Back and neck pain affects more than 90% of people at some point in their lives. Let the caring specialists at Eren Spine Center help start you on your way to a better back and neck. At Eren, we reserve surgery as a last resort, we’ll first try to provide pain relief through conservative treatments such as physical therapy and pain management. We work closely with the patient, physical therapy, and pain management to devise the most successful treatment plan to get patients back to a pain-free lifestyle.
If non-surgical treatment does not relieve your pain, then you may be a candidate for minimally invasive spine surgery. We utilize the latest operative treatments including motion-preserving surgical techniques such as cervical disc replacement and laminoplasty instead of cervical spinal fusion. For complex spinal deformities, we use CT navigated computer systems to accurately place screws. At the Eren Spine Center, we specialize in the management of all spine conditions including cervical, thoracic, and lumbar.
- Adult Scoliosis:
Scoliosis can be seen not only in children, but also in adults. However, scoliosis in adults is usually seen as it could not be diagnosed in childhood and has been brought into adulthood. Scoliosis may also be observed after the age of 50 due to spinal degeneration. Unlike scoliosis in childhood, the most common complaint of adults with scoliosis is pain. The pain is usually relieved with painkillers and physical treatment methods. As skeletal growth has ended, brace procedure with scoliosis corset is rarely performed. Surgical treatment may be required in some cases that are resistant to the relevant treatment methods.
How is adult scoliosis treated?
Conservative treatment
The majority of cases of adult scoliosis can be managed non-operatively through regular observation by a doctor, over-the-counter pain medications, and core-strengthening exercises to strengthen your abdomen and back and to improve flexibility. If you smoke, it’s important that you quit. Smoking has been shown to speed up the degenerative process.
In most cases, the doctor will recommend some forms of physical therapy, to both maintain strength and relieve pain. These may include:
Working to improve posture
Doing low-impact exercises, such as swimming
Daily stretching
Staying active
If pain is not relieved by oral medications or physical therapy, your doctor may recommend epidural (given around the spinal cord) or nerve block injections for more effective relief.
Surgical treatment
Surgery is necessary in some cases of adult scoliosis. This treatment is the last option because of the risks of complications from spinal surgery. Surgery may be suggested for the following reasons:
Pain. Surgery may be needed if back and leg pain from the scoliosis becomes severe and ongoing, and doesn’t respond to conservative treatment.
Spinal imbalance. Whether the spine remains balanced is important in assessing the scoliosis’ progression and the need for surgery. When we stand, the head should be balanced over the center of the pelvis when looking from the front, and over the hip joints when looking from the side. If the curve progresses to the point that this is no longer possible, patients will tend to progress over time and have more pain and disability.
Surgery is needed to improve quality of life. Although surgery is not recommended solely to improve appearance, some people find the symptoms of their spinal deformity unbearable. Their spinal imbalance, too, affects basic function and overall quality of life. Surgery is the only option in these cases. In younger adults the cosmetic deformity may be a major factor in the decision to have surgery but in older adults this is not usually the case. There are a variety of spinal surgical options, depending on each case. Generally, surgical procedures are designed to stabilize the spine, restore balance, and relieve pressure on nerves. Spine stabilization surgery fuses the bones of the spine together using bone grafts and then metallic implants to hold the spine in place.
Advances in surgical techniques and computer-assisted navigation systems make less invasive approaches possible, and recovery time quicker.
- Herniated Disc Surgery
Between each of the bones in your spine (the vertebrae) is a disc. These discs act as shock absorbers and help cushion your bones. A herniated disc is one that extends beyond the capsule containing it and pushes into the spinal canal. You can have a herniated disc anywhere along your spine, even in your neck, but it’s most likely to occur in the lower back (lumbar vertebrae).
You might develop a herniated disc from lifting something the wrong way or from suddenly twisting your spine. Other causes include being overweight and experiencing degeneration due to disease or aging.
A herniated disc doesn’t always cause pain or discomfort, but if it pushes against a nerve in your lower back, you may have pain in the back or legs (sciatica). If a herniated disc occurs in your neck, you may have pain in your neck, shoulders, and arms. Besides pain, a herniated disc can lead to numbness, tingling, and weakness.
Surgery involving the spine is typically not recommended until you’ve tried all other options. These may include:
nonsteroidal anti-inflammatories
pain relievers
exercise or physical therapy
steroid injections
rest
If these are ineffective and you have persistent pain that is interfering with your quality of life, there are several surgical options.
Diagnosis :
When considering surgery, make sure you see a qualified spine (orthopedic or neurosurgical) surgeon, and get a second opinion. Before recommending one surgical procedure over another, your surgeon will likely order imaging tests, which may include:
X-ray: An X-ray produces clear pictures of your vertebrae and joints.
Computed tomography (CT): These scans provide more detailed images of the spinal canal and surrounding structures.
Magnetic resonance imaging (MRI): An MRI produces 3-D images of the spinal cord and nerve roots, as well as the discs themselves.
Electromyography study (EMG): These measure electrical impulses along nerves and muscles.
These tests will help surgeon determine the best type of surgery for you. Other important factors in the decision include the location of your herniated disc, your age, and your overall health.
Types of surgery for herniated disc
After gathering all the information they can, surgeon may recommend one of these surgeries. In some cases, a person may require a combination of surgeries.
Laminotomy/laminectomy
In a laminotomy, a surgeon makes an opening in the vertebral arch (lamina) to relieve pressure on your nerve roots. This procedure is performed through a small incision, sometimes with the aid of a microscope. If necessary, the lamina can be removed. This is called a laminectomy.
Discectomy/microdiscectomy
Discectomy is the most common surgery used for herniated disc in the lumbar region. In this procedure, the portion of the disc that is causing the pressure on your nerve root is removed. In some cases, the entire disc is removed.
The surgeon will access the disc through an incision in your back (or neck). When possible, your surgeon will use a smaller incision and special instruments to achieve the same results. This newer, less invasive procedure is called microdiscectomy. In some cases, these procedures can be performed on an outpatient basis.
Artificial disc surgery
For artificial disc surgery, you’ll be under a general anesthesia. This surgery is usually used for a single disc when the problem is in the lower back. It’s not a good option if you have arthritis or osteoporosis or when more than one disc shows degeneration.
For this procedure, the surgeon enters through an incision in your abdomen. The damaged disc is replaced with an artificial disc made from plastic and metal. You may need to stay in the hospital for a few days.
Spinal fusion
General anesthesia is required for spinal fusion. In this procedure, two or more vertebrae are permanently fused together. This may be accomplished with bone grafts from another part of your body or from a donor. It may also involve metal or plastic screws and rods designed to provide additional support. This will permanently immobilize that portion of your spine.
Spinal fusion usually requires a hospital stay of several days.
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