Understanding Spinal Stenosis

Spinal stenosis is a condition that will eventually affect most men and women, although its physical effects may not be the same in every person. The treatment of spinal stenosis is one of the medical services available from Miami Back Specialists.

Understanding the Spinal Cord
The spinal column extends the length of our backs and allows us to stand, walk and generally move about. The column itself is comprised of more than 30 bones, known as vertebra, through which runs the spinal cord. An important element of the central nervous system, the spinal cord carries signals from the brain, making possible the normal functioning of the body.

The Causes and Effects of Spinal Stenosis

The condition can affect anyone and may result from a traumatic injury or the development of a tumor in the spine. It can also occur if the tissue between the bone, known as a disk, becomes herniated. However, it normally begins to develop after the age of 50 and is related to the general effects of “wear and tear” on the body. The narrowing of the spaces in the bone will eventually begin will impose pressure on the spinal column. The effects of this pressure translate into the condition known as spinal stenosis. Some of those with the condition may not have developed obvious symptoms. Others may experience neck or back pain, numbness in the extremities and muscle weakness. Spinal stenosis may occasionally affect the functioning of the bladder and digestive system.

Treating Spinal Stenosis
In addition to recognizing the symptoms, doctors can usually detect spinal stenosis through internal imaging techniques, including MRI scans. The condition can in some cases be treated with medications or through physical therapy. In other cases, surgery may be needed to increase the space in the bones. A spine doctor can help determine the nature of the problem and help the patient decide on the best course of action. Our team of doctors and pain specialists offer a variety of treatment options for spinal stenosis and other back problems. Contact us at 305-901-1511 for a free consultation.

Myths About Spine Surgery

Spine surgery has changed drastically in the past decade and Dr. Brusovanik has been at the forefront of the most innovative techniques in minimally invasive spine surgery. With the use of these new methods, Dr. Brusovanik’s patients are walking the night of their spine surgery and rarely need physical therapy after surgery. His patients’ great outcomes are achieved because Dr. Brusovanik is very selective with who he does surgery on. Patients first try conservative therapies and only after those options have failed does Dr. Brusovanik consider surgery. He also performs diagnostic injections that aid in determining the level in the spine that is causing the pain. With the aid of a detailed history, comprehensive physical exam, studying the patient’s imaging and these diagnostic injections; Dr. Brusovanik is able to perform the most appropriate procedure that will yield the greatest outcome.

Furthermore, the use of the minimally invasive technique results in no muscle injury and the smallest incisions. This leads to a faster recovery and Dr. Brusovanik’s patients are never required to wear a brace or placed on bed rest.

Plantar Fasciitis

Plantar fasciitis is one of the most common causes of heel pain. It is occurs when there is inflammation of the thick band of tissue that runs across the bottom of the foot called the plantar fascia. This band of tissue connects the heel bone to the toes.

It is common for patients with spine issue to present with a similar pattern of pain. As the nerves exit the spinal cord, they innervate different muscle groups, each nerve follows a distinct pattern down the extremities. The pathway for the S1 nerve is down the back of the leg to the heel of the foot. Patients may feel this heel pain and it can be confused with plantar fasciitis. It is important to distinguish the two by obtaining a proper history, physical exam and diagnostic imaging.

What to expect with an Anterior Lumbar Interbody Fusion with Percutaneous Posterior Stabilization (ALIF/PSF):

The purpose of an ALIF/PSF is to fuse the segment in the lumbar spine that is causing pain with movement, if those segments are indeed degenerative. The idea behind the fusion is that stopping movement at that segment will no longer cause pain. Prior to surgery, proving that pain is coming from a specific level is usually confirmed with injections.

An ALIF/PSF (CPT code: 22558) is usually done for the last 2 levels in the lumbar spine, L4-5 or L5-S1. A vascular surgeon does the exposure for Dr. Brusovanik and accessing the spine from the front of the abdomen just below the navel. Once the spine is exposed the disc is removed and an interbody with bone graft is placed in the disc space. The incision is then cleaned and closed using a plastic surgery technique. Over the next few months, bone grows in the disc space connecting the two vertebrae causing a fusion.

The patient is then turned onto his/her stomach; small incisions are made in the back where the screws are passed through the muscle planes. This technique prevents muscle injury. Screws are inserted into both sides of each vertebrae (above and below) the disc space being fused. Rods are then placed on each side to connect the screws, stopping any movement at the painful level.

Patients are encouraged to walk the same night of surgery and are kept in the hospital for 1-2 nights. Patients are able to perform their daily activities once they are discharged home. They are able to go back to work within 1-2 weeks. Patients with labor intensive work can return in 3-4 weeks.

Getting an Epidural Injection

At Miami Back Specialists we specialize in all kinds of treatments for backaches. We want to help you reclaim your happiness and comfort as soon as possible.

A common question many patients have prior to getting an epidural injection is “how long will the effects of the injection last”. It is a hard question to answer because everyone has a slightly different condition causing the pain. Pain varies from patient to patient. Therefore, it is hard to predict how long the effects of the injection will last and maybe more than one injection will be needed. Some patients can get full relief of their symptoms and avoid or postpone surgery all together. An epidural injection for back or neck pain is administered by a pain management physician who is usually dual certified in Anesthesiology. For more information, please do not hesitate to contact me at 305-467-5678 or private message me.

Leg Pain Symptoms that Indicate you need to Consult a Spine Doctor

As the human body ages, there are high chances of experiencing mobility problems, neck, and back pain that prevent you from enjoying a comfortable daily life. Whether you experience neck and back pain after lifting heavy objects, sleeping on hard surfaces, sitting in the chair for many hours, or bad postures, ultimately, you need to establish if the discomfort arises from lumbar spinal stenosis.

What is Spinal Stenosis?
Spinal stenosis is a common disorder that usually affects the neck, back, arms, and legs when the open spaces in your spinal canal begins to narrow. The narrowing of the cervical spine, or lumbar bones can put pressure on your spinal cord. Consequently, the spinal nerves will experience challenges.

How does Spinal Stenosis occur?
The narrowing of spinal spaces could take place in the cervical, thoracic, or lumbar regions but more commonly in the lumbar region. It is a narrowing of the spinal canal caused by disc herniation’s, injuries to the spine, changes in the spine related to age, or tumors which can cause pain, numbness or weakness in the legs.

When you experience numbness and pain in the legs, it is likely you suffer from spinal stenosis. A spinal specialist will want to find out if you experience any of the symptoms below:
+ Back pain.
+ Difficulties balancing the body while standing, bending, or walking
+ Leg cramps when you stand for long periods.
+ Numbness, tingling or burning sensation in the legs, lower back area, or buttocks.
+ Stiff thighs or legs.
+ Bladder issues or bowel dysfunction.
+ Weakness in the neck, clumsy hands

The Cure for Lumbar Spinal Stenosis and Leg Pain
Leaning forward and flexing the lower body part forward can temporarily relieve your painful symptoms by opening up your spinal canal.

If you have failed medications such as anti-inflammatories, or physical therapy has been ineffective, your doctor can also recommend an epidural steroid injections (ESI). If the conservative route does not alleviate your pain, there is a surgical procedure to open up your spine to offer a permanent cure for spinal stenosis. The most common type of surgery for spinal stenosis is called decompressive laminectomy, also known as spinal laminectomy or spinal decompression. This surgery is done to relieve pressure on the spinal nerve roots. During a laminectomy, the bony walls of the vertebrae, bone spurs or thick tissue, causing narrowing of the canal that allows compression of the spinal nerves are removed. This procedure is done to open the spinal canal and remove the pressure of the nerves.

Decompressive Laminectomy

At Miami Back Specialists our patients are our top priority. If you are suffering from back pain call Miami Back Specialists. Our team is here to help you.

Decompressive laminectomy, also known as spinal laminectomy and spinal decompression is the most common type of surgery done to treat lumbar (low back) spinal stenosis. Spinal stenosis is a narrowing of the spinal canal caused by age-related changes in the spine, injuries to the spine, herniated discs or tumors that may cause pain, numbness or weakness in the legs. This surgery is done to relieve pressure on the spinal nerve roots. In many cases, reducing pressure on the nerve roots can relieve pain and allow you to resume normal daily activities. During the Laminectomy, the lamina or bony walls of the vertebrae are removed, along with any bone spurs and/or thickened tissue that is narrowing the spinal canal and squeezing the spinal nerve roots. The aim of the procedure is to open up the spinal column to remove pressure on the nerves.

Symptoms of Spinal Stenosis:
+ Back pain
+ Difficulties balancing the body while standing, bending, or walking
+ Weakness in the feet, legs or buttocks
+ Leg cramps when you stand for long periods
+ Numbness, tingling or burning sensation in the legs, lower back area or buttocks
+ Stiff thighs or legs
+ Bladder issues or bower dysfunction
+ Weakness in the neck, clumsy hands

Cauda Equina Syndrome

The staff at Miami Back Specialists help treat a number of issues casing back pain, Cauda Equina Syndrome is one of the conditions they help treat.

Cauda Equina Syndrome is a serious but rare complication of a ruptured disc. It occurs when disc material is pushed into the spinal canal and compresses the bundle of lumbar and sacral nerve roots, causing loss of bladder and bowel control. Permanent neurological damage may result if this syndrome is left untreated.