Dr. Victor Kareh, Brain & Spine Surgery Associates

Spine and Brain Treatments

Cervical Spine Surgical Treatment

If the cervical spine condition cannot be treated by conservative measures (e.g. anti-inflammatory medications), oral steroids (e.g. Prednisone) can be prescribed for greater pain relief. Patients, however, are discouraged from taking oral steroids for long term use.

If cervical spine pain lasts more than 8 weeks and the patient’s quality of life is compromised, surgery may be an option. Cervical spine surgery has a high success rate. The success rate of surgery for a cervical herniated disc, for example, is 95-98%.

Thoracic Spine Treatment

Most thoracic disc conditions can be treated without surgery. Some of the more popular approaches include a prolonged period of rest, strengthening exercises, anti-inflammatory agents, spine manipulation, medications, and analgesics. Thoracic surgery is recommended only when there’s a strong possibility of a spinal cord dysfunction or acute chronic pain.

Depending on the location and position of the herniated disc, one procedure is an open thoracotomy which is done using a front approach crossing into the thoracic spine. This means the spine is reached via the chest. Minimal invasive surgery is possible; the surgeon makes small incisions.

Another procedure is called costotransversectomy usually recommended for lateral herniated discs. The spine is reached from behind or from the side and involves the removal of a rib.

Based on a study carried out among surgery patients, most surgeons now agree that the trans-thoracic approach appears to be the preferred method.

 

Headache Pain
cypress back pain

Minimally Invasive XLIF

When performing XLIF back surgery, your surgeon will approach your spine from the side of your body. You will be positioned on your side on the surgical table and two small incisions will be made. One of the incisions will be made on your side – this is the incision from which most of the surgery will be performed. Another incision will be made slightly behind the first, toward your back.

After you have been positioned, an x-ray will be taken to help your doctor precisely locate the operative space. Next, your skin will be marked at the site where the two small incisions will be made. Your surgeon will use the latest instrumentation to access the spine in a minimally disruptive manner. Disc preparation is the next step. This is done by removing the disc tissue, an action which allows the bones to be fused together. Several x-rays will be taken during this stage to ensure the preparation is correct. Once the disc has been prepared, the surgeon will then place a stabilizing implant into the space to restore the disc height and enable the spine to once again support necessary loads. Once in position, a final X-ray will be taken to confirm correct implant placement. In the event that further stabilization is necessary, the surgeon may choose to insert additional screws, rods, or plates into the vertebrae.cells that bridge space between the vertebrae and allow the bone to grow together. Increased stability and restoration of disc height often result in significant pain relief.

Anterior Cervical Discectomy & Fusion (ACDF)

ACDF is a surgical procedure intended to remove a herniated or diseased disc which provides relief to neck and arm pain. The pain is caused by the disc pressing on nerve roots.

Lumbar Spine Treatment

Lower back pain is common and in many cases, people obtain relief by adopting one or a combination of these conservative approaches:

  • Rest
  • Anti-inflammatory agents
  • Exercise
  • Narcotic or non-narcotic medication (discouraged for long term use)
  • Heat application
  • Muscle relaxers
  • Lumbar spine surgery is, of course, an option but only if conservative treatments have been exhausted and lower back pain persists to a point that it begins to erode the patient’s quality of life.

There are at least five known types of surgeries for chronic and severe low back pain but only your doctor and specialist can help you decide which is the most suitable surgery for you, taking into account certain factors.

lumbar spine cypress

Minimally Invasive TLIF

Minimally Invasive Transforaminal Lumbar Interbody Fusion (or TLIF for short) is a type of procedure performed on the spine. It covers four fundamental aspects:

The surgery is done through the foramen (a foramen is an opening that allows a nerve to pass in between bones);
It involves the lower back (lumbar);
Bone grafts are placed between two vertebrae;
Fusion is carried out to stabilize the spine
As the name of the procedure suggests, it is a surgery that is not invasive. This means that the surgeon makes tiny incisions and dilates the muscles that surround the spine and gently separates them. In aTraditional TLIF, the surgeon has to cut or remove the muscles from the spine. This can cause scarring and other complications. Minimally invasive TLIF, however, keeps the muscles and the vascular function intact.

Minimally Invasive XLIF

When performing XLIF back surgery, your surgeon will approach your spine from the side of your body. You will be positioned on your side on the surgical table and two small incisions will be made. One of the incisions will be made on your side – this is the incision from which most of the surgery will be performed. Another incision will be made slightly behind the first, toward your back.

After you have been positioned, an x-ray will be taken to help your doctor precisely locate the operative space. Next, your skin will be marked at the site where the two small incisions will be made. Your surgeon will use the latest instrumentation to access the spine in a minimally disruptive manner. Disc preparation is the next step. This is done by removing the disc tissue, an action which allows the bones to be fused together. Several x-rays will be taken during this stage to ensure the preparation is correct. Once the disc has been prepared, the surgeon will then place a stabilizing implant into the space to restore the disc height and enable the spine to once again support necessary loads. Once in position, a final X-ray will be taken to confirm correct implant placement. In the event that further stabilization is necessary, the surgeon may choose to insert additional screws, rods, or plates into the vertebrae.cells that bridge space between the vertebrae and allow the bone to grow together. Increased stability and restoration of disc height often result in significant pain relief.

Anterior Cervical Discectomy & Fusion (ACDF)

ACDF is a surgical procedure intended to remove a herniated or diseased disc which provides relief to neck and arm pain. The pain is caused by the disc pressing on nerve roots.