Category: General Questions

Arthritis of the spine is something that’s very common. In fact, it’s odd not to see some type of arthritis in the spine of people as they get over the age of 40. It has to be taken in consideration to somebody with a spine problem, whether it’s pain or dysfunction in terms of how much it’s contributing and how it should be addressed at the time of surgery.

A lot of times, some of it’s inconsequential or there, and doesn’t need to be addressed. Sometimes the arthritis itself can be the problem. It needs to be addressed.

The spinal infections can be a serious problem. Often they require surgical intervention, sometimes even emergent surgical intervention. Often they require more than one surgery. They typically require a combined team approach with the surgeon, the internal medicine doctor, and the infectious disease doctor to try and get rid of the infection.

It’s also not uncommon for them to need surgery later once the infection clears to reconstruct the spine.

I often get asked a lot by my patients, for their cervical hernia disc, which they should pick an artificial disc replacement or a fusion. Certainly the trend has been more towards artificial disc replacement over the years. It’s hard to compare these two very, very successful procedures over a 10 year span.

There just aren’t that many patients that we can look at at a 10 years to see who’s really doing better. It’s compounded by the fact that both procedures have a very high success rate. The procedures are almost identical in terms of risk technique.

Everybody can get a fusion. It’ll always fit. You can always see well enough to do a fusion.

A disc replacement can be a little finicky as to who it will fit in and who you can visualize on X-ray well enough to put a disc replacement in.

Well, one of the niche things that I address in my practice is addressing complications, or bad outcomes from patients that have had prior surgery. Of course, typically with another surgeon. These can be difficult situations and require a fair amount of experience, patience, and critical thinking on the part of the surgeon.

They also require a lot of understanding of the patient’s condition as this is someone who’s undergone usually major surgery that didn’t go as well as they helped.

The important thing is to look for ways to get them better by moving forward, seeing what problems you can address and what problems you can’t, and trying to get them better with the least intervention possible.

One of the most common injections I perform is in the lumbar spine. It’s called a transforaminal epidural steroid injection. That’s a long phrase just to describe a injection of steroid, not in the spinal canal, but next to the spinal canal, where the nerves exit that can be tailored very specifically to the pinched nerve in question.

The steroid medication can then trickle into the spinal canal, in ideal cases provide long-term lasting relief. It’s not uncommon to need more than one to get patients back to their optimal state. And frankly, it’s typically a good thing to try and, and select patients with lumbar problems before considering surgical intervention.