Spine Archive: Radicular

spine surgery

Pain Management vs. Spine Surgery: What is best for you?

Is spine surgery the best course of action for pain management? Learn more about Spine Surgery in Dr. Anthony Leone’s Knowledge Center.

Patients dealing with chronic back pain may be asking themselves if they are better off finding ways to combat their pain or if surgery is the better option. Not surprisingly, patients with pain want to find a way to relieve it once and for all. There are advantages and disadvantages to chronic pain management versus surgery.

It is best to consult your doctor in order to find the best possible course of treatment depending on your spinal condition. With the wide range of spinal deformities, diseases, and complications – there are many treatment options available to patients both surgical and non-surgical.

While programs to manage chronic pain can be preferable as rehabilitation as an escape, surgery may be the best option for you.

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Microdiscectomy & Sciatica

Want to find out more about sciatica and surgical intervention? Search here in Dr. Anthony Leone’s Knowledge Center.

The sciatic nerve runs down both legs from the lower back. Radiating pain can manifest along this nerve resulting in sciatica. In cases where this pain is a result of a lumbar disc degeneration, a microdiscectomy is an option. In a microdiscectomy, a small opening is made and a portion of the herniated disc is removed – relieving the pinched nerve. Typically, this surgery is recommended after non-invasive or non-surgical means have failed within a time period of about 4 to 6 weeks or otherwise determined by the doctor.

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Who is at Risk for Radiculopathy?

Do you have a labor-intensive job? You might be at a higher risk of developing radiculopathy. Read more here in Dr. Anthony Leone’s Knowledge Center.

Patients who work in physically demanding environments or patients who play contact sports have a higher risk of developing radiculopathy. This is because excessive or strenuous movement of the spine can result in compression of the spinal cord and nerves. Patients who also have a family history or who have other spinal disorders are prone to developing radiculopathy.

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Radiculopathy

To learn more about pain and the spine, search here in Dr. Leone’s Knowledge Center.

Radicular pain is typically caused by compression along the spine, among other symptoms such as numbness, tingling, and weakness. This condition is also referred to as radiculopathy when as nerves are compressed. Radiculopathy can occur in any area of the spine but is generally present in the lower back and neck.

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Decompression & Radicular Pain

To learn even more about radicular-associated pain, search here in the Knowledge Center of Dr. Anthony Leone.

Radicular pain is pain radiating directly along a spinal nerve. This radiating pain is caused by compression (sometimes inflammation as the result of a injury to the nerves). Typically, radicular pain can be treated by non-invasive treatments including physical therapy and medication. However, if these treatment options do not work, then decompressive surgery is an option to alleviate the trouble areas. Two surgeries that employ decompressive treatments are laminectomies and discectomies.

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Thoracic Disk Herniations, Erie Co.

Learn more from Dr. Leone regarding disk herniations here in the Knowledge Center.

Thoracic disk herniations (TDH) have been found in up to 11% of presumed asymptomatic individuals in autopsy studies. TDH can be symptomatic, however, causing axial pain, radicular pain, or even myelopathy. Patients may give a history of trauma, such as axial load or automobile accident.¹

¹Garfin MD, Steven. Orthopaedic Knowledge Update : Spine. Rosemont: American Academy of Orthopaedic Surgeons, 1997.

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Degenerative Lumbar Scoliosis, Erie Cnty

Scoliosis can greatly effect posture and lead to other potential problems. Learn more here, in Dr. Leone’s Knowledge Center.

Degenerative lumbar scoliosis can result from untreated idiopathic scoliosis, but it more frequently occurs independently as a sequela of the aging process in combination with osteoporosis. Many patients with degenerative lumbar scoliosis have a combination of both mechanical back pain and spinal stenosis. Patients may also present with radiculopathy because the neural foramen are narrowed at the concavity of the spinal deformity. Forunately, most of these patients are well balanced in the sagittal and coronal planes despite the magnitude of the curvature.¹

¹R. Vaccaro MD, Alexander. Orthopaedic Knowledge Update. Rosemont: American Academy of Orthopaedic Surgeons, 2005.

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Surgical Treatment of Degenerative Spondylolisthesis

The main goals of surgery are pain reduction, restoration of function, and preservation of neurologic function. The most common indication for surgery is persistent incapacitating claudication and radicular leg pain, which significantly compromises function, and the failure of 6 to 12 weeks of nonsurgical therapy to relieve symptoms.

¹R. Vaccaro MD, Alexander. Orthopaedic Knowledge Update. Rosemont: American Academy of Orthopaedic Surgeons, 2005.

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Cervical Discography

Controlled, perspective study of cervical discography in lifelong asymptomatic subjects and chronic, nonlitigious head and neck pain sufferers has the established the validity of this procedure in skilled and experience hands, MRI has been shown to be insensitive at detecting clinically significant lesions of cervical discs in patients suffering chronic axial and/or radicular pain without neurological deficit. The role of upper cervical discs and spinal structures in the pathogenesis of cephalalgia (cervicogenic headache) has been recently investigated and described. Cervical discography performed at all accessible cervical levels may aid the investigation of pain of suspected cervical discogenic origin.

¹Abitbol MD, Jean-Jacques. Orthopaedic Knowledge Update: Spine. Rosemont: American Academy of Orthopaedic Surgeons, 2002.

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Axial Pain

Occasionally patients will complain of central thoracic pain without any radicular component. In the upper thoracic spine this pain may be related to cervical spine pathology or shoulder girdle dysfunction, as has already been discussed. In the absence of cervical or shoulder etiology and without a frank thoracic disc herniation, intrinsic thoracic disc pain is a possibility. Thoracic discography has been shown to be a safe provocative test of pain in the thoracic spine and is the only objective means of identifying the level of discogenic pathology.

¹Abitbol MD, Jean-Jacques. Orthopaedic Knowledge Update: Spine. Rosemont: American Academy of Orthopaedic Surgeons, 2002.