Spine

The spine is one of the most complex and important systems in the human body. The spinal column is the body’s main support structure. Its thirty-three bones, called vertebrae, are divided into five regions: cervical, thoracic, lumbar, sacral, and coccygeal.

The medical treatment of spinal injuries and diseases requires an equally intricate knowledge of several disciplines, including orthopedics, neurology, chiropractic, vascular, and others. To offer the best possible level of spine care for our patients, Florida Orthopaedic Institute has developed a unique center of excellence totally and absolutely dedicated to the treatment of the spine.

Florida Orthopaedic Institute’s spine specialists focus on prevention, restoration of function, reduction in pain, and control of costs in developing any treatment for back pain. Education, exercise, medication, ultrasound, heat, massage, and chiropractic therapies are often applied as nonsurgical options to relieving spine pain. If nonsurgical approaches are not effective, the team is able to offer the latest advancements in state-of-the-art spine surgery.

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 Disc 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.

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, disc herniation, or degenerative disc 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.

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 disc pressing on a nerve root) that put pressure on or causes irritation to the sciatic nerve.
Sciatica can also occur when a disc 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.

Back Surgery: When Is It a Good Idea?

Back pain is a widespread occurrence, and practically everyone will experience back pain at some point. But not every back issue requires an operation. Progressively worsening pain issues should be checked by your physician to know whether or not you need specialized treatment, including surgery.

Back pain usually passes in time. Sometimes it might take a few weeks, but if it’s the result of a minor injury, it will go away.

On the other hand, if it doesn’t, consult your doctor. They will let you know which non-surgical and conservative measures you should exhaust first, before looking into a back operation. If unfortunately, these fail to alleviate the pain, then it’s time to talk about surgery.

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 discs 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 discs 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.

ALIF: ANTERIOR LUMBAR INTERBODY FUSION SURGERY

In an anterior lumbar interbody fusion (ALIF), the disc space is fused by approaching the spine through the abdomen instead of through the lower back. A three-inch to five-inch incision is made in the stomach, and the abdominal muscles are retracted to the side.

The main advantage of ALIF is that both the back muscles and nerves remain undisturbed.

DEGENERATIVE DISC DISEASE

Degenerative disc disease, also called DDD or degeneration of the intervertebral disc, is typically an age-related condition that happens when one or more of the discs between the spinal column’s vertebrae deteriorate or break down, leading to pain. Vertebral discs 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 disc 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 disc replacement.

ILIF: INTERLAMINAR LUMBAR INSTRUMENTAL FUSION

During an ILIF procedure, any damaged portions of the discs 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.