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Conditions & Treatments

Back & Spine

Back and neck pain can range from a mild inconvenience to a debilitating condition that can make everyday tasks difficult and dramatically lower your quality of life. Back and spine conditions may cause pain, weakness, numbness or tingling in your arms and legs, and in more serious cases lead to difficulty standing or walking, lost bowel or bladder control, and paralysis.

At Einstein, the physicians on our orthopedic team are experts in the treatment of a full range of back and spine conditions, with a focus on relieving your symptoms and restoring your quality of life. The conditions we treat include:

A herniated disc, also called a slipped, bulged or ruptured disc, occurs when the soft tissue between the vertebrae pushes through the ligamentous structures that surround it. This can push against the spinal nerves and result in pain, numbness, and weakness or tingling in your arms or legs, depending on where the nerve is compressed. In severe cases, a herniated disc can result in difficulty standing or walking, or the loss of bladder or bowel control.

Based on the severity of your condition, your doctor may recommend a variety of medications to relieve your pain, including over-the-counter medications, cortisone injections and muscle relaxers. Physical therapy may also be recommended, and in serious cases, your doctor may recommend surgery. In most cases, your surgeon can remove just the herniated portion of the disc, though in others your treatment may require removing the entire disc and fusing together two or more vertebrae.

When the sciatic nerve, which branches off from your spinal cord in your lower back, becomes pinched or compressed, pain that radiates from your back down your leg or tingling and weakness of the affected leg and foot can result. In some cases, mild sciatica may go away on its own. In others, your doctor may recommend medications, physical therapy or steroid injections to relieve your symptoms. If your sciatica is caused by a bone spur or a herniated disc, you may need surgery to relieve your symptoms.

Scoliosis is an abnormal curvature of the spine. Depending on the severity of the curve, scoliosis may lead to pain, difficulty walking, and leg pain or weakness if the spinal nerves are involved. In most cases, your doctor will recommend physical therapy and lifestyle changes to help relieve your pain. These may include maintaining good posture, regular stretching and low-impact exercises, and over-the-counter pain medications. In more serious cases, your doctor may recommend an epidural injection or nerve block to treat your pain, or spinal fusion surgery to help reduce the curvature, relieve your pain and prevent further deterioration.

Spinal stenosis is the narrowing of the space inside of your spine where your nerves are located. This can put pressure on your nerves, resulting in pain, weakness, tingling or numbness in different areas of your body, depending on which nerves are involved. Spinal stenosis may be caused by bony overgrowth, a herniated disc, thickened ligaments, tumors, arthritis or a spinal injury. Spinal stenosis often gets gradually worse over time.

Depending on the severity of your symptoms, your doctor may recommend physical therapy and medications to treat your symptoms, which may include steroid injections. In more serious cases, minimally invasive surgical procedures can be used to widen the space inside of your spinal column or remove small bone segments, with the goal of relieving symptoms without the need for spinal fusion surgery. In certain cases, another procedure called percutaneous image-guided lumbar decompression (PILD) may also be an option.

Spondylolysis is a crack or stress fracture in one of your vertebrae. Spondylolisthesis occurs when that stress fracture causes the bone to shift or slip forward onto the vertebra below it. These fractures typically occur in the lower spine, and are common in young athletes who put repeated stress on their lower back in sports such as football, gymnastics and weightlifting. However, older, less active adults may be diagnosed with this condition as well.

The pain associated with spondylolysis often feels similar to a muscle strain, and usually worsens with activity and improves with rest. The pain may radiate from the back to the buttocks and hamstrings. Depending on the severity of the injury, your doctor may recommend rest, physical therapy, pain medications and a back brace to help stabilize the area while the fracture heals or your symptoms resolve. In cases where the vertebra has slipped out of place (spondylolisthesis), your doctor may recommend spinal fusion surgery.

As you age, your bones become more brittle and porous, putting you at a greater risk of small fractures of the spine that can result in part of a vertebra collapsing. These compression fractures can result in back pain that can be persistent and significant in the setting of more severe or repetitive injuries. In some cases, your doctor may give you medication for the pain, and recommend a back brace and other lifestyle changes. In more serious cases, surgical treatments may be recommended.

Arthritis can occur anywhere in your body as the cartilage of your joints wears down, and is a common cause of pain. Learn more about arthritis treatments.

 

Treatment Options

Einstein offers the most advanced treatments for back and spine conditions. Depending on the severity of your symptoms, diagnosis and risk factors, your doctor will work with you to develop a personalized treatment plan, which may include:

In less serious cases, it may be possible to manage your symptoms without surgery through a combination of physical therapy, lifestyle changes and medication. These treatments may also be used in addition to other procedures in order to manage your symptoms and permit a full, fast recovery.

PILD is used to treat lumbar stenosis that is the result of a thickened ligament of your spinal canal in patients who are at high risk for surgical complications following larger open procedures. Your doctor may be able to remove a piece of this ligament using this minimally invasive procedure without the need for general anesthesia.

Sometimes called decompression surgery, these procedures are typically used to treat herniated discs and spinal stenosis by removing part or all of the back part of the affected vertebra (the lamina) in order to relieve pressure on your spinal cord.

Used to treat painful osteoporotic compression fractures, your surgeon performs a kyphoplasty by inflating a special balloon inside of your vertebral body to help restore its height and shape. A cement-like mixture is then injected into the open area created by the balloon. This can stabilize the bone, relieve your pain and avoid further damage.

In a minimally invasive procedure, your surgeon will remove parts of a herniated disc to relieve nerve pressure and pain.

In cases where the stability or integrity of one or more of your vertebrae or intervertebral discs is compromised, your surgeon may recommend spinal fusion surgery. This technique uses a bone graft to fuse two vertebrae together. This graft is stabilized as it heals with rods, plates or screws. Einstein’s back and spine specialists are trained in some of the most advanced spinal fusion techniques, including the XLIF (eXtreme Lateral Interbody Fusion) procedure, which reaches the lumbar region of the spine through an incision in your side. XLIF is less invasive than other spinal fusion techniques, thereby reducing the risk of a complication and helping your body to heal faster.

 

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