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Spine

The spine has two very important roles. The first is to provide a central strut to support the body from the head to the pelvis while being somewhat flexible. The second is to contain, protect, and distribute the spinal cord and nerves, which let the brain communicate with the rest of the body.  

In order to function as a flexible strut, the spinal column has bones (called “vertebrae”) and “discs,” which act as cushions between the vertebrae. These are connected in a series, while ligaments and muscles provide additional stability. 

The rear portion of the spinal column forms a tunnel – the “spinal canal.” The spinal canal contains the spinal cord in the cervical and thoracic areas (neck and upper back), while the lumbar spine (lower back) contains mostly nerve roots.

Over time, the discs’ cushioning ability can deteriorate, sometimes causing pain and stiffness. Strains may also occur in the muscles and tendons, and vertebrae may develop arthritis and “bone spurs,” as the joints and discs that connect them wear down.

Many spine conditions can be treated without surgery. This is especially true of generalized back and neck pain, which often can’t be cured surgically. 

Surgery can be an option when nonsurgical treatments fail, and/or when spinal cord or nerve compression is causing symptoms like pain, numbness, or weakness in the arms or legs.

If you’re living with spinal stenosis or other conditions affecting the spinal cord or nerves, conservative treatment is often a first choice. If these conservative methods are ineffective, then spine surgery can be considered to reduce pain and preserve function.

Surgical advancements mean that spine surgeries can often be performed with smaller incisions, shorter procedures, and less recovery time. 

Spine Conditions

Degenerative disc disease occurs as the discs in your spinal column begin to wear down, become flattened, and lose hydration. This is a normal and expected process as we age. In some people, it can cause symptoms.

A “herniated”, “ruptured”, or “slipped” disc refers to a condition where the outer wall of the disc has failed, and the softer inside material is compressing the spinal cord or nerves. This can happen anywhere in the spine. Depending on the location, it can cause symptoms in the arm (cervical) or leg (lumbar).

In addition to lower back pain, lumbar disc disease can lead to leg pain if the degenerated disc causes pressure (stenosis) on the spinal cord or nerve roots. This can happen as the degenerated disc bulges into the spinal canal and compresses nerves inside of it.

Like lumbar disc disease, cervical disc disease can cause neck pain and stiffness. It can also cause cervical stenosis. 

A pinched nerve is a result of compression of the nerve roots that travel from the spinal cord to other body parts. It can cause pain, weakness, numbness, and tingling in the arm or leg.  A radiculopathy can result from many conditions, including stenosis and disc herniations.

Scoliosis is where the spine curves abnormally. Some forms of scoliosis start in childhood and others develop later in life as the result of arthritis. Surgery for scoliosis is usually to restore balance to the spine and to prevent the scoliosis from worsening.

Lumbar stenosis occurs when the spinal canal narrows and compresses the spinal cord or spinal nerve roots, usually because of arthritic changes of the spinal column and/or disc problems. Lumbar spinal stenosis can cause radiculopathy in the leg or “claudication”, a painful aching sensation in the buttocks and thighs with standing or walking. Stenosis may get worse over time.

Narrowing of the spinal canal in the cervical spine can cause pain, numbness, and tingling down the arm. Compression of the spinal cord in the cervical spine can cause myelopathy – a dysfunction of the spinal cord. Myelopathy often entails loss of balance and coordination as well as difficulty using the hands for fine motor tasks such as handwriting or handling coins.  Myelopathy usually gets worse if left untreated and is normally treated surgically.

The sacroiliac joint (“SI joint”) refers to the area where the lower spine is connected to the pelvis. This connection is supported by the strongest ligaments in the body, but can be a source of pain. SI joint pain is often located deep in the buttock and is usually worse with transitional movements such as getting out of a bed or a chair.

A variety of other spinal disorders and conditions exist. Our care team has the experience and expertise needed to diagnose and treat your specific needs.

Spine Surgery

Many back conditions can be treated non-surgically. However, if non-surgical measures don’t provide relief, you may want to consider surgery. 

You may be a good candidate for spine surgery if:

  • Medications, corticosteroid injections, activity modifications and physical therapy/chiropractic care haven’t been effective for relieving pain or improving mobility.
  • You’re experiencing signs of nerve compression or damage, like muscle weakness, numbness, and arm or leg pain from a herniated disc or spinal stenosis.
  • Spinal stenosis symptoms prevent you from performing your daily activities, or you’ve noticed a decline in function of your arms or legs.
  • You have a herniated disc that isn’t healing or sacroiliac joint problems that won’t improve.

In these cases, a surgical evaluation with Dr. Potocki should be considered.

Persistent pain and loss of function can be very debilitating and affect all aspects of a person’s life. SPO understands; that’s why we offer a spectrum of advanced, personalized treatments to help you find lasting relief and regain your mobility

Top Spine Surgery Procedures

Learn about the most common surgical procedures.

Discectomies treat herniated discs that are pressing against the spinal cord or nerves and causing pain, numbness, weakness, and other symptoms. In a discectomy, the surgeon removes part of or all of a damaged disc. When the entire disc is removed, a disc replacement procedure or spinal fusion might also be performed.

Compressed nerves and spinal stenosis (narrowing of the spinal canal) are treated via a laminectomy, or spinal decompression. During the procedure, the surgeon removes the back part of the vertebrae (the lamina), and any bone spurs, disc herniations, or overgrown ligaments causing pressure. This decompresses pinched nerves and creates more space in the spine. Sometimes spinal fusions are performed at the same time if bone removal causes instability.

An artificial disc replacement switches out a degenerated, bulging, or herniated spinal disc for a prosthetic implant. Artificial disc replacement can be a good alternative to spinal fusion for people with healthy joints and bones and no additional spinal instability. This is most commonly done in the cervical spine (neck).

A spinal fusion is a very common procedure used to treat a large variety of conditions, including degenerated or herniated discs, spinal stenosis, pinched nerves, arthritis, spinal instability, and spinal deformities. There are many reasons and techniques used for spinal fusion; it usually involves implanting a device to hold the vertebrae together, in conjunction with bone grafts, which allows the vertebrae to grow together into one bone.

In some cases, a “minimally invasive” technique can be used for these procedures, including lumbar fusion surgeries. The benefits of minimally invasive surgery include smaller incisions (sometimes less than two inches), less scar tissue, less blood loss, and a lower risk of infection.

Even though you may go home from these surgeries the same day, there will likely be restrictions on movement and lifting. It may be several weeks to several months before you’re back participating in normal activities. 

It can be hard to care for yourself after spine surgery, and you may find you need extra help. Don’t be afraid to ask for help if you need it.