or artificial disks. The goal of this procedure is to relieve back pain and maintain normal motion.

In other procedures, like spinal fusion, your movement would be much more limited.

Although many people will deal with low back pain in their lives, most people won’t need surgery to correct it. Surgery is only considered when back pain doesn’t improve with treatment.

For patients who have tried all nonsurgical options and are still in pain, lumbar fusion surgery is the most common option for treating lower back pain. Fusion is pretty much what it sounds like, a “welding” process that fuses the painful vertebrae together so they heal in a single, solid bone.

Lumbar fusion helps many people, but the results vary. Also, some people who heal in the most ideal way still have no improvement in their back pain.

Some doctors believe that this is due to the fact that fusion prevents normal motion in the spine. Because of this, artificial disk replacement has come forward as an alternative treatment option.

Artifical disk replacement gained FDA approval in 2004 and over the past years, scientists discovered new designs that are being developed today.

Who is a Good Candidate for Artifical Disk Replacement?

In order to make sure you are the best possible candidate for disk replacement, your surgeon might want you to go through a few tests. Some of these tests include:

  • Magnetic resonance imaging (MRI) scans
  • Discography
  • Computed tomography (CT) scans
  • X-rays

The information they learn from these tests will help your surgeon determine whether or not you’re a good candidate for the surgery as well as pinpointing the source of your back pain.

As beneficial as this surgery is for many, it is not appropriate for everyone with low back pain. For the most part, good candidates have a few characteristics in common. They are:

  • Back pain caused by one or two intervertebral disks in the lumbar spine
  • No significant facet joint disease
  • No bony compression on spinal nerves
  • Not excessively overweight
  • No major surgery has been performed on the lumbar pine before
  • No deformity of the spine, like scoliosis

As long as you meet these criteria, and are in otherwise good health, you should qualify for the surgery.

The Procedure

For the most part, artificial disk replacement surgery will take between 2 and 3 hours.

Your surgeon will approach your lower back from the front through an incision in your abdomen. This way, the organs and blood vessels must move to the side, but it also allows your surgeon to access your spine without disturbing the nerves.

Typically, a vascular surgeon will assist the orthopedic surgeon with opening and exposing the disk space.

During the procedure, the surgeon will take your problematic disk out and insert an artificial disk into that space.

Artificial Disk Design

Some disk replacement devices make up the center of the intervertebral disk while leaving the outer ring in place, but this technology is still in the investigative process.

Mostly, the artificial disk will replace the outer ring and the center with a mechanical device that will stimulate the spine to function.

There are a bunch of different disk designs, all of them unique but maintaining a similar goal of reproducing the size and function of a normal disk.

There are disks made of metal and some made of metal and plastic both. This is similar to joint replacements in the knee and hip. These disks are made with medical grade plastic and medical grade cobalt chromium or titanium alloy.

Make sure you and your surgeon decide what disk is best for you.


For the most part, patients stay in the hospital for 1 to 3 days after the surgery. The length of your stay depends on how well controlled your pain is and whether or not you can function.

Patients are encouraged to stand and walk the day after surgery. With artificial disk replacement, bone healing isn’t required after the replacement, so usually, patients are encouraged to move in their midsection too. Early motion in this area can lead to faster recovery.

You will perform your basic routine during the first several weeks after surgery, just make sure you don’t hyperextend your back.


For the most part, patients can expect improvement of lower back pain in weeks or months after surgery.

This procedure will improve, but not completely eliminate, back pain. Make sure you have realistic expectations before going into surgery

Artificial Disk Replacement Research on the Horizon

The future of this procedure will likely have advancements in implant design and tools for diagnosing pain sources. It’ll also include ways to return the disk to normal function without needing to add any biomechanical device.

Artificial disk replacement isn’t considered a new technology, but the research continues on the outcomes of the procedure.

If you think you would be a good candidate for this procedure, visit us today to learn more.

Can scoliosis be cured

Can Scoliosis be Cured?

The transition between our early childhood and teenage years is a complicated weave of emotions, hormones, and life transitions. Yet that period can be far more stressful when combined with scoliosis.

A condition most often diagnosed during the puberty stage of one’s life, scoliosis can range from mild to severe. Left untreated, it can impact your posture and even endanger your health.

But what is it, exactly?

More importantly, can scoliosis be cured?

What is Scoliosis?

Scoliosis is a condition where the spine curves as it grows. It affects both the neurological and the muscular systems. This curve can either form in a “C” shape or back and forth like an “S”.

There are four different types of scoliosis:

  • Idiopathic Scoliosis, which has no known origin
  • Neuromuscular Scoliosis, which is caused by neuromuscular disorders
  • Congenital Scoliosis, which is a rare genetic defect
  • Degenerative Scoliosis, which develops in older adults

Most patients start to see symptoms of this abnormality between the ages of 10 and 14. This is because your body is growing and developing. Typically, you’ll see the most impact of your scoliosis during these formative years, but it can progress even after your teens.

This condition can occur in both male and female patients. However, it is more common amidst women.

What are the Symptoms of Scoliosis?

There are various signs of scoliosis. Some of them you can feel, while others you can see with the naked eye or on a medical scan. The most common include:

Seemingly Ill-fitting Clothes

Sometimes the symptom is as subtle as looking in the mirror and noticing your clothes don’t fit right.

You squint at your reflection, wondering why your shirt looks tighter in some areas than others, or why the edge of your shirt looks uneven compared to the opposite side.

This is caused by the tilt of your frame due to your spine’s curvature.

An Asymmetrical Back

Perhaps you are wearing a tank top or bathing suit when you, a friend, or family member notices your shoulders or back appear asymmetrical. This is another indicator of scoliosis.

A Change in Gait

Have you noticed yourself having trouble walking? Maybe your legs can’t seem to find the proper rhythm or one feels longer than the other. Scoliosis’ impact on your spin can misalign your hips, causing you to walk differently than normal.

You may even find yourself growing more fatigued since your body has to work harder to maintain balance.

A Noticeable Decrease in Range of Motion

As the spine begins to curve, it reduces its flexibility. Patients find it harder to bend their torso front to back or side to side.

An Increase in Back Pain

In severe cases of scoliosis, the curvature can lead to painful muscle spasms in the back, as well as deterioration of various discs and joints due to the strain.

Dangerous Levels of Pressure on Internal Organs

Scoliosis doesn’t just impact your skeletal frame. The sharp twists and angles can also cause pressure on your lungs and heart, hampering their function and creating hazardous health problems.

What are the Causes of Scoliosis?

While some cases of scoliosis may be caused by neuromuscular conditions like genetic defects, muscular dystrophy, or cerebral palsy, most cases have no defined cause.

Doctors have identified age, genetics, and sex as factors that play a role in how high a patient’s risk factor is in developing scoliosis. While most scoliosis patients have no prior history of it in their family, those whose family members have developed this condition are at a higher risk of doing so themselves.

Most cases develop during puberty, so young adults are less likely to receive scoliosis as a diagnosis. However, elderly adults may develop degenerative scoliosis after the age of 65.

Women are more likely to have this condition than men, but why it occurs still remains a mystery in most cases.

Can Scoliosis Be Cured?

While there is no cure for scoliosis, there are multiple scoliosis treatment options available on a case-by-case basis. First, a doctor must diagnose a patient’s scoliosis as well as his or her degree of severity.

This is done through imaging tests in order to identify the shape of your spine, as well as any underlying causes, such as an injury or the growth of a tumor.

For mild cases, your doctor may simply suggest monitoring your scoliosis, especially during your teen years. Since your body grows so rapidly during this period, your scoliosis also evolves rapidly.

If this is the case for you, your doctor will expect to schedule an appointment about once every six months.

Left unattended, scoliosis can damage the heart and lungs, cause severe back problems, and misalign your skeleton. If the scoliosis is severe then your doctor may require medical intervention.

This could include a brace or even surgery to help slow or reduce your spine’s curve. A brace is typically worn during a patient’s pubescent period in order to guide the spine into better alignment as it grows. This brace isn’t required after your bones have finished their growth period.

If surgery is required, this is typically done through a spinal fusion or installation of a metal rod. Although similar, these two forms of surgery implement a different approach to spinal realignment.

Spinal fusion uses small rods, wires, or other metal pieces to fuse certain vertebrae together. While this stiffens the back, it can improve the overall alignment.

The rod installation is a larger piece of hardware that is adjusted as the patient grows. Like the check-up appointments, these adjustments are made approximately once every six months.

Do You Think You Might Have Scoliosis?

While the answer to “Can scoliosis be cured?” may not be the one you were looking for, the good news is that there are many treatment options. If caught early enough, most patients can go on to lead normal, healthy, happy lives.

If you or a loved one are experiencing symptoms of scoliosis, contact your doctor. Patients in Hackettstown and Newton, New Jersey can book an appointment with our spinal surgery office without ever leaving their computer chair.

lumbar degenerative disc disease

Everything You Need to Know About Degenerative Disc Disease

Back pain is a problem that affects millions of people in America. As of 2017, nearly 55% of American adults were living with a back-related problem. Roughly 30% of these individuals believed their pain was stress-related, 26% felt it was due to weak muscles, and the same amount blamed physical work.

However, whatever the source of your back pain, it’s essential to have it checked out to ensure it’s not serious. There are many things that can go wrong with your spine that may require surgery or extensive physical therapy.

This includes lumbar degenerative disc disease (DDD). This condition is quite prominent among both men and women and deserves looking into if you have lower back pain.

Let’s review more about this condition.

What is Lumbar Degenerative Disc Disease?

Lumbar DDD is a form of spinal degeneration that can occur as a person ages or when trauma occurs. Any of the discs in your spine can begin degenerating. However, lumbar degeneration takes place in the lower back region.

It’s very common for these areas to degenerate after you develop bulging or herniated discs.

It’s also prominent in those diagnosed with scoliosis. The symptoms of disc degenerative disease vary from person to person. For instance, some may feel tingling and numbness in their buttocks and legs.

Then those who have disc injuries in the shoulders and neck may have numbness and tingling in the arms. In severe cases, it can lead to temporary paralysis in the arms or in one or both legs.

Degeneration in the discs located in the upper back can cause symptoms like severe migraines and headaches. Limb weakness, memory loss, and muscle spasms are other symptoms to watch for.

The Anatomy of Your Spine

Now, it’s important to note that DDD isn’t actually a disease. Nor is it guaranteed to worsen over time. Everyone experiences disc degeneration at some time in their life and in some cases.

There are three main parts of intervertebral discs. The first is annulus fibrosis, which consists of concentric collagen rings that bend and twist as you move. The second is the nucleus pulposus, which is the inside of the disc.

It has a gel-like consistency that’s made with water and proteins. The purpose of this is to provide a cushion between the discs.

And last, there are the cartilaginous endplates, which is located between vertebral bodies and discs. It’s made with cartilage that’s attached to the disc. In a way, it acts like a gatekeeper, controlling the number of nutrients and oxygen that passes through the disc space.

What Are the Symptoms of Degenerative Disc Disease?

In many cases, the onset of degenerative disc disease is low-grade. Some will feel no back pain and others will have a continuous but tolerable amount of pain in the region. In these individuals, it’s common for the pain to flare up for a few days or so.

Moderate Low Back Pain

Those living with moderate, continuous lower back pain tend to have pain in the area where the discs are damaged. The pain can generate in the groin, buttocks, and upper thighs. The type of pain reported by pain sufferers include dull aches that are mild to severe.

Pain Flare-ups

The individuals that have occasional pain flare-ups tend to suffer from increased aches for days or even weeks on end. After a while, the pain reduces to a moderate level. Then as the disc degenerates and gradually stabilizes, these flare-ups happen again.

Flare-ups are known to be sudden and severe, and in some instances can cause reduced mobility.

Localized Pain

If you’re feeling localized tenderness in your lower back, then this a potential sign of lumbar disc disease. It’s common for the disc that’s degenerating to become too sensitive to touch. This is because there’s inflammation and tension in the muscle around the damaged disc.

Leg Pain

All of your nerves coursing through your body connect through your spine. It’s not uncommon for low back pain to extend to other parts of the body, such as the legs. You may feel numbness, sharp shooting pains or numbness in your buttocks or back of your leg.

This tends to happen once the disc space collapses onto a nerve root, causing it to pinch. Some back pain sufferers complain of pinching in their neck and shoulders after sitting upright for too long.

Pain While Sitting

Ironically, a lot of back pain sufferers have issues with sitting for too long. It can lead to severe low back pain and stiffness, requiring you to change positions or stand up to alleviate the pain. The best way to sit for long periods of time is to sit in a chair that reclines and offers good lumbar support.

Walking and changing positions can help with the pain because you’re removing the pressure from the discs onto your joints and muscles.

Treatment Options for Degenerative Disc Disease

Now that you have a better idea of what DDD is, it’s time to look at some of the treatment options that are available.

Short-term treatment options include OTC and prescription pain medications. Using the heat and ice method, massage therapy, and chiropractic care are natural ways you can alleviate the pain. However, these are all for temporary relief and won’t treat the root problem.

This includes using epidural steroid injections, which reduce pain signals and inflammation. In many cases, patients use these injections with physical therapy.

But if your case is severe enough, surgery is a great option to consider. One type is lumbar spinal fusion surgery. It’s the standard procedure that grafts together two vertebrae to help reduce the pain by removing the motion of that part of the spine.

During surgery, the surgeon removes the entire disc from the space, then they either attach instruments or bone graft to the two vertebrae that will fuse together. This can take months to occur following the surgical procedure.

If this is something you’re interested in having done to treat your lumbar degenerative disc disease, then we can help. At Executive Spine Surgery, we offer surgical treatments and pain management services.

Contact us today to see how we can help you lead a life free of back pain!

bone spur symptoms

Bone Spurs: What Are They and Where Do They Come From?

Bone spurs can occur all throughout the body, including our hands, feet, spine, and any other joints within the body. However, you may or may not notice they’re there.

So what are bone spur symptoms, what causes them, and can they be removed? These are all common questions we receive from patients who receive a diagnosis, which is why we put together one cohesive blog to answer them all.

What are Bone Spurs?

A bone spur is when additional bone growth develops along the edges of your bones. Typically they occur around the areas where two bones join together, such as your joints or between the vertebrae in your spine.

They usually develop in response to wear and tear between your joints. Whether they’re harmful or not simply depends on how they grow and whether or not they impact the mobility of your bones.

What Causes Bone Spurs?

The most common cause of bone spurs is osteoarthritis.

Osteoarthritis is a degenerative bone disease that affects around 27 million Americans. Those with osteoarthritis experience a breakdown in the cartilage between the joints, which leads to friction between the bones.

This causes a host of different problems, including swelling, joint pain, and reduced mobility.

However, osteoarthritis isn’t the only cause of bone spurs. With age, injury, or wear and tear, the spine can develop spondylolithesis. Spondylolithesis is when an individual experiences damage or develops weakness in the facet joints and discs within the spine.

If this weakness is left untreated and continues to develop, it can lead to instability within the spinal structure. This creates stress within different parts of the spine, including the tendons, discs, and ligaments.

The body responds to this form of stress with new bone growth in an attempt to bring stability back to the spine. However, the development of these bones spurs can lead to other problems, including compression and pinched nerves.

Other causes of bone spurs include obesity, overuse of the joints, genetic predispositions, poor diet, and the narrowing of a patient’s spine.

What are the Most Common Bone Spur Symptoms?

As we stated before, some bone spurs may be completely asymptomatic. The only time symptoms occur is when the bones spurs impact the mobility of your joints or exacerbates them in some manner.

The type of symptoms you have depend on where the bone spurs are located.

Common bone spur symptoms include:

  • Difficulty bending or extending your leg due to pain within the knee
  • Feelings of numbness or weakness in your extremities due to pinched nerves or a pinched spinal cord
  • Difficulty controlling your bowels or your bladder due to pressure on your spinal nerves
  • Reduced or painful movement in your hip
  • Muscle spasms
  • Muscle cramps
  • Muscle weakness
  • Bumps that you can feel under your skin

You may discover these symptoms become exacerbated with exercise or joint use.

It’s important to keep in mind that experience these symptoms is not a guaranteed diagnosis. Because these symptoms can be indicative of other medical conditions or problems, you must receive a proper diagnosis from your doctor.

If you suspect bone spurs, your doctor will likely have you undergo tests in order to confirm or debunk this diagnosis. These tests usually include a physical examination as well as X-rays, CT’s, or MRI’s.

Your doctor may also conduct an electroconductive test to see if there is any nerve damage.

If you have questions about your diagnosis, symptoms, or causes, don’t be afraid to ask your doctor. He or she is responsible for answering any questions you may have regarding your health, treatment options, and any concerns associated with them.

How Do You Treat Bone Spurs?

If your doctor identifies that you have developed bone spurs that require treatment, he or she will provide you with options. Those options can vary depending upon where the bone spurs are located.

Depending upon the severity of your case, this treatment may be as simple as over-the-counter pain relievers to help with the side effects or therapy. In severe cases, you may require surgery in order to remove them.

Therapy options include steroid shots and/or physical therapy.

If you develop bone spurs within the spine, you may be required to undergo pain mapping prior to any surgical procedures. This is where a numbing agent is inserted into the area of the spine where the patient is experiencing pain.

Typically, this will temporarily relieve or stop the pain if your symptoms are caused by bone spurs. However, if your pain continues in spite of non-invasive treatment your doctor may recommend endoscopic foraminotomy.

Endoscopic foraminotomy is different from the more traditional means of bone spur removal. Safer and less invasive, it involves a very small incision as well as the use of a micro camera in order to remove the bone spur compression.

While this may sound indimidating, endoscopic foraminotomy is a much easier procedure than traditional surgery. It only requires a light, twilight sedation, and the incision is approximately the size of a fingernail.

This means less post-op pain and a significantly decreased recovery time for the patient. It is highly recommended for patients who require a spinal surgery in order to remove bone spurs causing nerve compression.

Explore Your Options for Bone Spur Removal in the Spine

If you have tried the more conservative options to bone spur treatment, but are still suffering from bone spur symptoms in the spine then it may be time to consider surgical options.

Make sure that you select a spinal surgeon with a good reputation and positive testimonials. Quality matters, especially when it comes to any sort of operation on the spine.

This area of your body houses multiple nerves and nerve endings that a good surgeon navigates with the utmost care. Careless or improper execution can lead to serious, and possibly permanent side effects.

If you are a patient within the Hackettstown or Newton, New Jersey area, give us a call. Dr. Carl Spivek is the President of Executive Spinal Surgery P.C. and he specializes in minimally invasive spinal surgeries.

These surgeries are safer and easier on the patient, making it the best available option today.

prolapsed disc

How to Know If You Have a Herniated Disc

Do you suspect you have a prolapsed disc in your back?

A herniated disc, also known as a slipped or prolapsed disc often causes intense back pain. If you’re not sure what the cause is, a prolapsed disc might very well be the culprit for your pain – but how can you tell?

A medical doctor is always needed for a certain diagnosis, but there are a few herniated disc warning signs to watch out for. In this guide, we’ll go over how to know if you have a herniated disc, as well as potential ruptured disc treatment and everything else you may need to know. Keep reading to learn how to make the pain disappear!

What is a Prolapsed Disc?

A slipped disc is often the cause of intense back pain with a sudden onset. It hurts because the disc usually presses a nerve in the spine, which can cause pain not just in the back, but in a leg or other body part.

The pain will often let up over the course of a few weeks, with rest and painkillers. However, if it doesn’t stop, you might need surgery or more intense treatment.

“Slipped” discs are somewhat misnamed: they don’t actually slip out of place. Instead, a part of the soft, inner part of the disc bulges through a weak point in the outer part of the disc. That’s why they’re called prolapsed or herniated discs.

The bulge of the disc is what pushes on the nerve, causing pain. Sometimes, the herniated area also becomes inflamed. This inflammation can further irritate a nerve and create swelling, adding even more pressure.

Any disk along the spine can become herniated. However, the issue happens in the lower back most often. The prolapse can be larger or smaller, but the larger ones tend to be more severe.

The Structure of the Spine

To understand how this can happen, it helps to understand more about how the back and spine work.

The spine is made up of small bones, or vertebrae. Each vertebra has a kind of flat, cylindrical shape and a disc rests between each one of these bones.

These discs are made of a kind of rubbery material, which gives our spine its flexibility. Each of these discs is constructed the same way: with a strong outer layer and a softer center.

Within the spinal cord are our nerves, which come from the brain and lead to every other part of the body. The spine keeps our nerves safe from damage, so they can do their job of sending messages from the brain to the body and vice versa.

We also have ligaments attached to our vertebrae. They offer more strength and support to the spinal structure. Muscles surround and attach to the spine as well.

When a disc becomes herniated, this seemingly small issue affects all of these different parts that work together. That’s why the symptoms of a prolapsed disc are often so severe.

Prolapsed Disc Symptoms

Is a herniated disc the cause of your back pain? Let’s take a look at the common symptoms that offer clues.

1. Back Pain

The most common prolapsed disc symptom is simple: pain in the back. However, this pain is usually severe and starts all of a sudden. If you have mild back pain or pain that starts out gradually, it’s probably not due to a herniated disc.

Laying still will usually make the pain feel better, but moving, sneezing, or coughing will increase the pain.

2. Nerve Pain

If you have pain in your nerve roots, that’s often another giveaway that the culprit is a slipped disc.

Nerve root pain happens because the slipped disc is pressing on a nerve that comes out from the spinal cord. It can also happen because the inflammation of the prolapsed disc is irritating the nerve root.

Even though the problem stems from the spine, you might feel pain at any or all points along the nerve’s pathway. For example, if the nerve extends down the leg, you might feel pain in your foot, calf, or knee.

The nerve root pain can be mild, severe, or anywhere in between. However, most of the time, it feels worse than your back pain does. This type of pain usually feels like a burning sensation.

Other nerves can be affected, but the nerve that’s affected the most often by a slipped disc is the sciatic nerve. This nerve is actually comprised of a number of smaller nerves that come from the lower back and extend down the backs of the legs.

3. Nerve Symptoms

In addition to pain, you might feel other symptoms because of the pressure of the prolapsed disc on your nerves. These symptoms can include numbness, weakness, or a “pins and needles” sensation. Again, the sciatic nerve is most often affected, so you’ll probably feel these symptoms in your foot or leg.

4. Cauda Equina Syndrome

In very rare cases, your nerve root issue could become cauda equina syndrome. This doesn’t happen often, but when it does, it’s a medical emergency and you must seek ruptured disc treatment right away.

In this disorder, the nerves being pushed on by the slipped disc are at the base of the spinal cord. In addition to pain in the lower back, the symptoms of this syndrome can include leg weakness, numbness between the legs, and issues with the bladder and bowels. For example, you might find yourself completely unable to use the bathroom.

If you don’t seek herniated disc treatments right away, this disorder could cause your nerves to sustain permanent damage, so don’t delay if you have these symptoms.

How to Treat a Herniated Disc

Minor prolapsed disc symptoms often go away on their own, with time. However, if you have this problem frequently or the symptoms don’t go away, you might need ruptured disc treatment.

Looking for reliable treatment for this and other spinal issues? Check out our treatment options here.

spinal injections

Spinal Injections: What Are They and How Do They Work?

The Bureau of Labor Statistics reports that one million back injuries sustained at work account for 20% of all workplace-related injuries and illnesses. This is second only to the common cold. In general, about 80% of the population has suffered from back pain.

For people who have radiculopathy (inflammation or damage to a nerve) or a herniated disc, spinal injections have proven to be one of the most effective treatments.

Needles can be scary, especially if they are meant for the spinal column. But they can be a lifesaver when it comes to back pain management.

Read on to find out what spinal injections are and why you might need one.

What Are Spinal Injections?

Spinal injections are also known as epidural injections. They are similar to the ones pregnant women get during childbirth. These injections are introduced into your epidural space, a space just outside the membrane protecting your spinal cord.

Epidural injections are also given during or after surgery as anesthesia and for treatment of chronic pain. Different medications are administered through these spinal injections including steroids, to manage pain and reduce inflammation in the back, legs, arms, and neck.

Doctors use an X-ray and a special dye to introduce the needle in the right place. This procedure is known as fluoroscopy Depending on where you’re experiencing pain, he or she will choose a location along the length of your spine closest to the inflamed and painful nerve.

The entire procedure takes about fifteen minutes and if you’re being medicated with a steroid, you should start to see the benefits in about 3 days. Pain relief differs in different people but on average it can last for months.

Who Can Get Treated with Spinal Injections?

There’s a wide variety of treatments available for back pain management. But there are certain conditions that are treatable by an epidural injection. They include pinched nerves, radiating pain from the spine, herniated disc and spinal stenosis.

Who Can’t Get Treated with Spinal Injections?

People with certain conditions should avoid spinal injections due to the risk.

These conditions include infections, diabetes mellitus, and blood clotting disorders. Also, people with the bleeding disorder, allergies to anesthetic agents or certain medications, and drug addictions should avoid it.

Depending on your condition, another treatment or pain relief option may be sought for you. Or the doctor may defer your injection until a favorable time.

How Do Spinal Injections Work?

Spinal injections deliver steroids and anesthetic directly into the epidural space. Occasionally, doctors may use a saline solution to flush the area and rid it of inflammatory chemicals in the space that causes the back pain.

Typically, doctors use a combination of cortisone, which is an anti-inflammatory medication and lidocaine, a quick-acting local anesthetic.

In general, spinal injections have two uses.

First, they are a diagnostic tool used to find the source of the pain. This can be in the back, leg, arm or neck.

Second, they help in pain relief. They are usually part of a comprehensive therapeutic program which almost always includes physiotherapy to improve spinal mobility and stability. This can include strengthening and stretching exercises.

Types of Spinal Injections

Spinal injections come in the following categories.

Epidural Injections

These relieve pain that radiates from the spine to an arm or leg. This occurs when a spinal nerve gets compressed or pinched.

Facet Joint Injections

They have both diagnostic and therapeutic value. They are commonly used when pain results from arthritic conditions or injuries. They are also used for pain relief in the neck, middle and lower back.

As a diagnostic procedure, the anesthetic gets injected into a joint or into the nerves that carry the pain signals. If the anesthetic reveals the nerve as the source of pain, then the pain signals get blocked permanently through radiofrequency ablation.

Sacroiliac Joint Injections

These are much like the facet joint injections. The sacroiliac joints are in the lower back, between the sacrum and ilium (pelvic) bones. These joints do cause lower back pain, usually unilaterally.

This injection also has both diagnostic and therapeutic value. To diagnose the pain, the SI join gets anesthetized with X-ray guidance.

This is the gold standard for diagnosing SI joint pain. If the pain improves with the anesthetic, then the pathology is confirmed.

As a therapy, a steroid injection will be given to relieve pain.

Provocation Diskography

This is a spinal injection only used for diagnosing pain. It does not relieve pain but rather causes it. This test gets done for those who have chronic back pain which doesn’t improve with conservative treatment.

Because of its ability to worsen back pain, it’s not performed commonly. But it can be useful for providing information if a surgery is being planned on the lower back.

Risks of Spinal Injections

All invasive procedures carry a certain amount of risk. With a .01 to .001% risk, infections are rare but possible. Bleeding can occur in patients taking certain medications or in people who have clotting, bleeding, and liver disorders.

Dural punctures do occur in 0.5% of the injections, where a doctor may breach the dural space leading to a wet tap that leads to a headache.

Direct trauma from the needle can also cause nerve damage. Yet, this is very rare since the procedure is done under visual guidance.

There may be some side effects of the steroid medication depending on which ones get used instead of the injection itself.

Some of them include severe localized pain which is temporary, headaches that resolve in 24 hours, insomnia, facial flushing, and fever (usually on the day of the injection).

You may also experience elevated blood sugar, anxiety, gastric ulcers, cataracts and a decreased immunity for a brief period.

Following your injection, if you experience a headache that improves on lying down then you may have a Dural puncture. You must relay this to the doctor.

Similarly, if you spike a fever of 101 degrees or more for over 24 hours, lose function or sensation in the extremities, or lose bowel or bladder control, speak to your doctor immediately.


Injections have never been a patient’s best option for getting treatment. But when you overcome your fear, it can be your best bet at getting healed. So, make sure that you consult your doctor about the various options that you have.

If you have any questions regarding the management of your back pain or need information about spinal injections, contact us.

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:

facet thermal ablation

How to Prepare for Facet Thermal Ablation

Back pain is an unfortunately common occurrence with an estimated 80% of the world population suffering from back pain at some point in their life. When that pain becomes chronic or when it is nerve pain, everyday activities can become excruciating.

Spinal and nerve pain caused by arthritis and/or joint degeneration can:

  • Limit mobility
  • Cause chronic pain
  • Make simple tasks impossible

Fortunately, there is a procedure called facet thermal ablation that can potentially alleviate this pain caused by issues in the facet joints of your spine.

Keep reading to learn about facet thermal ablation and how it can potentially help you.

What is Facet Thermal Ablation?

Facet thermal ablation is a minimally invasive procedure performed to alleviate pain in patients suffering from issues in the facet joints.

The facet joints in your spine refer to the joints in between the vertebrae the make your spine flexible. Cartilage is also found in these joints between the vertebrae to cushion the joints and the bones in your back.

When the cartilage wears down or when you’re suffering from disorders like arthritis, the way your facet joints line up and the way the bones touch changes. This can cause grinding, inflammation, tearing, and a loss of mobility.

These joints have a high concentration of sensitive nerves, making any damage or negative effects very painful. A facet thermal ablation is a procedure that can alleviate the pain and immobility caused by affected facet joints.

How Does Facet Thermal Ablation Work?

Unlike intense open surgical procedures that require anesthesia, this procedure is minimally invasive and requires no anesthesia. Instead, your back will be numbed and you’ll be given medication to help you relax.

You’ll be kept on conscious sedation so the doctor can ask you questions during the procedure. This might seem scary, but you’ll be completely relaxed and you probably won’t remember the procedure.

Next, the doctor will insert a needle into your back. The doctor will use something called a fluoroscope to guide the need into your back and find the areas causing pain and immobility.

Once in position, the doctor will insert a charged electrode into the tube. Using jolts of weak electricity via the electrode will essentially “numb” the nerves of the damaged facet joint.

This will prevent the nerves from sending pain signals to your brain, which will reduce the pain you feel in your back.

This is repeated for each joint that is in pain. The entire procedure only takes around 40 minutes and will produce little to no scarring.

What Conditions Can Be Helped with This Procedure?

You could be experiencing facet joint pain for a number of different reasons. A few of the most common conditions that can be helped with a facet thermal ablation procedure are:

  • Osteoarthritis
  • Facet Joint Syndrome
  • Joint Degeneration
  • Facet Hypertrophy
  • Facet Disease

Since each of these conditions affect the facet joints and result in joint and nerve pain, this procedure is commonly used as a treatment.

What Symptoms Will This Procedure Relieve?

Facet thermal ablation essentially numbs the nerves in the facet joints that are causing pain and immobility. This will help a number of your symptoms.

Pain. Because the nerves in the affected joints will be numbed by this procedure, you won’t feel the persistent or chronic pain that you were experiencing because of the joint degeneration.

Mobility. Patients find that this type of procedure can help their mobility in their neck and back.

Inflammation. Joint inflammation is a common symptom of arthritis and facet joint diseases. This procedure can reduce the inflammation in the joint and help reduce pain caused by that inflammation.

How to Prepare for Facet Thermal Ablation

Here’s what to expect:

Getting Approved

In order to be approved as a candidate for this procedure, you’ll need to make an appointment with an appropriate physician. They will be able to talk with you about your condition, examine you, and determine whether this procedure will benefit you.

Some physicians may recommend getting an X-ray or an MRI to examine your spine. You also likely won’t be approved for this procedure if you haven’t tried other treatments such as physical therapy or medication.

The Procedure

Once you are approved to get this procedure, you’ll be able to schedule an appointment. This is a minimally invasive outpatient procedure, which means it doesn’t require as much prep as a more intense and more invasive procedure.

The procedure itself takes around 30 minutes with an added 1-2 hours for observation and preparation pre- and post-procedure. Be sure to schedule this on a day when you don’t have work or school, as you will likely be out of commission for that day.


You should also arrange for a friend or family member to accompany you. Because of the sedation and the pain you might feel after the procedure, you’ll need them to drive you home.

Be sure to plan some low-key days in the 2 or 3 days following the procedure. You shouldn’t be doing any exercise or strenuous activity as you heal.

It can’t hurt to prepare some “sick day” supplies for the days following the procedures, like some comfort food or your favorite movies!

Wrapping Up

A facet thermal ablation can be a lifesaver for those suffering from chronic back pain. That might seem dramatic, but relief from chronic pain and immobility can give someone the freedom they need to live a normal life.

At Executive Spine Surgery, Dr. Carl Spivak will provide you with high-quality care that will make you feel safe and taken care of. If you have any questions or want to schedule an appointment to learn more about this procedure, contact us.

stem cell disc regeneration

How Does Stem Cell Disc Regeneration Work?

For many people, pain in the legs, hip, and back can be quite unpleasant.

One common cause of this pain is a degenerated disc, which is also known as degenerative disc disease. In the US, this condition is common as there are about 3 million cases every year.

Well, there are different treatments for such pain, including physical therapy, muscle relaxants, analgesic, nucleoplasty, and nonsteroidal non-inflammatory drugs. Surgical procedures may also be necessary for some instances.

One of the recent additions to the treatment options is stem cell disc regeneration. This procedure is already being advertised as an effective option for back pain. But, do you know how it works?

Keep on reading to learn more.

What Is Degenerative Disc Disease?

Degenerative disc disease occurs when normal activities that occur in the disc cause pain.

Ideally, these activities take place in nearly everyone over time. However, not everyone feels pain. Depending on your lifestyle, the disc can wear faster than in other people. When they get worn-out, you’ll start feeling pain.

Discs in the spine are made up of water. As you age, the water is lost, and the discs become thinner than before. This means your discs can’t absorb shock well. Also, they’re less cushioned, and this increases your risk of low back pain.

Also, the stress of daily activities can lead to tiny tears in the out water that contains nerves. Your discs may push through the tears, and this is what’s known as a herniated disc. When this happens, you’ll feel pain.

What is Stem Cell Disc Regeneration?

This is typically a medical process that involves the injection of stem cells into the disc. According to its proponents, the treatment works by preventing or slowing the degenerative process of the discs. It achieves this facilitating the production of new disc cells.

Scientists have already tried this injection on animals, such as rabbits, and it yielded promising results. As such, this has been a welcoming idea in the treatment of back pain in humans.

It’s hypothesized that stem cells turn into cartilage cells when injected into the disc. This allows the disc to regenerate and consequently, alleviating the pain. Doctors can harvest the stem cells from adults to use in treatment.

What Happens During the Procedure?

Well, the stem cell disc regeneration treatment is still in its infancy stage. However, experimental stem cell treatments have healed the damage that has occurred on the disc.

The procedure is minimally invasive. The doctor first extracts bone marrow from the patient’s hip bone. Then, they separate the stem cells through a procedure known as centrifugation. Alternatively, stem cells can be obtained from abdominal fat through a process called liposuction.

Your doctor will then use an X-ray to determine the ideal spot for injecting the stem cells. You can return to your normal routine after the injection.

Does it Work?

According to doctors, patients usually experience improvement two to three months after the treatment. Plus, you only need one treatment to get better.

However, in some cases, patients may need two or three injections. Also, a patient can’t have more than three injections within a span of 12 months.

Many doctors are claiming that disk regeneration using stem cells is the only effective alternative treatment for fusion and back surgery. It’s noted that the injection helps the disc to regenerate at a healthy rate. As such, patients should not worry about any possible complications.

Doctors also recommend undergoing physical rehabilitation following the treatment. Keep in mind that your recovery will depend on the degree of your spinal disc damage.

Why Use Stem Cells

Stem cells are ideal for this procedure because of their ability to repopulate. Essentially, they’re able to differentiate into discogenic cells.

In the past, doctors used to use embryonic stem cells. These are stem cells that are derived from the inner mass of the human embryo. Today, this is not the case since the adult stem cells are ideal for use, too.

Doctors can derive adult stem cells from the bone marrow or the adipose tissue. It’s noted that adipose-derived stem cells offer the ideal matrix for stem cell disc regeneration. This is because of their ability to generate the cartilage faster than bone marrow-derived cells.

Stem cells have also shown to communicate with nucleus pulpusus (NP) cells. This helps to produce anabolic growth factors that boost the cell function.

Possible Risks

As with any injection, there are potential risks, such as bleeding, infection, and nerve damage. Also, the risks depend on the area that’s receiving the injection.

It’s important to note that there’s no risk of allergy. This is because the doctor uses the patient’s own stem cells. With that in mind, every case is unique. At this time, there are no reports of any complications from patients.

There are FDA studies and trials that ongoing to help doctors understand more about the stem cell disc regeneration therapy.

What Does this Mean for Patients?

Several health centers and facilities, including Executive Spine Surgery, are already offering stem cell injections for degenerative discs. If you’re considering this treatment, it helps to find reputable doctors to provide it.

A good doctor will monitor your closely for potential benefits and side effects after getting the injection. Plus, they’ll help you know whether the treatment will work for you. This is because a severely degenerated disc has proven nearly irresponsive to treatment.

Severely degenerated discs that have lost all of their height usually have fewer cells living in them.

Final Thoughts

While stem cell disc regeneration has yielded promising results, it’s worth working with a doctor that assesses your situation well. Ideally, this treatment has considerable potential in revolutionizing the treatment of disc degeneration, herniations, and cartilage defects.

At Executive Spine Surgery, we treatment disc problems, such as bulbing, herniations, and degeneration. We offer a personalized approach to ensure all unique issues are addressed. THrough our minimally invasive treatments and pain management procedures, we’re sure to help you recover from your back pain.

Well, do you have any question about disc regeneration or back pain? Feel free to reach out to us, and we’ll be glad to help.

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.