Author Archives: Omair Ali

A doctor holding a part of human spine model

Spinal Cord Stimulation Treatment in Los Angeles

According to an estimate, roughly 20-40% of back surgeries in the US fail to relieve the patient of pain. It is a condition which is known as Failed Back Syndrome in which, for some reason, surgery could not treat the cause of the back pain. Now if you are someone who is facing a similar situation and you don’t want to go through the painful surgical procedure again, Spinal Cord Stimulation would be an effective treatment for you.

Book an appointment now with a spine surgeon in Los Angeles for Spinal Cord Stimulation treatment. You can call us at 213-369-4583 or fill out the contact form.

What is a Spinal Cord Stimulator?

A spinal cord stimulator (SCS) or dorsal column stimulator (DCS) is an implantable device that sends electrical signals to the spinal cord for the treatment of certain pain conditions. In simple words, a spinal cord stimulator is a device that is used to treat chronic pain. It is implanted in the body, typically in the lower back, and sends electrical signals to the spinal cord. These signals interfere with the pain signals that are sent to the brain, which can help to reduce the perception of pain. Spinal cord stimulators are often used to treat chronic pain conditions such as failed back syndrome, neuropathic pain, and chronic regional pain syndrome. They can be an effective treatment option for people who have not found relief from other pain management techniques, such as medication or physical therapy.

Who is a candidate for Spinal Cord Stimulation Treatment?

A girl showing symptoms of back pain

The primary objective of selecting patients for spinal cord stimulation is to ensure that they have the highest chance of benefiting from the treatment while minimizing the risks, complications and negative outcomes. The best way to achieve this goal is through a thorough assessment by a team of experts in various disciplines and a candid discussion with the patient about their expectations and objectives. This will help determine which patients are most suitable for spinal cord stimulation.

It is recommended for the following conditions:

  • Chronic back pain from failed spinal fusion (non-union)
  • Slow healing of fractured bones
  • Complex regional pain syndrome (CRPS)
  • Diabetes-related neuropathy (nerve damage)
  • Arthritis (Or Spinal Arthritis)

Surgical procedure for implanting SCS

The spinal implant is a two-step surgical process:

1. Trial

Before the implantation procedure, the patient will need to undergo a trial period during which a temporary spinal cord stimulator is placed on the skin to see if it helps to reduce their pain. If the trial is successful, the patient will then be scheduled for the implantation procedure.

2. Permanent Implant

If the results from the trial implant are promising, you will qualify for the permanent implant.

Procedure

The process for implanting a spinal cord stimulator typically involves the following steps:

  1. Anesthesia: The implantation procedure is typically performed under local anesthesia and sedation, although general anesthesia may be used in some cases.
  2. Incision: The surgeon will make a small incision in the skin to access the area where the device will be implanted.
  3. Implantation of electrodes: The surgeon will then implant the electrodes next to the spinal cord. The electrodes are thin wire leads that are connected to the generator, which will be implanted in a separate location.
  4. Implantation of generator: The generator, which is a small device that produces electrical signals, is usually implanted in the abdomen or buttocks.
  5. Closure: The incisions are closed with sutures or staples.

The procedure typically takes several hours to complete and is usually performed on an outpatient basis. After the procedure, the patient will need to rest for a few days before returning to normal activities.

Benefits of using a Spinal Cord Stimulator

A spinal cord stimulator is usually considered when the body’s natural healing process is slow or doesn’t respond to other treatment options. Chronic pain can be debilitating and affects millions of people worldwide. Traditional treatments such as oral medication and surgery can be ineffective or have unwanted side effects. Spinal cord stimulation is a revolutionary, non-invasive treatment option that offers adjustable and targeted pain relief, with limited or no side effects. Below we have discussed the advantages of spinal cord stimulation and how it can be a game-changer in managing chronic pain:

1. Personalized Pain Management

Not all patients experience the same level of pain even if they suffer from the same disorder. Spinal cord stimulation offers a wide range of pain adjustment options on the hand-held controller, and some models adjust automatically to the person’s movements. This gives patients the power to control their pain and experience a significant improvement in their quality of life.

2. Less Invasive

Spinal cord stimulation is a minimally invasive procedure that requires only one incision to implant the generator. The placement of the leads with electrodes is typically done with a hollow needle, rather than through an incision. This means patients experience less pain and recover faster, with fewer side effects and complications. If the stimulator doesn’t serve the purpose, it can easily be removed in the future.

3. Less dependence on Pain-killers

Spinal cord stimulation can significantly reduce the need for opioid medication. Studies show that more than a third of participants who received high-frequency therapy reduced or stopped taking opioid medications. This is a significant advantage for patients who have been dealing with chronic pain for many years.

4. Targeted Pain Relief

Spinal cord stimulation delivers pain relief only where it is needed, unlike oral medication which affects the whole body and causes sleepiness, constipation, or other problems unrelated to the pain. This targeted approach ensures that patients experience pain relief without unwanted side effects.

5. Affordable

Spinal cord stimulator is less costly when compared with other surgical and non-surgical treatments for back pain.

6. Long-lasting Pain Relief

One of the major benefits of a Spinal Cord Stimulator is that patients can enjoy a pain-free life for a long time without the need for any maintenance of frequent doctor visits.

Risks and Side effects associated with SCS

SCS is regarded as a secure, less invasive treatment for a number of painful disorders. However, complications, which may be broken down into two categories: device-related failure or biological causes, are observed in 30-40% of the cases. Lead migration, lead breakage, excessive or insufficient stimulation, intermittent stimulation, hardware malfunction, loose connections, and battery failure, are all examples of device-related difficulties. Infection, epidural hemorrhage, seroma, paralysis, cerebrospinal fluid (CSF) leakage, discomfort at the implant site, allergic response, and skin disintegration are examples of biological consequences.

Such complications can lead to the following side effects:

  • Infection – Almost all implants run the risk of causing infection in the body. In some cases, stimulators installed within the spine can cause infection creating the need for surgical treatment to cure the infection and remove the implant.
  • Problems with Lead – The hardware of the lead sometimes gets displaced or broken due to movement in the spine. It happens when the movement of the vertebra doesn’t match the flexibility or movement of the spine.
  • Decrease in the effectiveness of pain relief over time.
Neurosurgeon Los Angeles - Dr. Moksha Ranasinghe

SCS Implant At Southern California Brain & Spine Surgery

If you are looking for Spinal Cord Stimulation treatment in Los Angeles, you can visit our facility. Dr. Moksha Ranasinghe who is the lead Neurosurgeon here provides spinal cord stimulation treatment to patients suffering from chronic back pain. You can schedule an appointment by filling out the contact form or calling us at (213) 369 4583.

FAQs on Spinal Cord Stimulation Treatment

1. What are the components of a Spinal Cord Stimulation System?

A spinal cord stimulation system is made up of several parts, including an implanted power source known as a neurostimulator, thin wires with electrodes on the tips called leads, a clinician programmer used to program the neurostimulator, a patient programmer for managing pain relief, and a wireless external neurostimulator that mimics the therapy delivered by the implanted neurostimulator.

2. Are all Spinal Cord Stimulators the same?

No. Mainly, there are three types of Spinal Cord Stimulators;

  1. Conventional implantable pulse generator, or IPG. A battery is placed in the spine during an operation. When it runs out, the battery must be replaced in another surgery. This can be a good choice for people with pain in just one body part because they need less energy to manage their pain.
  2. Rechargeable implantable pulse generator. A battery is placed in the spine during an operation. You can recharge it without another surgery. Because the energy source is rechargeable, these stimulators can put out more electricity. This may be a better choice for people with pain in the lower back or both legs. The device is more powerful than conventional IPGs.
  3. Radiofrequency stimulator. This type of Stimulator is an older design. It uses a battery that’s outside the body. The stimulator is rarely used today because of newer designs and better technology. This includes rechargeable batteries. But like the rechargeable IPGs, these may be better for people with pain in the lower back and legs because of the device’s power.

3. Are there any risks of spinal cord stimulator surgery?

Spinal cord therapy is a safe procedure, however, there can be some complications such as infection, device damage, etc. Consult your doctor immediately if there are any complications after the implant.

4. How does Spinal Cord Stimulator Work?

In spinal cord stimulators, thin wires (the electrodes) are connected to a small, pacemaker-like battery pack. A generator is usually placed under the skin, usually near the buttocks or abdomen, between the spinal cord and the vertebrae (the epidural space). The remote control and antenna of spinal cord stimulators are both outside the body, so patients can send electrical impulses whenever they feel pain. Experts have come to understand that the device is possibly working by targeting multiple muscle groups directly from the spine. Additionally, they’ve learned that this treatment can alter how the brain senses pain.

Different stages of herniated and bulging disc

Bulging Disc vs Herniated Disc: Understand the difference

3D spine model showing a herniated disc

Herniated and Bulging Discs are some of the common causes of back pain in both young and old age. It is more common in old people because both occur due to the deterioration of the spine with age. Bulging disc and Herniated disc mean the same to most people but they are not. In what follows, you will learn the difference between a Bulging Disc and a Herniated Disc.

Schedule an appointment with a Neurosurgeon in Los Angeles: See Dr. Moksha Ranasinghe at Southern California Brain & Spine Surgery for the treatment of Bulging and Herniated Disc. You can book an appointment by calling (213)-369 4583 or filling out the contact form.

Structure of Spine

Let’s first understand the anatomy of the spine before we go on explaining the difference between Herniated and Bulging discs. You probably already know that the spine is composed of 33 bones (called vertebrae) stacked over one another. Between these bones, rubber-like fibrous discs are present allowing the vertebrae to slip over one another. Vertebrae and intervertebral discs together make the spinal column and are responsible for the smooth functioning of the spine while maintaining a limited range of motion.

Herniated Disc

The herniated disc gets its name from “hernias” which refers to an organ pushing through a muscle that holds it back. So a Herniated Disc is a condition in which gel-like fluid present in the center of the disc comes out by pushing the wall of the disc. In most cases, patients do not even know they have a Herniated Disc and feel no symptoms at all. However, in severe cases, this fluid can create a bulge creating compression on nearby spine nerves and leading to pain. Herniated Discs can occur in any part along the spine. It is more common in the lower back and neck but the Thoracic spine (middle of the spine) can also get a herniated disc.

Bulging Disc

A bulging disc is very much similar to a Herniated Disc but instead of the gel-like fluid coming out of the disc, it is just pushing the wall of the disc. What it means is that the fluid inside the disc has not ruptured. You can say that a bulging disc is one step behind the herniated disc because if the fluid inside the disc breaks through, it will be termed a Herniated Disc. Bulging discs are less likely to be the cause of pain as the bulge has not ruptured through to compress the neighboring spine nerves like in Herniated Disc.

Why are Herniated and Bulging discs considered to be the same?

People who refer to both Bulging and Herniated discs as Herniated Disc are not wrong. It is because a bulging disc is also a Herniated Disc in the initial stage. Let us clarify this by listing down the stages of a Herniated Disc;

  • Degeneration (when the bulge starts to appear)
  • Prolapse (when the bulge shows growth)
  • Extrusion (this is when the gel-like structure ruptures the disc and protrudes out)
  • Sequestration (when the fluid is no longer attached to the disc)

So bulging disc is one of the initial stages of Herniated disc. Bulging disc when left untreated changes to Herniated disc.

How does the Pain from Herniated and Bulging Disc feel?

If you are experiencing back pain, you might be asking yourself questions like; what if it is because of minor muscle pull or muscle strain and not a disc herniation? By observing the symptoms, you can tell if your back pain is serious or not. Back pain due to a herniated or bulging disc feels different. Following are some of the symptoms you need to look for;

  • Loss of bladder and bowel control
  • Numbness, tingling, and burning sensation in limbs
  • Radiating pain
  • Pain that stays for more than 2 weeks
  • Acute pain triggered when walking or moving

What causes Disc problems in People?

A man standing with both hands on back showing signs of back pain

Some factors make people more vulnerable to getting a Herniated or Bulging disc. These include;
Age – This is the most common cause of disc problems. As we grow old, our bones deteriorate and lose the strength to provide the necessary support to our bodies. Moreover, the cartilage between bones also dries up with age causing friction in joints. Soft and brittle spine discs get cracked easily and thus making it possible for the inner fluid to herniate.
Obesity – Overweight people put extra stress on their spines than necessary. It is also difficult for the backbone to provide support to a heavier body. Thus, the spine gets overused making it susceptible to injuries.
Lifestyle – People who live a poor lifestyle in terms of eating, exercising, maintaining postures, etc. get a herniated disc way sooner than people who do not.
Physically demanding sports – In young people, who do combat sports, sustain injuries during their career which makes them more vulnerable to diseases like a degenerative discs. A severe injury can give you a herniated disc immediately.

You can read in detail about the causes of Hernaited Disc in one of our other articles.

Treatment

If the disc has herniated, surgery is the only remedy. You can try conservative methods but that will only help in managing the pain and won’t give you a permanent solution. There are different types of surgeries used to treat a Herniated disc. For example, discectomy and Artificial Disc Replacement.

The article provides an overview of Herniated discs vs Bulging discs. If you feel any of the symptoms discussed in the above paragraphs, it is strongly recommended that you consult a neurosurgeon immediately so you can have timely treatment.

A man holding his foot showing signs of foot pain

Can I have foot pain due to a Back Injury?

The connection between the back and foot might seem remote but it is not. It is possible to experience foot pain due to back injury as there are nerves in your spine that extend all the way down to your legs and feet. Any injury to the spine can damage these nerves and the effect can trickle down to the feet. However, foot pain due to back injury is different from normal foot pain. Coming next, you will learn the connection between a back injury and foot pain and how you could tell if your foot pain is due to a problem in your spine. 

See a Neurosurgeon in Los Angeles for the treatment of foot pain due to back injury: You can schedule an appointment with Dr. Moksha Ranasinghe who is the lead neurosurgeon at Southern California Brain & Spine Surgery. Fill out the contact form or call the clinic at (213)-369 4583.

Symptoms of Foot Pain due to Back Injury

Foot pain due to back injury

Normal foot pain due to an ankle twist or a minor injury goes away within 4-5 days with little massage and care. Food pain that is caused as a result of spinal injury worsens over time. Such foot pain exhibits the following symptoms;

  • Numbness and tingling in the foot
  • Pain that radiates from the lower back
  • Weakness in legs
  • Numbness in the area around the hip, calf, and leg

What Causes Foot Pain?

Spinal nerves in your lumbar (lower) spine travel all the way down to your legs and end at your feet. Foot pain is normally caused when there is a compression or irritation in the nerve roots. Other than this, nerve compression in the hip, knee or foot itself can also cause foot pain. 

Following are some of the most common reasons that can cause nerve compression in the lumbar spine leading to foot pain. 

Disc degeneration is one of the main causes of lower back pain that can lead to foot pain. There are many other diseases that are caused due to disc degeneration, for example, facet joint syndrome in the lower back, scoliosis, bone spurs, osteoarthritis, etc. In this condition, discs in vertebrae get degenerated due to wear and tear as a result of aging. These discs have gel-like fluid in them that slips through the crack of deteriorated discs and compresses the nearby spinal nerves. 

  • Lumbar Spinal Stenosis

Spinal stenosis refers to a condition in which the space inside the vertebrae gets narrowed due to reasons like arthritis, herniated disc, osteophytes, etc. Symptoms of spinal stenosis take time to appear. Normally, people with ages above 50 are diagnosed with spinal stenosis but it can also occur in young people in case of direct injury to the spine. 

  • Disc Herniation

Vertebrae have soft jelly-like discs between them to provide stability and flexibility to the spine. Disc herniation occurs when the soft part within these discs slips out due to a crack in the outer port portion of the disc. It creates a bulge that can compress nerves in the lower spine causing pain.

  • Spondylolisthesis

Spondylolisthesis occurs when a vertebra in the spine slips onto the other vertebra below/above it. When a vertebra slips out of its position, it can exert pressure on the neighboring nerves causing nerve compression. Spondylolisthesis can occur anywhere in the spine but it commonly occurs in the lumbar spine.

Sciatica

This is one of the most common conditions associated with foot pain. It derives its name from the sciatic nerve that originates from your lower back and runs all the way down to your feet. This nerve gets compressed due to one of the reasons mentioned above and causes foot pain. You can tell apart the foot pain due to sciatica from regular foot pain by observing symptoms. If your foot pain is accompanied by pain in your lower back and you sense tingling and numbness in the foot, it is most probably due to sciatica.

Treatment of Foot Pain due to Back Injury

Depending upon the cause of foot pain, different treatment methods can be used. Two major categories of treatment for foot pain due to back injury are; nonsurgical or conservative treatments and surgical treatments. 

Conservative Treatments

If the nerve compression is not severe, different combinations of conservative treatments can help manage the pain. Following are some of the most commonly used conservative treatments;

Surgical Treatments

If the underlying issue cannot be treated with nonsurgical methods, it becomes necessary to treat it with surgery. By now, you must have realized that the major reason for foot pain due to back injury is compression in the lumbar spine. So surgery would be needed that can decompress the nerves and relieve patients of pain. For example, if you have a Herniated Disc, it can be treated with microdiscectomy and a degenerated disc is replaced by artificial disc replacement surgery.

Surgery is a permanent solution to nerve compression however, it comes with risks. At times, patients do not feel comfortable going under the knife as they are afraid of post-surgical infections, excessive bleeding, or being put under anesthesia. 

Read more about different surgical and non-surgical treatments for back pain

Minimally Invasive Surgical (MIS) Methods

Open surgeries have many drawbacks; excessive blood loss and long recovery periods to name a few. To avoid these, neurosurgeons nowadays use less invasive techniques. Minimally invasive surgeries are less painful and have a fast recovery. However, not all conditions are treated with MIS. Your doctor will decide which approach to go with. He/she takes into account a number of factors; location and severity of the injury, age of the patient, patient’s preference, and medical history.

Lower Back Pain After Accident

After getting into a vehicle accident, feeling sore in one or more parts of the body is expected. It is also common to get one’s back twitched during the collision and feel lower back pain after an accident. Most of the time, back pain goes away with some rest and over-the-counter painkillers. However, if this is not the case and you feel severe back pain after 2 weeks of the accident, this can be a sign of serious injury. In such a situation it becomes important to know the cause. In what follows, we will explain why you might be feeling back pain long after the accident and what could be done about it.

Spine surgeon in Los Angeles Dr. Moksha Ranasinghe

Consult a Spine Surgeon in Los Angeles

This article will provide you with a good understanding of lower back pain after an accident, its causes, and treatments. You can get a fair idea if your back pain is serious and what steps you can take further. However, for complete diagnosis and timely treatment, you should see a neurosurgeon. 

You can see a neurosurgeon in Los Angeles by visiting Southern California Brain & Spine Surgery. Schedule an appointment by filling out the contact form or calling us at (213)-369 4583.

Symptoms of Lower Back Injury After Accident

For a few days after the accident, you might not be able to differentiate your backache from your overall body ache as you will be feeling sore all over. With time, if the body ache recovers but the back pain doesn’t, it indicates there might be an injury to your back. Now, a minor injury to the back causing spasm or muscle pull is not very serious and can be cured with nonsurgical treatments. However, if the spine has been damaged in any way, it is a worrisome situation. But how could you know which one is the case? One way is to look for symptoms. A minor back injury has different symptoms from a spinal injury.

Minor Back Injury Symptoms

  • Spasm
  • Severe pain but bearable
  • Doesn’t last for more than 2 weeks
  • Gets better with massage and other treatments

Serious Spine Injury Symptoms

  • Unbearable pain in the lower back
  • Pain that radiates from the source to legs, arms, or forearms
  • Loss of control over bladder and bowel
  • Tingling or numbness in feet, arms, or legs
  • Faintness and sweating
  • Insensitivity to touch or needles

What Causes Lower Back Pain After Accident?

A man sitting with his hand on the back showing signs of backache

The neck and back are most likely to get injured in a car accident. What might seem like a little collision, has the chance of injuring your spine. There are many possible causes of back pain after an accident. It could be due to a traumatic injury, such as a herniated disc or spinal cord injury. Or, it could be the result of whiplash, which can damage the soft tissues in the neck and back.

Given below are some of the potential causes of lower back pain after an accident:

Whiplash

Whiplash refers to the back-and-forth motion. During a car accident, due to a collision, a person’s neck moves back and forth with force, causing injury to the neck. It is one of the most common injuries sustained during a vehicle accident. Normally, whiplash injuries the cervical spine only but if the collision is severe, the lower back can also get hurt to compensate for the overall effect. Depending upon the severity of the collision, the injury can be as minor as getting a neck sprain or as big as getting a herniated disc.

Slipped Disc or Herniated Disc

Our vertebrae are composed of several discs that are stacked over one another. Inside these discs is a soft jelly-like substance known as Nucleus Pulposus that works as a shock absorber for the spine. When the vertebrae sustain a serious injury during an accident, this jelly-like substance breaks the wall and protrudes from the disc. This creates a bulge that can lead to compression of spinal nerves causing pain to the person.

Vertebral fractures

People of age or with medical conditions like osteoporosis can suffer vertebral fractures due to an accident. This can also be one of the causes of lower back pain after an accident. If the fracture is minor, you might not feel much pain but a little crack can always turn into a major fracture. And therefore it is always recommended to have X-ray scans after an accident.

Sprains and Strains

These are comparatively less serious conditions and can be treated with conservative methods. Strains and sprains occur when excessive stress is exerted on the back muscle. In the worst cases, a person might tear his muscle or ligament.

Injury to Facet Joints

The facet joints are joints in the spine located in the back of the spine (also known as the posterior side). There are facet joints at each vertebral level, one on each side of the spine. These joints, if healthy, glide and slide over one another as a person moves his back and prevent over-twisting. High-impact vehicle collisions can damage these joints making it hard for a person to do his daily activities.

Treatment for Lower Back Pain After Accident 

treatment options for lower back pain after accident

As discussed above, if the cause of the back pain is diagnosed to be minor, conservative treatments will suffice. These include;

  • Massage
  • Medications
  • Yoga
  • Heat and ice therapies

In case of serious injuries to the spine, surgical treatment is given to the patient. Different surgical methods can be used to treat lower back pain after an accident caused by serious injury;

  • Discectomy
  • Spinal Fusion
  • Vertebroplasty
  • Laminotomy
Best spine health tips feature image

Best Spine Health Tips to Follow for a Strong Back

Living with back pain can be difficult and what’s more painful is to undergo back surgery for its treatment. Although back surgery has a great success rate, it is still possible to feel back pain even after the surgery. So it’s important to learn the best ways to care for your spine and prevent getting a backache. Whether you’re looking for methods to prevent back pain from occurring or need relief from an existing issue, here are some of the most common and effective spine health tips to follow to prevent backache!

5 Best Spine Health Tips to Follow

As it is said, prevention is better than cure; Living a healthy lifestyle can prevent the occurrence of back pain as you age. Based on the latest research, we have put together a list of the 5 most effective spine health tips that you can follow to live a pain-free life. Let’s dive in!

1. Always maintain a good posture

Good posture is one of the most important spine health tips one can give you. Proper posture helps to keep your spine in alignment and takes the strain off of your muscles and joints. It also helps to prevent pain and injuries.

There are a few simple things you can do to improve your posture:

  • Stand up straight. Imagine a string attached to the top of your head, pulling you upward. Keep your shoulders down and back, and tuck your chin slightly inward.
  • Sit up straight. When sitting, make sure your back is against the chair and your feet are flat on the floor. Avoid slouching or hunching over.
  • Use proper lifting techniques. When lifting something heavy, squat down and use your legs to lift it rather than bending over from the waist. Keep the object close to your body as you lift it.

2. Keep your weight in check

Obesity is considered to be one of the major reasons for spinal deformation. People who are overweight find it difficult to maintain the right posture while moving around. Excessive abdominal fat puts a lot of stress on your spine leading to conditions like a degenerative or herniated disc. To keep your weight under control, you can follow the guidelines given below;

  • If you are overweight, besides working on decreasing your belly fat you also need to do exercises to strengthen your spine. You can do different stretches and yoga poses that target back muscles.
  • To lose weight fast, you need to be on a calorie deficit. What it means is that you need to burn more calories than you are eating. You can do this by having a calorie counter application on your mobile that tells you the number of calories in every food you eat.

3. Do Back Exercises

Any list of spine health tips is incomplete without back-targeting exercises. Having a strong core strengthens abs and back muscles. A sturdy core provides support to the spine and takes the pressure off your lower back. When lifting heavy objects, if the core is not built-up well, the weight takes a toll on the back and thus increases the chances of injury. You can do the following exercises to strengthen your back;

Bridges
Bridges are one of the most effective exercises that target lower back muscles. They are easy to do and do not require any equipment. You can do them at home with a little warm-up.

Partner-assisted stretches

For this exercise, you will need one of your friends or family members to help you. Lie down on your back with your palms on the floor. Bend your legs and have someone push them into your stomach gently.

Quadruped leg raise

Quadruped Leg raise

This is another exercise that targets your entire abdominal region, lower back, and hamstrings. See the demonstration to understand this exercise. You can also raise the arm opposite your lifted leg to make it more challenging.

Lift weights
Weight training is known to provide strength to the body and improve overall stability. You can target your back muscles with light or heavy weights. Some of the exercises you can perform with weight to target your back are Kettlebell swings, Deadlifts, Lat pull-downs, and single-arm dumbbell rows.

If you already have a backache, we would recommend you consult a doctor before you do weight training exercises for your back.

4. Eat Healthy

Spine Health tips also include changing your eating habits to improve your overall health. As already discussed, healthy eating habits also help to avoid obesity which is a major reason for spinal deformity. To ensure a healthy intake of food, you can follow the guidelines given below;

  • Use dairy products as they are rich in calcium and vitamins, preventing your bones from diseases like osteoporosis.
  • Vegetables and fruits are one of the primary sources of nutrients required by your body. Make sure your diet has different sorts of vegetables and fruits.
  • Calcium-rich diet doesn’t do any good if your body is low on Vitamin D. Your body absorbs Calcium in the presence of Vitamin D that you can get from foods like salmon, egg yolk, and mushrooms.
  • You also need to be disciplined in terms of foods you cannot eat. Alcohol and tobacco consumption can decrease the water level in your spine making it vulnerable to injuries. Cut down on tobacco and alcohol consumption.

5. Regular health checkups

Getting regular health checkups is something many people tend to avoid. But it is as important as all other spine health tips discussed above. There are many ways in which health checkups can keep you safe from getting a backache. Physical examination indicates any injury to the spine that can result in serious medical complications later. If any indications of injury are found, your doctor confirms it by scans like X-rays and MRI.

You might also want to read: Spinal Cord Injury and Diagnosis: Complete guide

See a Spine Surgeon in Los Angeles

If you feel any symptoms of back pain for more than a week, we strongly recommend you see a doctor. You can see a neurosurgeon in Los Angeles by visiting our clinic. To schedule an appointment, call us at 213-369-4583 or fill out the contact form.

Sciatica During Pregnancy cover image

All You Need To Know About Sciatica During Pregnancy

Pregnancy means a lot of firsts — like feeling the incredible first flutter of your baby moving. But constant back pain? Although this is something you might not have expected, back pain, often leading to sciatica during pregnancy, is pretty common. You are after all carrying so much extra weight.

Your body experiences many physical and hormonal changes during the entire pregnancy period. With each passing day, your baby grows, and your body has to adjust. Unfortunately, these changes also sometimes lead to unfamiliar aches and pains. While some mothers-to-be may experience dull, throbbing aches in the middle of the back, others may suffer from sciatica during pregnancy.

Sciatica during pregnancy is a common issue for women. Also called lumbar radiculopathy, sciatica during pregnancy is a painful but, fortunately, a temporary condition. Those who suffer from this often describe it as a “radiating pain” that travels from the sciatic nerve to the back of the thigh.

Symptoms of Sciatic During Pregnancy

Aches and pains that result from sciatica during pregnancy range from mild to excruciating. A tingling sensation in one part of your body and pain in another area is one of the common symptoms. Other symptoms include: 

  • Feeling a burning sensation in the lower back and buttocks 
  • Feeling pain that travels from your pelvis to the back of your leg 
  • Feeling a sudden jolt of pain
  • Feeling pain that worsens when you cough, sneeze or sit for long periods
  • Feeling numbness, tingling in one leg or foot, or muscle weakness

What Causes Sciatica During Pregnancy?

Sciatica occurs when the sciatic nerve is pinched because of the compression of the spine in some way. Typically, this is due to a herniated disk or an overgrowth of bone, which causes inflammation, numbness, and pain.

Pregnant women often experience spinal compression, which affects the sciatic nerve. There are several reasons why they might go through this. One of them is linked to the hormone released during pregnancy – Relaxin. Naturally, your body produces this hormone to relax your ligaments and prepare your pelvis for childbirth. However, loose ligaments and a growing uterus often shift the body’s center of gravity and pinch the sciatic nerve. This leads to shooting pains down the legs.

Another cause of sciatica during pregnancy is the growing baby that puts additional weight on your unstable joints and muscles. Sometimes, the baby’s position may also cause sciatic nerve compression.

This pain often comes and goes in most cases, but it can be constant for some women. While it may be uncomfortable for the mother-to-be, this compression and pain don’t harm the baby.

pregnant woman sitting in bed with her hand on belly

What To Do If You’re Suffering From Sciatica During Pregnancy?

To heal sciatica, time and rest are required. In this situation, discomfort is common, but severe pain is not. You can take certain over-the-counter (OTC) medications to help you curb the excruciating pain. However, to ensure that these medications don’t harm your baby, it is essential to consult your doctor beforehand. Here are some other simple home remedies that you can try to help ease constant body aches:

Use a heating pad, cold pack, or take a hot shower. 

The heat helps to relax tight muscles, often aggravated by carrying extra weight. Sometimes, using a cold pack on your lower back and rear pelvis can also help ease the pain.

Keep moving.

It is natural to curl up into a ball when you’re going through such severe pain. However, you must maintain some gentle movement in your daily routine. This is helpful in the long run. A simple walk, yoga session, slight bending or twisting, or low-impact activities can help you soothe your muscles and mind.

Pay attention to the pain.

It is vital to notice small things and any activities that irritate your sciatic nerve. It is suggested to avoid heavy lifting and take frequent breaks on your job.

Get a massage.

Evidence suggests that prenatal massage not only reduces stress, improves blood circulation, and regulates hormones but also helps you lower sciatic nerve pain.

See a physical therapist.

If you find your sciatic nerve pain very disturbing and hindering your normal day activities, see a professional physical therapist who can provide you with stretches and strength-building exercises. 

Sleep on your side.

You should also avoid sleeping on the side of your body that hurts. You can use a full-body pillow to support your hips and legs. This will help you take the pressure off the compressed nerve. 

When Should You See A Doctor For Sciatica During Pregnancy?

If rest, icing or other self-care methods are not improving your sciatic nerve pain condition after a week, or you are experiencing severe numbness, tingling or problems in urinating, it is recommended to see a spine surgeon to discuss your symptoms as soon as possible. The spine surgeon will first perform a physical examination to observe any indication of injury. Then to confirm if there is a lumbar nerve root compression, he/she might perform X-rays and MRI scans.

How Will Sciatica Be Treated?

If no nonsurgical treatments, including medications or physical therapy, worked, you’re experiencing persistent disabling sciatica, and your condition is causing cauda equina syndrome (which includes symptoms such as bladder dysfunction, severe numbness in the buttocks, or incontinence), a spinal decompression surgery may be required.

Spinal decompression surgery is an umbrella term that includes various surgical procedures that remove any disc herniation or stenosis to ease back and leg pain. The surgery depends on which nerve roots are affected. These decompression surgeries include:

  • Laminectomy
  • Laminoplasty
  • Laminotomy
  • Lumbar microdiscectomy

Get Spinal Decompression Surgery

If you have been experiencing excruciating back pain and looking for surgical treatment, Southern California Brain & Spine Surgery is here to help. We have been among the best spine care facilities treating patients with spine problems for more than ten years. Dr. Moksha is the lead neurosurgeon here who has been awarded as the best neurosurgeon in Los Angeles by findatopdoc.com for three consecutive years. You can schedule an appointment with her by filling out the contact form or calling (213)-369 4583.

Featured image for XLIF Surgery

XLIF Surgery: All You Need to Know

Extreme lateral interbody fusion (XLIF) surgery is a minimally invasive procedure that involves accessing the lumbar spine from the side. It is an alternative to traditional open-back surgery and can be performed as an outpatient procedure. The surgeon makes small incisions in the patient’s side and uses special instruments to reach the lumbar spine. The goal of XLIF surgery is to relieve pain by treating spinal disorders and stabilizing the spine.

If you or someone you know is considering XLIF surgery, read on for everything you need to know about the procedure.

What conditions does XLIF surgery treat?

XLIF surgery is used to treat conditions that could not be treated with conservative methods (such as steroid injections, physical therapy, pain medication, etc.) and has continued to cause pain to the patient. These include:

  • Herniated discs
  • Degenerative disc disease
  • Spinal stenosis
  • Tumors of the spine
  • Scoliosis
  • Kyphosis

Procedure

XLIF Procedure

After having you go through the pre-surgical tests, the staff at the doctor’s clinic will let you know the date and time for your surgery. You might want to read this guide on how to prepare for back surgery for a step-by-step guide to help you with preparing for XLIF surgery.

XLIF surgery is a minimally invasive procedure that is performed through small incisions on the patient’s side. The procedure starts with giving anesthesia to the patient. When the patient is asleep, the surgeon will access the spine by going between the patient’s ribs. To locate the damaged area, the doctor examines the X-ray reports. Once the surgeon has access to the spine, they will remove any herniated discs or other debris that may be causing pain. Since in the XLIF procedure the surgeon works very close to the nerves in the spine, Electromyography EMG is used that guides the surgeon about his/her instrument position with respect to the nerves in the spine. It helps to avoid any further damage to the already damaged spinal column. Removing a part of the spine creates space within the vertebrae that is filled by placing a bone graft. Depending upon the number of discs removed and the overall shape of the spine, additional screws, plates, and rods can also be used. This keeps the spine stable and prevents future injuries. The surgery usually takes about two hours to complete.

Benefits of XLIF Surgery

Recovery after XLIF Surgery

XLIF surgery is a newer, minimally invasive alternative to traditional spine surgery. Unlike other spine surgeries, XLIF does not require any large incisions or cutting of muscles and tissues. Instead, the surgeon accesses the spine through small incisions in the side of the patient’s body. This results in less pain and a quicker healing time for the patient. XLIF is also successful in treating a variety of different spinal conditions, whereas other surgeries may only be effective for certain types of conditions. Some salient upsides to XLIF surgery include;

  • One of the biggest benefits of XLIF is reduced surgery time. The technique can be completed in as little as one hour, which means less time under anesthesia and in surgery.
  • Minimally invasive surgical methods lead to less scarring, less blood loss, and faster recovery times.
  • Since the surgeon accesses the disc space from the side, you won’t damage any sensitive back muscles or ligaments. Mostly, patients can walk to their homes the same day after surgery.
  • You will be able to resume your daily activities very soon after the surgery as recovery after XLIF doesn’t take more than 30 days.

Recovery after XLIF Surgery

Most people who have XLIF surgery experience a quick and easy recovery. However, as with any surgical procedure, there are a few things you should expect and be aware of during your recovery. Here are some things to keep in mind:

  • You will likely be up and walking around the same day as your surgery.
  • You may experience some pain and discomfort for the first few days after surgery. This is normal and can be managed with pain medication.
  • You will need to take it easy for the first week or two after surgery. Avoid strenuous activity and lifting heavy objects.
  • Your incisions will be covered with dressings that will need to be changed regularly.
  • You will need to follow up with your surgeon for regular checkups.

Risks and Complications of XLIF Surgery

Although XLIF surgery is a safe surgical procedure, there do exist some risks when taking it up. Following is a list of some potential risks in an XLIF surgery;

  • Deep clotting in Veins
  • Reaction to Anesthesia
  • Failure of implant fusion
  • Different kinds of infections can occur
  • Injury to the nerves within the spine
  • Failure to relieve the patient of the pain (A condition known as Failed Back Syndrome)

Get XLIF Surgery in Los Angeles

In case you have been experiencing back pain and looking for minimally invasive surgical treatment for it, we are here to help. Southern California Brain & Spine Surgery is among the best spine care facilities in Los Angeles treating patients with spine problems for more than 10 years. Dr. Moksha Ranasinghe is the lead neurosurgeon here who is a top-rated spine surgeon in Los Angeles on websites like Yelp, findatopdoc.com, Google Businesses, and Healthgrades. You can schedule an appointment with her by filling out the contact form or calling (213)-369 4583.

Types of Neck Surgery - Banner Image

The Most Common Types Of Neck Surgery Explained

Often the neck is injured either due to accidents or some kind of physical activity, such as playing sports. It can also be due to wear and tear of the vertebrae due to aging. Injuries to the cervical vertebrae lead to many challenges in everyday life, and it’s important to treat them quickly to avoid sustaining further damage. In this article, we will explore the most common types of neck surgery, look at when they are required, and explain their procedures briefly.

If you are experiencing any symptoms of neck pain that hint at sustaining a serious neck injury, you can talk to our spine surgeon in Los Angeles by calling (213) 369-4583.

Different Reasons for Undergoing a Neck Surgery

There are many reasons why someone might need neck surgery. The most common reasons include;

No matter the reason, neck surgery is a serious procedure that should only be undertaken after careful consideration and consultation with a qualified neurosurgeon. If you are experiencing neck pain or other symptoms that may warrant surgery, be sure to get a comprehensive evaluation to ensure that all nonsurgical treatment options have been exhausted first. 

You might also want to read: How spinal cord injuries are diagnosed and treated?

Types of Neck Surgery

Types of Neck Surgery

Choosing among different types of neck surgery entails considering the type of injury one has sustained as well as the location of the injury. The type of neck surgery can only be finalized after the full-fledged diagnosis has been conducted. Here are a few most used types of neck surgery;

1. Cervical Discectomy and Fusion (CDF)

In this surgery, the damaged part of the disc is removed from the cervical spine which relieves pressure from the spinal cord or nerve root resulting in pain alleviation. It is followed by surgical fusion of vertebrae above and below the disc together. Fusion is performed to provide stability and strength to the spine as after the removal of a disc, the spine fails to maintain its shape which can lead to further implications. This surgery is performed through an incision in the front of the neck and thus the name anterior.

Under ACDF, different surgical options are used to treat patients. A good doctor explains all the options to the patients along with their potential risks and complications. For example; how many vertebrae levels will be treated, types of implants to be used for fusion, etc. 

2. Multilevel Cervical Laminectomy and Fusion

Cervical laminectomy is a procedure performed to relieve pressure on the spinal cord or spinal nerve roots. This pressure is most often caused by herniated disks, thickened ligaments, or bone spurs. The surgeon begins the procedure by making an incision in the back of the neck. Once the incision is made, the surgeon will carefully remove a portion of the vertebral lamina (the back part of the vertebra that covers the spinal canal). This relieves pressure on the spinal cord or spinal nerve roots. After the lamina has been removed, the surgeon will place a fusion cage (graft cage) between the vertebrae. It will be filled with bone graft material allowing vertebrae to fuse over time. In some cases, metal rods and screws may also be used to help stabilize the spine during healing. The goal of cervical laminectomy is to relieve pressure on the spinal nerve roots and to stabilize the spine. 

This procedure is usually performed as an outpatient procedure, which means that you will be able to go home on the same day as your surgery. However, some patients might be asked to stay for a couple of days depending on their medical conditions and the care they require. Recovery times vary depending on each patient, but you can expect to feel some soreness and stiffness in your neck for several days after your surgery.

3. Cervical Disc Replacement Surgery

Cervical disc replacement surgery is a type of neck surgery that is used to treat damaged or herniated discs in the neck. The cervical spine is made up of vertebrae that are separated by discs. These discs act as shock absorbers and allow the spine to move freely. Over time, these discs can become damaged or herniated, causing pain and inflammation. Cervical disc replacement surgery involves removing the damaged disc and replacing it with an artificial disc.

Minimally Invasive Neck Surgery

Equipment for minimally invasive neck surgery

Surgeons have been performing spine surgeries conventionally for a long time which involved making large incisions in the body. Now, with technological advancement, it has become possible to perform minimally invasive spine surgeries using video cameras and other endoscopic instruments. Neck surgery can also be performed using minimally invasive techniques. This approach has several benefits including a short recovery period, less loss of blood, and less pain during the operation.

Neck Surgery in Los Angeles

If you have been experiencing consistent pain in your neck for a long time and feel that you might need surgical treatment, you can talk to the neurosurgeon in Los Angeles at our facility. Here at Southern California Brain & Spine Surgery, Dr. Moksha Ranasinghe provides top-quality treatment to patients suffering from spine disorders. You can schedule an appointment by calling us at 213-369-4583 or filling out the contact form.

Failed Back Syndrome

Back Pain Even After Surgery: Failed Back Syndrome

After dealing with back pain for months, maybe even years and trying all non-surgical back pain treatments, you decided to go ahead with surgery. The surgery was a success, and for a few months, you finally have the relief you’ve been searching for. But then, suddenly, the pain comes back. What gives? It turns out, you may be suffering from a condition called Failed Back Syndrome. In this article, we will explore the causes and symptoms of this condition, as well as treatment options.

What is Failed Back Syndrome?

If you’ve had back surgery and are still experiencing pain, you may have failed back syndrome (FBS). Even though the name sounds final, it is possible to manage back pain due to FBS and improve quality of life. Let’s take a closer look at FBS, its symptoms, and treatment options.

FBS is a condition that causes chronic pain even after back surgery. It can occur when the original problem was not fully corrected or when scar tissue from the surgery puts pressure on the nerves. In some cases, FBS is caused by nerve damage that occurred during the surgery.

Symptoms of Failed Back Syndrome

The most common symptom of FBS is continuing pain in the low back and legs. The pain may be dull or sharp and can vary from mild to severe. Other symptoms include:

  • Tingling or numbness in the legs
  • Weakness in the legs
  • Difficulty standing or walking for long periods of time

Diagnosis

For the diagnosis, doctors can use different methods. Initially, the doctor will look for the more obvious signs during physical examination. For example, identifying the source of back pain, restricted movement in the spine, using a hammer to test the responsiveness of the patient’s body etc. Provided that the doctor finds symptoms of FBS, he/she will ask you to get scans such as MRI and CT scans. These scans will help ensure if the pain is actually due to the FBS and not for any other reason that the doctor might have missed in the initial examination. 

Treatment Options for Failed Back Syndrome

Failed back syndrome can be difficult to treat because it is often unclear what is causing the pain. A variety of treatments may be recommended, including physical therapy, epidural injections, and medications. In some cases, repeat surgery may be necessary in an attempt to relieve the pain. Despite treatment, failed back syndrome can be a chronic condition with episodes of flare-ups and remission periods.

  • Medications: Pain relievers, anti-inflammatory drugs, muscle relaxants, and antidepressants may be prescribed to help manage pain.
  • Epidural steroid injections: These injections deliver medication directly to the inflamed area to help reduce swelling and pain.
  • Radiofrequency ablation: This procedure uses heat to destroy the tumors or any outgrowths in the body.
  • Surgery: If the condition is severe and the doctor feels that conservative treatments won’t do any good, surgery is performed.  

What causes Failed Back Syndrome?

Failed back syndrome (FBS), also called post-laminectomy syndrome, is a condition that can occur following surgery to the lumbar spine. The vast majority of patients who undergo surgery for conditions such as herniated discs or spinal stenosis have successful outcomes and experience relief from their pain. However, some individuals continue to have pain even after their surgery for different reasons.

You might also want to read: The reasons for getting a herniated disc

There are a number of potential causes of failed back syndrome. One possibility is that the original problem was not completely resolved by the surgery. For example, if a disc herniation was only partially removed, residual compression on the spinal cord or nerve roots can still lead to pain. Additionally, scar tissue can form around the incision site or at other locations in the spine, causing pain by irritating surrounding tissues. In some cases, the source of pain cannot be determined.

How Failed Back Syndrome is Treated?

Failed back syndrome (FBS) is a condition characterized by chronic pain in the lower back and legs. Even after surgery to correct the underlying cause of the pain, many people with FBS continue to experience pain. While there is no cure for FBS, there are treatments that can help manage the pain and improve quality of life.

Common treatments for FBS include:

  • Medications: Pain relievers, anti-inflammatory drugs, muscle relaxants, and nerve blocks can all be used to help manage FBS pain.
  • Physical therapy: A physical therapist can develop a customized exercise program to help stretch and strengthen the muscles around the spine.
  • Injections: Epidural steroid injections and other types of injections can help reduce inflammation and pain.
  • Surgery: In some cases, surgery may be necessary to decompress nerves or remove scar tissue.

See a Spine Surgeon in Los Angeles

If you have been experiencing back pain after spine surgery, you can consult Dr. Moksha Ranasinghe at Southern California Brain & Spine Surgery. She is an experienced neurosurgeon in Los Angeles who specializes in treating spine conditions. To schedule an appointment, fill out the contact form or call us at 213-369-4583.

A person showing signs of thoracic spine pain

Thoracic Spine Surgery: All You Need to Know

Anatomy of Thoracic Spine

The thoracic spine is the middle section of the spine, and it is made up of 12 vertebrae (T1 to T12). It is located just behind your chest. The pain in the thoracic spine can be caused due to several reasons. However, not all reasons require surgical treatment. If you are scheduled for thoracic spine surgery, it is important that you understand what to expect. This article will provide you with all the information you need. We will discuss the procedure itself, as well as the risks and recovery process. This information will help you feel confident and prepared before your surgery!

Why is Thoracic Spine Surgery Performed?

It is typically performed to treat conditions that cause pain or compression in the middle area of the spine. Some common reasons for thoracic spine surgery include:

Preop Guidelines

Successful surgery and recovery entail strict adherence to pre-op guidelines. The guidelines are very much similar to other spine surgeries.

  • You will need to fast for at least six hours before the time of your surgery.
  • Avoid drinking alcohol and smoking as they can hinder the effect of anesthesia.
  • Blood thinners must also be avoided to prevent excessive blood loss during surgery.
  • Provide accurate answers in pre-surgery meetings regarding your medical history, allergies, lifestyle choices, etc.
  • Other than these general guidelines, there are 5 perioperative spine assessments identified by the Congress of Neurological Surgeons; Osteoporosis assessments, nutrition assessments, pulmonary evaluation and optimization, opioid evaluation, and surgical risk assessment.

Procedure for Thoracic Spine Surgery

The thoracic spine surgery itself is fairly complex, and it usually takes several hours to complete. During the surgery, your surgeon will access the thoracic spine through an incision in your back. Once they have access to the spine, they will remove any damaged or diseased tissue. In some cases, they may also need to fuse together some of the vertebrae to stabilize the spine. The specific type of thoracic spine surgery that is required will depend on the underlying condition being treated.

After your surgery, you will be closely monitored in the hospital for any complications. Once you are discharged, you will need to take it easy and avoid strenuous activity for at least six weeks. You will also need to follow up with your surgeon periodically to make sure that your recovery is progressing as planned.

Types of Thoracic Spine Surgery

There are different types of thoracic spine surgery, each designed to address a specific problem or condition. The most common type is called the laminectomy. This procedure involves removing the lamina, which is the bony plate that covers the spinal cord. Laminectomies are often performed to relieve pressure on the spinal cord or nerves.

Other types of thoracic spine surgery include;

Spinal fusion – This procedure involves joining two or more vertebrae together. This is often done to stabilize the spine and relieve pain.
Decompression – This procedure involves relieving pressure on the spinal cord or nerves by removing bone or other tissues.
Disc replacement – This procedure involves removing a damaged disc and replacing it with an artificial disc.

Your surgeon will choose the appropriate procedure after evaluating your medical condition.

Risks Involved in Thoracic Spine Surgery

Most spine surgeries are safe and do not lead to any major medical complications. However, different people have different risk vulnerabilities. There are several factors that determine this risk. For example, medical history, overall health condition, age, coexisting medical conditions, and Osteoporosis. Following are some of the common risks that need to be considered when undergoing thoracic spine surgery;

  • Surgical site infection
  • Nerve damage
  • Injury to the spinal cord (rare)
  • Blood clots
  • Spinal fluid leak
  • Spinal headache after surgery

It is important to discuss all of the potential risks and side effects of thoracic spine surgery with your surgeon before having the procedure. This will help you to make an informed decision about whether or not this type of surgery is right for you.

Recovery after Thoracic Spine Surgery

A patient recovering after thoracic spine surgery

After undergoing thoracic spine surgery, it is important to follow your surgeon’s instructions for a successful recovery. Depending on the type of surgery you had, you may be able to go home the same day or may need to stay in the hospital for a few days.

In either case, you will need to take it easy for the first few days or weeks and avoid any strenuous activity. You may also need to wear a brace to support your spine as it heals. Physical therapy can also be helpful in regaining strength and mobility.

Most people are able to return to their normal activities within a few months, although some may experience ongoing pain or other issues. Follow-up appointments with your surgeon are important to ensure that your recovery is on track. Working with a professional physiotherapist for smooth and fast recovery is also recommended.

Choosing the right surgeon can make things a lot easier for you in terms of getting smooth treatment and post-surgical assistance. Before you finalize the surgeon for your treatment, spend some time researching different doctors. Shortlist doctors based on their experience and patient ratings. For this purpose, you can check websites like Yelp and Healthgrades.

Spine surgeon in Los Angeles

See a Spine Surgeon in Los Angeles

Looking for a spine surgeon in Los Angeles for thoracic spine surgery? Schedule an appointment with Moksha Ranasinghe MD at Southern California Brain & Spine Surgery. She has been treating patients with spine problems for more than 20 years. For appointment scheduling, you can call (213)-369 4583 or fill out the contact form available on our website.