I am 39 year-old woman with left leg pain and numbness. What can I do?

Your left leg pain and numbness is probably from a “pinched” nerve in your back.  This is called Sciatica.  Sciatica in a 39 year old is most commonly caused by a disk herniation.  Treatment for sciatica varies from rest, physical therapy, anti-inflammatories, steroid injections and surgery.   Pain that is not improving, very severe or associated with neurological deficits (weakness, foot drop, numbness or bowel and bladder incontinence or retention) may require spinal surgery.

In the past spinal surgery was a big deal.  You were admitted to the hospital, put to sleep under a general anesthetic and had your back half opened up to expose the spine.  The muscles were retracted and damaged and the bone was removed.  This bone removal is called a laminectomy or laminotomy, depending on how much lamina was removed.  Then the traversing nerve and thecal were retracted and the disk was found and removed.

Today disk surgery is much simpler.  Disk surgery can be done through a spinal endoscope (such as JOIMAX), this is often called Laser spine surgery, even though the laser is not necessary today.  The big advancement of “Laser spine surgery” is the used of an endoscope.  An endoscope is a pen-sized micro-video camera that is placed inside the spine to the herniated disk pinching the sciatic nerve.  Tiny instruments are inserted through the endoscope to remove the disk.   The sciatica leg pain often improves very quickly often before surgery is over.

Schedule an Appointment to learn more about endoscopic spine surgery and how it can help you!

How long does it take for anterior cervical discectomy and fusion (ACDF) surgery to fuse?

Anterior cervical discectomy and fusion is a surgical disk removal procedure through the front of the neck relieving pressure off the spinal cord and nerves.  After the neural elements are well decompressed and the endplates of the vertebrae are prepared a piece of bone is placed into the emptied disk space.   This bone may be from the patients body (usually the hip) or can be specially prepared from cadaveric bone.

The bone graft then must incorporate into the spinal vertebrae.   The bone from the upper and lower vertebrae slowly grow into the graft ultimately making one large “bone”.   This can be a slow process.  Fusion usually takes 6 to 12 months or more.   I wold not expect you to be fused in 3 months.  Initially the bone weakens and then slowly becomes stronger as the bone from the other vertebrae grow through it.  The healing is not complete until fusion is completed. I would recommend giving it more time.

Artificial disk replacement is a new option to cervical fusion.  The procedure is done in a similar manor to the anterior cervical discectomy and fusion.  The disk is removed and the endplates are prepared.  An artificial disk is then placed into the neck instead of the bone graft.  Even though artificial disks are relatively new medical technology there may be significant advantages including early return to activity since you do not have to wait for the bone to fuse and less wear and tear at the adjacent disks spaces which may lead to further spinal disease after a fusion.

Endoscopic cervical discectomy is another fusion sparing option for removal of cervical disks.  The spinal cord and nerve are decompressed, spinal motion is maintain and no metal disk is placed into the neck.

For more information please Schedule an Appointment.

Good Luck!

I have tailbone pain, making sitting and standing up very uncomfortable.

Tailbone pain often results form falls or injuries to your coccyx.  Rarely pain may arise from lesions in the tail bone such as cancer.  Many traumatic injuries to the tailbone may respond to hemorrhoid cushion (which takes pressure off the tailbone and helps pain and swelling settle), anti-inflammatory medicine or steroid injections, rarely patients may need tailbone surgery.  For treatment options for back pain please click Read More.  Good Luck!

I have left shoulder pain radiating down to my hand.

Shoulder, arm and hand pain may arise from problems in the neck, shoulder, arm or hand. Most commonly this type of pain is secondary to a disk pinching a nerve in the neck (cervical radiculopathy) or thickened ligament pinching the median nerve in the hand (carpal tunnel syndrome), but there are many possibilities for neck and arm pain.

Many people benefit from physical therapy and anti-inflammatories for neck pain and hand brace for carpal tunnel syndrome. People who fail to improve may benefit from steroid injections and/or surgery.  For more information on treatment options please click Read More or contact Executive Spine Surgery.  Good Luck!

Is there a link between strength and the development of scoliosis?

Scoliosis is the curvature of the spine.  Scoliosis may result from juvenile scoliosis in kids (unknown cause), spine, arthritis, neurologic disease, surgery, injury, etc.  Neurologic disease such as a spine tumor may cause back muscle weakness resulting in scoliosis. Scoliosis is not caused from being out of shape or not working out at the gym (that is being weak).  I hope this information answers your question.

For more information please click on Does scoliosis cause pain?  Good luck!

Is it bad to use a back brace?

Frequent use of a back brace may lead to weakening of your back muscles and the development of increased back pain. It is best to strengthen your core muscles to stabilize your back to decrease back pain.  I recommend starting Yoga.  Yoga is a great exercise to strengthen your abdomen and back, improve flexibility and loose weight!  For more information please contact Executive Spine Surgery.  Good Luck!

Does everyone eventually get some form of spondylosis?

Spondylosis is degenerative arthritis of the spine.  Most, if not all, people develop evidence of spondylosis on X-rays, CT or MRI, since it is normal wear and tear changes of the spine.   Fortunately many people do not develop significant pain or other symptoms from it.  For more information click on Back arthritis or Sciatica.  Good Luck!

Does everyone eventually suffer from degenerative disc disease?

Degenerative disk disease is the wearing out of your disks in your back.  This is a slow process resulting from drying out of the nucleus pulposus changing how the disk manage forces. Over time the disk may darkens, collapse, bulge, tear and rupture producing leg pain called Sciatica.

Everyone or at least most people develop radiologic evidence of degenerative disk disease if they live long enough, but not everyone will have pain and suffering as a result of it.  There are many new treatments for degenerative disk disease including artificial disk replacement, endoscopic discectomy and annuloplasty,  Endoscopic Spinal Fusion (that is Endoscopic Lumbar Interbody Fusion or ELIF). 

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

What causes neck and shoulder blade pain and arm tingling?

The neck and shoulder pain and arm tingling may be from a disk pinching a nerve in your neck. This often will cause spasms in the shoulder and lower neck.   You may benefit from rest, physical therapy and/or anti-inflammatory medicine.  If the pain does not improve with conservative treatment you may benefit from steroid injections or surgery depending on the cause of the pain.  There is new endoscopic spine surgery options for treatment of symptomatic disks in the neck.  Good Luck!

Will my pain go away after L4-L5 spinal fusion surgery?

Pain may improve, stay the same or worsen after fusion surgery.  The majority of people will see improvement in there pain, but few people will have complete pain relief.  Unfortunately spine surgery does not give you a new uninjured back.   I would discuss what the likelihood of you improving with your surgeon.

Spinal fusion surgery  is usually done through an open traditional technique causing significant skin, muscle and bone damage.  Recently open traditional fusion surgery is being replaced by percutaneous endoscopic fusion techniques I call Endoscopic Lumbar Interbody Fusion (ELIF).  These surgeries appear to have less bleeding, soft tissue and bone damage compared to open traditional fusion surgery.  Due to less soft tissue and bone damage these endoscopic surgeries appear to have less post-operative pain and a quicker recovery.

For more information on percutaneous endoscopic fusion surgery please contact Executive Spine Surgery.   Good Luck!

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