All posts by Legacy Neurosurgery

Americans are Living Longer, but So Are Our Spines

According to a recent national study from Parker, one of America’s leading aging services organizations, most Americans appear hopeful and optimistic about aging.

“This survey underscores how American society’s views on aging are changing for the better, especially as the Baby Boom generation reaches retirement age and beyond,” says Roberto Muñiz, President and CEO of Parker. “Seniors are staying more vibrant, active, and connected well into their seventies, eighties, nineties, and beyond, and society is beginning to embrace that fact.”

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What is Sciatica?

In order to best understand sciatica, it’s important to first understand the literal “ins and outs” of what it’s caused by, what it feels like and how to treat it.

The first misconception to address is that sciatica is not an actual medical diagnosis- it’s a symptom of a medical condition.  More specifically, it’s the uncomfortable symptom of tingling, numbness, weakness or pain running from the lower spine, through the buttock, into the back of the thigh and down through the foot- the route of the largest single nerve in your body, the sciatic nerve.

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Bigger is Not Better for Back Surgery

With minimally invasive spine surgery (MISS) advancements, people with major back conditions have some exciting new treatment options. Understanding the best option for your back needs begins with better understanding what MISS is and the benefits it delivers.

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minimally invasive spine surgery

Get Back to Living Without Pain

If you are a weekend golfer, avid skier, outdoor enthusiast, or simply a dedicated desk-job employee, you may experience back and sciatica pain (tingling, numbness or weakness that originates in the lower back and travels through the buttock and down the leg). If that pain has not responded well to conservative care, you may be a candidate for an exciting new alternative to open spine fusion surgery.

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proper snow shoveling tips

Winter Shoveling Tips  

Shoveling snow is one of the most thankless cold-weather tasks. Up north, they have giant plow trucks and snow-blowers to move unwanted snow. Unfortunately, here in Arkansas, it is up to us to move the nasty stuff manually, unless you want to wait a few days until it has melted! But if you need to get out, it can be treacherous as thawing snow during the day turns to icy frozen sheets at night. Removing the snow from your walks and driveway is the safest way.  Here are some tips to help you get through this necessary evil without injury.

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MIGLIF Abstract

Retrospective Review of an MIS Lumbar Fusion Technique in Outpatient and Hospital Settings

Scott Schlesinger, M.D. (Legacy Neurosurgery and Spine, Little Rock, AR)


Introduction:  Advances in MIS surgery have helped expand the number of procedures that may be performed safely on an outpatient basis.  Patients may benefit from decreased tissue disruption that potentially minimizes pain, blood loss, complications, hospital stay, and recovery time.   Our clinic has combined MIS techniques with image guided navigation to develop a lumbar fusion procedure that can be performed through a single midline incision with cortical screw trajectory, achieving direct decompression, fusion, and instrumentation, permitting patients with low comorbidities to be treated on an outpatient basis.  Here we compare surgical results from outpatient and hospital settings.


Methods:  Under IRB approval, a retrospective chart review of a consecutive series of adults with lumbar stenosis and instability, treated over an 11-month period by one surgeon, was performed.  Charts were reviewed for demographics, diagnosis, medical history, surgical parameters, and complications.


Results: A total of 73 patients with degenerative disease positive for radicular pain and segmental instability were reviewed (Table 1).  Outpatients (n=40) were single level procedures, while hospital patients (n=33) were treated at one (n=28) or two levels (n=5).  Average OR time was 204±51 minutes for outpatients and 221±61 for hospital patients (Table 2).  Average estimated blood loss was 345cc±198 for outpatients and 298cc±217 for hospital patients.  All surgical incisions were <2cm and no blood transfusions were required.  All outpatients were successfully discharged on the same day.  Average stay for hospital patients was 2.5±2.6 days.  There were no unanticipated complications or trends observed.


Conclusion:  Surgical outcomes in this series demonstrate the initial benefits of the midline technique in outpatient or hospital settings.  Navigation, cortical bone trajectory, and keyhole incision allows direct decompression and instrumentation, optimizing MIS in the lumbar spine.  Long-term, prospective clinical studies may further demonstrate the safety and long-term efficacy of this technique.


Table 1.  Patient Demographics                                                                                                 

Outpatient (n=40) Hospital




Age 52.1 ± 8.6 62.4 ± 17.0 56.8 ± 14.0
Sex 24 Males

16 Females

15 Males

18 Females

39 Males

34 Females

Prior Surgery   (any lumbar level) 15 Yes (38%)

25 No

15 Yes (45%)

18 No

30 Yes (41%)

43 No

Levels Treated All single levels 28 single level

5 two-level

68 single level

5 two-level


 Table 2. Surgical Parameters and Intra-Operative Complications

Outpatient (n=40) Hospital (n=33) Total (n=73)
Surgical Parameters
·   OR Time (Minutes) 204 ± 51 221 ± 61 212 ± 56
·   Est. Blood Loss (CC) 345 ± 198 298 ± 217 324 ± 206
·   Hospital Stay (days) Same Day 2.5 ± 2.6 1.1 ± 2.1
Intra-Op Complications (n)
·   Intra-Op Durotomy 2 3 5
·   Dural Fistula 1 0 1
·   Cardiac Issue 0 1 1
·   Urinary Stasis 1 1 2
·   Psuedomemingocele Repair

       (From prior fusion surgery)

0 1 1

Submitted to the 2017 Annual Meeting of the Congress of Neurological Surgeons, to be held October 7-11, 2017 (Boston, MA)

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back pain

5 Bad Habits You Don’t Know Are Causing You Back Pain

You hear about the typical reasons for back pain all the time; a slipped disc, a work injury, a genetic disorder. But you may not know all the things you do on a daily basis that indicate you’re headed towards a whole heap of pain. Back pain often isn’t an instantaneous thing. It usually occurs as a culmination of things that have happened to your body over the years. So, we’ve put together the top five bad habits that you might not even know are contributing to your pain or might contribute to pain in the future.

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