We are happy to answer all of your questions.
Where is my neck and arm pain coming from? How is the numbness in my hand related to my neck? Where is my back and leg pain coming from? How is the numbness in my foot related to my low back?
When this degeneration occurs in the neck a patient will likely experience neck pain, as well as pain that travels down the arm. Sometimes this pain is also associated with numbness or tingling. Interestingly, the distribution of the tingling helps the doctor identify which nerve is being pinched. This is very helpful in targeting treatment. If you remember this, then the next time your fingers start to tingle, take note of which fingers are involved. This will greatly help the doctor formulate a treatment plan.
Similarly, when this premature spinal degeneration occurs in the low back, a patient will experience low back pain or even hip pain. This may also include pain or numbness that radiates down the leg. Numbness or tingling in the toes may also be part of this same problem. The ability to identify which toes are tingling the most also helps to identify which nerves are being pinched.
A painful spine can sometimes be the result of other disease conditions such as tumors. Fortunately this is much less common. Neurosurgeons are well equipped to deal with all of these conditions and can offer multiple treatment options. Additionally, your Neurosurgeon can help coordinate care between the different physicians that may be needed to treat your condition.
Does your office have physician assistants or nurse practitioners? Will I see the doctor on every visit?
Can I schedule a second opinion visit? I was told that I needed surgery on my spine, but I am not sure that I want to go through with it. What are my options?
Neurosurgical training is seven years long. Those seven years are spent entirely on understanding the diagnosis and treatment of disorders of the brain and spine. The focus of a Neurosurgeon is always on the brain and spine as this is the core of their training.
Orthopedic Surgeons are most similar to Neurosurgeons. Orthopedic training covers a wide spectrum of diseases that includes caring for the spine and other joints in the body. Orthopedic surgeons learn how to fix broken arms and legs, and how to replace a knee or hip. Most Orthopedic Surgeons that focus on spine have had additional training in that area. An orthopedic surgeon is not able to treat disorders or diseases of the brain.
There is a great deal of overlap between what each of these physicians can provide. Certainly, if you have a fractured arm or leg, or are in need of a knee or hip replacement, then an Orthopedic Surgeon is an absolute necessity. If you have a brain lesion then a Neurosurgeon is necessary. But what if you have a spine problem? All of these doctors will be able to offer you some recommendations and therapeutic options. However, our belief is that a Neurosurgeon is best qualified to diagnose and treat any painful condition relating to the brain and spine.
Generally speaking, acupuncture is a safe therapy. However, it would be wise the meet with a medical doctor prior to pursuing acupuncture so that more serious medical conditions can be ruled out first.
Typically, these types of fractures occur in patients 50 years or older. The cause of the fracture is usually osteoporosis. Kyphoplasty or Vertebroplasty is usually not the sole treatment for traumatic fractures of the spine that might result from a car accident.
Neurosurgeons are well suited to perform these procedures.
There are many different types of spinal procedures. Many of us know someone who has had a neck surgery for a pinched nerve or a low back surgery for low back pain. Sometimes the procedure involves a simple decompression and other times it involves a decompression and fusion.
So, what is the difference?
A simple decompression is an operation where the surgeon will remove some ‘bone spurs’ or overgrown tissues to take the pressure off of the nerves. This procedure does not usually involve the placement of instrumentation. When we say instrumentation, we mean screws and rods or other metallic implants. A simple decompression can be done in the neck, mid-back or low-back.
A decompression and fusion is a similar procedure but after the decompression is performed the surgeon will place screws and rods, or similar devices, to further stabilize the spine. This operation can be done in the neck, mid-back or low-back. The process is somewhat more involved, and the recovery can take more time. The goal of this surgery is to encourage the bones to grow together, or fuse. Once the bones fuse together, then the pain will decrease. The fusion process can take up to three months. It is worth noting that smoking and other factors can slow down the fusion process and delay the benefits of surgery.
Many patients ask if they will still have movement in their neck or low back following a fusion operation. The answer to this question is almost universally yes. There are some fusion operations in which you would likely notice no difference at all. Conversely, there are some uncommon fusion procedures that will cause a noticeable decrease in spinal mobility. Your safest bet would be to ask your doctor prior to the procedure.
So…. why would anyone want to have a spinal fusion? The answer is actually quite simple: to get out of pain. Fusion operations are just like any other surgery, in that, it is very important to select the right operation for the right patient. This part is up to the surgeon. A good surgeon will be very careful in selecting an appropriate candidate for the surgery. This is especially true in low back surgery. We have found that careful patient selection has resulted in very pleasing results for both our patients and our doctors.
As you can see, surgery is a team sport. Before you consider going down this road, you should make sure that you have a good relationship with your surgeon. Be certain that he or she will be there for you before, during, and after the surgery. Some surgeons feel it is acceptable for you to see someone else after your surgery. We feel differently. Our doctors will meet with you on every visit, every time, without exception.
If I have a neck fusion, will I still be able to move my neck? If I have a lumbar fusion, will I still be able to bend and twist my low back?
Beyond those therapies, you should consider physical therapy as a safe and often helpful option.
If physical therapy is not helpful, then spinal epidural injections are an option. This procedure takes less than one minute and can provide long lasting relief.
MRI technology obtains images using magnetism. There is no radiation. A typical MRI scan may last 20 minutes or longer. An MRI does require you to lie within the imaging tube, which may cause some patients to feel claustrophobic. If you have a pacemaker or a spinal cord stimulator, you will not be able to get an MRI. Additionally, if you have some metallic implants, you will not be able to get an MRI. Newer metallic implants are made from titanium and are indeed MRI compatible. It would be safest for you to discuss any implants with your doctor prior to proceeding with the MRI.
The myelogram portion of this procedure requires the injection of contrast dye via a spinal tap. This dye then temporarily outlines the nerves and provides more detail when obtaining the CT scan. The scan itself takes the same amount of time as it would without the dye injection – just several minutes.
IF YOU ARE ALLERGIC TO IODINE OR ANY TYPE OF SHELLFISH YOU MUST NOTIFY YOUR DOCTOR AND THE TECHNOLOGIST. YOU MAY REQUIRE SPECIAL MEDICATIONS BEFORE YOUR EXAM. IF YOUR ALLERGY IS SEVERE ENOUGH, THEN YOU MAY NOT BE A CANDIDATE FOR THIS TEST.
Laser technology is not effective for removal of bony overgrowths, such as bone spurs, which are one of the most common conditions contributing to spinal pain. Additionally, laser technology has no role in fusion surgery.
As you can see, lasers play a very limited role in state-of-the-art spine surgery. In our practice we value safety, efficacy and delivering proven treatments options.