Spine, back, or neck pain

An orthopedic spine specialist treats intense, chronic neck and low back agony. Assessment and treatment for spinal stenosis,pinched nerves and sciatica and slipped or herniated plates advertised. We specialize in degenerative, deformity and injury of the spine. Surgical medications incorporate insignificantly intrusive techniques for diskectomy, laminectomy, disc substitution, Xstop, and kyphoplasty. Depends on far reaching history physical exam, MRI and CT imaging is done to analyse the treatment plan further.

Not all spinal stenosis needs a back fusion

Spinal stenosis is a common diagnosis among patients with back pain and sciatica. The term lumbar spinal stenosis refers to a narrowing of the space available for the nerves in the low back. The common symptoms of spinal stenosis includes radiating pain which can start in the back and buttocks and travels to the thighs and calves which makes walking and standing for prolonged periods challenging. Often, patients with spinal stenosis discover that by leaning on a walker or shopping cart helps alleviate the radiating pain and burning and heavy sensation in the legs. The reason for this is due to a natural opening of the space available for the nerves when we pitch or bend forward. The natural history of spinal stenosis is episodic flare ups which are often are self-limiting in nature improving with time, anti-inflammatories and activity modifications. In a small percentage of patients, the symptoms become chronic and affect a patient’s quality of life. The limiting effect on function and independence is often a catalyst for patients to seek a more definitive intervention. This is when the care of a spine surgeon is most needed.

The most common goals of low back (lumbar) spine surgery include:

  1. Decompression of the spinal canal to allow more space for the nerves to function
  2. Stabilization of individual motion segments of the spine which are moving out of sync

The gold standard for surgical management of lumbar spinal stenosis is a lumbar laminectomy. The lamina of our spine are the vertical bony “roofs” which overlay the spinal nerves. A traditional laminectomy removes the complete “roof” to allow the surgeon access to the spinal canal to release and remove the build-up of inflammatory tissue which is causing the stenosis. Often metal rods and screws are added to increase the stability of the area of decompression.

Are there any new options available for this common problem? Can a fusion be avoided? Yes!

A device now available prevents the need for excess muscle to be cut, affords a smaller incision with less blood loss and a quicker recovery back to normal activity. The device’s name is Coflex. It is a metallic spacer which is placed in between the lamina (the vertical bony ‘roof’) to allow for a continuous opening of the canal. This device is press-fit into the space after a microscope is used to minimally invasively open-up the canal to release the stenosis without removing excess bone and allowing for normal motion after the surgery by avoiding a fusion. The device recreates the normal tendency of patients to try lean forward to open-up the space for the nerves in the spinal canal. But now with the decompression done and the device in place the patient can stand up and walk with a straight posture and for longer distances and duration. The procedure is done under general anesthesia and is usually performed in under two hours. An overnight stay in the hospital is recommended. The patient is up walking the day of surgery and independent in activities of daily living right away.