Spine Surgery

Lower Back Symptoms:

• Electric type shooting pain that radiates down one or both legs
• Weakness in one or both legs
• Numbness and tingling in one or both legs
• Loss of bowel or bladder control (which can in most cases be a sign of something more serious and should be evaluated immediately)

Neck Symptoms:

• Electric type shooting pain that radiates down one or both arms
• Weakness in one or both arms
• Numbness and tingling in one or both arms
• Burning that radiates to the neck, shoulder, shoulder blade or arm

Non-surgical Treatments

• Anti-inflammatories
• Oral medications can be used to reduce inflammation, thereby improving pain. By reducing pain, the hope is to allow patients to resume a more normal lifestyle while natural healing is given time to occur.
• Physical therapy
• Our team of spine physical therapists are trained to promote pain relief and educate the patient on techniques to reduce re-injury.
• Epidural Steroid Injections (ESI)
• Injections of an anesthetic along with a steroid medication. They can be used for both diagnostic and therapeutic reasons in the spine. Dr. Dolphin reviews every patients’ physical exam and imaging studies to determine the type of epidural steroid injection that will offer the patient the most relief.

Surgical Treatments

Minimally Invasive Microdiscectomy

Dr. Michael Dolphin performs minimally invasive outpatient microdiscectomy, which is designed to relieve pain from a disc bulge/herniation. This procedure is done for patients that have not responded to conservative treatment methods. The procedure removes the herniated part of the disc material that is pressing on the nerve or the spinal cord, retaining the unaffected disc for continued function. Once the part of the disc that is pinching the nerve is removed, the pain and numbness improve. Dr. Dolphin performs this procedure in lower back utilizing muscle sparing techniques and when indicated, utilizing tubular retractors to minimize tissue injure. His techniques have been perfected over 10 years and result in less damage to the muscles, allowing for a quicker return to normal activities. Dr. Dolphin also performs a similar procedure for herniated discs in the neck. The patient is positioned in a sitting position and using a muscle sparing approach, the cervical disc herniation is removed. This relieves the pressure on the nerve(s) improving the numbness and radiating pain. The cervical laminoforaminotomy, is a minimally invasive procedure that relieves pain without performing a fusion, thus not causing any issues with decreased neck range of motion.

Posterior Cervical Laminoforaminotomy (Minimally Invasive)

Dr. Dolphin performs the posterior cervical laminoforaminotomy procedure for herniated discs in the neck. The patient is positioned in a sitting position, and utilizing a muscle sparing approach, the cervical disc herniation is removed. This relieves the pressure on the nerve(s) improving the numbness and radiating pain down the arm. The cervical laminoforaminotomy, is a minimally invasive procedure that relieves pain and numbness without performing a fusion. Compared to the cervical fusion, this allows for a completely normal range of motion after surgery as well as less chance for future neck deterioration. When either a lumbar or cervical microdiscectomy procedure is complete, a few stitches are placed in the incision which is then covered with steri-strips and a water resistant dressing. This allows the patient to shower immediately. Patients can return to non-strenuous work within one to two weeks following surgery. However, more physically demanding professions, usually require 4-6 weeks before returning to full activity.

Anterior Cervical Discectomy with Fusion (Minimally Invasive)

Cervical disc herniations can also be removed through the front of the neck (anterior approach) to alleviate pain, numbness and tingling resulting from nerve root and spinal cord pressure. This procedure is utilized in situations where there is not only a disc herniation, but also arthritis, with bone spurs causing nerve compression. When performing this procedure, stabilization, of the disc space is then performed in the form of a fusion. Typically, a plate and screws made of metal, are inserted to provide immediate spine stabilization while the bone fusion is healing. Dr. Dolphin performs this procedure with a minimally invasive approach, through an incision approximately one inch in length, allowing for a quicker recovery and also the ability to do the procedure on an outpatient basis.

Lower Back Symptoms:

• Radiating pain or heaviness in the leg(s) with walking or standing
• Low back pain
• Numbness and tingling that radiates down the leg(s)

Neck Symptoms:

• Neck stiffness and pain that becomes worse with activity
•  Weakness or numbness within the arm(s) or hand(s)
•  Pain in the back of head with headaches
• Difficulty with balance

Non-surgical Treatments

While there is no cure for spinal stenosis, in some cases, medication, physical therapy (traction), injections or regular exercise can provide relief to patients. Over the counter medications such as Tylenol, Advil, Motrin or Aleve, may relieve pain. Epidural steroid injections, in many cases, provide a great deal of relief for patients. These may be temporary, but depending on the patients’ medical status and activity level, they may be appropriate.

Surgical Treatments

Laminotomy (Minimally Invasive)

Each vertebrae of the spine consists of a vertebral body on the front side and a bony canal on the back side. In between each of these is a disc. The back part of the spine or the bony canal, houses the spinal cord and nerves. The back side of the canal or “roof” of this canal is referred to as the lamina. Minimally invasive laminotomy involves the removal of a small area of this lamina on either one or both sides of the spinal nerves, to allow for decompression of the nerves. The procedure takes approximately 30 minutes and is done on an outpatient basis. Patients are allowed to return to activity as tolerated is immediately, letting their post-surgical pain guide them.

Laminectomy (Minimally Invasive)

Minimally invasive laminectomy is a surgical procedure that removes the entire lamina, or bony “roof” to the spinal nerves. The goal of this procedure is to alleviate pressure on the nerves. This procedure is one of the most successful procedures, when performed on the appropriate patient. The procedure takes approximately 1 hour. Patients are typically able to go home on the same day of surgery. Because of the minimally invasive approach used by Dr. Dolphin, patients are allowed to return to activity as tolerated, allowing their post-surgical discomfort to guide them.

Anterior Cervical Discectomy with Fusion (Minimally Invasive)

Cervical stenosis can be relieved through the front of the neck (anterior approach) to alleviate pain, numbness and tingling resulting from nerve root and spinal cord pressure. This procedure is utilized in situations where bone spurs are causing nerve compression. Careful surgical technique allows for removal of the bone spurs, relieving the nerve/spinal cord compression. When performing this procedure, stabilization, of the disc space is then performed in the form of a fusion. Typically, a plate and screws made of metal, are inserted to provide immediate spine stabilization while the bone fusion is healing. Dr. Dolphin performs this procedure with a minimally invasive approach, through an incision approximately one inch in length, allowing for a quicker recovery and also the ability to do the procedure on an outpatient basis.

Posterior Cervical Laminoforaminotomy (Minimally Invasive)

Dr. Dolphin performs the posterior cervical laminoforaminotomy procedure for isolated cervical stenosis caused by bone spurs in specific locations of the neck. The patient is positioned in a sitting position, and utilizing a muscle sparing approach, the bone spur is removed. This relieves the pressure on the nerve(s) improving the numbness and radiating pain down the arm. The cervical laminoforaminotomy, is a minimally invasive procedure that relieves pain and numbness without performing a fusion. Compared to the cervical fusion, this allows for a completely normal range of motion after surgery as well as less chance for future neck deterioration.