Spine

Interventional Spine

The spine specialists of Florida Orthopaedic Institute understand how living with chronic spine pain can adversely affect your life. For this reason, the spine team of Florida Orthopaedic Institute applies the latest technology available for diagnosis and treatment of an array of painful spinal conditions.

Interventional treatment options are often more efficient and effective than traditional therapy for spine (back and neck) pain and discomfort. In addition, new interventional spine techniques are an exceptional, minimally invasive alternative to conventional surgery.

Minimally Invasive Spine Surgery

If you have chronic back pain that has not responded to nonsurgical treatments, minimally invasive spine surgery may be a solution for you. Unlike an open spine procedure, minimally invasive spine surgery combines technological advances with state-of-the-art practices that reduce both the size of your incision as well as your hospital stay. Certain spine conditions respond very positively to this procedure as opposed to many conventional open spine surgeries. Minimally invasive spine surgery involves fewer risks than open spine surgeries.

The Florida Orthopaedic Institute’s spine specialists have both the experience and skill to perform the procedure safely and effectively. Since minimally invasive spine surgery is an extremely advanced technical procedure, our specialized surgeons are dedicated to continuing their knowledge of all up-to-date procedures and many are personally involved in assisting with the creation of new technologies.

Artificial Disk Replacement (ADR)

Artificial disk replacement (ADR) is an alternative treatment option for low back pain instead of lumbar fusion. It preserves a more normal motion of the spine. While many patients are helped by lumbar fusion, the results of the surgery can vary.

In artificial disk replacement, a synthetic or “artificial” disk replaces worn or damaged disk material between the small bones in the spine (vertebrae).

Artificial disk replacement is designed to relieve back pain while maintaining more normal motion. Artificial disk replacement has been used in the U.S. since 2004, and research studies have demonstrated greater than 89-97% good or excellent results from ADR surgery.

Spinal Fusion

Spinal fusion surgery stops the motion at a painful back joint, decreasing the pain that is generated from the joint.

Spinal fusion surgery is also used to treat other spine conditions including a weak or unstable spine (caused by infections or tumors), fractures, scoliosis, or deformity.

To learn more about spinal fusion surgery, click below.

Piriformis Syndrome

Piriformis syndrome is a condition in which the piriformis muscle in the buttocks irritates the sciatic nerve. It is fairly common, with more than 200,000 cases in the U.S. per year.

Symptoms include numbness, tingling, or pain in the buttocks and down the leg. These symptoms can worsen after sitting for a long time, climbing stairs, walking, or running.

Treatments include massage, stretching exercises, anti-inflammatory drugs, or surgery.

Laminectomy

A laminectomy is a type of surgery in which all or part of the vertebral bone (lamina-the roof of the spinal canal) is removed. It is used to help ease pressure on the spinal cord or the nerve roots from injury, tumors, herniated disk, or narrowing of the canal (spinal stenosis).

Pressure is most commonly caused by bone spurs (bony overgrowths within the spinal canal), which can occur in those who have arthritis in their spines. In some people, these overgrowths are a normal side effect of the aging process.

When more-conservative treatments such as medication, physical therapy, or injections have failed to relieve symptoms, a laminectomy is generally the next step. If symptoms are severe or worsening dramatically, it may also be recommended.

Kyphoplasty (Balloon Vertebroplasty)

This minimally-invasive procedure repairs vertebral compression fractures (VCFs). It helps restore the spine’s natural shape by treating pathological vertebral body fractures due to osteoporosis, cancer, or benign lesions. Many patients experience rapid pain relief after the procedure.

Osteoporosis causes more than 750,000 – 800,000 spinal fractures each year in the United States. It is a condition characterized by low bone mass and deterioration in the microarchitecture of bone tissue. While vertebral fractures are the most common osteoporotic fractures, approximately two-thirds are undiagnosed and untreated.

Discectomy

When abnormal disk material presses on a nerve root or the spinal cord, causing pain, numbness, or weakness by stressing the spinal cord or radiating nerves, it can be resolved with a discectomy procedure. A discectomy removes a portion of an intervertebral disk.

Other symptoms include abnormal bladder and bowel functions and progressive neurological problems such as motor weakness or sensory deficit in the lower body. Patients who have pain radiating from the back and hip into the legs through the spine and persist after an adequate conservative management course are also candidates for a discectomy.

Anterior Cervical Corpectomy & Discectomy

A corpectomy is a procedure that removes herniated or degenerative vertebral disks in your neck that are compressing the spinal nerves and spinal cord. An anterior cervical corpectomy uses a surgical approach through the front of the neck.

An anterior cervical corpectomy removes damaged vertebrae and intervertebral disks and replaces them with a bone graft or implant. This helps relieve painful pressure on spinal nerves.

In a discectomy, only the damaged portion of a disk and bone spurs are removed. In a corpectomy, the disks, bone spurs, and vertebrae are removed.

EPIDURAL INJECTIONS FOR SPINAL PAIN

In epidural spinal injections, a steroid is injected directly around the dura, the sac around the nerve roots that contains cerebrospinal fluid.

Epidural Injections help reduce inflammation associated with common conditions such as spinal stenosis, disk herniation, or degenerative disk disease. The flushing effect from the injection helps remove or “flush out” inflammatory proteins from around structures that may cause pain.

Epidural steroid injections are successful in relieving lower back pain for approximately 50% of patients. The effects of the injection may be temporary (one week to one year). Epidural injections can be very beneficial in providing relief for patients during an episode of severe back pain and allow patients to progress in their rehabilitation.

INTERLAMINAR IMPLANTS

Interlaminar implants, also known as interlaminar spacers, are spinal implants that are used as a minimally invasive surgical option to treat certain types of spinal stenosis. They can relieve the pain and symptoms from nerve compression caused by stenosis. The surgically implanted spacer is inserted between spinal segments to support your spine and provide the necessary space for nerves to function without pain. Unlike a spinal fusion, interlaminar implants preserve motion so your spine can still move naturally.

Interlaminar implants can help relieve back problems from conditions such as spinal stenosis, spondylolisthesis, and degenerative arthritis.

Sciatica

Sciatica describes symptoms of pain, numbness, or weakness that spread from the sciatic nerve down the lower back to the buttocks and leg. Medically sciatica is termed lumbar radiculopathy. Sciatica is a symptom of an underlying condition, not a diagnosis.

Most sciatica symptoms result from lower back disorders (like a herniated disk pressing on a nerve root) that put pressure on or causes irritation to the sciatic nerve.
Sciatica can also occur when a disk degenerates – releasing inflammatory proteins that irritate the adjacent nerve. There are other additional causes of sciatica.

Symptoms are usually only felt on one side of the body, including a combination of leg and foot pain, weakness, tingling or numbness. Pain can be searing or sharp versus achy or throbbing. Symptoms are felt in different areas of the leg and into the foot, depending on where the sciatic nerve is compressed.

Vertebroplasty

Vertebroplasty is a procedure for stabilizing compression fractures in the spine, by injecting a special cement into back bones (vertebrae) that have cracked or broken. When the cement hardens, it stabilizes the fracture and supporting the spine. These compression fractures are often caused by osteoporosis.

For those with severe, disabling pain, vertebroplasty can relieve pain, increase mobility and reduce the use of pain medication. It is typically an outpatient procedure.

Scoliosis

Scoliosis is a condition that causes the spine to curve to one side. Scoliosis most commonly affects the spine at the chest and the lower back, but it can affect any part of the spine. It happens most often during the growth spurt just before puberty.

Scoliosis often appears in children and is more common in females than in males. The cause of most scoliosis is unknown, but it can be caused by conditions such as cerebral palsy and muscular dystrophy.

In most children the curve corrects itself with growth, so treatment is not needed. They are monitored closely, usually with X-rays, to see if the curve is getting worse.

Based on the degree of curvature and the age of the child, a combination of bracing and physical therapy may be recommended.

A very small number of patients with scoliosis may require surgery to keep it from worsening and to straighten severe cases of scoliosis.

Whiplash and Whiplash Associated Disorders (WAD)

Whiplash is a neck strain caused by a forceful, rapid back-and-forth movement of the neck. Usually associated with car accidents, the injury can also result from any impact or blow that causes your head to jerk forward or backward. A sports accident, physical abuse or other trauma can cause whiplash or neck strain.

Besides auto accidents, neck strains afflict many amateur and professional athletes. Those who play contact sports like football are especially prone to neck strain.

Common symptoms of neck strains include headaches, neck pain and stiffness. In more severe cases, it can cause Whiplash Associated Disorders (WAD) with more chronic and widespread symptoms.

Discitis

Discitis (sometimes spelled diskitis) is inflammation that develops in the intervertebral disks of your spine, located between your vertebrae. Although discitis is uncommon, when it occurs it can be devastating.

Discitis can be caused by bacteria, virus, or fungus but most commonly occurs when bacteria directly invade the disks from other parts of the body. Causes and contributing factors include endocarditis (a bacterial heart infection), IV drug use, diabetes, older age, poor nutrition, and staphylococcus aureus.

Pinched Nerves

A pinched or irritated nerve in the neck can cause pain, numbness, or weakness radiating into the chest or arm. Technically called a cervical radiculopathy, the symptoms include sharp pain and tingling in the neck or arm.

While a pinched nerve condition can be chronic (lasting for years), it often improves without treatment. A pinched nerve needs professional medical diagnosis, and lab tests or imaging are often required.

DEGENERATIVE DISK DISEASE

Degenerative disk disease, also called DDD or degeneration of the intervertebral disk, is typically an age-related condition that happens when one or more of the disks between the spinal column’s vertebrae deteriorate or break down, leading to pain. Vertebral disks normally act as a cushion between the vertebrae, but there is a loss of cushioning, fragmentation, and herniation when they break down.

Symptoms can include weakness, numbness, and pain that radiates down the leg. In some cases, the spine loses flexibility, and bone spurs may pinch a nerve root, causing pain or weakness. There may also be no symptoms.

Degenerative disk disease is very common, with over 3 million cases per year in the U.S. It can develop as a natural part of the aging process, but it may also result from injury to the back.

Treatments such as exercise, medication, and physical therapy can help, but this condition can’t be cured. Nonsurgical treatments are usually recommended if daily life activities can be completed with manageable pain levels and if the pain does not interrupt sleep or activity. Surgery is generally recommended if the patient has limited ability to function in everyday life.

Outpatient Spine Surgery

Improvements in surgical techniques and technology over the past decade have allowed for more spine surgeries to be performed in outpatient surgery centers, outside of the traditional hospital setting. Minimally invasive surgical techniques are less intensive and enable patients to recover at home instead of at the hospital.

The four most common types of outpatient back surgery done at Florida Orthopaedic Institute are lumbar microdiscectomy, lumbar laminectomy, anterior cervical decompression and fusion, and anterior cervical disk replacement.

ILIF: INTERLAMINAR LUMBAR INSTRUMENTAL FUSION

During an ILIF procedure, any damaged portions of the disks are removed, and bone is placed in the empty space to help fuse the vertebra above and below. Metal implants are used to stabilize the spine until the spinal fusion takes place.

The ILIF procedure uses a smaller incision, has less blood loss, less post-operative pain, and a quicker return to activity. It is generally performed in an outpatient setting or a shorter hospital stay.

FORAMINOTOMY

Foraminotomy is a procedure that relieves pressure on nerves compressed by the intervertebral foramina. Intervertebral foramina are the passages through the bones of the vertebrae where nerve bundles pass from the spinal cord to the body.

This procedure enlarges the opening through which the root of a spinal nerve passes as it exits the spinal column. It can relieve symptoms such as burning, numbness, or pain caused by nerve compression.

Foraminotomy has a high success rate has been considered the gold standard for the surgical treatment of lumbar foraminal or far lateral stenosis.