All Posts in Category: Minimally Invasive Surgery

Cervical Radiculopathy

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See below for some common symptoms and treatments for cervical radiculopathy.

  • Radiating arm pain and/or numbness and tingling
  • Usually due to a ruptured or herniated disc in the cervical spine or narrowing of the exit hole for the nerve also called neural foramen stenosis
  • May be also associated with cervical spinal stenosis which can lead to spinal cord damage or cervical myelopathy
  • If not associated with spinal cord compression can be initially treated with conservative care
  • Conservative options include: Neuropathic medications, physical therapy and manipulation therapy, Cervical Epidural Injections
  • Surgery is usually via an ACDF or anterior cervical discectomy and fusion from the front of the neck for refractory cases and/or those with severe neurological issues including spinal canal stenosis.
  • When indicated surgery is usually very successful and the benefits far outweigh the risks
  • Other causes less common of this type of pain may include shoulder disease, neuropathy, CTS, brachial plexopathy, vascular disease

Images obtained via google

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Intraoperative Navigation

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What is intraoperative navigation?

Sophisticated imaging equipment that is used during surgery to provide accurate anatomical localization of important structures.

How does it help in spine surgery?

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In 2018 Legacy Spine and Neurological Specialists and Scott Schlesinger,MD proudly announce the arrival of the least invasive spinal fusion surgery option available.

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MIS spine surgery in 2018

Minimally invasive spine fusion has gotten even less invasive over the last couple of years.  I patented the MIGLIF MIS fusion surgery in the prior 2 years and still use this for many patients that need pedicle screw stabilization.  However, over the last several months, I have started utilizing a new approach that takes the MIS approach to an even greater less is more level.

This is the Vari-lift stand alone expandable inter-body fixation device.  With this I have been able to reduce the OR time to around 1.5 hours  for a extensive yet MIS neural decompression and inter-body fusion.  With this device and surgical approach offered at Legacy Spine and Neurological Specialists and Legacy Surgery Center we have had great results and very rapid recovery with much faster return to normal life than the standard open lumbar fusion surgery.

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What is causing my leg pain?

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There are many potential sources of leg pain. The nerves that provide motor and sensory function to the legs start in the lower back. These are called the lumbar nerves. Leg pain that starts in the lower back and radiates down the leg is often referred to as ‘sciatica.’

Some causes of leg pain from a lumbar spine problem include:

Disk Herniation

where the soft cushion between the bony vertebrae of the spine herniates from its normal position and causes compression of the lumbar nerves

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Numbness of the Hands

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Patients frequently complain of numbness and tingling of the hands.

The most common causes include:

    • Carpal Tunnel Syndrome (CTS)
    • Ulnar Nerve Compression
    • Spinal cord compression and other conditions of the spinal cord that cause cervical myelopathy.
    • Cervical radiculopathy
    • Peripheral neuropathy.
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What is laser spine surgery?

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Lasers have been used for many years in medicine and surgery. Their role, however, in spinal surgery is extremely limited and for good reason.

Lasers can be used to cut through soft tissues like skin and fat. This can also be done using a traditional scalpel without the risk of thermal (heat) injury to surrounding tissues and without the significant expense of using a laser.

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Smoking adds complicated risks to spinal procedures

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Many surgeons, especially neurosurgeons, urge patients to stop smoking before spinal procedures, particularly, spinal fusions.

Why?

An extensive amount of research has found that smoking cigarettes prolongs the healing process and causes complications. Below is a list of problems that can arise:

  • Decreased rate of successful fusion (called non-union or pseudoarthroses)
  • Poorer clinical outcomes, including pain reduction
  • Poor rehabilitation after surgery, and prolonged healing process
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Is your bulging disk causing your back pain?

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As our bodies age so do our spines. Arthritic changes will be present in the spine which include bulging disks, degenerative disk disease and joint changes. The degree that these changes occur are often related to genetics. A simple bulging disk is actually an extremely common finding on MRIs of the spine and is not an indication for surgery. There are many other structures in the low back and neck that are very sensitive to pain especially the muscles and numerous joints that support the spine. These are more often the cause of low back and neck pain and are treated with conservative therapies. Occasionally a disk will actually herniate out of the normal position between the vertebral bones and cause pressure on spinal nerve resulting in extremity pain. The disk herniation itself is not painful but can result in pain by causing inflammation and/or pressure on these spinal nerves. If extremity pain from a compressive herniated disk cannot be fixed with conservative treatments sometimes surgery is indicated. Our neurosurgeons are trained to read spine MRIs, understand the complicated anatomy of the spine and perform neurological exams to determine appropriate treatment options. 

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Lumbar Disc Disease

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Symptoms

Symptoms vary depending on the severity of the condition, and may range from no symptoms to severe pain in the back and or legs with variable degrees of numbness, tingling and weakness in the legs.

Causes

The lumbar discs are the cushions between each of the lumbar vertebrae in the lower back. These cushions are composed of an inner layer of material called the nucleus pulposus, which is surrounded by fibrous bands called the annulus. The nucleus material is a gelatinous core that has the consistency of “boiled shrimp”. These cushions serve as the shock absorbers in our lower back, just like the shock in your car. These “shock absorbers” experience daily wear and tear.

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Myelopathy

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Myelopathy is a term used to describe dysfunction of the spinal cord. This most commonly occurs due to degenerative or aging changes in the spine.  Degenerative changes occur in everyone to varying degrees. Common radiologic signs of degenerative changes include enlargement of the joints, degradation of the disks and bone, bone spurs and even herniated disks. Most of the time these changes do not cause problems. However, in some patients these changes can cause significant narrowing of the spinal canal resulting in spinal stenosis. Stenosis can cause pressure on the spinal cord and cause spinal cord dysfunction or myelopathy. The spinal cord relays information from the brain to the rest of your body and myelopathy can interrupt these important neurological pathways causing discomfort.

Symptoms may include: 

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