Spine treatments
The goal is not the most surgery.
It is identifying the right treatment, and when surgery is necessary, using the least invasive approach that fully solves the problem.
Most patients seen here for neck or back pain do not have an operation. That is not a policy, it is what the conditions require: disc herniations frequently resorb, nerve inflammation settles, and a great deal of back pain improves with conditioning and time.
So the treatments below sit at the end of a sequence rather than the start of one. What follows is the sequence, then the operations, then the honest account of what each one does and does not do.
Before surgery
What is tried first.
Time, and knowing when it is working
A great many disc herniations resolve without an operation as the fragment resorbs and the inflammation settles. Waiting is a treatment decision with a rationale behind it, not a delay, and it comes with a timeframe and a description of what would change the plan.
Targeted physical therapy
Aimed at the specific problem rather than a generic core programme. What suits lumbar stenosis is different from what suits sacroiliac joint pain, and a patient who has had months of the wrong programme has not really had therapy.
Injections, for two reasons
An image-guided injection can settle an inflamed nerve or joint enough to restore sleep and function. It also tests a hypothesis: meaningful relief from an injection placed at one level is evidence that the level is the right one.
Activity modification that preserves function
Identifying the movements that reliably provoke symptoms and working around them, rather than reducing activity across the board. People who stop moving lose conditioning, which makes everything that follows harder.
Procedures
When an operation is warranted.
Each page states who the procedure suits, what it cannot do, and what the alternatives are. None of them lists only benefits.
How the spine is reached
These describe the approach rather than a specific operation.
- Minimally Invasive Spine SurgeryIt is a description of the approach, not a specific operation.
- Endoscopic Spine SurgeryIt is the smallest of the minimally invasive approaches, and the trade-off for that is a narrow working channel.
- Robotic and Navigation-Assisted Spine SurgeryThe robot does not perform the operation.
Neck
Procedures for cervical nerve and cord compression.
Lower back
Procedures for lumbar nerve compression and instability.
Pelvis
The sacroiliac joint, worked through in order.
A fair question
Ask which finding makes the operation necessary.
A good answer names a structure: a slip that moves between flexion and extension films, a nerve root compressed at a specific level. A general answer about arthritis or degeneration is worth a second look.
Where to be seen
Consultations are available at all eight Academy offices.
Not sure which is closest? See the areas we serve, or call (312) 313-1086.