Spine Brain Neurological and Neurosurgery Experts at Palm Springs Area
Neck and Back Pain (Most require non-surgical management)
Neck Pain
Neck Pain
Neck Pain
Neck pain when axial and isolated only, most commonly can be treated with non-surgical approach. When associated with pain radiating to arms, numbness, or weakness it requires immediate attention. See our spine specialists for proper work up.
Back Pain
Neck Pain
Neck Pain
Back pain when axial and isolated only, most commonly can be treated with non-surgical approach. When associated with pain radiating to legs, numbness, or weakness it then requires immediate attention. See our spine specialists for proper work up.
Neck Pain: by Dr. Limonadi
Types of Neck Pain
There are generally three types of neck pain:
1-Axial or mechanical neck pain which is localized in the neck and is felt directly in the muscles and joints. They can be caused by issues of the joints, bones, or muscles of the neck such as muscle spasm due to poor posture
2-Radicular Pain which typically radiates to arm or shoulders and is caused by a pinched nerve or nerve root, sometimes accompanied by tingling or numbness
3-Referred neck pain which is caused by a disease process elsewhere but the pain is felt in the neck such as in case of a tumor at the base of skull.
Initial Conservatives Management
-Understanding and correction of the cause of pain like posture
-Time
-PT (caution when it comes to neck)
-Meds (try to avoid narcotics)
-Diet (anti-inflammatory) and Hydration
-Alternative medicine such as acupuncture
When you should see a Doctor
1-Persistent neck pain more than a few days
2-Radiates down the one or both arms, or spine
3-If it involves numbness and tingling, weakness, or balance problems
4-If accompanied by headache, fever, dizziness, or weight loss.
Case Presentation: Progressive paralysis
70+ year old man with progressive weakness and numbness of arms and legs, with loss of manual dexterity. He had become wheelchair bound.
MRI of C spine shows severe compression of spinal cord at C34, C45, and C56. This is caused by progressive degenerative process and aging of spine.
Case Presentation by Dr. Limonadi
How to treat this?
The goal is to rescue the compressed spinal cord which has lead to progressive weakness, and loss of function of arms and legs, as well as pain.
ACDF is procedure of choice and is commonly performed by neurosurgeons.
ACDF or Anterior Cervical Discectomy and Fusion results in decompression of spinal cord anteriorly with least disruption of stabilizing muscles of the neck.
It is also commonly performed for decompression of nerve roots causing arm pain, weakness, or numbness in specific distribution depending on the nerve root involved.
In this case we need to remove the diseased disk at C34, C45, and C56, and therefore, decompress the spinal cord and nerve roots.
Disks and nerve roots are shown in yellow.
This is a commonly performed microsurgical surgery operation by neurosurgeons and involves making a 2-3 inch skin incision on the neck after general anesthesia.
Natural skin crease is used to minimize scar formation later.
View through the Surgical Microscope:
Dr. Limonadi is removing the diseased disk
After removing the diseased disk, and decompressing the spinal cord and nerve roots, it is replaced by a disk graft to maintain proper height and alignment of spine.
Post Op Xray shows excellent position of instrumentation.
Most importantly patient did excellent and despite long-term disability returned to normal function and from wheel chair to walker, then cane, and eventually walked independently without assistance. His numbness was also limited only to his fingers and feet.