Category Archives: Articles on Spine

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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 […]

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, a minimally invasive procedure, begins with administering anesthesia to the patient. While the patient is asleep, the surgeon accesses the spine through small incisions between the ribs. Using X-ray reports, the surgeon locates the damaged area and removes any herniated discs or debris causing pain. Electromyography (EMG) guides the surgeon in positioning instruments near the spine’s nerves to prevent further damage. After removing a portion of the spine, a bone graft is placed to fill the space within the vertebrae. Additional screws, plates, and rods may be used for spine stability. The surgery typically lasts about two hours.

Benefits of XLIF Surgery

Recovery after XLIF Surgery

This type of 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;

  • XLIF offers one of the biggest benefits: reduced surgery time. Completing the technique in as little as one hour results in 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.
  • You will need to change the dressings regularly to cover your incisions.
  • 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

Accidents or physical activities like playing sports often cause neck injuries. 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. This article will briefly explain […]

Accidents or physical activities like playing sports often cause neck injuries. 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. This article will briefly explain the procedures of the most common types of neck surgery and discuss their requirements.

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)

Surgeons remove the damaged part of the disc from the cervical spine, relieving pressure from the spinal cord or nerve root and alleviating pain. They then surgically fuse the vertebrae above and below the disc to provide stability and strength to the spine. This procedure is through an incision in the front of the neck, hence earning it the name “anterior.”

Different surgical options are used to treat patients under ACDF. A good doctor explains all the options to the patients along with their potential risks and complications. For example, surgeons will determine how many vertebrae levels to treat and which types of implants to use for fusion.

2. Multilevel Cervical Laminectomy and Fusion

The cervical laminectomy procedure aims to alleviate pressure on the spinal cord or spinal nerve roots, typically caused by herniated disks, thickened ligaments, or bone spurs. Beginning with an incision in the back of the neck, the surgeon carefully removes a portion of the vertebral lamina, covering the spinal canal. This action relieves pressure on the spinal cord or nerve roots. The surgeon inserts a fusion cage (graft cage) between the vertebrae and fills it with bone graft material to promote fusion over time. In some instances, the surgeon may also utilize metal rods and screws to stabilize the spine during the healing process. The goal of cervical laminectomy is to relieve pressure on the spinal nerve roots and to stabilize the spine. 

Surgeons typically perform this procedure as an outpatient procedure, allowing patients to return home on the same day. However, some patients may need to stay for a couple of days based on their medical conditions and required care. 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

Surgeons use cervical disc replacement surgery to treat damaged or herniated discs in the neck, which consists of vertebrae 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. Surgeons can also perform neck surgery 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

Consult our Los Angeles neurosurgeon if you’ve had long-standing neck pain and are considering surgery. 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-1

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, […]

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?

Failed-Back

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

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 […]

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.

A doctor with the model of human spine

Open Spine Surgery: All You Need to Know

Back pain is quite a common medical condition; almost every person has groaned “oh, my back!” once in their lifetime. The reasons for the back pain can be numerous ranging from minor muscle pull to severe disc herniation. Surgical treatment is required for back pain that is chronic and persists for more than a month. […]

Back pain is quite a common medical condition; almost every person has groaned “oh, my back!” once in their lifetime. The reasons for the back pain can be numerous ranging from minor muscle pull to severe disc herniation. Surgical treatment is required for back pain that is chronic and persists for more than a month. In the following paragraphs, you will be explained why open spine surgery is required, how it is performed, and other related information to help you understand the procedure.

Choosing Open Spine Surgery as a Treatment Option

When patients come to doctors complaining about back pain, initially doctors try to cure them with conservative treatments (read about comparison between surgical and nonsurgical back pain treatments). These include using medications, physiotherapies, massage, and other non-invasive techniques. However, if the spine is damaged severely, for example, there is a fracture in the vertebra, and the doctor sees no use in giving nonsurgical treatments, he/she will recommend an appropriate surgery.

A doctor explaining patient about the procedure of open spine surgery

Now, choosing between open or closed surgery takes into account multiple factors;

  • Personal preference of the patient
  • The expertise of the doctor (Not every doctor has the expertise to perform minimally invasive surgeries)
  • The success ratio of open vs closed surgery in the case under consideration
  • The medical condition of the patient. Patients who are above 70 take more time to recover after surgery and thus they are not fit for open surgery.

Open Spine Surgery Procedure

Before we go on to explain the procedure for open spine surgery, let’s go through pre-op instructions.

Pre-Op Guidelines to Follow

  • Six weeks before the day of surgery, you should stop consuming alcohol and smoking. Substances from alcohol and tobacco can get into your bloodstream and have an effect on your body’s reaction to anesthesia.
  • Two weeks prior to the surgery, you should not take any drugs or substances that can thin your blood. Increasing fluid intake and having plenty of sleep are recommended.
  • Get reports for all the tests recommended by your doctor. These normally include blood tests and medical imaging.
  • Get in good shape by engaging in a short course of physical therapy. It will improve your physical conditioning and elevate your activity level so as to expedite recovery after surgery.

Procedure

A standard open spine surgery starts with a large incision. There are two approaches used; Anterior and Posterior. Under the anterior approach, the incision is made in front of the body whereas, in the posterior approach, the surgeon accesses the vertebrae from the back of the body. The size of the incision is normally about six inches. After making an incision, the surgeon will get access to the vertebrae by dissecting the spinal muscles. This process of pulling spinal muscles away from the bone is called retraction.

Once the doctor has access to the affected region, he/she will perform necessary surgical procedures. These include removing a part or whole of the vertebra, fusing multiple vertebrae, etc. Following the procedure, the surgeon easily places screws or bone graft material to provide stability to the spine. After the surgery is complete, ligaments, skin, and muscles are stitched back as they were before.

The patient is transferred to an observation room where he/she is carefully monitored. The doctor and staff look for any signs of complication while the anesthesia wears off. Surgical drains can also be used for draining out any blood collected in epidural space during surgery.

Risks Involved in Open Spine Surgery

In the past, all the surgeries were open and therefore it is also called a traditional surgical method. However, with the advent of technology, it is now possible to perform some surgeries with the help of cameras and endoscopy instruments. This procedure is getting popularity as the traditional methods pose several risks;

  • Damage to the soft tissues during retraction
  • Excessive loss of blood
  • Failed back syndrome – when the surgery performed couldn’t cure the pain
  • Implant migration – a condition in which the implant installed by the surgeon shifts from the site it was placed.
  • Dural tear – During surgery, the doctor can accidentally nick the covering over the spinal cord

Recovery after Open Spine Surgery

A nurse helping patient with recovery from open spine surgery

Recovery from open spine surgery entails great discipline in terms of taking recommended diet, doing appropriate exercises, and having prescribed medication. You will need to follow a new lifestyle for a couple of months after your surgery. Given below are some of the things you can do to make your recovery comfortable and fast;

  • Twisting and bending after the surgery is contraindicated. Have a physical therapist assist you with learning how to get in and out of the bed.
  • Use a reacher to grab things off the floor and walk with the help of a cane.
  • While the wounds heal, you will experience a lot of pain that you can manage with prescribed medications.
  • Mostly, patients do not need any back braces but it’s recommended to have yourself checked by the doctor to know if you need to use a brace.
  • Drink plenty of fluids and stool softener to avoid constipation due to narcotic medications.
  • Take special care of the incision area. Protect it from water and germs to avoid infection development.
  • You will able to resume activities like driving, lifting light objects, sex, etc. after six weeks of the surgery. Complete rehabilitation can take anywhere between 2 to 6 months.
  • Visit your doctor and physical therapist regularly to ensure everything is fine.

Consult a Spine Surgeon in Los Angeles

Being in a situation where you need open spine surgery can be quite stressful. However, an experienced and empathetic spine surgeon working in one of the best neurosurgical clinics in Los Angeles can make things easy for you. That’s what Moksha Ranasinghe MD offers. You can schedule an appointment with her simply by filling out the contact form or calling 213-369-4583.

 

A person showing signs of cervical spinal stenosis

Things to Avoid with Cervical Spinal Stenosis

A series of connected bones (also known as vertebrae) and soft jelly-like discs make up your spine. These vertebrae together make a canal in which the spinal cord rests serving as a connection between your brain and body. Due to wear and tear or conditions like osteoarthritis, the spinal canal gets narrow and causes a […]

A series of connected bones (also known as vertebrae) and soft jelly-like discs make up your spine. These vertebrae together make a canal in which the spinal cord rests serving as a connection between your brain and body. Due to wear and tear or conditions like osteoarthritis, the spinal canal gets narrow and causes a medical condition known as spinal stenosis.

Best Spine surgeon in Los Angeles - Dr. Moksha Ranasinghe

Do you need surgical treatment for Cervical Spinal Stenosis?

Conservative treatments do not provide a permanent solution for cervical spinal stenosis. Sometimes, surgical treatment is the only resort to treat spine conditions. If you have been experiencing cervical spine pain and are not sure what treatment you need, you can consult Dr. Moksha Ranasinghe at Southern California Brain & Spine Surgery. To schedule an appointment, fill out the contact form or call 213-369-4583.

About Cervical Spinal Stenosis

Spinal stenosis can occur in any part of the spine – upper, middle, or lower. If it occurs in the upper region of your spine (C1 – C7) i.e., neck, it is called cervical spinal stenosis. In some cases, stenosis can be severe enough to cause nerve compression or injury to the spinal cord leading to serious medical conditions. However, most of the patients can be treated or at least manage their stenosis pretty well with non-surgical treatments.

Causes

The most common cause of spinal stenosis is the deterioration of the spine that occurs over the years. Some people are also born with a condition in which the spinal canal is not fully developed. Other than these, the following are some of the causes of spinal stenosis;

Disc HerniationHerniated disc or slipped disc can cramp the space in the spinal canal.
OsteophytesOsteophytes also known as bone spurs are bony outgrowths developed along the vertebrae. These outgrowths, if large enough, can produce congestion within the spinal column.
Injuries – In case of vehicle accidents or any other event that causes injury to the spine, bones in the spine move out of place. It can result in swelling of the tissues which can put pressure on the nerves within the spine.
Tumors – Cancerous tumors can also be a cause of spinal stenosis as they produce compression in the spine.

In what follows, you will be explained things to avoid with cervical spinal stenosis. Following these guidelines will help you recover from the condition without any invasive procedure.

Things to Avoid with Cervical Spinal Stenosis

Although cervical spinal stenosis is a musculoskeletal condition that cannot be properly treated but managed conservatively. To improve life quality, various conservative treatment protocols are adopted. Daily activities are monitored by patients themselves to accommodate their health conditions. The primary objective of the patients suffering from cervical stenosis is to avoid activities that elevate the symptoms. Hereinafter laid down are the things to avoid with cervical spinal stenosis;

Avoid neck rotation exercises

A patient suffering from cervical spinal stenosis is suggested to avoid exercises that stress the neck and escalate the pain and discomfort. Slight degrees of flexion, extension, and bending of the neck are recommended but rolling or rotation exercises are highly contraindicated in the patient suffering from cervical spinal stenosis. To strengthen the neck and maintain range of motion, a few exercises are preferred including chin tuck, side tilt, and shoulder circles.

Avoid neck strains

One of the major things to avoid with cervical spinal stenosis is to reduce the additional strain on the neck. Neck strain increases the chances of nerve impingement, muscular swelling, and muscle spasms which in turn lead to chronic cervical spinal stenosis. Strains on the neck can be escalated when you bend your neck while using mobiles and laptops for an extended period.

Avoid awkward neck postures

Multiple awkward neck postures are also common in patients suffering from cervical spinal stenosis. Avoid cradling your neck to your ear during calls, carrying overly heavy weights on your head, or one shoulder bag. These postures exert hyperextension stretches and impinge the nerve which in time paramount the joint stiffness and cervical spinal stenosis. Usage of hands-free and two-strap bags to expand weight on both shoulders symmetrically may reverse neurological damages.

Avoid Contact sports

Contact sports such as football, basketball, ice hockey, diving, jogging, and martial arts add additional trauma and are significantly risky to the cervical spine. In advanced cases, patients can face slipped discs and potential nerve impingement as well. Things to avoid with cervical spinal stenosis during contact sports are jerky movements, sudden ballistic movements, and whip-lash injuries which can worsen cervical spinal stenosis.

Avoid poor sleeping positions

Certain sleeping positions aggravate neck rotation which is extremely crucial for patients suffering from cervical spinal stenosis such as sleeping on your gut. Use appropriate neck braces to keep your cervical spine intact while you sleep.

Don’t ignore early symptoms

One of the mistakes people make with cervical spinal stenosis is ignoring indications when they are in the early stages. For example, while performing activities of daily living (ADLs) like dressing, bathing, and showering, if you feel persistent pain in your neck you must get yourself checked timely.

Avoid Alcohol consumption and smoking

Consumption of excessive alcohol impedes the healing process and it can worsen limb numbness and weakness. One of the major things to avoid in cervical spinal stenosis is chronic alcoholism. Similarly, smoking accelerates nerve damage by compromising the vascular supply to the nerve through atherosclerosis. Avoiding smoking habits diminish local hypoxia and nerve damage.

Avoid poor dietary habits

A healthy diet helps in maintaining healthy body weights and keeps the discs hydrated. However, poor dietary habits increase body weight and inflammation as well. Heavyweights and bulky muscles put extra pressure on the cervical spine. Thus, avoiding poor dietary habits help in mimicking pain in patients with cervical spinal stenosis.

A young man showing signs of lower back pain due to weightlifting

How to Relieve Lower Back Pain from Lifting Weights?

It is quite common for people to experience lower back pain from lifting weights. Weightlifting can give you sore muscles and a bad back by putting extra pressure on your spine while you perform this activity. The lower back pain due to weight lifting fades away with time provided that you continue to maintain a […]

It is quite common for people to experience lower back pain from lifting weights. Weightlifting can give you sore muscles and a bad back by putting extra pressure on your spine while you perform this activity. The lower back pain due to weight lifting fades away with time provided that you continue to maintain a good form and do it the right way. However, if the pain persists and becomes worse over time, it can be a sign of serious medical conditions like spine damage or torn ligament.

Diagnosing the Cause

Before you start treating your lower back pain from lifting weights, you first must identify the root cause. As the treatment entirely depends upon the cause of the pain. If the pain is due to a minor spasm, non-surgical treatments would suffice but if you have damaged your vertebra, you will be going to need surgical treatments.

Pulling a back muscle during Weightlifting

A man sitting with his hand placed on back showing signs of pulled muscle

Muscles have fibers in them that are responsible to facilitate and organize the movement of your limbs and tissues. Symptoms of a pulled muscle in the back are;

  • Pain is concentrated in the lower back and doesn’t travel down to the legs or feet
  • In case of a muscle strain, the pain is usually dull, sore, and achy.
  • Patients with pulled muscle experience a limited range of motion. They also complain about feeling severe pain with specific movements for example bending forward or standing from a seated position.

Treatment

Pulled muscles, when compared to other back injuries, are easier to treat. Conservative treatments like therapies, medications, massage, and exercises can very much cure a strained or pulled muscle. In most cases, patients are rehabilitated within 4 to 6 weeks.

  • Take some rest – If you experience any of the symptoms above, immediately stop lifting weights otherwise the condition could get worse.
  • Use Ice and Heat Pads – Icing is normally done immediately after the injury to numb the area and reduce swelling. Once the swelling is controlled, then you can use the heat pads to increase the blood flow and expedite the healing process.
  • Keep moving – Gentle stretching exercises like Yoga after a couple of days of injury can strengthen the affected muscles. Other rehabilitation exercises include Knee-to-chest exercises, Figure of four (for deep muscle stretches), SLR (Straight leg raise), and Wall sits.
  • Soft tissue massage is the treatment of choice which is highly effective when done in the direction of fibers.
  • To relieve pain, stiffness, and discomfort, certain medications are prescribed to weightlifters which include NSAIDs (ibuprofen and naproxen), muscle relaxants (baclofen), and topical ointments (capsaicin, lidocaine, and Diclofenac gel). These medications can help weightlifters in speeding up the recovery process in combination with other conservative treatments.
  • Application of transcutaneous electric nerve stimulator (TENS) and ultrasound in weightlifters can also help manage lower back pain.

Spine Injuries during Weightlifting

Muscle spasms and strains are common in weightlifting but sometimes, things can go bad and athletes end up injuring their spines. Such situations are not normally life-threatening but these require immediate surgical treatment. One of the most common spine injuries due to weight lifting is disc herniation.

Disc Herniation

Disc herniation refers to the slipping of the gel-like sac that is present between each of your vertebrae. In some cases, a person can have a slipped disc without even knowing about it. He/she might not experience any symptoms whatsoever. In other cases, the slipped disc can cause nerve compression leading to tingling and numbness in the back.

Treatment

If the herniated disc is causing chronic and persistent pain, your doctor can recommend the following invasive surgical procedures;

  • Decompression surgery
  • Laminectomy
  • Laminotomy
  • Discectomy and microdiscectomy

For weightlifters, surgery must be avoided as the chances to resume your weightlifting career are very slim after a spine surgery.

Preventing Lower Back Pain from Lifting Weights

A coach helping a girl with posture adjustment

As they say, prevention is better than cure. Sports that are as extreme as weightlifting always come with chances of sustaining injury. Having said that, injuries can be avoided by being a little preventive. Given below is a list of a few important things you can follow to minimize the chances of any back injury and prevent lower back pain;

  • To decrease pain and increase function, muscle strengthening is highly preferred in weightlifters for future sustainability. As a result, the stronger the muscle, the lesser the chances of sustaining injuries during weightlifting.
  • Poor postures, flawed execution of exercises, lifting excessive weights and can lead to injuries in weightlifters, especially when doing squats and deadlifts.
  • Warm-up and cool-down exercises are mandatory before and after the session to enhance the flow of blood to your muscles and lessen the chance of injury.
  • Always start with sets of slight stretching exercises and slowly move towards the progression of a higher level of resistance.
  • Knee locks can be prevented when standing from sitting by keeping your knees soft and straightening your back throughout the lifting.
  • Ballistic exercises should be prevented until and unless monitored by a coach.
  • Use equipment like a back brace and belt to safeguard your spine against jerks and uncontrolled movements.
  • A coach is a must-have for weightlifters to always count for their attempts and safe activity performance.
  • Weightlifters’ education should be preferred for avoiding muscle overload exercises that are prone to injuries in the lumbar area.
Neurosurgeon Los Angeles - Dr. Moksha Ranasinghe

See Dr. Moksha Ranasinghe for Back Pain

Schedule an appointment with Dr. Moksha Ranasinghe for back pain treatment. You can fill out the contact form available on the website or call (213) 369-4583 to speak to someone at the clinic.

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How to Prepare Yourself for Back Surgery?

Once all the conservative treatments fail to relieve you of the back pain, back surgery is the last resort doctors often suggest. There could be a lot of reasons for which back surgery is performed; herniation/degeneration of disc, osteophytes or an injury to the spinal cord to name a few. After you have been given […]

Once all the conservative treatments fail to relieve you of the back pain, back surgery is the last resort doctors often suggest. There could be a lot of reasons for which back surgery is performed; herniation/degeneration of disc, osteophytes or an injury to the spinal cord to name a few. After you have been given the date of surgery, you must wonder if there is anything that I need to do or should not do. How do I prepare for the back surgery? You will find answers to these questions and many other similar ones in the article below.

Back surgery can be once in a lifetime experience and it is normal to have questions about the procedure. While the surgeon responsible for carrying out your surgery alerts you about the major do’s and don’ts, it is better to get to know about pre-surgery and post-surgery care. It won’t only help you with avoiding any possible complications but also make the road to recovery smooth.

Medical Clearance

Your doctor will conduct a preoperative evaluation known as medical clearance. This evaluation ensures that you are fit to undergo the proposed treatment and that it identifies any potential life-threatening complications that could arise from the surgery. The surgeon you have chosen for your back surgery will ask you to get medical clearance from your doctor as it is a basic requirement before any surgery.

Cut down on Nicotine Usage

a doctor warning his patient to stay away from smoking

Patients who are scheduled for any major surgery are strongly discouraged from consuming nicotine. The benefits of quitting smoking are endless, however, the following are some ways in which nicotine intake in any form can be dangerous for someone going under the knife;

  • It inhibits the recovery process after surgery.
  • It disturbs the blood flow by narrowing the blood vessels.
  • Smokers run a greater risk of heart attack, pneumonia, and blood clots.
  • Smoking damages the lungs and makes it difficult for the patient to breathe normally under the influence of anesthesia.

It can take anywhere between 5 days to three weeks for your stomach to be detoxified of nicotine. So it is a good idea to stop smoking or any intake of nicotine 1 month before your surgery.

Eat Healthy

a couple cooking healthy food


Various surgical procedures necessitate distinct dietary plans, not only regarding pre- and post-surgery eating restrictions but also in adhering to a recommended diet regimen that can enhance the surgery’s success. Below, we outline some general eating guidelines expected for patients to follow when preparing for back surgery;

  • A healthy body recovers faster after surgery than a non-healthy one. Following this, take a balanced diet with all the essential nutrients and proteins. Sources of protein can be eggs, meat, low-fat milk, and fish.
  • Doctors generally advise patients to abstain from eating anything for 7 to 8 hours before surgery.
  • You must be taking several anti-inflammatory medications like Ibuprofen and Naproxen to help you manage your back pain, however, you must stop having them 2 weeks prior to the surgery. Additionally, refrain from using blood thinners like aspirin to minimize the risk of excessive blood loss.

In such cases, we recommend seeing a nutritionist, as they are professionals who can devise a tailored-fit diet plan for you. Eating habits can make a world of difference in your road to recovery from back surgery.

Get Equipment to Help Yourself

an old lady trying to reach for her glasses with the help of a grabber

Recovering from back surgery can take a lot of time. During the recovery period, performing routine activities such as driving, bathing, and moving around will be different post-surgery. It would be a good idea to buy some equipment that can help you move around. These include;

  • A walker
  • Recliners
  • Back brace
  • Bathroom accessories (Shower seat/Toilet Seat)
  • Grabber devices

Rehabilitation after Back Surgery

Having successful back surgery is only a half-done job. Complete recovery takes a lot of discipline and effort. It is not uncommon to feel extreme pain after the first few days of the surgery. Moreover, serious complications might arise if patients become negligent. To avoid such situations, seeing a professional physiotherapist would be a good idea. He/she will chalk out a plan for you to ensure a smooth recovery and help you get back to living a normal life again after back surgery.

Neurosurgeon Los Angeles - Dr. Moksha Ranasinghe

Get a Second Opinion on Your Back Surgery

If you happen to be in Los Angeles, you can see Dr. Moksha Ranasinghe at Southern California Brain & Spine Surgery for an expert opinion on getting back surgery. She has been treating patients with back problems for many years and is rated as the best neurosurgeon in Los Angeles by findatopdoc.com for three consecutive years (2019-2021). Our facility trains staff professionally to assist patients with their treatments and recovery. You can rely on us for complete treatment of your back problems. To schedule an appointment, you can fill out the contact form given below or call us at (213) 369-4583.

Bone spurs causing disc osteophyte complex

Disc Osteophyte Complex: Symptoms, Causes, and Treatments

Disc osteophyte complex is a spinal ailment caused due to the formation of osteophytes in the spine affecting the intervertebral disc. Osteophytes (also called bone spurs) are the bony outgrowths that can develop as a result of your body’s natural reaction to any damage or irritation caused to the bones or ligaments in the spine. […]

Disc osteophyte complex is a spinal ailment caused due to the formation of osteophytes in the spine affecting the intervertebral disc. Osteophytes (also called bone spurs) are the bony outgrowths that can develop as a result of your body’s natural reaction to any damage or irritation caused to the bones or ligaments in the spine. These bone spurs when developed on multiple vertebrae can causes compression in the spinal cord or on the nerve roots.

See a spine surgeon in Los Angeles: If you are experiencing any symptoms of Osteophyte complex, you can consult our doctor in Los Angeles by calling at 213-369-4583 or filling out the contact form on our website.

You might also want to read: What are the things to avoid when suffering from Cervical Spinal Stenosis?

Causes and Symptoms of Disc Osteophyte Complex

A young woman in her bed showing signs of neck pain

As mentioned above, the development of osteophytes is a result of the body’s reaction to damage. This reaction can take place due to one of the following reasons;

  • It can be due to shock, trauma, or any direct injury to the bones in the spine.
  • The Disc Osteophyte complex can also occur due to aging or obesity as both weaken the spine over time. As a result, the body starts producing bone spurs to provide stability to the deteriorating structure of the spine.
  • Bone spurs that lead to the development of the Disc Osteophyte Complex can also be caused when the cartilage between the discs is torn.

At times, symptoms do not become noticeable immediately. When the bone spurs start to grow, they start compressing the nerves giving you a sensation of mild pain. Depending upon the location of the osteophytes (Cervical, Thoracic, or Lumbar), a patient can show different symptoms including;

  • Stiffness in the neck
  • Headache
  • Numbness and tingling in one or both arms
  • Weakness in arms or legs
  • Radiating pain in arms, shoulders, or thighs
  • Pain that increases with physical activities

How is the Disc Osteophyte Complex diagnosed?

You might already know that the spine is categorized as cervical (C1-C7 vertebrae), thoracic (T1-T12), and lumbar (L1-L5). Osteophytes can be developed in any part of the spine. For diagnosis, your doctor will start by going through your medical history. He/she will also check for swelling and points of pain by palpation. If a patient shows signs of Disc Osteophyte Complex in physical examination, the doctor conducts imaging tests like X-ray or MRI to get an internal picture and ensure the presence of the disease.

Treatments for Disc Osteophyte Complex

Once the presence of the Disc Osteophyte Complex is confirmed, patients can be recommended surgical or nonsurgical treatments (such as using pain-killers, massages, and back braces). It primarily depends upon the medical condition of the patient and the severity of the disease for determining what treatment to go for. Conservative treatments include the following;

An old man getting massage therapy

Therapy and Massage – Therapies involve gentle exercises, yoga, and stretches that help to relieve tension around the spine muscles and improve the range of motion in vertebrae.
Medications – Non-steroidal drugs, pain killers, muscle relaxants, spinal injection, and anti-inflammatory medications (NSAIDs) are the medications doctor normally recommends for pain relief due to bone spurs.
Weight control – If you are overweight, the first thing your doctor will tell you is to lose weight. Maintaining a healthy weight takes the pressure off the spine and decreases the pain due to bone spurs.
Acupuncture – Some acupuncturists claim to treat pain due to bone spurs using herbal products.

Related readings: You can read about the comparison between surgical and non-surgical treatments for back pain in another article on our website.

Non-surgical treatments can only help in relieving pain but they do not provide a permanent solution to the problem. Bone spurs keep growing over time and can cause severe pain (paralysis in some cases) if left untreated.

Osteophytectomy Procedures

The procedure through which osteophytes or bone spurs are cut is called osteophytectomy. According to the diagnostic reports, different surgical procedures can be used to treat Disc Osteophyte Complex.

Laminectomy
This procedure is carried out when bone spurs are compressing the spinal nerves. The doctor removes the bone spur or any other tissue which is causing pressure on the nerve roots. This creates space for the compressed nerves to relax and thus relieves the patient of the pain.

Foraminotomy
Foraminotomy serves the same objective as Laminectomy however, instead of removing a part from the vertebrae, it enlarges the pathway (known as Formen) through which nerves pass.

Open vs Minimally Invasive Surgery
In the past, most surgical treatments required making a large incision in the body. This approach had many drawbacks; more pain, longer hospital stays, and longer recovery time to name a few. With the advent of technology in the field of surgery, now doctors can treat patients with video-assisted surgeries. This method is called Minimally Invasive surgery. Disc Osteophyte Complex can be treated with such a procedure provided that the surgeon has the required skills and equipment.

Recovery after Surgery
Like with any other major surgery, recovery after osteophyte removal also takes time. If the procedure was minimally invasive, the healing process is relatively faster. However, in the case of open surgery, complete recovery can take up to anywhere between 3 to 6 months.

Neurosurgeon Los Angeles - Dr. Moksha Ranasinghe

Talk to a Neurosurgeon in Los Angeles

If you have been experiencing any symptoms indicative of Disc Osteophyte Complex, you can talk to our doctors at Southern California Brain & Spine Surgery. Here we have Dr. Moksha Ranasinghe who is a provides healthcare services to patients suffering from spine and brain diseases. You can easily schedule an appointment by filling out the contact form available on our website or calling (213) 369-4583.

A lady with a bend in her spine

Scoliosis Surgery: What is it and how is it performed?

Scoliosis is a spinal deformity in which the spine is curved sideways. It is most commonly found in adolescents who are born with it for reasons yet to be discovered. However, adults can also develop scoliosis due to degeneration of discs or reasons that could not be discovered during childhood like cerebral palsy.If the curve […]

Scoliosis is a spinal deformity in which the spine is curved sideways. It is most commonly found in adolescents who are born with it for reasons yet to be discovered. However, adults can also develop scoliosis due to degeneration of discs or reasons that could not be discovered during childhood like cerebral palsy.
If the curve in the spine is mild, doctors keep it under observation with regular X-rays to make sure the curve is not getting worse. However, surgeons perform scoliosis surgery to restore the original form of the spine in cases of severe curvature.

Neurosurgeon Los Angeles - Dr. Moksha Ranasinghe

See a Spine Surgeon in Los Angeles for Scoliosis Surgery

In cases as sensitive as Scoliosis, it is recommended that you see a spine specialist for comprehensive diagnosis and treatment. If you are in Los Angeles, you can visit Southern California Brain & Spine Surgery and see Dr. Moksha Ranasinghe for Scoliosis treatment. She has been treating patients with spine diseases for many years and has been rated as the best spine surgeon in Los Angeles for three consecutive years by findatopdoc. You can schedule an appointment with her by filling out the patient form or calling (213) 369-4583.

Types of Scoliosis

Based on the causes, we can categorize scoliosis as follows;

Congenital Scoliosis

Congenital scoliosis starts developing when a baby is inside his mother’s womb. During fetal development, incomplete formation of vertebrae results in a sharp bend in the spine.

Neuromuscular Scoliosis

Neuromuscular scoliosis is another very common type of scoliosis mostly found in kids. Sometimes weakening of back muscles due to conditions like Spina bifida and cerebral palsy causes the spine to bend. It happens because back muscles fail to provide the necessary strength and thus the spine loses its shape.

Degenerative Scoliosis

This form of scoliosis is more likely to be found in adults than in kids. It occurs when a spine gets deformed due to wear and tear. Degeneration of the spine is a result of aging, tumors, infections, or arthritis.

Idiopathic Scoliosis

When the cause of scoliosis cannot be identified, people commonly refer to it as idiopathic scoliosis. Like congenital scoliosis, it is present at the time of birth for unknown reasons. It is commonly understood that idiopathic scoliosis results from genetic factors that run in families.

Who Qualifies for Scoliosis Surgery?

As mentioned earlier, healthcare professionals treat mild curvatures or bends in the spine nonsurgically, using methods such as braces, massage, and physical therapies. Curvature is considered to be sharp and problematic if;

  • It is greater than 50 degrees (in kids who are still growing)
  • It is greater than 50 degrees that have progressed more than 10 degrees (in patients who have reached skeletal maturity)
  • Hindering the functionality of the parson
  • Causing unbearable pain
  • Becoming problematic for the heart and lungs

Scoliosis Surgery

Spine surgeon standing in operation theatre

Provided that the conservative treatments for Scoliosis fail, doctors recommend patients for surgery. Spinal fusion is the most common surgical procedure used to cure scoliosis.

Spinal Fusion Surgery

In this procedure, the doctor fuses the vertebrae to remove the bend in the spine and correct its deformity. The fusion is carried out by using bone grafts or metal implants like rods and screws. Spinal fusion is found to be effective in restoring curvature by 50 percent or more.

Procedure

The doctor will make an incision to reach where fusion needs to be performed. For this purpose, an Anterior or Posterior approach can be used. In the former approach, the surgeon approaches the spine from the front rather than from the back like in posterior surgery. Posterior is the most frequently used approach when it comes to treating scoliosis and adolescents or adults.

Once the surgeon has access to the spine, he/she will make adjustments to remove the curvature and straighten the spine. It also involves placing the rods or bone grafting material acquired from the patient’s body. The whole procedure can last anywhere between 4 to 8 hours depending upon the severity of the curvature and the number of points where fusion is needed. After the surgery is complete, the incision is stitched.


In addition to anterior and posterior surgical procedures, surgeons also perform minimally invasive surgery (MIS), also known as Video-Assisted Surgery. Surgeons use advanced cameras and surgical equipment in MIS to perform spinal fusion. The surgeon performs the complete surgery through a very small incision in the body. MIS is preferred due to its ability to cause less pain and involve a very short recovery period.

Recovery after Scoliosis Surgery

Undergoing fusion surgery only completes half the task. To achieve complete vertebrae fusion, you must follow a comprehensive recovery plan involving medication, physical therapy, and a recommended diet. You will be able to move after two to three days of the scoliosis surgery. To fully recover and go back to doing normal physical activities can take anywhere between 6 to 12 months. For a smooth recovery from the scoliosis surgery, follow the instructions given below;

  • Take complete bed rest during the first week after the surgery to let the wound heal.
  • Keep the incision site clean and dry
  • Avoid bending or twisting your back
  • Take protein-rich food, fruits, and vegetables
  • See a physiotherapist for helping yourself with the recovery process. He will chalk out a plan for you that will involve light exercises and massages.