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Written by becomepainfree

January 31, 2013 at 4:01 pm

Posted in Laser Back Surgery, laser spine procedures, Laser Spine Surgery, Low back pain, Lumbar and Cervical Radiofrequency, Lumbar Microdiscectomy, M.D., Mayo Clinic, Mayo Clinic Spine Surgeon, Mayo Clinic Trained Surgeons, Medical Education, MINIMALLY INVASIVE, minimally invasive disc healing, Minimally Invasive Laser Spine Surgery | Spine Surgeons | Dallas, minimally invasive procedures, Minimally Invasive Spine, minimally invasive spine procedures, Minimally Invasive Spine Surgery, Minimally Invasive Stabilization, Minimally Invasive Surgery, MIS, Myofascial pain syndrome, Neck pain, Neck Pain Treatment Texas, Neuropathic Pain, non-invasive procedures, North American Spine Society, Open Surgery and Minimally Invasive Surgery, Overuse Injuries, Pain, pain disorders, Pain Doctor, Pain Doctor Dallas, Pain Doctor Fort Worth, Pain Doctor Irving, Pain Doctor Plano, Pain Doctor Texas, Pain Doctors, Pain Dr, pain management, Pain Medicine, Painful nerve injuries, Painful osteoarthritis, patients’ own stem cells, Pelvic pain/Genital pain, Pinnacle Pain, Pinnacle Pain Group, Positive Side Effects, posterior spinal fusion, Presbaterian Pain, Proven Results, PRP, Radicular Syndrome, Radiofrequency Ablation and Lesioning, Regenerative Medicine, Robotic Guided Spine Surgery, Robotic Spine Surgery, Rockwall Back Doctor, spinal cases from children, Spinal cord injury spasticity and pain, Spinal Cord Stimulator Trial, Spinal Fusion, Spinal Stenosis, Spine Microdiscectomy, Spine Pain Plano, Spine Surgery, Spine Surgery Addison, Spine Surgery Coppell, Spine Surgery Dallas, Spine Surgery Doctor, Spine Surgery Houston, Spine Surgery McKinney, Spine Surgery Mesquite, Spine Surgery Plano, Spine Surgery Robot, sports injuries, Stem Cell Therapy, stem cells, surgical treatment of spinal disorders, Texas, Texas Back Institute, Texas Health Pain, Texas Spine Consultants, Transforaminal Endoscopic Discectomy, True minimally invasive procedures, Work Comp Injury, Workers Compensation Injury

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Central Cord Syndrome

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Central Cord Syndrome (CCS) is an incomplete injury to the cervical cord resulting in more extensive motor weakness in the upper extremities than the lower extremities. The mechanism of injury occurs from a hyperextension injury with pre-existent osteophytic (abnormal bony outgrowth) spurs, without damage to the vertebral column.

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Mechanism and Causes of Injury

CCS occurs typically in patients with hyperextension injuries where the spinal cord is squeezed or pinched between anterior cervical spondylotic bone spurs and the posterior intraspinal canal ligament, the ligamentum flavum. The ligamentum flavum is a strong ligament that connects the laminae of the vertebrae. It serves to protect the neural elements and the spinal cord and stabilize the spine so that excessive motion between the vertebral bodies does not occur.

The injury occurs as a result of anterior and posterior compression of the spinal cord, leading to edema, hemorrhage or ischemia to the central portion of the spinal cord. The site of most injuries is in the mid-to-lower cervical cord. Due to the anatomical lamination of the corticospinal tract with the arm fibers medially, and the leg fibers laterally, the arms are affected more so than the legs, resulting in a disproportionate motor impairment.

Symptoms

Patients are typically left with motor weakness of the upper extremities and lesser involvement of the lower extremities. A varying degree of sensory loss below the level of the lesion and bladder symptoms (urinary retention) may both occur.

Incidence

This syndrome more commonly affects patients age 50 and older who have sustained a cervical hyperextension injury.

CCS may occur in patients of any age and is seen in athletes who present with not only hyperextension injuries to their neck but associated ruptured disc(s) with anterior cord compression.

CCS affects males more frequently than females.

Diagnosis

Evaluation of the patient includes a complete history, a thorough neurological exam, MRI and CT of the cervical spine, and cervical spine x-rays including supervised flexion and extension x-rays.

    • Magnetic resonance imaging (MRI): A diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology; can show direct evidence of spinal cord impingement from bone, disc, or hematoma.
    • Computed tomography scan (CT or CAT scan): A diagnostic image created after a computer reads x-rays; can show the shape and size of the spinal canal, its contents, and the structures around it.
    • X-ray: Application of radiation to produce a film or picture of a part of the body can show the structure of the vertebrae and the outline of the joints. X-rays of the spine delineate fractures and dislocations, as well as the degree and extent of spondylitic changes. Flexion/extension views assist in evaluation of ligamentous stability.

 

Surgical Treatment

Acute surgical intervention is not usually necessary unless there is significant cord compression. Prior to the CT-MRI era, surgical intervention was thought to be more harmful because of the risk of injuring a swollen cervical cord and worsening the deficit. However, with advanced imaging technology such as CT and MRI, patients with compression of the spinal cord secondary to traumatic herniated discs and other lesions can be quickly diagnosed and surgically decompressed. In cases with anterior bony ridges and spinal canal narrowing secondary to ligamentous thickening and or stenosis, acute surgery is usually not performed until the patient has made maximum recovery. Reassessment at that time may lead to surgery depending on the underlying cause. If there is significant motor weakness after a period of recovery, or neurological deterioration or spinal instability, then surgical intervention may be considered.

Nonsurgical Treatment

Nonsurgical treatment consists of immobilization of the neck with a cervical orthosis, steroids unless contraindicated, and rehabilitation with physical and occupational therapy.

Outcome

Many patients with CCS make spontaneous recovery of motor function while others experience considerable recovery in the first six weeks post injury.

If the underlying cause is edema, recovery may occur relatively soon after an initial phase of motor paralysis or pareses. Leg function usually returns first, followed by bladder control and then arm function. Hand movement and finger dexterity improves last. If the central lesion is caused by hemorrhage or ischemia, then recovery is less likely and the prognosis is more devastating.

The prognosis for CCS in younger patients is favorable. Within a short time, a majority of younger patients recover and regain the ability to ambulate and perform daily living activities. However, in elderly patients the prognosis is not as favorable, with or without surgical intervention.

 

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Regenerative Medicine

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Administering undifferentiated stem cells to an injured disc has made adult stem cell regenerative medicine in spine a reality. Adult stem cell regenerative medicine holds the promise of stabilizing or even reversing the degenerative changes associated with aging or following traumatic injury. Current clinical use of stem cells is very limited, in part by the cumbersome approval process. The use of concentrated bone marrow aspirate (BMC) as a “stem cell” preparation is currently the simplest and safest way of utilizing the regenerative potential for mesenchymal stem cells (MSCs) to promote tissue regeneration. In fact, stem cells concentrated from bone marrow have been shown to stimulate the formation of bone, cartilage, ligament and tendon, and dermal tissues.

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Conservative treatment options for lumbar and cervical pain associated with discogenic disc disease (Pfirrmann Grades 3-6) are limited. Treatment options include pain medication, steroids, physical therapy, and chiropractic care. Reversal of disc pathology has not been achieved with current available treatment modalities. Failure of these nonoperative treatments may leave surgical intervention as a treatment option.

The goal of utilizing MSCs is to not only potentially provide pain relief from the painful degenerative disc, but to reverse the degenerative process. There are three methods for placing MSCs into the painful nucleus pulposus.

The use of allogeneic mesenchymal precursor cells (MPCs) is currently being evaluated as a part of an FDA Phase I clinical trial. Extracted from donors and expanded in number by tissue culture, this process isolates and grows the stem cells into pure MPCs which are injected into the nucleus pulposus. This technology does not have FDA approval.

Utilizing expanded, autologous MSCs for injection into the painful disc is the second method. Federal regulations require the approval of an Investigational New Drug application supported by prospective, randomized clinical trials for the use of expanded autologous MSCs. The FDA has not approved this technology.

The third method involves autologous point of care therapy. This technology does not require FDA approval. The patient’s own MSCs are directly injected into the nucleus pulposus of the symptomatic degenerated disc(s) using standardized two needle discography technique. This requires fluoroscopic visualization and 2-3cc of MSCs are slowly injected into the symptomatic nucleus pulposus.

Early analysis of the research data reveals the average lumbar pre-treatment Oswestry Disability Index (ODI) was 56.5% and improved to 22.4% at three-month follow-up (P=0.0001). The average lumbar pre-treatment Visual Analogue Scale (VAS) for pain was 7.9 (on a scale of 1-10) and improved to 4.2 at three months (P=0.0005).

There have been no complications associated with the iliac crest aspiration or disc injection. Thus far no patient in the study has undergone spine surgery following treatment. Results obtained with this technique suggest its potential clinical efficacy in the treatment of moderate to severe degenerative disc disease. These results require verification with longer follow-up and randomized prospective studies.

For more information regarding treatment options please visit our websites at http://www.becomepainfree.com

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Confusion about Spinal Fusion, Spine Fusion, Spine Fusion Surgery, Back Fusion Surgery, Back Surgery

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Spinal Fusion is used to treat spinal instability and alleviate chronic mechanical back pain but many people are unsure of what spinal fusion actually does.  Spinal fusion is surgery to permanently connect two or more vertebrae in your spine, eliminating motion between them.

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Spinal fusion involves many techniques designed to mimic the normal healing process of broken bones. During spinal fusion, your surgeon places bone or a bone-like material within the space between two spinal vertebrae. Metal plates, screws and rods may be used to hold the vertebrae all together, so they can heal into one solid unit.

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Because spinal fusion surgery immobilizes parts of your spine, it changes the way your spine can move. This places additional stress and strain on the vertebrae above and below the fused portion, and may increase the rate at which those areas of your spine degenerate.

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About Minimally Invasive TLIF Transforaminal Lumbar Interbody Fusion

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Overview  from https://www.becomepainfree.com/

A Transforaminal Lumbar Interbody Fusion (TLIF) is an operation often indicated for patients suffering from back and/or leg pain caused by the natural degeneration of the disc space or some type of traumatic event.

The Minimally Invasive TLIF technique is a less invasive option incorporating the use of specially designed instruments that allow surgeons to achieve the same clinical goals of traditional, “open” TLIF but with much smaller incisions, causing less damage to the surrounding soft tissue.

 

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Procedure

The technique incorporates use of the II Tubular Retractor System and CD  II Spinal System. The METRx® II System provides minimally invasive access to the spine through tubular portals, while the CD  II Spinal System uses an innovative arc device to percutaneously (without a large skin incision) deliver screws and rods for spinal fusion.

* Through a minimal incision in the patient’s back, the surgeon uses specially designed dilators in the  II Tubular Retractor System to spread the muscle and tissues of the back. A tubular retractor, or “portal”, is then inserted over the dilators to maintain a clear pathway to the spine.

* Accessing the spine through the II Tubular Retractor, the surgeon removes a portion of the bone and the disc material, and places an implant in the disc space between the vertebral bodies. This spacer may serve to restore the natural height of the disc space, “unpinch” the nerves, and act as a scaffold for bone growth or “fusion” between the vertebral bodies.

* Finally, the surgeon may use the  Spinal System to place screws and rods in a minimally invasive fashion. These screws and rods are intended to stabilize the vertebral bodies while the bone fuses or heals.

Your browser may not support display of this image. Traditional, “open” TLIFs may often involve significant blood loss and a lengthy hospital stay. However, the Minimally Invasive TLIF technique may offer many patient benefits, including:

* Decreased intraoperative blood loss2
* Shorter hospital stays1
* Smaller incisions and scars
* Decreased post-operative medication needed while in the hospital1

1 Isaacs. Minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion. J. Neurosurg: Spine. 3:98-105, 2005.

2 Park, Won Ha. Comparison of one-level posterior lumbar interbody fusion performed with a minimally invasive approach or a traditional open approach. SPINE 32(5):537-543, 2007.

 

Minimally Invasive Spine surgery These Dallas Doctors perform minimally invasive spine procedures: 

(These surgeons have extensive experience in both neurosurgery and orthopedics)  

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THE REAL EXPERTS IN MINIMALLY INVASIVE SPINE TREATMENTS, MIS, MINIMALLY INVASIVE SPINE, Dallas, Coppell, Fort Worth, Addison, Plano Texas, TX

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BecomePainFree.com compared to traditional open spine surgery, utilizes the knowledge of important anatomy, along with cutting-edge technology, to treat your spinal condition without causing undue injury to the surrounding soft tissues. Computer-assisted technology (such as computer navigation, nerve monitoring, and pain mapping) and highly specialized tools and instrumentation provide for the safe and effective treatment of your pain. Nearly all chronic neck and back pain that cam be treated openly (the most invasive), can be performed minimally invasively at MINIMALLY INVASIVE BECOMEPAINFREE.COM. These modern and advanced minimally invasive techniques are used to treat common back and neck degenerative conditions like herniated disc and spinal stenosis, as well as bone spurs, bulging discs, and sciatica to name a few.

MINIMALLY INVASIVE BECOMEPAINFREE.COM doctors are trained spine specialists who never use the typical expandable retractors. Our innovative and cutting edge minimally invasive spine equipment allows us to go between the muscle, often through an incision as small as 3 mm (the size of a large piece of rice), to avoid cutting the muscle altogether, this resulting in the most patient focused procedures which benefits include the smallest incisions you can possibly achieve, less blood loss, and considerably faster recovery times.


A few of the advantages of
MINIMALLY INVASIVE BECOMEPAINFREE.COM:

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Unlike other practices, MINIMALLY INVASIVE BECOMEPAINFREE.COM surgeons are trained spine specialists, more specifically, fellowship-trained and educated in the most innovative, minimally invasive technologies on the medical market. As leaders and innovators in their field, the MINIMALLY INVASIVE BECOMEPAINFREE.COM doctors are advisers to many international spine technology companies and have helped design many groundbreaking tools for the spine surgery industry.

Call Us: (214) 396-3647 | (888) 373-3720  Fax #:  (888 )238-9155 | E-mail Us https://www.becomepainfree.com/

 

Written by becomepainfree

January 25, 2013 at 5:44 pm

Posted in About Laser Spine Surgery, Comprehensive list of advanced minimally invasive procedures, fellowship in Disorders of the Spine, fellowship trained Orthopaedic Spine Surgeon, Fellowship-trained spine surgeons, Fort Worth Orthopedic Surgeon, Innovative pain mapping process, Laser Back Surgery, laser spine procedures, Laser Spine Surgery, Low back pain, MINIMALLY INVASIVE, minimally invasive disc healing, Minimally Invasive Laser Spine Surgery | Spine Surgeons | Dallas, minimally invasive procedures, Minimally Invasive Spine, Minimally Invasive Spine Surgery, Minimally Invasive Stabilization, Minimally Invasive Surgery, MIS, Open Surgery and Minimally Invasive Surgery, spinal cases from children, Spinal cord injury spasticity and pain, Spinal Cord Stimulator Trial, Spinal Stenosis, Spine Microdiscectomy, Spine Pain Plano, Spine Surgery, Spine Surgery Addison, Spine Surgery Coppell, Spine Surgery Dallas, Spine Surgery Doctor, Spine Surgery McKinney, Spine Surgery Mesquite, Spine Surgery Plano, Spine Surgery Robot, surgical treatment of spinal disorders, True minimally invasive procedures

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Laser spine surgery is a minimally invasive surgery highly acclaimed by surgeons across the nation

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Laser Spine Surgery/Endoscopic Spine Surgery

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Laser spine surgery is a minimally invasive surgery highly acclaimed by surgeons across the nation. It was introduced over 30 years ago, and has recently been excessively rising in popularity with evolved technology and knowledge. Laser spine surgery is typically a go-to procedure for patients with neck and back pain. Using lasers, doctors and neurosurgeons can more precisely target soft tissue to help relieve pain and ridding of excess dead tissue surrounding the spine. It is also a procedure used to trim any bulging or herniated discs to ease pressure on the spinal column and nerves.

Laser spine surgery has historically has been done by “going under the knife”, but with laser spine surgery, patients can rest assured that this minimally invasive procedure requires concentrated beams of light to relieve back pain. With laser spine surgery, the effects are safer and much more controlled. The result of the surgery is less blood loss, which results in a faster healing process, and minimal scarring due to it being less invasive. Also, using lasers can greatly decrease the amount of damage to any muscles or spine surrounding tissues because of the increased ability to control the concentrated beam of light, rather than “hand and knife.”

Although laser spine surgery is said to have unproven benefits by the National Institute of Health, doctors everywhere have relied on its usefulness to help relieve back and neck pain in countless patients. Laser spine surgery has become wildly popular in the medical field, and it is continuously and rapidly growing into an effective, helpful, and patient-convenient procedure that will undoubtedly continue to climb the charts.

Call Us: (214) 396-3647 | (888) 373-3720
Fax #:  (888)238-9155 | E-mail Us

Written by becomepainfree

January 22, 2013 at 5:25 pm

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