Thoracic & lumbar degenerative disc disease is a condition that occurs when one or more discs between the vertebrae of the thoracic & lumbar level of the spinal column deteriorates. The gel-like material wears out, in most cases due to aging, losing its cushioning ability The body reacts by laying down bone to stabilize the spine, known as bone spurs, which can cause pain for the patient in middle and lower back, as well as numbness, tingling, or weakness in the legs. Nonsurgical treatment options such as medication, rest, exercise, and physical therapy may be recommended for those with no evidence of nerve root compression or muscle weakness. Additional conservative options may include steroidal injections, and where these treatments fail to provide relief, surgery is considered, in which a discectomy is performed to remove the affected disc(s).

Degenerative joint disease is the most common form of arthritis, marked by the breakdown of cartilage in joints and can occur in almost any joint in the body. As degeneration progresses in the thoracic & lumbar parts of the spine, those soft areas in the cartilage crack and wear down, exposing bone and causing irritation in the back. Other symptoms of degenerative joint disease include pain, stiffness, limited range of motion, loss of flexibility, and muscle spasms. In most cases, treatment for degenerative joint disease is non-surgical and can include physical therapy, pain medication, injections, and other modalities. Severe cases may warrant spine surgery.

Between each vertebrae in the spine is a structure called the intervertebral disc. An intervertebral disc is made up of 2 parts: the outer, fibrous ring and a gel-like center. When the outer ring is torn, the center can push out and put pressure on other structures in the area, like spinal nerves. Symptoms may include back pain, stiffness or reduced range of motion, sensory changes such as tingling or numbness in the nerve that has been affected, loss of motion, and difficulty sitting or bending. However, if the damaged disc is not pressing on a sensitive structure, the patient may also remain symptom-free. Most pain from a herniated disc will resolve over a few weeks to a couple months with nonsurgical treatment and pain management. If the pain lasts longer or if the pain or damage is severe, spine surgery may be an option, which can include a laminectomy or discectomy in which part of all of the damaged disc is removed.

Thoracic & lumbar facet syndrome is a form of arthritis that affects the facet joints in the middle and lower part of the spine. Facet joints are located on the back of the spine and are responsible for connecting the vertebrae and providing stability. Loss of cartilage and fluid in these joints causes friction between the bones, resulting in bone spurs on the facet joints, which can cause symptoms like neck pain, pain and tenderness at the level of the affected joint, muscle spasms, changes in posture, and loss of motion. For mild symptoms, nonsurgical treatment includes activity modification to reduce flare-ups, physical therapy, or joint injections. Severe cases may warrant spine surgery.

Radiculopathy is commonly referred to as a pinched nerve, when the nerve roots that exit the spine are damaged or irritated. At each level in the spine, a nerve exits and travels in a specific path to skin and muscles. Because nerves are responsible for pain, sensation, and strength, compression of a nerve in the thoracic & lumbar part of the spine may result in pain, sensation changes, or weakness at different locations of your body, including the back and legs. Non-surgical treatment options for radiculopathy may include medication or steroid injections. If symptoms aren’t relieved with conservative treatments, surgery may be recommended to reduce the pressure on the nerve root.

With age, your spinal canal can start to narrow, which can put pressure on the nerves that travel through the spine. The narrowing is usually caused by arthritis of the spinal column and discs between the vertebrae. When the thoracic & lumbar spine begins to narrow, symptoms may occur in the back and legs. While some can be born with a narrower spinal canal, most cases are the result of aging and wear and tear on the spine. Other causes of spinal stenosis can include herniated discs, overgrowth of bone or bone spurs, and spinal injuries. For mild cases of stenosis, conservative treatment such as pain medication or physical therapy is recommended. Steroid injections can help reduce inflammation and relieve some of the pain. For more progressive cases, surgical options such as a laminectomy may be recommended to relieve the pressure on the spinal cord or affected nerve roots.

Lumbar trigger point injection is a minimally invasive procedure that is used to relieve pain and muscle tension in the lower back. It involves the injection of a small amount of medication, such as a local anesthetic or steroid, directly into a trigger point, which is a tight band of muscle that is causing pain or discomfort.

The injection is typically performed under local anesthesia and guided by ultrasound or fluoroscopy to ensure accuracy and safety. The medication works to numb the pain and reduce inflammation, while also helping to relax the muscles and increase blood flow to the affected area.

Lumbar trigger point injection can be an effective treatment option for patients with chronic low back pain or muscle spasms that have not responded to other conservative treatments such as physical therapy, medication, or massage therapy. It is generally a safe procedure, although like any medical intervention, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

A lumbar epidural injection is a procedure that involves the injection of medication into the epidural space in the lower back, which is the area surrounding the spinal cord and nerve roots. The injection can be used to provide pain relief and reduce inflammation in the lower back, as well as to diagnose and treat underlying conditions that affect the nerves in this area.

The procedure is typically performed under local anesthesia and guided by fluoroscopy or ultrasound to ensure accuracy and safety. A small needle is inserted into the epidural space, and a mixture of medication, such as a local anesthetic and/or steroid, is injected into the area to provide pain relief and reduce inflammation.

Lumbar epidural injections can be an effective treatment option for patients with conditions such as herniated discs, spinal stenosis, or sciatica, who have not responded to conservative treatments such as physical therapy or medication. The injection can provide temporary relief of pain and inflammation, allowing patients to participate in physical therapy or other treatments that can help address the underlying condition.

While lumbar epidural injections are generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

A lumbar medial branch block is a diagnostic procedure that is used to identify the source of pain in the facet joints of the lower back. The facet joints are small joints located between the vertebrae in the spine, and they can become inflamed or irritated, leading to pain and discomfort.

During a lumbar medial branch block, a small amount of local anesthetic is injected into the area surrounding the medial branch nerves, which are the nerves that supply sensation to the facet joints. If the injection provides immediate pain relief, it is a strong indication that the facet joints are the source of the pain.

The procedure is typically performed under local anesthesia and guided by fluoroscopy or ultrasound to ensure accuracy and safety. The injection is usually performed on an outpatient basis and takes only a few minutes to complete.

Lumbar medial branch block can be an effective diagnostic tool for patients with chronic lower back pain that has not responded to conservative treatments such as physical therapy or medication. By identifying the source of the pain, doctors can develop a more targeted and effective treatment plan to alleviate symptoms and improve quality of life.

While lumbar medial branch blocks are generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

Lumbar facet radiofrequency ablation (RFA) is a minimally invasive procedure that uses heat to destroy nerve fibers that transmit pain signals from the facet joints in the lower back. The procedure involves the insertion of a small electrode into the area surrounding the facet joint, which is then heated using radiofrequency energy to create a lesion on the nerve tissue, thereby blocking the pain signals.

The procedure is typically performed under local anesthesia and guided by fluoroscopy or ultrasound to ensure accuracy and safety. The electrode is inserted through a small incision in the skin and positioned near the nerve fibers, where it delivers controlled heat to create a lesion that disrupts the pain signals. The procedure takes approximately 30-60 minutes to complete.

Lumbar facet RFA can be an effective treatment option for patients with chronic lower back pain due to facet joint problems who have not responded to other conservative treatments such as physical therapy, medication, or injection therapy. The procedure can provide long-lasting pain relief, allowing patients to participate in physical therapy or other treatments that can help address the underlying condition.

While lumbar facet RFA is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

Lumbar provocative discogram is a diagnostic procedure that is used to identify the source of chronic lower back pain that has not responded to other diagnostic tests such as X-rays or MRI. It involves the injection of a small amount of contrast dye into the center of one or more intervertebral discs in the lower back, which are the shock-absorbing cushions between the vertebrae in the spine.

During the procedure, the patient is typically sedated and lying on their stomach. A small needle is inserted into the center of the disc under fluoroscopic guidance, and a small amount of contrast dye is injected into the disc. The injection can cause pressure and pain that mimics the patient’s usual back pain. After the injection, the patient is asked to describe any pain they feel, and imaging studies are performed to assess the structure of the disc and the extent of the dye spread.

Lumbar provocative discogram can be an effective diagnostic tool for patients with chronic lower back pain who have not responded to other diagnostic tests. By identifying the specific discs that are causing pain, doctors can develop a more targeted and effective treatment plan to alleviate symptoms and improve quality of life.

While lumbar provocative discogram is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

Lumbar endoscopic discectomy is a minimally invasive surgical procedure that is used to treat a herniated disc in the lower back. It involves the use of a small camera and specialized surgical instruments that are inserted through a small incision in the skin to access the herniated disc and remove the portion that is compressing the nerves and causing pain.

During the procedure, the patient is typically under general anesthesia or conscious sedation. A small incision is made in the skin, and a small camera and surgical instruments are inserted through the incision to access the herniated disc. The surgeon then removes the portion of the disc that is pressing on the nerves, relieving the pain.

Lumbar endoscopic discectomy is considered a minimally invasive procedure, and as a result, it typically has a shorter recovery time and fewer complications than traditional open surgery. Patients may be able to go home the same day or stay in the hospital for a short period of time for observation.

Lumbar endoscopic discectomy can be an effective treatment option for patients with a herniated disc in the lower back who have not responded to other conservative treatments such as physical therapy or medication. The procedure can provide relief from chronic back pain, improve mobility and quality of life.

While lumbar endoscopic discectomy is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

Sacroiliac joint steroid injection is a procedure used to relieve pain and inflammation in the sacroiliac joint, which is located in the lower back where the spine meets the pelvis. This joint can become inflamed and painful due to arthritis, injury, or other conditions.

During the procedure, the patient lies on their stomach, and a local anesthetic is used to numb the skin and surrounding tissue. A needle is then inserted into the sacroiliac joint under fluoroscopic or ultrasound guidance, and a mixture of a local anesthetic and a corticosteroid is injected into the joint.

The corticosteroid is a powerful anti-inflammatory medication that can reduce inflammation and relieve pain in the sacroiliac joint. The anesthetic provides immediate pain relief, and the steroid provides longer-lasting relief by reducing inflammation.

Sacroiliac joint steroid injection can be an effective treatment option for patients with chronic lower back pain due to sacroiliac joint problems who have not responded to other conservative treatments such as physical therapy, medication, or other injection therapies.

While sacroiliac joint steroid injection is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

A Ganglion Impar Block is a minimally invasive procedure used to treat chronic pelvic and perineal pain. The ganglion impar is a cluster of nerves located at the base of the spine, and it is responsible for transmitting pain signals from the pelvic region.

During the procedure, a local anesthetic or a mixture of anesthetic and steroid is injected into the ganglion impar using a needle under fluoroscopic guidance. The injection helps to block the transmission of pain signals, providing relief from chronic pelvic and perineal pain.

Ganglion Impar Block is typically performed on an outpatient basis and can be repeated if necessary. Patients may experience temporary numbness or weakness in the affected area, but these side effects usually resolve within a few hours.

While Ganglion Impar Block is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

Lysis of adhesion of the lumbar spine is a surgical procedure that involves the removal or separation of adhesions, which are bands of scar tissue that can form between the lumbar vertebrae and surrounding tissues. Adhesions can form after surgery or due to inflammation or injury, and can cause pain, restricted range of motion, or other complications.

During the procedure, the surgeon uses minimally invasive or open surgical techniques to identify and separate the adhesions, using tools such as lasers, electrocautery, or surgical scissors. The goal is to free any nerves or other tissues that are trapped or tethered by the adhesions, allowing them to move freely and function normally.

Lysis of adhesion of the lumbar spine is typically performed under general anesthesia and may require a hospital stay of a few days. Recovery time can vary depending on the extent of the adhesions and the location of the surgery, but patients may require several weeks or months of rest and physical therapy before returning to normal activities.

Lysis of adhesion of the lumbar spine can be an effective treatment option for certain types of chronic pain or complications caused by adhesions, such as restricted range of motion or nerve compression. However, there are potential risks and complications associated with this procedure, such as bleeding, infection, or damage to surrounding tissues or organs. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

A spinal cord stimulator (SCS) trial is a temporary procedure used to determine whether a patient would benefit from a permanent spinal cord stimulator implant. An SCS is a device that sends electrical impulses to the spinal cord to alleviate chronic pain. It consists of a small generator that is implanted under the skin and connected to electrodes that are placed near the spinal cord.

During the SCS trial, the surgeon places temporary electrodes in the epidural space, the area surrounding the spinal cord. The electrodes are connected to an external generator that is worn outside the body. The patient will then be asked to perform daily activities and keep a record of their pain levels during the trial period, typically lasting between three to seven days.

If the trial is successful in reducing the patient’s pain levels by 50% or more, the patient may be a candidate for a permanent SCS implant. The implant procedure involves the surgical placement of a small generator under the skin and electrodes in the epidural space, which are connected to the generator by wires.

Spinal cord stimulation can be an effective treatment for chronic pain conditions, such as failed back surgery syndrome, neuropathic pain, and complex regional pain syndrome. However, as with any medical procedure, there are potential risks and complications associated with SCS, including infection, bleeding, device failure, and nerve damage. Your doctor can discuss the risks and benefits of SCS and whether it is appropriate for your specific condition.

A spinal cord stimulator (SCS) is a device that is surgically implanted under the skin and sends electrical impulses to the spinal cord to alleviate chronic pain. It consists of a small generator that is implanted under the skin and connected to electrodes that are placed near the spinal cord.

To have a permanent spinal cord stimulator implanted, a patient will first undergo a trial period to determine whether the SCS is effective in reducing their pain levels. If the trial is successful and the patient and their doctor decide that a permanent SCS is appropriate, the patient will undergo a surgical procedure to have the generator and electrodes implanted.

During the surgery, the surgeon will make a small incision and place the electrodes in the epidural space, the area surrounding the spinal cord. The generator will then be implanted under the skin in the abdomen, buttocks, or upper chest, and connected to the electrodes by wires. The procedure is typically done under local anesthesia, and the patient may go home the same day or after a short hospital stay.

After the implantation procedure, the patient will be given instructions on how to use the device, including how to adjust the settings and recharge the battery. The device can be programmed to provide different levels of stimulation depending on the patient’s pain levels and activity level.

Spinal cord stimulation can be an effective treatment for chronic pain conditions, such as failed back surgery syndrome, neuropathic pain, and complex regional pain syndrome. However, as with any medical procedure, there are potential risks and complications associated with SCS, including infection, bleeding, device failure, and nerve damage. Your doctor can discuss the risks and benefits of SCS and whether it is appropriate for your specific condition.

Microdiscectomy of the lumbar spine is a surgical procedure that is performed to relieve pressure on the nerves in the lower back caused by a herniated disc. A herniated disc occurs when the soft center of a disc in the spine pushes through a crack in the outer layer of the disc and presses on the nearby nerves.

During the procedure, the patient is typically under general anesthesia. A small incision is made in the skin, and a small portion of the bone over the affected disc is removed to access the herniated disc. The surgeon then removes the portion of the disc that is pressing on the nerves, relieving the pain.

Microdiscectomy is called “micro” because it is performed using a small incision and specialized surgical instruments, which minimize damage to surrounding tissues and allow for a faster recovery time than traditional open surgery.

Microdiscectomy of the lumbar spine can be an effective treatment option for patients with a herniated disc in the lower back who have not responded to other conservative treatments such as physical therapy or medication. The procedure can provide relief from chronic back pain, improve mobility, and quality of life.

While microdiscectomy is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

Anterior lumbar fusion is a surgical procedure used to treat certain types of lower back pain, such as degenerative disc disease, spinal stenosis, or spondylolisthesis. During the procedure, the surgeon accesses the spine through an incision in the front of the body, typically the abdomen.

The surgeon then removes the affected disc or discs and replaces them with a bone graft or implant. The bone graft or implant serves as a spacer between the vertebrae, promoting the growth of new bone and eventually fusing the affected vertebrae together.

Anterior lumbar fusion is a major surgical procedure that is typically performed under general anesthesia. Patients may need to stay in the hospital for a few days after the procedure and may require several weeks or months of recovery time before returning to normal activities.

Anterior lumbar fusion can be an effective treatment option for certain types of lower back pain, especially when conservative treatments such as physical therapy or medication have not been effective. The procedure can provide relief from chronic back pain, improve mobility, and quality of life.

While anterior lumbar fusion is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

Posterior lumbar fusion is a surgical procedure used to treat certain types of lower back pain, such as degenerative disc disease, spinal stenosis, or spondylolisthesis. During the procedure, the surgeon accesses the spine through an incision in the back of the body.

The surgeon then removes the affected disc or discs and replaces them with a bone graft or implant. The bone graft or implant serves as a spacer between the vertebrae, promoting the growth of new bone and eventually fusing the affected vertebrae together.

Posterior lumbar fusion is a major surgical procedure that is typically performed under general anesthesia. Patients may need to stay in the hospital for a few days after the procedure and may require several weeks or months of recovery time before returning to normal activities.

Posterior lumbar fusion can be an effective treatment option for certain types of lower back pain, especially when conservative treatments such as physical therapy or medication have not been effective. The procedure can provide relief from chronic back pain, improve mobility, and quality of life.

While posterior lumbar fusion is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

XLIF (eXtreme Lateral Interbody Fusion) is a minimally invasive surgical technique used to treat certain types of lower back pain, such as degenerative disc disease, scoliosis, or spondylolisthesis. During the procedure, the surgeon accesses the spine through small incisions on the patient’s side, without having to cut through muscles or other tissues in the back.

The surgeon then removes the affected disc or discs and replaces them with a bone graft or implant. The bone graft or implant serves as a spacer between the vertebrae, promoting the growth of new bone and eventually fusing the affected vertebrae together.

XLIF is performed under general anesthesia, and patients typically spend a shorter time in the hospital and have a faster recovery than with traditional open surgery. The procedure can provide relief from chronic back pain, improve mobility, and quality of life.

While XLIF is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

TLIF (Transforaminal Lumbar Interbody Fusion) is a surgical technique used to treat certain types of lower back pain, such as degenerative disc disease, spinal stenosis, or spondylolisthesis. The procedure involves accessing the spine through an incision in the lower back.

The surgeon then removes the affected disc or discs and replaces them with a bone graft or implant. The bone graft or implant serves as a spacer between the vertebrae, promoting the growth of new bone and eventually fusing the affected vertebrae together. In a TLIF procedure, the surgeon also places screws and rods to help stabilize the spine.

TLIF is typically performed under general anesthesia, and patients may need to stay in the hospital for a few days after the procedure. Recovery time can vary but may require several weeks or months of rest and physical therapy before returning to normal activities.

TLIF can be an effective treatment option for certain types of lower back pain, especially when conservative treatments such as physical therapy or medication have not been effective. The procedure can provide relief from chronic back pain, improve mobility, and quality of life.

While TLIF is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

SI joint fusion is a surgical procedure used to treat certain types of lower back pain caused by problems with the sacroiliac joint, which is the joint that connects the sacrum (triangular bone at the bottom of the spine) to the pelvis. The procedure involves fusing the sacrum to the pelvis using bone grafts or implants to stabilize the joint and prevent movement.

During the procedure, the surgeon accesses the SI joint through an incision in the lower back or buttock. They remove any damaged cartilage or bone and place the bone graft or implant between the sacrum and pelvis. The bone graft or implant serves as a spacer to promote the growth of new bone and eventually fuse the joint together.

SI joint fusion is typically performed under general anesthesia and may require a hospital stay of a few days. Recovery time can vary but may require several weeks or months of rest and physical therapy before returning to normal activities.

SI joint fusion can be an effective treatment option for certain types of lower back pain caused by SI joint problems, especially when conservative treatments such as physical therapy or medication have not been effective. The procedure can provide relief from chronic back pain, improve mobility, and quality of life.

While SI joint fusion is generally considered safe, there are potential risks and complications, such as infection, bleeding, or nerve damage. Your doctor can discuss the risks and benefits of this procedure and whether it is appropriate for your specific condition.

Robotic-assisted spine surgery is a minimally invasive surgical technique that uses advanced technology to assist the surgeon in performing spine surgery with increased precision and accuracy. The technology involves a robotic arm that is controlled by the surgeon and provides real-time feedback during the procedure.

The robotic arm is equipped with a camera and instruments that can be manipulated by the surgeon. The camera provides a high-resolution, 3D image of the surgical site, which allows the surgeon to see the anatomy in greater detail and make more precise incisions.

During the procedure, the surgeon uses a joystick to control the robotic arm and place the instruments at the surgical site. The robotic arm also provides real-time feedback to the surgeon, which helps to ensure that the instruments are precisely placed and that the procedure is being performed correctly.

Robotic-assisted spine surgery is typically used for procedures such as spinal fusion, disc replacement, and spinal decompression. The benefits of robotic-assisted surgery include smaller incisions, less blood loss, less postoperative pain, and a faster recovery time compared to traditional open surgery.

However, like any surgical procedure, there are potential risks and complications associated with robotic-assisted spine surgery, including infection, bleeding, nerve damage, and anesthesia-related complications. Your doctor can discuss the risks and benefits of robotic-assisted spine surgery and whether it is appropriate for your specific condition.