Dr. Naveen Agarwal

Treatments

Spine Rehabilitation Treatment

Spine-related pain is one of the most complex conditions in modern medicine. Back problems are a common complaint, and mastering treatment modalities for the spine remains one of the “final frontiers” in clinical medical practice. Having said that, Spine Correction Center of the Rockies offers one of the most effective spinal rehabilitation programs in Colorado. No matter the reason behind your back pain, we may be able to help.

Steroid Injections for Spine Treatment

A lumbar epidural steroid injection (lumbar ESI) is an injection of anti-inflammatory medicine — a steroid or corticosteroid — into the epidural space around the spinal nerves in your low back. The main goal of lumbar epidural steroid injections is to manage chronic pain caused by irritation and inflammation of the spinal nerve roots in your low back (the lumbar region of your spine) due to certain conditions or injuries.

Posterior Lumbar Interbody Fusion

Spinal fusion is a surgical procedure used to correct problems with the small bones in the spine (vertebrae). It is essentially a welding process. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone. Spinal fusion is a treatment option when motion is the source of the pain — the theory being that if the painful vertebrae do not move, they should not hurt.

Decompression and Spine Fusion

Spinal decompression surgery relieves symptoms caused by pressure (or compression) on the spinal cord and/or nerve roots. Bulging or collapsed disks, arthritic facet joints, thickened ligaments, and bony growths as spurs can narrow the spinal canal and the spinal nerve openings (causing irritation). Spinal decompression surgery can be performed with or without spinal fusion.

Microscopic Decompression

Microscopic decompression is a method of enlarging a spinal canal through a microscopic view. Such minimally invasive spinal decompression only requires local anesthesia and a minimal incision of 2 cm, which leaves minimal scar and recovers quickly.Microscopic cervical decompression can help relieve myelopathy and radiculopathy–compression of the spinal cord and nerve roots–that produce several symptoms, including

Laminectomy Spine Surgery

A laminectomy surgery is a common type of spine surgery. During the procedure, a spine surgeon removes a small section of bone (called the lamina) from the lower spine. This is often used in the lower spine (lumbar laminectomy) but may also be needed in the neck (cervical laminectomy) or the middle of the back (thoracic laminectomy). The natural process of aging of the bones of the spine starts around age 30

Transformational Lumbar Interbody Fusion

Anterior Cervical Corpectomy and Fusion

When the cervical disease encompasses more than just the disc space, the spine surgeon may recommend removal of the vertebral body as well as the disc spaces at either end to completely decompress the cervical canal. This procedure, a cervical corpectomy, is often done for multi-level cervical stenosis with spinal cord compression caused by bone spur (osteophytes) growth.

Anterior Cervical Discectomy and Fusion

Anterior cervical discectomy and fusion (ACDF) is a surgery to remove a herniated or degenerative disc in the neck. An incision is made in the throat area to reach and remove the disc. A graft is inserted to fuse together the bones above and below the disc. ACDF surgery may be an option if physical therapy or medications fail to relieve your neck or arm pain

Posterior Cervical Laminectomy

Cervical stenosis can place pressure on the spinal cord. If most of the compression is in the back, the cervical stenosis can be treated with a posterior cervical laminectomy. The objective of this procedure is to remove the lamina to give the spinal cord more room.
The skin incision is in the midline of the back of the neck and is about 3 to 4 inches long.
The para-spinal muscles are then elevated from multiple levels.

Vertebroplasty

vertebroplasty are ways of treating vertebral body compression fractures, which are small breaks in the thick mass of bone that makes up the front part of your spinal column. Vertebral body fractures lead to the collapse or compression of a vertebra, causing your spine to shorten and curve forward. This can result in pain and a kyphotic deformity. Thinning of bones, or osteoporosis, is the main cause of vertebral compression fractures.

Spinal Fusion

Spinal fusion is a surgical procedure used to correct problems with the small bones in the spine (vertebrae). It is essentially a welding process. The basic idea is to fuse together two or more vertebrae so that they heal into a single, solid bone. This is done to eliminate painful motion or to restore stability to the spine. Spine surgery is usually recommended only when your doctor can pinpoint the source of your pain. To do this, your doctor may use imaging tests

Foraminotomy

A foraminotomy is a surgical procedure. It enlarges the area around one of the compressed nerves in your spinal column. Your spinal column is made up of a chain of bones called vertebrae. The intervertebral disks sit in between vertebra and act as a cushion. Your spinal column houses your spinal cord and helps protect it from injury. The spinal cord sends sensory information from the body to the brain. The spinal cord also sends motor commands from the brain to the body.

Spinal Decompression Surgery

Spinal decompression can be performed anywhere along the spine from the neck (cervical) to the lower back (lumbar). The surgery is performed through an incision in the back (posterior) muscles. The lamina bone forms the backside of the spinal canal and makes a roof over the spinal cord. Removing the lamina and thickened ligament gives more room for the nerves and allows for removal of bone spurs (osteophytes).

Minimally Invasive Spine Surgery

Minimally invasive spine surgery is a method of performing surgery. In a “traditional” open surgery approach, your surgeon makes a single long incision (cut) through your skin. To help your surgeon clearly see the surgical site, a relatively large amount of muscle and surrounding soft tissue are spread or pulled out of the way or removed from bone. This can result in more muscle damage and pain after surgery.

Discectomy

A discectomy is a form of spinal decompression surgery to treat a herniated disc (sometimes called a "slipped disc"). A herniated disc occurs when a piece of a spinal disc bulges or ruptures and slips out of place, which can put pressure on a spinal nerve. This, in turn, may cause neck pain, back and/or leg pain (as may be felt in sciatica), leg weakness, leg numbness or cauda equina syndrome.

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Frequently Asked Questions

Depending on the type of surgery you have, you may feel better almost immediately. Or, it could take months before you have complete relief.

Wearing a back brace
Not lifting heavy objects
Avoiding bending at the waist
To consult with a physical therapist as you reintroduce exercise into your routine
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The usual age of onset of severe low back pain is between 30 and 50 years of age. The most likely reason is that the degenerative process has begun, and individuals in that age range are still active enough to stress their bodies and place somewhat degenerative discs at risk for injury. It is also common in this age group for individuals to be very preoccupied with their life and occupation and in turn not take as good care of themselves as when they were younger. This leads to increased stress on the discs predisposing them to injury. The incidence of low back pain is equal between males and females. It is not uncommon for adolescents to experience low back pain. While this was previously thought to be a sign of severe potential problems, it is now recognized as common entity and usually not dangerous. Fortunately, it is often self-limiting as adolescents learn good body mechanics and participate in proper strengthening and conditioning for their spine and overall body.

A spinal disc is the ligamentous structure that attaches one vertebra to the next adjacent vertebra. The purpose of the disc is to allow for motion of the spine. Many people consider the disc to be a “shock absorber” between the bones of the spine. This is just one purpose of the disc. Another important function of the disc is to allow for motion in the spine. The disc is a very tough ligament that allows the spine to move in multiple directions, i.e., flexion, extension, side-bending to the right or left, rotation to the right or left, and distraction and compression along the axis of the spine. A healthy disc has a soft central portion, which is often likened to a jelly-like center. The outer portion of the disc consists of very tough ligaments arranged circumferentially. It is made of multiple layers crisscrossing as they encompass the jelly-like center. This very tough outer ligamentous portion allows the spine to move in multiple directions. The disc itself lacks any specific blood supply or nerves within the disc. However, the outside of the disc is richly innervated with nerve fibers. These nerve fibers on the outside of the disc if stimulated or irritated can cause severe back pain. Learn more about spine anatomy.

A physical therapist will determine whether you will need special equipment to keep you safe and comfortable. The therapist will let the team know what equipment may be necessary and place the order with a medical equipment provider. The equipment either will be delivered to Mount Sinai or to your home or rehabilitation facility on the day of your discharge.

If pain is progressive, severe, and disabling, surgery is strongly considered. Numbness, tingling, and weakness are all possible signs of nerve compression and may indicate a need for surgery before nerve damage becomes permanent. Pressure on the spinal cord can be very dangerous and may require surgery. Surgery may be preventative if the spinal cord is at risk of being damaged. Surgery may also be needed if there is significant deformity of the spine.

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