Conditions We Treat

Click below for detailed information on some of the conditions we treat.

Cervical Spondylosis

Cervical spondylosis is a chronic degenerative condition of the cervical spine that affects the vertebral bodies and intervertebral disks of the neck.  The disks loose water content and shrink and spurs often form as osteoarthritis develops.  It is quite common and progresses with age. 

Many people do not have symptoms.  However, symptoms can present anytime.  Symptoms include pain or stiffness of the neck.  If narrowing of the canal around the nerves occurs, patients can experience any of the following: neck pain, headache, arm or leg pain, numbness/tingling/weakness of the arms or legs.  Difficulty with walking and lack of balance and coordination can also occur.  Occasionally it can cause problems with controlling bowel and bladder function. 

Diagnosis of this condition is based on a history with a physical exam.  Imaging can include x-rays, CT scans, or MRI of the neck.  Sometimes an EMG which is a nerve study may be ordered. 

Treatment is based on symptoms and is aimed at reducing pain and improving function.  Often physical therapy and non-steroidal anti-inflammatories (NSAIDs) help to alleviate symptoms.  In some cases muscle relaxers can also help.  If symptoms are not relieved, a steroid injection into the area affected by the spondylosis can help.  When symptoms don’t improve with conservative treatment or if there is progression of neurologic symptoms, sometimes surgery is recommended.

Surgery often involves a fusion.  This is a surgery in which part of the disk and occasionally part of the bone is removed.  A graft is placed along with a plate and screws.  It is often done from the front of the neck, but in some circumstances can be done from the back of the neck. 

Post-operatively most patients are hospitalized 1-2 days.  A brace may be worn during the healing phase.  Recovery is generally about 3 months.

Lumbar Spinal Stenosis

Lumbar spinal stenosis is a chronic degenerative condition of the lumbar spine that affects the vertebral bodies and intervertebral disks of the low back.  As the disks loose water content and shrink and spurs often form as osteoarthritis develops.  The ligaments can also thicken.  This results in narrowing of the spinal canal where the nerves travel.  It is quite common and progresses with age and usually affects people over the age of 50. 

Many people do not have symptoms.  However, symptoms can present anytime.  Back pain may or may not occur with spinal stenosis.  Symptoms often include pain, numbness, tingling, or weakness of the legs that becomes work with walking and improves with sitting or leaning forward (such as while pushing a grocery cart).  Occasionally it can cause difficulty with balance or coordination or problems with problems controlling bowel and bladder function. 

Diagnosis of this condition is based on a history with a physical exam.  Imaging can include x-rays, CT scans, or MRI of the low back.  Sometimes an EMG which is a nerve study may be ordered. 

Treatment is based on symptoms and is aimed at reducing pain and improving function.  Often physical therapy is ordered for strengthening of the muscles.  Many patients with spinal stenosis can ride a stationary bike without pain.  Also, non-steroidal anti-inflammatories (NSAIDs) can help to alleviate symptoms.  In some cases muscle relaxers or medications such as Neurontin or Lyrica can also help.  If symptoms persist, a steroid injection into the area affected by the narrowing can help.  When symptoms don’t improve with conservative treatment or if there is progression of neurologic symptoms, sometimes surgery is recommended.   

Several types of surgery can be done depending on the severity of the disease, patient’s age and other medical conditions.  Sometimes a device called an X-Stop is used to decrease the pressure on the nerves.  This is an outpatient procedure with a recovery typically lasting 2-4 weeks.  A laminectomy is a more invasive surgery which involves removing fragments of bone and soft tissue which are pushing on the nerves.  This involves a 1-3 day hospital stay and may involve bracing.  Typical recovery is 6-8 weeks.  In more severe cases a laminectomy may be combined with a fusion which is a surgery involving screws and rods being placed and occasionally a bone graft is taken.  Usual hospital stay is 4 days and recovery is usually 3-6 months.  These surgeries are often done from the back. 

Degenerative Scoliosis

Scoliosis is an abnormal curve of the spine.  It can be congenital or degenerative.  In degenerative scoliosis, patients may have a pre-existing scoliosis and a curve can increase with further arthritic change.  A patient could also develop an abnormal curve over time as the discs have asymmetric collapse from wear and tear.  This type of scoliosis can come from osteoarthritis or osteoporosis and compression fractures.  

Many people do not have symptoms.  When symptoms do occur, typically they develop after the age of 50.  Back pain can be the worst symptom with scoliosis.  Other symptoms can include pain, numbness, tingling, or weakness of the legs.  In some cases patients have difficulty walking because of the abnormal curve.  Occasionally it can cause difficulty with balance or coordination or problems with problems controlling bowel and bladder function. 

Diagnosis of this condition is based on a history with a physical exam.  Imaging can include x-rays, CT scans, MRI, or milligram of the spine.  Sometimes an EMG which is a nerve study may be ordered. 

Treatment is usually based on symptoms and is aimed at reducing pain and improving function.  Often physical therapy and non-steroidal anti-inflammatories (NSAIDs) help to alleviate symptoms.  In some cases muscle relaxers can also help.  If symptoms persist, a steroid injection into the spine can help.  When symptoms don’t improve with conservative treatment or if there is progression of neurologic symptoms or the curve, sometimes surgery is recommended.   

Surgery often involves a fusion from the back of the spine, front of the spine, or both.  It involves use of screws, rods, and a bone graft.  Surgery is done to improve the curve and lower pain levels.  Fusing the spine stops the motion between the joints.  These are typically extensive surgeries requiring hospital stays of 5 or more days.  A brace may also be prescribed following surgery.  Typical recovery from these surgeries can be 6-12 months. 

Lumbar Degenerative Disk Disease

Lumbar Degenerative Disk Disease is a chronic degenerative condition of the lumbar spine that affects the vertebral bodies and intervertebral disks of the low back.  The disks loose water content and shrink and spurs often form as osteoarthritis develops.  It is quite common and progresses with age. 

Many people do not have symptoms.  However, symptoms can present anytime.  Symptoms include pain or stiffness of the back.  If narrowing of the canal around the nerves occurs, patients can experience any of the following: back pain, leg pain, numbness/tingling/weakness of the legs.  Difficulty with walking and lack of balance and coordination can also occur.  Occasionally it can cause problems with controlling bowel and bladder function. 

Diagnosis of this condition is based on a history with a physical exam.  Imaging can include x-rays, CT scans, or MRI of the low back.  Sometimes an EMG which is a nerve study may be ordered. 

Treatment is based on symptoms and is aimed at reducing pain and improving function.  Often physical therapy and non-steroidal anti-inflammatories (NSAIDs) help to alleviate symptoms.  In some cases muscle relaxers can also help.  If symptoms are not relieved, a steroid injection into the area affected by the disk degeneration can help.  When symptoms don’t improve with conservative treatment or if there is progression of neurologic symptoms, sometimes surgery is recommended.

Surgery often involves a fusion.  A fusion stops the motion at the level the surgery is being done.  This is a surgery in which screws and rods are placed and occasionally a bone graft is taken.  It is often done from the back, but is some circumstances can be done from the front. 

Post-operatively most patients are hospitalized about 4 days.  A brace may be worn during the healing phase.  Recovery is generally about 3-6 months. 

Compression Fracture

Compression fractures cause a collapse of the vertebrae or body of the bone.  It can occur from trauma, weak bone (such as from osteoporosis), primary or metastatic cancer of the bone, or infections.  It can involve the neck (cervical), mid-back (thoracic), or low-back (lumbar).  They can occur at any age. 

Diagnosis of this condition is based on a history with a physical exam.  Imaging can include x-rays, CT scans, or MRI of the spine.  Sometimes a bone scan may be ordered. 

Often compression fractures are associated pain in the area where the fracture has occurred.  Pain from these fractures typically improves as the bone heals.  This usually takes about 12 weeks.  A brace is often prescribed for wear while the fracture is healing.  The brace is intended to limit activities such as bending and twisting which could cause more pain and could affect the healing of the bone.  Medications such as narcotics or muscle relaxers may be prescribed to help with managing the pain while the fracture heals. 

In some patients, a kyphoplasty may be offered.  This is a minimally invasive procedure in which small needles are put into the affected bone and a small balloon is inflated into the bone creating a space in which bone cement is inserted to stiffen the bone.  This surgery typically improves pain quickly and allows patients to return to their activities.  The surgery is done as an outpatient procedure. 

After bracing or surgery, physical therapy is often prescribed to help patients improve their strength and allow them to return to their usual activities.