Treatment Options at NeuroCare Long Island
The board-certified, fellowship trained neurosurgeons at NeuroCare Long Island offer a wide range of surgical treatment options, including minimally invasive and robotic guided surgeries, for patients with back, neck and brain related conditions and have specialized expertise in the following procedures:
Our board-certified neurosurgeons perform artificial disc replacement surgery as a motion preserving procedure where a damaged disc in either the lumbar or cervical spine is replaced with an artificial disc.
Not every case of back and/or neck pain requires surgery or can be healed with surgery. Many, if not most of our patients actually see significant improvement of their symptoms by following conservative treatment options or lifestyle changes.
Some of the most commonly use conservative treatment options for back and neck pain are:
Physical therapy does not only treat pain, it also looks for the root cause of your problem. With exercises like stretching, core strengthening, low impact aerobics, TENS stimulation and manual therapy, your physical therapist can help you get back to a pain free life and restored range of motion
Pain Management can involve recommendations for medication or injection therapy, procedures and stimulators. The neurosurgeons at SpineCare Long Island will always refer you to board-certified pain management physicians for treatment and will follow up with everyone on your care team to ensure best quality of care and optimal outcomes.
You know best what works for you. Sometimes it’s a cold pack, other times applying heat or getting a massage can help loosen up tens muscles or a light strain. Some patients find relief stretching or going for regular walks, while others rely on NSAIDs, non-steroid anti-inflammatory drugs. Please discuss with your physician which of these home remedies are appropriate for your condition before giving them a try.
Chiropractic adjustment is a procedure in which trained specialists (chiropractors) use their hands or a small instrument to apply a controlled, sudden force to a spinal joint. The goal of this procedure, also known as spinal manipulation, is to improve spinal motion and improve your body's physical function.
Chiropractic adjustment is safe when it's performed by someone trained and licensed to deliver chiropractic care. Serious complications associated with chiropractic adjustment are overall rare.
Chiropractic adjustment can be effective in treating low back pain, although much of the research done shows only a modest benefit — similar to the results of more-conventional treatments. Some studies suggest that spinal manipulation may also be effective for headaches and other spine-related conditions, such as neck pain.
Not everyone responds to chiropractic adjustments. A lot depends on your particular situation. If your symptoms don't begin to improve after several weeks of treatments, chiropractic adjustment might not be the best option for you. (Source: www.mayoclinic.org)
Research has shown that acupuncture can be a successful therapy for those suffering from back and neck pain and our neurosurgeons will gladly recommend certified acupuncture therapists to you.
Dating back thousands of years in Traditional Chinese Medicine (TCM), acupuncture is based on the theory that blockages in the energy flow of the body cause illness and that inserting thin needles in to the body along certain pathways can unblock and restore the energy flow of the body.
In Western Medicine, it is believed that acupuncture stimulates the nervous system, encouraging the body to release endorphins, opioids, neurotransmitters and other substances, helping to restore emotional and physical wellness
Reducing your body weight puts less stress on your spine and your body in general. If weight loss is something you consider, please speak to you doctor or get help from a registered dietitian.
If conservative treatment options for scoliosis have failed, corrective surgery is the next step in bringing your spine back in line. The standard procedure for scoliosis correction is a spinal fusion. The idea is to realign and fuse together the curved vertebrae so that they heal into a single, solid bone.
Today’s technology and tools, enable our board-certified, fellowship trained neurosurgeons to improve patients’ curves significantly.
Minimally Invasive Spine Surgery’s goal is primarily to stabilize the vertebrae and spinal jojnts and to relieve pressure from the spinal nerves – often times a result of herniated discs, scoliosis or bone spurs. At NeuroCare Long Island we use the latest minimally invasive techniques and instrumentation to help patients recover in a shorter period of time and allow for a quicker return home.
Benefits of minimally invasive spine surgery include:
- Smaller incision and smaller scar
- Less damage to tissues and muscles
- Less blood loss
- Less post-operative pain
- Less painful recovery
- Quicker return to activity
Spinal Cord Stimulators disrupt the pain signals traveling between the spinal cord and the brain. Stimulation is delivered by a neurostimulator — a device similar to a pacemaker — implanted under the skin.
The impulses travel from the device to the spine over thin insulated wires called leads.
The leads deliver mild electrical impulses to an area near your spine. By interrupting pain signals between your spinal cord and your brain, the stimulator may help you get back to doing the everyday things you love most. (Source: www.medtronic.com)
Spinal fusion is a surgical procedure used to correct issues with the vertebrae in your spine. You can think of the process as something comparable to welding where the idea is to fuse two or more vertebrae together to create a single, solid, healthy structure
Whenever a spinal fusion is performed, a bone graft – a small piece of bone material is inserted into the spaces between the vertebrae to promote the fusion.
To give the structure more stability while the bones are fusing, metal rods and screws are put in place.
Conditions We Commonly Treat
The board-certified, fellowship trained neurosurgeons at NeuroCare Long Island are highly skilled in the diagnosis and treatment of brain & spine conditions.
To find out more about the conditions we treat, please choose from the following options:
Cervical Medullary Syndrome is a condition given to a constellation of symptoms that come from brainstem compression or traction. The etiology can be from trauma, inflammation, infection, or hereditary disorder. Symptoms can include headache, numbness, visual disturbances, swallowing difficulties, swings in blood pressure with changes in position, and weakness and lack of coordination in extremities.
The diagnosis can be difficult and is usually done with a variety of tests including a flexion-extension high resolution MRI. This can at times bring out ligamentous injuries and instability where the skull connects to the upper neck.
Treatment is also varied from wearing a hard cervical collar to see if symptoms resolve, conservative treatment such as physical therapy and pain management, to complex surgery.
Back pain is the single leading cause of disability worldwide and experts estimate that over 80% of the population will experience back pain at some time in their lives.
50% of those will have more than one episode within a year. The good news is: In 90% percent of all cases, the pain gets better without surgery.
What can cause back pain:
- Sprain ligaments or muscles
- Herniated or bulging discs
- Spinal Stenosis
- Osteoporosis
- Irritated joints
- Sports injuries
- Arthritis
- Poor posture
- Obesity
- Spinal Tumors
- Fractures
For treatment options, whether conservative or surgical, please click here.
Neck pain is a common condition seen by our neurosurgeon, whether it is a result of poor posture, osteoarthritis or muscle strains. In rare cases, neck pain can be a result of a more serious problem such as a disc herniation, facet arthropathy or a spinal tumor.
If you experience loss of strength in your arms or hands, pain shooting down your shoulder and arm, or numbness in your hands or fingers, please seek medical care.
Cervical radiculopathy occurs when a nerve in the neck is compressed or irritated at the point where it leaves the spinal cord. As a result, pain in shoulders, muscle weakness and numbness that travels down the arm into the hand.
Symptoms might include:
Radiculopathy occurs often with aging when discs in the spine start to dry out and stiffen. The body responds to these changes by creating bone spurs to strengthen the discs. Unfortunately, this results in the narrowing of the nerve root exit and pinches the nerve.
In some cases, radiculopathy gets better over time and does not require treatment. If pain or other symptoms persist, the following treatment options can be considered:
- Physical therapy
- Medication
- Steroid injections in the spine
Surgery may be recommended to treat underlying conditions related to radiculopathy, including:
- Spinal decompression surgery
- Spinal Fusion
- Disc replacement surgery
A spinal tumor is an abnormal mass of tissue within or surrounding the spinal cord and/or spinal column. Tumor cells grow and multiply uncontrollably, seemingly unchecked by the mechanisms that control normal cells. Spinal tumors can be benign (non-cancerous) or malignant (cancerous). Primary tumors originate in the spine or spinal cord, and metastatic or secondary tumors result from cancer spreading from another site to the spine.
Spinal stenosis occurs when the spaces in your spine narrow and compress your spinal cord or the nerve roots exiting each vertebrae.
Spinal stenosis most often occurs in the lower back and the neck.
While some patients have no symptoms, others might experience pain, tingling, numbness or muscle weakness.
Causes of Spinal Stenosis:
- Wear and Tear
- Bone Spurs
- Herniated or Bulging Discs
- Spinal Fractures or Injuries
- Spinal Tumors or Cysts
- Arthritis
Most patients can be treated conservative with physical therapy, medication, acupuncture, massage and/or chiropractic care, while patients with severe cases may require surgery.
Please click here to see treatment options for spinal stenosis and other back and neck related conditions.
A herniated or slipped disc happens when some of the soft internal section of a spinal disc (the so called nucleus) slips out through a crack in the disc’s lining. (Think of a disc as a jelly donut that you squeeze until the jelly comes out.)
A disc herniation commonly occurs in the lower back, but can also happen in the neck (cervical spine) or middle back (thoracic spine).
Caused by gradual wear and overuse as a result of repeated movement, herniated discs are also more prevalent in older people as their discs become drier and weaker over time. In addition, medical conditions such as spinal stenosis and connective tissue disorders can increase the risk for disc herniations.
As discs become more dehydrated and stiffen with age, they may start to compress, causing the outer layer to bulge into the spinal canal, contributing to compression of the nerve. As the discs may bulge from left to right, rubbing against the nerves branching out from the spinal cord, symptoms may be felt in one side of your body or both. Many times, bulging discs don’t cause any symptoms and don’t require treatment.
In some cases, bulging discs can cause the following symptoms:
- Pain in the shoulder, arm or neck
- Numbness, tingling or weakness in arms or fingers
- Sciatic pain shooting down you lower back, legs and feet
Facet Arthropathy is a painful, arthritic condition of the facet joints. Facet joints allow the spine to twist and bend and are responsible for the alignment of the spine. Over time, aging can cause the facet joints to wear down and arthritis may occur just like in other joints.
Patients presenting with facet arthropathy tend to have lower back pain that worsens with standing, bending backwards and twisting. Most commonly, the pain is centered on one particular part of the spine and can feel like a dull ache.
Spinal fractures are broken bones in the back, neck or spine and vary widely in severity. Causes can be a result of trauma, conditions such as osteoporosis, tumors or, rarely, genetic conditions.
Although some spinal fractures require surgery, most can be successfully treated non-surgically.
Possible treatment options include:
- Nonsurgical immobilizing devices such as casts, braces, and traction
- Spinal stabilization, decompression (for compression of nerve roots or spinal stenosis), and vertebrae fusion surgeries that include:
- Laminectomy: Used to perform posterior decompression
- Corpectomy: Used for unstable vertebral fractures that require removal of the vertebral body
- Spinal fusion: Uses screws, internal bracing, and/or bone grafting to fuse vertebrae together
Spondylosis is a descriptive term rather than a clinical diagnosis and describes general spinal degeneration as a result of degenerative osteoarthritis of the spine. The space between your vertebrae narrows as the protective cartilage that cushions the ends of the vertebrae wears down with age. Over time, patients experience lower back and/or leg pain, numbness when standing or walking as well as a forward bending posture.
Spondylolisthesis is a condition involving instability of the spine, meaning the vertebrae move more than they should. If a vertebra slips out of place onto the vertebra below, it may put pressure on a nerve, causing cause lower back pain or leg pain.
The word spondylolisthesis comes from the Greek words “spondylos”, meaning "spine" or "vertebra," and “listhesis”, which means "slipping, sliding or movement.”
When the curve of your spine differs from the normal, gentle S-shape that can be seen from the side, or when the straight line down the back of your spine is “off”, a spinal deformity might be the reason. A healthy spine, supported by muscles, tendons and ligaments in your back, gives your body the support it needs to sit, stand, bend, twist and walk. Depending on how severe the deformity is, you might experience symptoms such as pain, numbness, weakness, tingling, loss of function, and maybe even trouble breathing.
Our board-certified neurosurgeons treat a variety of deformities, including:
Scoliosis is an abnormal lateral curvature of the spine, most often diagnosed in childhood or early adolescence.
Some cases of scoliosis are related to conditions like cerebral palsy or muscular dystrophy (so called neuromuscular scoliosis) and a small percentage is considered congenital – meaning they result from embryological malformation of one or more vertebrae and may occur in any location of the spine.
Most cases however, are idiopathic, meaning that all other causes are excluded. This accounts for about 80% of cases.
In adults, degenerative scoliosis of the lumbar spine is the most commonly diagnosed form of scoliosis, mainly affecting people 65 years of age and older. In many cases, degenerative scoliosis is accompanied by spinal stenosis, making activities of daily living challenging.
Signs and symptoms of scoliosis may include:
- Uneven shoulders
- Uneven Waist
- Rib cages are at different heights
- The entire body leaning to one side
- A prominence on one side of the back when bending forward
Please view treatment options for scoliosis and other deformities here.
While everyone has some degree of curvature in their spine, a curve of over 45 degrees is considered disproportionate and called Kyphosis. Kyphosis can be asymptomatic, with exception of appearing unusually curved or hunched over. Some patients, however, can experience the following symptoms:
- back pain and stiffness
- tenderness of the spine
- tiredness
For adults with kyphosis, back pain can be a debilitating problem as the entire body has to compensate for the spinal deformity. Some patients with severe kyphosis might even experience difficulties breathing and eating.
What causes kyphosis?
- age – as people get older, their spinal curvature can increase
- poor posture (postural kyphosis)
- abnormal development of the spine in the womb (congenital kyphosis)
- Kyphosis can also develop as a result of a spinal injury.
To explore treatment options, please click here.
A healthy spine naturally curves from front to back. While the lumbar spine (lower back) is slightly curved forward, the Healthy spines curve naturally from front to back. The lower has a slight forward curve, the thoracic spine (upper back) bends gently backwards.
When the spine has an extreme inward curve, this is referred to as lordosis or swayback.
The risk of lordosis increases conditions like obesity, osteoporosis and spondylolisthesis, to name a few.
While muscle pain is one of the most common symptoms of lordosis, patients might also experience numbness, tingling and weakness and, in more severe cases, loss of bladder control and difficulty maintaining muscle control.
When the lower spine loses some of its normal curve and there is a front-to-back imbalance of the spine, making it harder for people to stand upright, this is called Flatback Syndrome.
While a healthy spine has an inward curve in the lower/lumbar spine (lordosis), an outward curve in the middle/thoracic spine (kyphosis) and an inward curve (lordosis) in the neck/cervical spine, patients with Flatback Syndrome have lost the lumbar lordosis and the center of gravity is put too far forward.
Some of the symptoms associated with Flatback Syndrome are chronic pain, difficulty standing upright and problems with activities of daily living.
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