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.
Many surgeons, especially neurosurgeons, urge patients to stop smoking before spinal procedures, particularly, spinal fusions.
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:
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.
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.
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.
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.
Ulnar Neuropathy is a disorder that involves the ulnar nerve (one of the major nerves in the arm). Ulnar neuropathy is usually due to entrapment in the elbow area, the region of the “funny bone”. This entrapment may be spontaneous and related to thickening of adjacent ligaments and muscles. This can be related to a prior injury in the area with associated scar formation that leads to a delayed onset of the nerve compression often years after the injury “tardy ulnar palsy”.
Foot drop is a term used to describe difficulty raising your foot upwards (dorsiflexion). This may be most noticeable when trying to walk as people with foot drop often complain of tripping and dragging their foot. Foot drop can be caused by a number of underlying neurological problems and should be evaluated by your physician.
Our primary goal is to relieve patient’s pain, while taking the least invasive route. Often times when someone has neck pain, it is best to start with Cervical Epidural Steroid Injections. Cervical Epidural Steroid injections are often used to relieve pain in the neck, arms and shoulders. Neck pain is often caused by conditions like herniated discs, bulging discs, arthritis and spinal stenosis, which can cause compression and pinched nerves. To relieve pain associated with these, we often times recommend getting a series of three injections
Cervical Radiculopathy is the clinical description of pain and/or neurological symptoms usually caused by a pinched nerve in the neck. Any condition that compresses or irritates a cervical nerve can cause cervical radiculopathy.
Stenosis is a common spinal condition caused by arthritic build up in the joints (facet joints) and ligaments in the lower back. In addition, one may have a disc bulging that causes pressure on the nerves passing through the narrow canal.
Symptoms:
Back and leg pain down one or both legs, numbness or tingling, weakness often associated with electric shocks running from the back to the feet. These symptoms are increasingly aggravated, at a varying degree while walking, and improve when sitting or stooping forward.