All Posts Tagged: arkansas neurosurgery

Screwless | Lumbar Interbody Fusion (S-LIF)

THE WORLD’S LEAST INVASIVE LUMBAR FUSION SURGERY: the S-LIF, Developed by and available exclusively at Legacy Spine & Neurological Specialists.

Sciatic nerve pain can be disruptive. Constant pain and numbness due to a compressed nerve with spine instability can hinder your daily life. So can invasive spinal surgery and the recovery time that comes along with it. But not anymore, thanks to S-LIF technology.

The S-LIF is the least invasive option for lumbar fusion surgery available anywhere in the world. When Dr. Schlesinger developed the MIG-LIF procedure in 2015, it was the least invasive fusion option also done through a keyhole outpatient surgery. While this was a great breakthrough at the time in MIS spine surgery, Dr. Schlesinger felt that the next logical step was to achieve the same outcome with even less surgery.

Through application of his microsurgical skills and experience in delicate surgery on aneurysms and tumors of the brain, this next step became a reality. The S-LIF is the least invasive option in the world for many patients with the need for a decompression and fusion of the lumbar spine. It is not for all patients as some still require more invasive surgery. But for those that are candidates for MIS surgery, this is an outstanding option.

The S-LIF procedure is performed by our two talented neurosurgeons Scott Schlesinger, MD, and Dominic Maggio, MD. Scott Schlesinger, MD has practiced neurosurgery since 1992. He trained in Neurosurgery at UT Southwestern with a fellowship in Lausanne, Switzerland. He has received multiple awards and multiple recognitions as the Best Neurosurgeon in the state. Dr. Schlesinger is the founder of Legacy Spine and Neurological Specialists and the developer of the S-LIF procedure.

Dominic Maggio, MD joined the Legacy team in July 2021. He is an excellent surgeon who specializes in the S-LIF procedure as well as a wide variety of other spinal surgery. He trained at the University of Virginia-National Institutes of Health neurosurgery program and received multiple awards for his research and clinical skills. He subsequently did a fellowship at Ohio State University in complex and minimally invasive spine surgery techniques.

To find out if the S-LIF is an option for you or for more information please call or send us a message today. We look forward to the opportunity to serve you!

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Legacy Updates!

Important Announcements To Legacy Spine and Neurological Specialist’s Patients

While 2020 and 2021 have been very challenging and unprecedented years, we do have some very good news to brighten the day of all our Legacy team and patients!

Kelli Schlesinger MD and I are excited to announce that Dominic Maggio MD Neurological Surgeon will be joining our Legacy practice in July.  Dr. Maggio joins us from his complex spine fellowship at Ohio State University and his neurosurgery residency at University of Virginia, Charlottesville.  He comes with tremendous training and experience  from two of the best neurosurgery  training programs in the country.  He is a very talented neurosurgeon with expertise in minimally invasive and complex spinal surgery.  He will be moving to Little Rock with his lovely family with 3 young children.

We will continue to offer telehealth services for the foreseeable future to facilitate your treatment plan, particularly those of you who live long distances away. We are excited about some new MIS technology and innovation‘s coming our way this year and in continuing to use our outpatient minimally invasive SLIF surgery (Screwless Lumbar Interbody Fusion) when a fusion surgery is needed on the lower back through a key hole incision.   For the last four years we have worked with some innovative spinal companies and imaging technology companies to develop the most minimally invasive lumbar fusion surgery option that is available anywhere in the world!


Additional developments:

In May, Dr. Flaxman and Dr. Magnuson, anesthesia pain management doctors of Southern Regional Anesthesia Consultants (SRAC), will be joining our team in performing injection procedures at the Legacy Surgery Center.  They also offer medical pain management services at their office for patients needing medication management.

Dr. Carlos Roman, an anesthesia pain provider of Proper Pain Solutions (PPS) will no longer be performing procedures at Legacy Surgery Center.   However, his pain management partner Dr. Eugene Becker will be performing injection procedures on patients we have clinically shared with PPS at Legacy Surgery Center.

Notice:     PPS Drs. Roman and Becker perform pain procedures at other facilities in the state.  Their Little Rock office is adjacent to our surgery center.  Due to these factors accidents can happen with where you are scheduled for future spinal injection procedures.  We want you to be aware of this possibility and if it happens we urge you to remind their scheduler of your desire for your procedures to be carried out exclusively at Legacy Surgery Center if you desire our continued concomitant care and back up in case of any need for urgent surgical care.

Why?  In the best interest of your spinal care it is our medical policy that all the patients we are caring for undergo all needed spinal procedures at Legacy Surgery Center.

Why?    All spine procedures carry a small but definite risk of complications including spinal bleeding that could possibly need emergency neurosurgery operative intervention.    If spinal procedures are done elsewhere and there is an unforeseen complication needing urgent surgery, there will be a significant delay in our ability to intervene.    This could possibly lead to irreversible paralysis that might have otherwise been avoided if not for the delay.   Also, and very importantly, when spinal procedures are performed elsewhere, we have limited ability to participate in your spinal management plan, have difficultly accessing the images from the procedures and the records of such as compared to the ease of such when done here at Legacy Surgery Center.   We believe in staying directly involved in all aspects of your spinal care to ensure the best possible quality of all of your treatment plan.  As neurological specialists we are trained in attention to detail.  We cannot achieve these goals when procedures are done on your spine elsewhere.

Therefore if you are a patient that has seen either PPS doctor at any of their clinic sites in Little Rock, Morrilton and Russellville and you are inadvertently offered or scheduled for spine procedures at one of the other outpatient surgical facilities where they work, you can and should insist that your spine procedures be performed at Legacy Surgery Center by Dr. Becker or by Legacy physicians if it is your desire that our Legacy Neurological physicians remain the “Captain” of your Spine-care-ship and be readily available for any possible emergency surgical care.

Why?   There is far more to your spine care than the actual injection of a medication with a needle into your spine.     Most pain management doctors are anesthesiologists or physical medicine rehabilitation doctors who not trained in neuro-imaging, neuro-anatomy, neuro-pathology and neuro-physiology like our Neurosurgeon and Neurologist specialists are.  PPS pain management doctors Becker and Roman are excellent at anesthesia pain management.    But they are not only not trained as surgeons of the spine, they are not surgeons of any kind.  Surgery is a field of expertise that takes 7 years of post medical school training and cannot be learned as a weekend course.   I strongly advise you to always confirm that whoever is proposing to do any form of open surgery that involves an incision and putting anything in your body other than a needle on any part of your body is in fact a trained board certified or board eligible surgeon in that field.  Nothing could be more important than confirming this for any form of spine surgery offered to you as there are pain management doctors that are performing open surgical procedures on the spine including placing spinal implants in patients after merely taking a course.  This is not the kind of training you want for your spine surgery needs!  

We strongly feel that all patient’s spine care diagnosis and plan should be created and managed by a neurological spine specialist or by spinal orthopedic surgeons regardless of who does an actual injection procedure.  We also strongly feel that whoever is your spinal surgeon should be on staff at the site where any spinal injection procedures are being performed on you regardless of who does the actual injection procedure for the reasons above – in case of a surgical emergency complication and for access to the information, records, and images for continuity of your care. 

We stay actively involved in your care all along the way with adjustments whenever necessary based on your response to various interventions starting with the least invasive plan first even if you do not initially need surgery or ever need surgery.   We are also well prepared and experienced with minimally invasive surgical options should such be necessary.

We are happy to continue to manage of your spine care if you continue to see either doctor of PPS for medication management as long as you insist that any of your spine procedures are done at our location by Dr. Becker or us for all the reasons above.  There will be no interruption of your care with these changes and apologize for any confusion this may cause.

If you instead desire to transfer your overall spine care management to PPS, we can be available at any point in the future to resume your care surgical or non surgical in the future.

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Intraoperative Navigation

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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Becker’s Presentation by Dr. Schlesinger

Becker’s ASC Review

This past month, our very own Dr. Scott Schlesinger was a featured speaker at this years’ Becker’s Ambulatory Surgery Center Review Conference. Over 1500 physicians and administrators from around the country attended the conference.

Dr. Schlesinger took the stage to discuss the MIGLIF procedure. 

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F.I.T.T Principle

In the world of physical therapy a very common goal is to increase strength. Some patients love the hands on approach with a skilled therapist while others choose to hit the gym. So if you are one of those individuals that would like to try it on your own there is a very important training tool to keep in mind. The FITT Principle:

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Is your bulging disk causing your back pain?

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


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.

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Ulnar Neuropathy

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”.

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How to Avoid Neck Pain at Work

Have you ever arrived to work and before the hectic day has even begun you are already experiencing the nagging and far too familiar feeling of neck pain?

By: Jessica Beggs, DPT (Legacy Neurosurgery Physical Therapist)

There are many sources of neck pain but one that is commonly overlooked is body positioning throughout the work day. According to a recent study by Caio et al. neck pain is a common condition that can cause substantial disability and is of high prevalence with individuals who perform occupational activities while sitting and leaning.1 So, what type of employment fits that job description? This data is not limited to computer programmers and call centers but instead could be applied to nearly all job styles! When sitting, leaning forward is a position that the body sometimes naturally assumes especially when driving a car, using a phone, or working on a computer. It requires countless muscle fibers to recruit and a conscious effort to maintain upright posturing.

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Congratulations to Dustin Johnson for his Playoff Opener Win

The Play by Play

Dustin Johnson is cool under pressure! Despite falling five shots behind Jordan Spieth after five holes Sunday in the Northern Trust, Johnson never panicked.

The seemingly insurmountable deficit was wiped clean in five holes, with Johnson making two birdies and Spieth finding water on the sixth hole for a double-bogey. Spieth, then making another bogey on the ninth. From the 11th on, Johnson out-dueled Spieth and won the opener of the FedExCup Playoffs with two great performances on the final hole.

On the 72nd hole, Johnson, facing a make-or-break situation, buried an 18-footer  for par to force a playoff, and then claimed the hardware on the first extra hole, when he unleashed the longest drive on the 18th all week — a 341-yarder that easily cleared the lake — and then struck a 60-degree wedge to 3 feet and made the putt to win.

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