Spine Care

Our spine serves many important purposes. Made up of 24 moveable bones (vertebra) that support our weight and hold us upright, it is also important to our movement. But the most important function is protecting our spinal cord.

If you’ve been experiencing neck and/or back pain, whether it’s new or you’ve had it for years, it could be the result of issues with your spine. Our spine specialists offer decades of experience and knowledge in surgical and non-surgical spine care management.

We offer a team approach to spine care, working closely with physical therapists, physiatrists and pain specialists to create individual care plans, educate patients on their conditions, and encourage non-surgical care when appropriate.

Meet our Specialists

Dr. Cyrus Ghavam

Spine Care

Spine care treatments

To learn more about each treatment, click on the item for further details.

Facet Joint Injections and Blocks

The facet joints are responsible for bending, flexing, and twisting the spine. Like all joints in the body, the facet joints are covered in cartilage that enables smooth and pain-free movement. Facet joints that are effected by osteoarthritis (OA), a disease characterized by the wearing away of joint cartilage and soft tissues, cause spine pain. Non-surgical treatment options that may be used to treat mild to moderate cases of facet joint OA include rest, activity modification, anti-inflammatory medications, and physical therapy. Severe facet joint OA or facet joint OA that does not respond to non-surgical treatment options may require minimally invasive surgical intervention in the form of a facet joint injection and block. The spine specialists at Hope Orthopedics regularly perform facet joint injection and block procedures that are customized to meet the unique needs of patients.

A Facet Joint Injection and Block Procedure at Hope Orthopedics

Patients who have their facet joint injection and block procedure at Hope Orthopedics experience little to no pain or discomfort during their procedure. A mild sedative is taken to help patients feel relaxed. Local anesthesia is administered via injection into the surgical area so patients are completely numb. After patients are placed in a comfortable position, the procedure is performed step-by-step as follows:

  • X-ray guiding needle insertion. A needle is gently guided into the facet joint.
  • Injection. Anesthetic and corticosteroid medications are injected into the joint. Nerves near the facet joints are numbed and thus blocked from sending pain signals to the brain.

A tiny dressing is placed over the mark the needle made. Total procedure time is approximately 15-30 minutes.

Recovery

Patients are able to walk but not drive after their procedure. Patients may the leave office once a family member or friend is ready to drive them home. Ice and over-the-counter pain medications may be used to easily control pain and soreness. Patients are advised to rest after their procedure. A short 24-hour recovery is all that is needed before patients can return to their day-to-day lives.

Results

The anesthetic medication used during the procedure numbs the joint and nerves and quickly decreases pain. The corticosteroid works to reduce inflammation caused by OA. In most cases, facet joint injections are used as a part of a comprehensive OA treatment plan geared towards decreasing inflammation and pain. Patients who are experiencing pain that is associated with spine movement are encouraged to schedule an appointment with one of the spine specialists at Hope Orthopedics.

Caudal Injections

A caudal injection is a minimally invasive procedure that is used to relieve lower back and lower extremity pain. The procedure involves the injection of steroid and anesthetic medications into the lowest part of the epidural space. Pain and symptoms like burning, numbness, tingling, and weakness are quickly reduced after the procedure. When used as part of a comprehensive treatment plan focused on treating the condition that causes lower back and lower extremity pain, a caudal injection can be extremely beneficial to patients. The spine surgeons at Hope Orthopedics specialize in caudal injection procedures.

A Caudal Injection Procedure at Hope Orthopedics

A caudal injection procedure is performed on an outpatient basis using only a mild sedative and a local anesthetic. Patients rest comfortably on their stomachs during the procedure. X-ray guidance is used to target the exact area where medications will be administered. A needle is gently guided into the area and the medications are slowly injected. The needle is removed. It leaves a very tiny mark that is easily covered using a Band-Aid. Total procedure time is approximately 30 minutes.

Recovery

Patients will be monitored for a short period of time after their procedure. This is solely for precautionary measures. Patients may be driven home by a family member or friend once they are cleared by their specialist. Patients should rest at home after their procedure. The only activity that should be performed is light walking around the house. Patients may return to work and normal activities 24-hours after their procedure.

Results

Pain and symptom relief after the procedure can occur very quickly. Results from the are only temporary; however, they may help patients cope with immediate pain while other treatment options gradually improve the underlying cause of it. In this regard, caudal injections can be an important part of effectively treating lower back and lower extremity pain. Patients who are interested in finding out if caudal injections are the right treatment option for their condition are encouraged to schedule an appointment with one of the spine specialists at Hope Orthopedics.

Nerve Blocks

A nerve block is a minimally invasive spine pain treatment option that has been used for a very long time. When a combination of corticosteroid, anesthetic, and opioid medications are injected near a nerve that is causing pain, the pain signal sent from the nerve to the brain is blocked and pain is no longer felt. Many times, nerve blocks are used to provide patients with acute pain relief while other treatment options, like physical therapy, gradually improve the condition that is causing pain. Minimally invasive nerve block procedures that are performed by the spine specialists at Hope Orthopedics are tailored to meet the individual needs of patients and perfectly fit into a holistic treatment plan geared towards maximum and long-lasting results.

A Nerve Block Procedure at Hope Orthopedics

The spine specialists at Hope Orthopedics take every measure possible to ensure patients are relaxed, comfortable and feel no pain or discomfort during their procedure. Patients are usually given a mild sedative before the procedure. A local anesthetic is administered via injection. The procedure is carried out using the following steps:

  • Positioning. Patients lie face down on comfortable pillows and cushions.
  • Skin preparation. Alcohol is used to clean the skin. A topical sterilization solution is applied to prevent infection.
  • Needle insertion. X-ray guidance is used to place a small needle near the nerve that will be injected.
  • Nerve block. The nerve block medications are injected. The nerve becomes numb. Inflammation is reduced.

The needle is removed and the tiny mark it made is covered using a Band-Aid. Total procedure time is approximately 15-45 minutes.

Recovery

A nerve block is an outpatient procedure. Patients may return home after their spine specialist clears them to do so. This is usually 10-15 minutes after the procedure. A family member or friend is responsible for driving patients home. Patients may walk after their procedure, but should not return to work or perform any activities. After a short 24-hour recovery, patients may return to their normal activities and lives. Pain and soreness may present but are easily controlled by applying ice to the area that was injected and taking over-the-counter pain medications.

Results

Results are seen immediately or shortly after the procedure. Pain and other symptoms decrease. Results are only temporary. As previously mentioned, the purpose of a nerve block is to provide acute pain relief while other treatment options cure the condition that is causing pain. Pain caused by the following conditions can be treated using a nerve block:

  • Degenerative disc disease
  • Spinal stenosis
  • Herniated disc
  • Sciatica
  • Spondylosis

Patients who are experiencing spine and/or extremity pain and would like to receive an accurate diagnosis and customized treatment plan are encouraged to schedule an appointment with one of the spine specialists at Hope Orthopedics.

Epidural Steroid Injections

Inflamed spinal nerves are a common cause of neck, back, and extremity pain. When inflamed spinal nerves do not respond to nonsurgical treatment options like rest, activity modification, and anti-inflammatory medications, a minimally invasive epidural steroid injection procedure may be performed. The procedure is one of the most commonly used minimally invasive spine procedures because it provides patients with fast-acting pain relief. The spine specialists at Hope Orthopedics perform epidural steroid injections that target inflamed nerves and quickly decrease pain.

An Epidural Steroid Injection Procedure at Hope Orthopedics

An epidural steroid injection procedure at Hope Orthopedics is a step-by-step process. A mild sedative is given to patients to help them relax. Local anesthesia is used to numb the area where the injection will occur. Patients feel very little (if any) pain or discomfort during the procedure. The following steps are used to perform the procedure:

  • Positioning. Patients are positioned face down on the procedure table. Pillows and cushions are used to ensure maximum comfort.
  • Skin preparation. The skin is cleaned with alcohol and sterilized using a topical sterilization solution.
  • Needle insertion. A needle is inserted into the surgical area. X-ray guidance is used to position the needle near inflamed nerves.
  • Medication injection. Corticosteroid and anesthetic medications are injected near inflamed nerves.

A Band-Aid is placed over the tiny needle mark. Total procedure time is approximately 15-45 minutes.

Recovery

Patients remain in the office for a short period of time after their procedure. They are monitored by nurses and staff members to ensure pain is controlled. Once cleared, patients may return home. A friend or family member is responsible for driving. Patients may walk after their procedure. Soreness may be easily managed using ice and pain and anti-inflammatory medications. It usually takes patients 24 hours to recover from their procedure.

Results

Epidural steroid injections are known to produce fast, if not immediate, results. Pain and other symptoms that are caused by the following conditions may be effectively treated using the procedure:

  • Degenerative disc disease
  • Herniated disc
  • Spinal stenosis
  • Spondylosis
  • Sciatica

Results may last anywhere from a few days to many months. In most cases, epidural steroid injections are used in conjunction with other treatments options to provide patients with a complete treatment solution to the condition that is causing their pain. Patients who are in pain and would like to find out if epidural steroid injections can help them are encouraged to schedule an appointment with one of the specialists at Hope Orthopedics.

TLIF (Transforaminal Lumbar Fusion)

A diseased or damaged intervertebral disc is one of the most common causes of lower back and/or lower extremity pain. When non-surgical treatment options like anti-inflammatory medications and physical therapy do not reduce pain caused by a diseased or damaged disc, surgical intervention may be necessary. A TLIF (transforaminal lumbar interbody fusion) is a minimally invasive spine surgery (MISS) that removes a diseased or damaged disc and replaces it a bone graft implant. The incision that is used to perform the procedure is a posterior lateral one—made from the back and to the side of the midline. Important spinal nerves are not disturbed during surgery because the approach allows the spine surgeon to avoid retracting them. Following surgery, patients experience less pain and recover faster than they would have had they undergone traditional spine surgery.

A TLIF Procedure at Hope Orthopedics

A team of medical professionals works together during a TLIF procedure. A board-certified anesthesiologist administers general anesthesia, monitors vitals, and if necessary gives pain medications. The spine surgeon performs the procedure using the following steps:

  • Incision. A posterior lateral incision is made.
  • Exposure. Minimally invasive techniques are used to visualize the spine
  • Intervertebral disc removal. Microscopic instruments are used to removed the disc
  • Implant. An implant packed with bone graft is placed between adjacent vertebrae
  • Fixation. Tiny screws and rods are used to fixate the vertebrae


Special sutures are used to close the incision. Total procedure time is approximately two hours. Patients are brought to their private hospital room after they recover in the post-operative recovery unit.

Recovery and Results

Patients stay in the hospital while they regain their strength. They learn how to get up and walk with the help of registered nurses and physical therapists. Postoperative appointments occur after two, six, and twelve weeks. Bone healing is monitored throughout the entire process. Patients are released to return to activities as bone healing progresses.

One of the advantages of a TLIF is that it can be used to treat a variety of conditions. The most common of which include the following:

  • Degenerative disc disease
  • A herniated disc
  • Spinal stenosis

Scoliosis, spondylolisthesis, and sciatica can also be treated Patients who are experiencing symptoms of back and/or extremity pain, numbness, burning, or weakness may experience tremendous relief after an XLIF procedure. Patients who are interested in finding out if an XLIF is a solution to their pain problem are encouraged to schedule an appointment with one of the spine specialists at Hope Orthopedics.

Thoracic Laminectomy

Pain in the thoracic (mid-back) region of the spine can be quite problematic. Mid-back pain that does not respond to non-surgical treatment options can limit patients’ abilities to perform their jobs or daily living activities. A thoracic laminectomy is a special type of minimally invasive spine surgery (MISS) that is used to treat the most common cause of mid-back pain: spinal stenosis. The spine surgeons at Hope Orthopedics specialize in performing minimally invasive thoracic laminectomy procedures.

A Minimally Invasive Thoracic Laminectomy at Hope Orthopedics

A minimally invasive thoracic laminectomy is performed under general anesthesia. A board-certified anesthesiologist is responsible for anesthesia administration and monitoring patients to make sure they are completely asleep and can feel no pain. The steps used to perform the procedure consist of the following:

  • Incision. An incision is carefully made over the vertebrae that will be operated on.
  • Laminectomy. The back wall (lamina) of vertebrae that are affected by spinal stenosis is removed. This decompresses pinched nerves by creating space for the spinal cord and spinal nerve roots.

After the laminectomy is complete, the incision is carefully closed. Sterile dressings are used to ensure the incision heals properly. They are also used to prevent infection. Total procedure time is approximately 1-2 hours.

Recovery

The procedure may be performed on an outpatient or inpatient basis. A general timeline for recovery is as follows:

  • 2-3 days after their procedure patients may get up and start walking.
  • Patients first follow-up appointment with their spine specialist will occur approximately 2 weeks after surgery. Stitches will probably be taken out at this appointment.
  • 4-6 weeks after surgery patients will be allowed to increase their activity levels.

The timeframe for complete recovery depends on the healing processes of patients and their responses to physical therapy. At each postoperative appointment, patients are given important information regarding how their recoveries are progressing.

Results

Following the procedure, patients are in less pain because their spinal canal is wider and their nerves are no longer compressed. Cramps and other problems that were caused by spinal stenosis cease. Patients are able to live happy, healthy and pain-free lives after they have fully recovered from surgery. If you are experiencing mid-back pain and would like a treatment solution, please contact Hope Orthopedics to schedule an appointment with one of our spine specialists.


PLIF (Posterior Lumbar Fusion)

A posterior lumbar interbody fusion (PLIF) is a very common minimally invasive spine surgery (MISS). It is used to treat conditions that compress the spinal cord or spinal nerve roots and cause pain in the lumbar spine (lower back) and/or extremities. The conditions include the following:

  • Degenerative disc disease. Age-related changes to the intervertebral discs of the spine.
  • Spinal stenosis. The narrowing of the spinal canal.
  • A herniated disc. The protrusion of a portion of an intervertebral disc into the spinal canal.

Patients who undergo a PLIF at Hope Orthopedics can look forward to long-lasting symptom relief.

A PLIF at Hope Orthopedics

A team approach is used to perform a PLIF at Hope Orthopedics. A board-certified anesthesiologist administers general anesthesia. A team of surgical nurses work together to position patients and make sure they are completely relaxed and comfortable. A spine surgeon performs the procedure using advanced minimally invasive techniques, which include the following:

  • Incision. A small incision is made.
  • Exposure. A series of dilators are used to create a small space.
  • Disc removal. Microscopic instruments are used to remove the disc.
  • Implant insertion. Vertebral anatomy and height are restored after a bone graft filled implant is placed between adjacent vertebrae.
  • Fixation. The implant is secured and fixated using rods and screws.

The majority of the procedure is performed under live x-ray guidance. Total procedure time is approximately two hours.

Recovery

Patients who undergo a PLIF usually stay in the hospital for 1-3 nights after their procedure. Their pain is controlled while they regain strength. Nurses and physical therapists work closely with patients throughout their stay. Patients go to follow up appointments two, six, and twelve weeks after their surgery. X-rays are taken at follow up appointments to make sure the bones are healing properly. Patients are slowly allowed to return to physical activity as their recovery progresses.

Results

Patients see a significant improvement in symptoms that were caused by nerve compression. As their bones heal, patients will regain strength and be able to perform day-to-day activities. Range of motion will decrease after surgery because of the formation of a single solid vertebra; however, patients will experience far less (if any) pain. Patients who are interested in finding out if a PLIF is a procedure that can help relieve their pain are encouraged to schedule an appointment with one of the spine specialists at Hope Orthopedics.


Lumbar Fusion

Lumbar (lower back) pain caused by movement can be effectively treated using a minimally invasive lumbar fusion procedure. The procedure is only indicated when pain does not respond to non-surgical treatment options. The goal of the procedure is to eliminate pain by fusing adjacent lumbar vertebrae, thus stopping movement at painful vertebral segments. The spine specialists at Hope Orthopedics are experts at performing minimally invasive lumbar fusions.

A Minimally Invasive Lumbar Fusion at Hope Orthopedics

A board-certified anesthesiologist administers general anesthesia and monitors patients throughout the entire procedure. The approach that is used to perform the procedure may be made from the front (an anterior approach), back (a posterior approach), or side (a lateral approach). The type of approach depends on patients’ conditions and the preference of the surgeon. The following steps are used to perform the procedure:

  • A very small incision is made
  • Muscles and soft tissues are retracted so the lumbar spine may be visualized
  • The intervertebral disc at a painful vertebral segment is removed
  • An implant filled with bone graft is placed in the vertebral space
  • Adjacent vertebrae are fixated using tiny screws and rods

The incision is closed and is covered with sterile dressings and an adhesive bandage. Total procedure time is approximately two hours.

Recovery

A minimally invasive lumbar fusion is usually performed as an inpatient procedure. Patients are brought to a private room after their procedure is complete. They are taken care of by registered nurses and physical therapists. Patients usually return home two to three days after their procedure.

Patients will be in significantly less pain after their procedure; however, they will not be allowed to return to work or day-to-day activities until their spine surgeon clears them to do so. The formation of bone into a single, solid vertebra is an important part of recovery. Bone growth is monitored throughout the entire recovery process. Total recovery time is approximately eight months.

Results

A minimally invasive lumbar fusion stabilizes and fuses lumbar vertebrae so they no longer produce pain. Patients experience significant lower back and lower extremity pain relief after their procedure. As bone healing takes places and patients regain their strength, they are able to live pain-free, happy lives. Conditions that the procedure can be used to treat include the following:


  • Degenerative disc disease
  • Spondylolisthesis
  • Spinal stenosis
  • Scoliosis
  • Lumbar vertebrae fractures

Patients who have any of these conditions or are experiencing lower back and/or lower extremity pain may contact Hope Orthopedics at any time to schedule an appointment. Our orthopedic spine specialists provide patients with solutions to their spine pain problems.

Correction of Spondylolisthesis XLIF (Lateral Lumbar Fusion)

Spondylolisthesis is a condition characterized by the forward movement of a vertebra. The lumbar (lower back) region of the spine is the region where spondylolisthesis most commonly occurs. To correct vertebral alignment and reduce pain and other symptoms, a minimally invasive XLIF (lateral lumbar fusion) can be performed. The key advantage the procedure has over traditional spine surgery is the lateral (from the side) minimally invasive approach. Less muscle and soft tissue damage allow patients to recover faster. They also experience far less post-surgical pain. The spine specialists at Hope Orthopedics provide spondylolisthesis patients with a spondylolisthesis treatment solution using an XLIF.

An XLIF Procedure at Hope Orthopedics

An XLIF is performed as an outpatient procedure. General anesthesia is administered by a board-certified anesthesiologist. After patients are asleep and comfortably positioned, the procedure is performed using the following steps:

  • Incision. A small lateral incision is made so the surgeon can perform the procedure without damaging the large back muscles.
  • Exposure. Live x-ray guidance is used to place a small probe near the area that will be operated on. Dilation tubes of increasing diameters are placed over the probe to create a small opening.
  • Vertebra removal. Tiny instruments are passed through the opening created by the dilators. The instruments are used to remove the disc of the vertebra that slipped forward. The disc wall is left intact.
  • Implant insertion. An implant filled with bone graft is inserted into the intervertebral space. Normal anatomy is restored as the implant rests securely against the disc wall. Screws and rods are placed in the vertebrae to hold them in a fixed position.

Incision closure is carefully performed to ensure a noticeable scar does not develop after surgery. Sterile dressings are used for infection prevention and maximum healing purposes.

Recovery

Patients return home with a family member or friend after their surgery. Over the course of a few days, patients will regain strength and be able to stand up and walk on their own. Patients see their spine specialists approximately two weeks after their procedure. At six weeks, patients are usually cleared to perform light activities. A complete recovery occurs when bone graft and existing bone fuse to form a single solid vertebra that does not move.

Results

Normal spine anatomy is restored following the procedure. Patients range of motion is limited; however, they are no longer in pain. Patients live much healthier and happier lives after their procedure. Countless patients who have had their procedure performed by one of the spine specialists at Hope Orthopedics have received results they never thought were possible.

ALIF (Anterior Lumbar Fusion)

An ALIF (anterior lumbar interbody fusion) is a relatively new minimally invasive spine surgery (MISS). The distinguishing feature of the procedure is the approach:

  • An incision is made on the front part of the stomach
  • The abdominal muscles and sac that contains the abdominal contents are gently moved to the side
  • The spine is visualized

This type of approach is advantageous because the back muscles are not disturbed in any way during surgery. Patients experience less post-surgical pain, respond well to physical therapy, and recover quickly. Common conditions that the procedure is used to treat include the following:

  • Degenerative disc disease (DDD)
  • Spondylolisthesis
  • Scoliosis

The spine specialists at Hope Orthopedics have the knowledge, training, and skills necessary to provide patients with excellent ALIF results. Countless patients have had their lower back and/or lower extremity pain eliminated after a successful ALIF procedure.

An ALIF Procedure at Hope Orthopedics

A board-certified anesthesiologist is responsible for administering general anesthesia and making sure the patient is completely asleep and does not feel any discomfort or pain during the entire procedure. Once the patient is positioned and rests comfortably, the following steps occur:

  • A 3-5-inch anterior incision is made
  • The abdominal muscles and sac are gently moved aside and retracted
  • The diseased or damaged intervertebral disc is removed
  • An implant is placed in the disc space
  • The vertebrae are fixated using tiny screws and rods
  • The incision is carefully closed

The implant that is inserted into the disc space contains bone graft that will fuse with existing bone to form a single solid vertebra that does not move. Total procedure time is approximately 1-2 hours.

Recovery

An XLIF is performed on an inpatient basis. Patients stay in a large and comfortable private hospital room for 1-3 days after their procedure. Hospital staff, including registered nurses and physical therapists, work with patients to help them regain strength. Patients will get up and walk shortly after their procedure. Patients see their spine specialist two weeks after surgery. Throughout the course of several months, bone healing will take place and patients will slowly be cleared to perform physical activities. A complete recovery occurs when the vertebra is completely fused.

Results

Following an XLIF procedure at Hope Orthopedics, patients experience symptom relief. Back and extremity pain, burning, numbness, and weakness are reduced or eliminated. Because the procedure is performed using minimally invasive techniques, healing occurs must faster than it would if a traditional spine surgery was performed. Patients who are experiencing back and/or extremity pain and would like a treatment solution are encouraged to contact Hope Orthopedics and schedule an appointment with one of our spine specialists.

Cervical Micro-Laminotomy/Discectomy

Neck pain can be one of the worst types of pain. Neck pain that does not respond to non-surgical treatment may require surgical intervention. A cervical micro-laminotomy/discectomy is a minimally invasive spine surgery (MISS) that is used to treat various conditions that cause neck pain. Patients who undergo a cervical micro-laminotomy/discectomy recover quickly and experience significant symptom relief or symptom elimination.

The Procedure

A cervical micro-laminotomy/discectomy is performed under general anesthesia. A board-certified anesthesiologist administers anesthesia and monitors patients to make sure they are completely asleep and can feel no pain. An orthopedic spine surgeon performs the procedure using the following steps:

  • Incision. A small incision is made over cervical vertebrae that will be operated on.
  • Exposure. Soft tissues are gently retracted to expose the cervical spine.
  • Visualization. Microscopic equipment is used to visualize vertebrae, the spinal cord, and spinal nerve roots.
  • Laminotomy/Discectomy. Microscopic instruments are used to carefully remove pieces of vertebral bone and/or intervertebral disc that are pinching the spinal cord and/or nerve roots.

Sutures are used to close the incision and sterile dressings are used to cover it. A neck brace is placed on patients to immobilize the neck and ensure healing. Total procedure time is approximately one to two hours.

Recovery

Many patients recover in as little as four weeks. For others, more time may be necessary. The main advantages of MISS are the following:

  • A faster recovery
  • Less post surgical pain

These advantages are made possible because the tiny incision and special instruments used to perform minimally invasive spine surgery damage the muscles and soft tissues of the neck to a much lesser degree than traditional spine surgery procedures.

Results

Following the procedure, the cervical spinal canal is wider and the spinal cord and/or nerve roots are no longer compressed. Patients experience significant symptom relief in regards to the following:

  • Neck pain
  • Upper extremity pain
  • Neck and/or upper extremity tingling, numbness, weakness
  • Loss of fine motor control in the hand

Patients who do not smoke, adhere to the advice of their orthopedic specialist and physical therapist, and live a healthy lifestyle can look forward to long lasting results.

Conditions Treated

A cervical micro-laminotomy/discectomy is used to treat conditions that narrow the spinal cord. The most common conditions include the following:

  • Spinal stenosis
  • A herniated disc
  • Degenerative disc disease

These advantages are made possible because the tiny incision and special instruments used to perform minimally invasive spine surgery damage the muscles and soft tissues of the neck to a much lesser degree than traditional spine surgery procedures.

Artificial Cervical Disc Replacement

An artificial cervical disc replacement is a minimally invasive spine surgery (MISS) that is used to remove a diseased or damaged cervical disc and replace it with an artificial one. The procedure is very popular because patients experience significant symptom relief without a decrease in range of motion. For many patients, an artificial disc replacement is the perfect alternative to a fusion procedure. An artificial disc replacement is usually only performed as a single level procedure.

An Artificial Cervical Disc Replacement at Hope Orthopedics

The spine specialists at Hope Orthopedics are able to provide patients with maximum symptom relief and long lasting results. A cervical disc replacement is performed using the following step-by-step approach:

  • Anesthesia. A board-certified anesthesiologist administers general anesthesia to put the patient to sleep.
  • Incision. A 1-2-inch incision is made on the front the neck.
  • Disc removal. Muscles and soft tissues are gently moved and retracted. The majority of the intervertebral disc is removed. Portions of the outer wall are left in tact.
  • Implant insertion. An artificial disc is inserted into the intervertebral space. The outer wall that was left in tact holds the implant in the perfect anatomical position. Vertebral height is restored and pinched nerves are decompressed.

The incision is closed using sutures. Sterile dressings and an adhesive bandage are used to cover the incision. This promotes healing and prevents infection. A neck brace is put on the patient so their neck remains in an anatomical position while healing takes place.

Recovery

An artificial cervical disc replacement is usually performed on an outpatient basis. Patients may return home after members of the postoperative recovery team clear them to do so. A family member or friend is responsible for driving patients home and staying with them for the first couple days. Patients usually return to work and normal day-to-day activities two to six weeks after their procedure. Patients see their orthopedic spine specialist to track their progress throughout the recovery. Complete recovery time varies.

Results

Neck and upper extremity pain that was associated with a diseased or damaged disc goes away after the procedure. Patients range of motion returns because the artificial disc acts as a healthy and functional intervertebral disc. Patients return to work and activities they love with very little (if any) limitations. Patients who are experiencing neck and/or upper extremity pain and would like to find out if an artificial cervical disc replacement is a procedure that can help them are encouraged to schedule an appointment with one of the specialists at Hope Orthopedics.

Micro-lumbar Laminotomy

A micro-lumbar laminotomy is a special type of minimally invasive spine surgery (MISS). It is used to decompress pinched spinal nerve roots in the lumbar (lower back) region of the spine. The difference between a laminectomy and a laminotomy can be explained as follows:

  • Laminectomy. Complete removal of the back wall (lamina) of a lumbar vertebra.
  • Laminotomy. Partial removal of the lamina.

A laminotomy is beneficial to patients who have a condition that is serious enough to require surgery but not serious enough to undergo a laminectomy. The spine specialists at Hope Orthopedics perform minimally invasive micro-lumbar laminotomy procedures that are designed to treat the unique conditions and symptoms of each patient.

A Micro-Lumbar Laminotomy at Hope Orthopedics

General anesthesia that is administered by a board-certified anesthesiologist is used during a micro-lumbar laminotomy. Medications are given to patients before, during, and after surgery so very little discomfort or pain is felt. The two surgical techniques that may be used to perform the procedure are the following:

  • Tubular. A small incision is made. Tubes of increasing sizes are passed through the incision until the specialist can view the lumbar vertebrae. Micro-instruments are passed through the tubes and then used to carefully remove portions of the lamina that are pinching nerve roots.
  • Endoscopic. A small incision is made. A tiny camera is inserted into the incision. The lumbar vertebrae are visualized on a video monitor that is connected to the camera. Micro-instruments are used to remove portions of the lamina.

Micro-Lumbar Discectomy Results

Incisions are closed using special sutures. Sterile dressings are placed over incisions to promote healing and prevent infection. Total procedure time is approximately one to two hours.

Micro-Lumbar Laminotomy Recovery

Patients are brought to the post-operative recovery room after their procedure. The majority of patients are able to be driven home by a family member or friend after the procedure. One of the advantages of a micro-lumbar discectomy is the recovery time is very short. Many patients are able to return to their normal lives in six weeks or less.

Micro-Lumbar Laminotomy Results

Symptom relief in the form of decreased pain, numbness, tingling, and weakness in the lower extremities and lower back is seen. Often times, patients experience significant symptom improvement within a few days. Complete results are not seen until the vertebral bone heals and nerve inflammation goes down. The time frame for complete results is dependent on the initial condition and healing processes. Patients will be told exactly how long their recovery will take before their surgery.

Condition Treated

Spinal stenosis refers to the narrowing of the spinal canal and subsequent pinching of spinal nerve roots. The main symptoms of spinal stenosis are pain, numbness, tingling, and weakness in the lower extremities and lower back. When portions of the back wall of a lumbar vertebra are removed during a micro-lumbar laminotomy, the spinal canal becomes larger and nerve roots are no longer pinched. Significant symptom relief occurs. Patients who experience the symptoms of spinal stenosis are encouraged to schedule an initial consultation with one of the spine specialists at Hope Orthopedics.

Micro-Lumbar Discectomy

A herniated disc is one of the most common causes of lower back and lower extremity pain. A herniated disc that does not respond to non-surgical treatment options may be treated using a minimally invasive micro-lumbar discectomy procedure. During the procedure, portions of a herniated disc that is compressing nerve roots are removed. Patients who have the procedure experience significant symptom relief or elimination after a short recovery period. The spine specialists at Hope Orthopedics have provided countless patients with a solution to their pain problem using a micro-lumbar discectomy.

A Micro-Lumbar Discectomy at Hope Orthopedics

A micro-lumbar discectomy is typically performed as an outpatient procedure. General anesthesia is used to ensure the patient feels no pain or discomfort throughout the procedure. At Hope Orthopedics, a board-certified anesthesiologist always administers anesthesia. The following steps are used to perform the procedure:

  • Incision. A 1-1/2-inch vertical incision is made over the area where the herniated disc is located.
  • Exposure. Special instruments and retractors are used to gently move soft tissues and muscles so the herniated disc and nearby nerve roots can be visualized.
  • Disc removal. Micro-instruments are used to carefully removes pieces of a disc that are compressing nerve roots.

Incisions are closed using sutures that will be taken out in approximately two weeks. A sterile dressing and Band-Aid are placed over the incision. Total procedure time is typically 1-1/2-hours.

Micro-Lumbar Discectomy Recovery

After their procedure, patients are brought to the post-anesthesia care unit (PACU). They are monitored by registered nurses while the effects of anesthesia subside. Patients return home after they are awake and their pain is controlled. A family member or friend is responsible for driving patients home. Patients should have someone stay with them the first few days after their procedure. Throughout the recovery process, patients will regain strength and their ability to perform day-to-day functions will quickly increase. Working with a physical therapist is an important part of the recovery process. In most cases, recovery takes approximately six weeks.

Micro-Lumbar Discectomy Results

A herniated lumbar disc can cause symptoms in the lower extremities and lower back. Patients who have a herniated disc may present with any or any combination of the following:

Condition Treated Using a Lumbar Laminectomy

A lumbar laminectomy is used to treat spinal stenosis, a condition characterized by the narrowing of the spinal canal and subsequent pinching of the spinal cord or spinal nerve roots. The most common cause of spinal stenosis is osteoarthritis. The symptoms of spinal stenosis typically include any or any combination of the following:

  • Pain
  • Numbness
  • Tingling
  • Weakness

Identifying symptoms is an important part of the treatment process. Once symptoms are identified, patients are encouraged to schedule an appointment with an orthopedic spine specialist so their condition can be formally diagnosed and treated. The spine specialists at Hope Orthopedics have the knowledge, experience, and skills required to accurately diagnose conditions and come up with effective treatment plans.

Lumbar Laminectomy

A lumbar laminectomy is one of the most commonly performed minimally invasive spine surgeries (MISSs). It is used to remove the back portion of a diseased or damaged lumbar (lower back) vertebra that pinches the spinal cord or spinal nerve roots. Patients who undergo the procedure experience symptom relief in a very short period of time. Because the procedure is performed in a minimally invasive fashion, patients experience less postsurgical pain, recover faster, and have a less noticeable scar. The spine surgeons at Hope Orthopedics specialize in performing minimally invasive lumbar laminectomy procedures designed to help patients live pain-free and happy lives.

A Lumbar Laminectomy Procedure at Hope Orthopedics

A lumbar laminectomy is usually performed under general anesthesia. A board-certified anesthesiologist is responsible for administering anesthesia and pain medications and monitoring patients throughout the entire procedure. Once patients are comfortable and completely asleep, the orthopedic spine specialist performs the procedure using the following steps:

  • Incision and exposure. A small incision is made. Retractors are used to gently move lower back muscles aside so the lumbar vertebrae can be visualized.
  • Vertebral bone removal. The back portion of a diseased or damaged vertebra is carefully removed using tiny surgical instruments.
  • Incision closure. The surgical incision is closed using sutures that will be removed approximately two weeks after the procedure. Sterile dressings are placed over the incision. An adhesive gauze is placed over the sterile dressings.

Patients are woken up and taken to the postoperative recovery unit after their procedure. Total procedure time is dependent on the severity of patients’ conditions. Generally, procedures take approximately one to two hours.

Lumbar Laminectomy Recovery

Patients’ vitals and pain levels are monitored by the postoperative recovery team, which includes an anesthesiologist and registered nurses. After patients are completely awake and pain is controlled, they may be driven home by a family member or friend. If an overnight hospital stay is necessary, patients will be brought to their private room. One of the most important parts of recovery is physical therapy. Patients and physical therapists work together to improve strength, flexibility, and function. Total recovery time is usually four to six weeks.

Lumbar Laminectomy Results

The spinal cord or spinal nerve roots are no longer pinched after the procedure. Patients experience significantly less (if any) back or extremity pain after their procedure and recovery. Patients who follow the advice of their orthopedic spine specialist and are dedicated to physical therapy can expect maximum results.

Condition Treated Using a Lumbar Laminectomy

A lumbar laminectomy is used to treat spinal stenosis, a condition characterized by the narrowing of the spinal canal and subsequent pinching of the spinal cord or spinal nerve roots. The most common cause of spinal stenosis is osteoarthritis. The symptoms of spinal stenosis typically include any or any combination of the following:

  • Pain
  • Tingling
  • Numbness
  • Weakness

Symptoms most often present in the lower extremities. They may also present in the lower back. An initial consultation with one of the specialists at Hope Orthopedics is geared towards identifying symptoms and then treating them appropriately. A patient-focused approach is always used to provide patients with maximum results.

Anterior Cervical Discectomy and Fusion (ACDF)

The intervertebral discs of the cervical spine sit between adjacent vertebrae. Their main functions are (1) absorb the load placed on the vertebrae and (2) preserve neck anatomy. A cervical disc herniation occurs when a disc herniates and protrudes into the spinal canal. Many times, a herniated disc can compress the spinal cord and cause neck pain, arm pain, weakness, and impaired ability to perform fine motor movements with the hand. An anterior cervical discectomy is a minimally invasive spine surgery that can be used to treat a herniated disc that does not respond to non-surgical treatment. The experience and skills of the spine specialists at Hope Orthopedics are used to provide patients with maximum and long-lasting or permanent ACDF results.

An ACDF at Hope Orthopedics

An ACDF may be performed as an outpatient or inpatient procedure. Patients who have the procedure will know beforehand if they will need to stay in the hospital overnight. The procedure is performed under general anesthesia that is administered by a board-certified anesthesiologist. The steps used to perform the procedure are the following:

  • Incision. A tiny incision is made on the front of the neck.
  • Exposure. Microscopic visualization and instruments are used to move soft tissues so the herniated disc can be seen.
  • Discectomy. The portion of the disc that is compressing the spinal cord is removed.
  • Fusion. Bone graft is packed into space between adjacent vertebrae. Rods and screws are used to hold adjacent vertebrae in place.

Special sutures are used to close the incision. Sterile dressings and a Band-Aid are placed over the incision. A neck brace is placed on the patient to immobilize the neck while it heals.

ACDF Recovery

The anterior incision and minimally invasive techniques used to perform the procedure damage very little neck muscles and soft tissues. This provides patients with following benefits:

  • Less post surgical pain is experienced
  • Recovery time is significantly shortened
  • A less noticeable scar forms

Patients will be monitored throughout their recovery process to make sure bone formation is taking place and the vertebrae are fusing to form a single solid bone. Physical therapy is used to help patients increase strength and flexibility. Recovery time can vary. Patients who have their procedure performed by one of the specialists at Hope Orthopedics will know every step in the recovery process and about how long it will take for a complete recovery.

ACDF Outcomes

Patients experience significant symptom improvement or symptom elimination after their procedure. Neck pain, arm pain, and weakness that used to cause tremendous problems are no longer issues. Fine motor control of the hand is regained. Patients who follow the instructions of their orthopedic specialist and physical therapist can look forward to maximum results that help them live a much happier life.