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Office Hours: |
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Monday
8:00AM - 4:00PM |
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Tuesday*
Surgical Operating |
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Wednesday*
Surgical Operating |
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Thursday*
Surgical Operating |
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Friday
8:00AM - 4:00PM |
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No Evening or Weekend Office Hours |
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Below is a list of some frequently asked questions, but please feel free to call our office if you need additional information. We are always pleased to assist you. If you need Adobe Acrobat Reader to view the articles, click here.
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Speak to the doctors, nurses, and other medical experts who know the surgeon and his/her results. Anesthesiologists and operating room nurses first hand see the technical skill of the surgeon. Word of mouth from other patients can also be helpful.
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The spine is made up of many vertebral bodies (building blocks). Between these are discs (shock absorbers). Over time, the center of these discs can herniate (come out of) the disc and push on the nerves in the spine. |
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No, only about 20% of discs produce significant enough spinal cord or nerve root compression to warrant surgery. |
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As neurosurgeons we are trained to operate on the brain and spinal cord. We utilize operating microscopes and microinstruments on a routine basis. When dealing with the fine structures of the spinal cord, this training is critical. |
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This describes the removal of the bony arch which is located in back of the spine (neck, mid back, lower back). Its removal is often described as a "decompression".
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It describes how operations are done from the front of the neck if something is pressing on the front of the spinal cord or nerve roots.
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If arthritis or discs are located in the back of the spine, they may be removed from the back of the neck. |
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It describes too much motion at a spinal level. This may be due to a previous accident, to arthritic changes in the joints and bones which allow for too much motion to occur, or may be secondary to surgery where bone had to be removed to free nerve tissue. |
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A fusion or joining together of bones can be required to keep bones, which are next to each other from moving too much. They typically utilize the patient's bone in conjunction with titanium metal instrumentation.
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Absolutely. Neurosurgeons do spine surgery including fusions. We take bone grafts and place instrumentation consisting of rods, screws, plates, typically utilizing electrical monitoring of spinal cord function.
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If the disc is located centrally or somewhat off to the side, an approach from the front of the neck is appropriate. For example, a disc at C5-C6 is removed under the microscope with intraoperative monitoring.
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Yes. Your own bone may be harvested from the iliac crest (hip bone but not involving the hip joint). Your own bone (autograft) is then inserted between the vertebrae created when bone is removed to take out the disc.
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Yes. Studies have shown higher fusion rates with your own bone.
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Yes, but this has a slower rate of fusion and certain incidence of graft fracture and infection. |
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When surgery is performed from the front of the neck, a titanium plate can be applied to the front of the bone graft to help keep the graft in place.
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Better fusion rates have been demonstrated with the addition of a plate in front of the neck. It also helps prevent the bone graft from popping out.
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Yes, if you have very extensive arthritis in the front of the neck requiring the removal of 2 or more vertebral bodies (bones of the neck), then an operation from both the front and back are performed at the same time.
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Yes, in some cases where discs and arthritis can be accessed from the back of the neck.
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If there is too much motion at a lumbar spinal level, any time the patient moves, the nerve tissue can be transiently compressed resulting in pain and transient or permanent neurological injury or deficits. When the pressure is taken off (laminectomy, decompression), fusion may be required.
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Yes. There is an artificial material now available, which includes no cadaver material, which helps supplement, your own bone in performing a fusion in the lower spine.
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No, in many instances, particularly with older patients with more substantial degenerative disease, the risk of injuring the nerve tissue is higher with minimally invasive approaches. Microscope assisted procedures performed through somewhat larger openings often prove safer and more effective.
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An MR study is performed first as it does not involve radiation. It provides excellent information regarding the soft tissues (nerves, muscles etc.) of the spine. However, CT studies better demonstrate bone and bony disease. Therefore, often the two are ordered when a spinal operation is performed.
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Yes, they provide an overview of the bones of the spine (cervical, thoracic, lumbar). Plain X-rays can document whether the spine is stable (does not move abnormally) or unstable (shows too much movement). |
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Some patients may need treatment before they are candidates for surgery. In some cases, cardiac stress tests may demonstrate a blockage in the heart which requires a stent or operation. |
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Yes. Patients with severe medical problems such as advanced heart disease, histories of stroke requiring blood thinners, very advanced age, and other factors may not be candidates for an operation.
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