Back pain results in severe discomfort to an individual and various measures are taken to treat it that includes invasive and non-invasive treatments. Medication and physiotherapy are the initial treatment regime followed by Neurologists. The last resort, when nothing else works, will be a spine surgery.
Dr. David L. Masel, MD, FAANS, FACS, Board Certified Neurosurgeon at Specialty Care Clinics has more than 30 years of experience is committed to treat back pain with spine surgeries including:
- Minimally invasive spine surgery
- Spinal Compression Fracture Treatment
- Spinal Cord Stimulation
- Spinal Fusion
- Spinal Reconstructive Surgery (Scoliosis)
- Neuro-stimulation
- Disc Replacement affecting the nervous system
Spinal surgery might be required for various spine problems like:
- Herniated or ruptured discs
- Scoliosis
- Kyphosis
- Spinal deformity
- Degenerative disease
- Trauma
- Tumor
- Infection of the spine
- Growth disorders
- Neuromuscular disorders
- Myelomeningocele
- Types of Spine Surgery
Several types of spinal surgery that might help in treating back pain, including the following:
1. Minimally invasive spine surgery
- Introduction – Minimally invasive spine surgery (MISS) is an alternative to traditional open surgical procedures to treat various spinal disorders, including degenerative disc disease, herniated disc, scoliosis, and spinal stenosis.
- Goal – The aim of this surgery is to stabilize the vertebral bones and spinal joints that would relieve pressure applied to the spinal nerves. Minimally invasive spine surgery is attempted initially to treat your pain or debilitating back problems, like pain injections.
- How the surgery works – The surgery involves percutaneous or mini-open small incision procedures. As an alternative to cutting through soft tissues surgery requires segmental tubular retraction that creates an expandable tunnel passing between muscles to access the spinal column. An endoscope that is a small video camera, displays visuals of the surgical region on a monitor during the process to the spine surgeon. Surgical imaging systems and image-guidance technologies like fluoroscopy (real time x-ray), are applied during surgery to isolate key aspects of the patient’s spinal anatomy.
- Benefits and risks – Spine surgery has benefits such as Small incisions, Less pain, Low risk of infection, Short hospital stay, Quick recovery time, Less scarring, Reduced blood loss along with potential risks such as Bleeding, Blood clots, Nerve damage, Return of symptoms, Failed fusion (referred to as pseudarthrosis or non-union) and Infection.
- Problems treated using this surgery – Dr. David Masel is highly qualified to treat various spinal conditions with minimally invasive spine surgery such as-
- Degenerative disc disease
- Herniated disc
- Lumbar spinal stenosis
- Spinal deformities such as scoliosis
- Spinal infections
- Spinal instability including spondylolisthesis
- Vertebral compression fractures
- Spinal tumors
2. Spinal Compression Fracture Treatment
- Introduction – A compression fracture is caused due to loss of bone mass mainly osteoporosis that occurs as part of ageing. This involves both treatment of the fracture as well as underlying osteoporosis that led to the fracture.
- How it Works– Surgery is essential when chronic pain results from a spinal compression fracture persists regardless of rest, activity modification, back bracing, and pain medication. Surgical procedures used to treat spinal fractures are:
- Vertebroplasty – This is effective for relieving pain and helping to stabilize the fracture. Low viscosity cement is injected under high pressure directly into the collapsed vertebral, with the aim of stabilizing the fracture along with relieving the associated back pain.
- Kyphoplasty – This helps in correcting the bone deformity as well as reduces or stops the pain associated with spinal compression fractures. The technique helps in restoring some or all of the lost vertebral body height resulting from the compression fracture.
- Prevention of Compression Fractures– Prevention of recurrence of compression fracture is a crucial part of the treatment plan involving treatment of underlying osteoporosis. The treatment regime would involve: calcium supplements, increased vitamin D intake, incorporating weight-bearing exercises, and hormone replacement therapy for women.
- Problems associated with spinal compression – Dr. David Masel is highly qualified in minimally invasive surgery techniques involved in treating neurological disorders affecting the spine such as:
Herniated disc- Spinal stenosis
- Spina bifida occulta
- Spine trauma
- Spinal tumors
- 3. Spinal Cord Stimulation
- What is a Spinal Cord Stimulator – Aim of spinal cord stimulation treatment is to mask pain signals before reaching the brain to trigger the pain receptors. It aids people in better managing chronic pain and reduces the use of opioid medications. It is proven to be a better option for people suffering from chronic back, leg or arm pain and with no or very little relief from other therapies.
- How it Works? – Spinal cord stimulators is a small device consisting of thin wires -the electrodes; and a small battery pack -the generator. The electrodes are implanted in the epidural space; that is space between the spinal cord and the vertebrae, whereas the generator is implanted under the skin, mainly near the buttocks or abdomen. Spinal cord stimulators send the electrical impulses via remote control (outside the body) when the patient feels pain. The electrical signal helps to mask the pain signal being sent to the brain, however they do not treat the source of pain.
- What is Spinal Cord Stimulator Used for? – Spinal cord stimulators are used if non-surgical treatment provides very little or no relief from pain. Various conditions could be treatment using this treatment mode like:
- Back pain mainly due to failed back surgery syndrome
- Post-surgical pain
- Arachnoiditis (painful inflammation of the arachnoid
- Heart pain or angina that is untreatable by other treatments
- Injuries to the spinal cord
- Nerve-related pain caused by severe diabetic neuropathy or cancer-related
- Peripheral vascular disease
- Complex regional pain syndrome
- Pain after an amputation
- Visceral abdominal pain and perineal pain
- Dr. David Masel is highly qualified and experienced in treating neurological disorder that are affecting the spine such as:
- Herniated disc
- Spinal stenosis
- Spina bifida occulta
- Spine trauma
- Spinal tumors
4. Spinal Fusion
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- What is spinal fusion – Spinal fusion is a surgical procedure that helps in correcting problems occurring in the small bones in the vertebrae, which are the small and interlocking bones of the spine. Spinal fusion has many names such as arthrodesis or anterior spinal fusion or posterior spinal fusion or vertebral interbody fusion.
- What is the use of spinal fusion – Spinal fusion is a welding process that joins 2 or more vertebrae permanently into one solid bone with no spaces between the vertebrae. An extra bone fills the space existing between the two separate vertebrae, with no space between them when the bone heals. The procedure results in no mobility between the treated vertebras that decreases flexibility. Usually the flexibility is reduced in a small section of the spine as well as do not limit the motion to a great extent. Spinal fusion also prevents the stretching of nerves as well as surrounding ligaments and muscles. It is beneficial when the motion is the main source of pain including movement occurring in a part of the spine caused by arthritis or injury, disease, or the normal aging process.
- Risks Involved – The primary healthcare provider would discuss the potential complications and risks associated with the spinal fusion surgery such as:
- Infection
- Bleeding
- Pain at the site of graft
- Reoccurring of the symptoms
- Pseudoarthrosis
- Nerve Damage
- Blood Clots
Pain management and rehabilitation are main parts of recovery. Pain is a natural part of the healing process which is usually managed with medications for short-term pain relief after surgery including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local anesthetics. The solidification of the bone takes about several months but it involves physical therapy which is recommended after 6 weeks to 3 months post-surgery. Maintaining a healthy lifestyle along with the health care provider’s instructions will significantly increase the chances of a successful outcome.
What is Spinal Fusion used for? – Dr. David Masel is highly qualified and experienced in treating neurological disorder that are affecting the spine such as:
- Tumors
- Spinal stenosis
- Herniated discs
- Degenerative disc disease
- Fractured vertebrae
- Scoliosis
- Kyphosis
- Spinal weakness or instability
- Spondylolisthesis
5. Spinal Reconstructive Surgery
Spine surgery, or reconstructive spine surgery is mainly recommended after the traditional therapy fails and minimally invasive surgery does not improve the condition of the patient. Spine surgery is recommended to patients having deformity or misalignment affecting the major segment of the spine.
This would involve more than one part of the spine as well as corrects substantial spinal deformities along with balancing the newly shaped spine with support of rods and pins, and connects the vertebrae together. Sometimes, the entire vertebrae is removed and replaced by means of artificial devices to replace the diseased segment.
Recovery from Spine Surgery – The aim of spinal reconstructive surgery is to relieve pain along with restoring spinal nerve function caused due to broken vertebrae, resulting from disc herniation or instability, as well as correcting a spinal deformity.
Call us at (469) 545-9983 to book an appointment with our expert spine surgeon Dr. David Masel.