Spine Treatment & Surgery
At The Center for Musculoskeletal Disorders, we are dedicated to providing a full range of diagnostic and treatment services for back pain, neck pain and spinal disorders. This includes both non-operative and operative treatments. Our goal is to relieve spine-related pain and restore normal function.
In addition to surgery, when indicated, our physicians and staff members specialize in non-invasive techniques whenever possible. If surgery is indicated, patients benefit from the developments of the past two decades, which have enabled techniques in minimally invasive surgery to advance to the point where spinal surgery is not only extremely effective, but trauma to the body is greatly reduced. In addition, the success rate in alleviating pain and restoring function is quite high. From sciatica to lumbar disc disorders, from sports to work related injuries, we are experienced in a wide array of conditions and treatments.
The hallmark of The Center for Musculoskeletal Disorders is our individualized approach to patient care. You are not subjected to a cookie cutter solution, nor is your spinal pathology. Therefore, we take the time to listen to you, to view your studies, to diagnose accurately, and to come up with a personalized plan. This is probably the most important aspect of any medical or surgical procedure, and certainly the case when it relates to spinal surgery. Our unique and personalized approach toward spinal conditions and disorders is as distinct as each one of our individual patients.
We know that no two patients are the same, and no two situations are ever quite the same, either. That is why we custom-tailor a treatment program for every patient on a case-by-case basis. We are committed to considering every aspect of your unique situation to ensure you receive the best possible care.
Spine Surgeons & Interventional Spine Doctors
Jonathan Lewin, MD
Orthopedic Spine Surgeon
Vagmin Vora, MD
Orthopedic Spine Surgeon
Steven Horowitz, MD
Interventional Spine & Pain Management
Jonathan Simhaee, MD
Interventional Spine & Pain Management
Michael Harbus, DO
Interventional Spine & Pain Management
Spinal Conditions & Disorders
Our team of experts diagnoses and treats spine pain due to a variety of conditions. At CMD, we believe that patient understanding is an important part of our care and we go to great lengths to ensure everyone comprehends their conditions.
The spine is a complex combination of joints, discs, muscles and nerves, all of which provide a vital service to our anatomy. When the spine is somehow impaired, that can lead to pain and lack of function. A variety of afflictions—from degeneration to trauma—can negatively impact the spine. At The Center for Musculoskeletal Disorders, we combine experience with cutting-edge technology to diagnose and treat the many common conditions of the spine.
Spinal Treatments & Surgical Procedures
We provide diagnostic and treatment services for a variety of spine conditions. From non-invasive solutions to minimally invasive surgical procedures, our specialists use the most advanced techniques available.
At The Center for Musculoskeletal Disorders, our spine treatments include a broad range of options, both non-surgical and surgical. We exhaust all non-invasive methods before considering surgery. When surgery is indicated, we perform the latest minimally invasive procedures. In fact, our experts have transformed the field of spine surgery.
- Activity Modification
- Anterior Cervical Fusion
- Anterior Lumbar Interbody Fusion (ALIF)
- Cervical Laminectomy
- Chiropractic Care
- Disc Replacement
- Endoscopic Lumber Fusion
- Epidural Steroid Injection
- Facet Injections
- Intervertebral Cages
- Laminotomy and Discectomy
- Lumbar Laminectomy
- Lumbar Spinal Fusion
- Neck & Back Braces
- Occupational Therapy
- Pain Medications
- Pedicle Screws and Rods
- Percutaneous Discectomy
- Physical Therapy
- Plateless Cervical Fusions
- Posterolateral Spinal Fusion
- PRP Therapy
- Radiofrequency Ablation
- Robotic Surgery
- Sacroiliac Joint Fusion
- Sacroiliac Joint Injection
- Transforaminal Lumber Interbody Fusion (TLIF)
- Spinal Cord Stimulators
- Stem Cell Therapy
- Weight Loss
FAQ – Spine Disorders & Surgery
What sets the Center for Musculoskeletal Disorders apart?
We believe that every person is entitled to an individualized approach. Your spine is not a cookie cutter, nor is your spinal pathology. And therefore, we take the time to listen to you, to accurately diagnose, to view your studies, and to come up with a plan which is made for you and not for someone else. That is probably the most important aspect of any medical or surgical procedure, and certainly when it relates to spinal surgery.
Do most spinal conditions need surgery?
Absolutely not. The majority of spinal conditions are lumbar sprains and strains, cervical sprains and strains and mild disc herniations which can be managed with a combination of conservative modalities such as physical therapy, anti-inflammatory medications, mild narcotic medications, and at times, injections. Modalities such as chiropractic and acupuncture also play an important role. In instances when these conservative modalities fail, then a patient can be considered for spinal surgery. In a very, very small instance of cases, spinal surgery is emergent but that is very rare.
Can my surgery be done in a minimally invasive manner?
Over the last 20 years, spinal surgery has gone from a maximal conditional invasive approach to a more minimally invasive approach. At the Center for Musculoskeletal Disorders, we are committed towards maintaining a cutting-edge knowledge of this new technology. However, each case has to be evaluated on an individualized basis. Your case may be amenable to a minimally invasive spinal surgery. Within minimally invasive spinal surgery there are various categories. It is important to be well-examined by your physician, including the x-ray, CT scan and/or MRI studies and then an appropriate plan. Approximately 10 – 20% of the time, spinal pathologies and spinal surgeries can be done through a minimally invasive or a hybrid minimally invasive approach.
How much time will I need to be out of work?
That depends. If surgery is done on a minimally invasive level, the answer is perhaps only a day or two. However, even in those settings, it is a good idea to try and allot some time off; perhaps a week to 10 days. In other instances, in which there is fusions and/or osteotomies which need to be done, the time off from work will be much more extensive, perhaps in the range of 2 – 6 weeks and sometimes beyond. Again, each case is different and no two spinal situations are alike.
Can my discs be replaced?
Yes. Over the last 10 – 12 years, more and more lumbar and cervical discs have been replaced. However, depending on the pathology, a disc replacement may be too aggressive a procedure for your given case. Discuss the issue of disc replacement with your surgeon.
If surgery is necessary, what should I look for in a doctor?
Be sure that the doctor that you choose to perform your spinal surgery has taken his time to fully examine you, fully evaluate your studies, and fully describe to you the procedure and/or risks and complications. If he or she is unable to do so to your liking, think twice about that doctor.
Second of all, the best results are in the settings of a team approach where the spinal surgeon, the spinal assistant, as well as the spinal anesthesiologist have done the procedure before, are comfortable with each other, and are comfortable with the setting of the operation.
Can the surgery be done in a hospital or an ambulatory surgery center?
It depends on the case. Some of the more minimally invasive procedures can be safely done in an ambulatory surgery center. Even those surgeries which are slightly more complex, such as a one-level cervical disc replacement or fusion or a lumbar disc replacement or fusion, can often be done in an ambulatory surgery center with the patient going home within 6 – 23 hours. Patients with comorbidities and/or for longer procedures are more safely done in a hospital setting. Be wary of physicians or practices which are steering you to have a surgery done in a particular setting, when you are uncomfortable with it.
If I have a spinal surgery, what are the chances of me needing additional surgery at a later date?
Excellent question. Overall, it can be said that there is approximately a 5 – 15% chance of the necessity for revision or additional surgery in the spinal setting. That additional surgery may be at the level which was operated on, because of further degeneration or collapse, or at an additional level, either above or below the surgery. This means that we have to think very carefully about choosing the spinal surgery which we undergo, choosing the levels, as well as choosing the physician to perform the operation.
I have heard so many bad things about spinal surgery. How can I feel confident in proceeding with a procedure even though I am in pain?
Spinal surgery has gotten a bad rap over the last 10 – 15 years. Although it is true there is the potential for major complications, the most feared and dread complication- i.e., that of paralysis, is the rarest and most unlikely to actually take place. Very often, friends and/or relatives are giving opinions which are based very little on fact. As often as we hear that a patient has been told that they could end up paralyzed, it is very rare to actually find someone who suffers from this dreaded complication from the result of a routine spinal surgery.
Is spinal surgery dangerous?
All surgery has inherent risks. Certainly, spinal surgery has its own set of risks which may include infection, pain at the incision site, lack of fusion, as well as neurological complications. However, with well-trained hands, the incidence of complications differs very little than from other surgical conditions. It is important to discuss with your doctor what he feels the overall chances of a particular complication are in your given setting.
Spine Surgery Overview
The primary purpose of back or neck surgery is to correct an anatomical lesion in individuals who fail to show improvement with conservative (nonsurgical) treatment. Back and neck surgery is indicated in a number of scenarios, and there are multiple options available depending on how the symptoms present.
Minimally Invasive Surgery
Minimally invasive surgery is offered to treat many sources of neck and back pain. Because of the many advantages it offers, this procedure is often preferred by patients and surgeons when possible. The surgery is performed using an endoscope, which is inserted through half-inch incisions. The endoscope connects to a camera that projects what is going on inside the body onto a large screen.
When patients have minimally invasive surgery as opposed to open surgery, they experience less pain and recover more quickly. With such small incisions, the muscle surrounding the cut is less impacted and heals faster, leaving a much smaller scar. Minimally invasive procedures are available for patients suffering from low back pain, spinal stenosis and herniated discs, among others.
Determining Eligibility for Surgery
Eligibility for surgery depends on a number of factors. The most important of these is that the surgeon can identify a specific cause of the pain the patient is experiencing. It is important to speak with a spine specialist at length to determine if the surgical process and its benefits are worthwhile. Pain level and degree of debilitation are also taken into account by the surgeon.
If the patient’s daily life is greatly impacted by the pain level and he or she cannot complete simple tasks, surgery might be the best option if no conservative methods have helped the patient thus far. Along with minimally invasive options, surgeons also perform open surgeries that are more invasive and have longer recovery times for more advanced conditions. Surgical options are dependent on the presenting symptoms and degree of debility.
What to Expect After Surgery
Minimally invasive surgeries have the quickest recovery times. With such small incisions there is less physical area that needs to recover. In some instances, a patient who has surgery in the morning can be back at his or her home that night. For cases that do not qualify for minimally invasive surgery, the recovery times can be longer.
Depending on the specific surgery, condition, and patient’s individual fitness level, recovery periods can range from a few months to a year. For the most part, the more complex the surgery is, the longer the patient’s recovery period. However, every patient has a unique set of symptoms and recovery rate, so it is difficult to determine the specific amount of time.
After suffering for months or years from neck or back pain, surgery will alter how the patient interacts with the world. Researching the pros and cons before meeting with a surgeon will allow the patient to have an informed interaction.