Top Spine Surgery in NJ
At Princeton Neurological Surgery, we offer excellence in complex spine surgery and minimally invasive spine surgery to patients in New Jersey and surrounding areas. Dr. Lipani is a board certified, fellowship-trained top spine surgery specialist. Common procedures include spinal fusion surgery, laminectomy, and microdiscectomy. Dr. Lipani also treats patients who require revision spinal surgery and spine surgery patients who are considered too challenging to be treated at other institutions.
Diagnosing Spine Pain
Chronic back pain can be debilitating and as a sufferer, you will have likely been in regular consultation with a specialist regarding your options. It may be comforting to learn that the majority of back pain sufferers do not require spine surgery. Most back pain results from muscle strain or spasm. Other common diagnoses include chronic degenerative arthritic changes that affect the spinal column and intervertebral discs.
“Princeton Neurological Surgery is highly recommended. I received top notch care from the moment I walked into the office. The staff are friendly and knowledgeable. Kathy handled all my insurance pre-certifications and made sure that no aspect was a stress to me. Dr. Lipani is the absolute best. He takes the time to fully explain and answers questions, has a great bedside manner, and saw me every day of my hospital stay after surgery, even on a holiday. I wouldn’t let any other neurosurgeon but Dr. Lipani and his staff treat me. The best in the area.”
Non-Surgical Treatment Options
We want our potential spine surgery patients to first explore all other avenues before deciding they need surgery. Unless surgical intervention is urgent, Dr. Lipani usually has patients who’ve consulted with him wait for at least six weeks before proceeding with surgery. This allows the exploration of various conservative, non-surgical treatments to see if they can stem the pain the patient is experiencing. After all, only around five percent of back/spine problems eventually require surgery.
Here are some possible conservative treatment options:
- Pain medication — Alleviating the pain with medication is usually a first step. Typical pain medications include acetaminophen, NSAIDs, oral steroids, muscle relaxers, and anti-depressants. Narcotic options should be avoided unless absolutely necessary due to their addictive qualities.
- Heat or ice — Application of a cold pack or heat pad, sometimes alternating between the two, can be surprisingly effective if done diligently.
- Manipulation — Spine adjustments by chiropractors, osteopathic doctors, and other qualified providers can relieve lower back pain by reducing pressure, increasing flexibility, improving blood flow, and reducing muscle tension.
- Massage — Massage therapy improves blood flow. This in turn reduces muscle stiffness and aids the healing of strained muscles.
- Exercise — Back exercises and physical therapy will usually focus on core strengthening, along with stretching and low-impact aerobic exercise.
- Changing behaviors — If you sit all day at work, it may help to request a standing desk. If you’re overly sedentary, start incorporating movement and exercise.
- Epidural steroid injections — Injecting a steroid directly into the outer part of the dural sac, which surrounds the spinal cord, can reduce inflammation around a compressed nerve root for a period of weeks.
Do I Need Spine Surgery?
Deciding whether to undergo spine surgery can be a big decision for an individual. However, not all spine surgery is elective. For example, if your spinal cord is compromised to the point of interfering with neurologic function, such as weakness or numbness in extremities, urgent spinal surgery may be recommended in an effort to preserve function. Delaying spine surgery in these cases may result in irreversible nerve damage. Additionally, non-urgent spinal conditions may develop into urgent conditions that gradually or suddenly compromise neurologic function.
Symptoms That Lead to Spine Surgery
Typical symptoms that may require urgent spinal surgery include:
- Sudden onset of arm or leg weakness
- Numbness in the trunk
- A difficulty with fine hand motor control
- Gait clumsiness
- Spastic gait
- Bowel and/or bladder dysfunction
- Perianal numbness.
- Debilitating back pain that does not respond to medication
Common Spine Conditions
There are many spinal conditions that patients can suffer from. The following are some of the most frequently experienced spinal conditions.
- Herniated Disc: Also known as a Ruptured Disc is another common cause of back pain. Treatment options range depending on the severity.
- Spinal Stenosis: Spinal stenosis is a term that describes the narrowing of the bony canal through which a nerve root or spinal cord travels. Bony restriction around the spinal cord or nerve root may impair its function and result in symptoms. It can cause pain in the back, arms, or legs depending on the level of stenosis.
- Lumbar Spine Arthritis: This condition affects the joints in the spine and can cause significant discomfort or pain even without moving.
- Spondylolisthesis: The destabilization of the spinal vertebrae when one vertebral body slips upon an adjacent vertebra. The slip may result in spinal cord and/or nerve root compression.
- Sciatica: Caused by damage or pinching of the sciatic nerve, the large nerve that runs down the legs, and can be caused by a herniated or slipped disk, piriformis syndrome, pelvic injury, fracture or pelvic tumor.
If I Don’t Have Surgery, Can Permanent Damage Occur?
In many cases, surgery may not be absolutely necessary, but it presents your best chance to stop your severe pain. In rare cases of spinal stenosis, permanent nerve damage can occur because of the pressure being applied to the nerve roots. If this happens, the patient can develop permanent numbness and/or weakness in the area served by the nerve. This can lead to problems with balance and incontinence.
How Do I Know Which Spine Surgery Is Best For Me?
There are many options for spine surgery. Dr. Lipani will discuss your condition and the appropriate procedures with you. In some cases, such as when treating stenosis, surgery may not alleviate all of the pain. In every case, except severe pain and urgent conditions, such as after a traumatic injury, the first options will be to try conservative treatments before opting to have surgery.
Spine Surgery Procedures
Our team of experts headed by top spine surgeon Dr. John Lipani offers complex and minimally invasive spine surgery procedures, some of which are listed below:
- Spinal Fusion: Surgery that joins together two vertebrae in the spine. Fusion permanently joins two vertebrae together so there is no longer movement between them that causes pain.
- Cervical Spinal Surgery: Performed to correct part of the spine in the neck, including problems with the bones (vertebrae), discs, and nerves.
- Spinal Surgery Lumbar: Corrects problems with the spinal vertebrae, disks, or nerves of the lower back, also known as the lumbar spine.
- Minimally-invasive Spinal Surgery: Similar to the cervical spinal surgery, our team of specialists will cater to your needs by developing a plan to ensure the quickest recovery following the best treatment.
- Spinal Surgery Thoracic: Corrects problems with the spinal bones, disks, or nerves of the mid back, also known as the thoracic spine.
If you don’t see a surgery that will help your spinal condition see the list below to select which Surgical Spine Procedures or Non-Surgical Spine Procedure you would like to learn more about.
Surgical Spine Procedures
Non-Surgical Spine Procedures*
*Please Note: non-surgical procedures are for educational purposes only. We do not offer non-surgical procedures at Princeton Neurological Surgery. Patients requiring these procedures will be referred to other local New Jersey specialists prior to committing to surgery at our practice.
Spine Surgery Recovery
As you would expect, this depends on what your surgery was, along with the degree of your symptoms that called for surgery. Recovery is complicated and involved. Dr. Lipani will discuss what to expect for your particular surgery during your consultation.
Here are some basics of what will happen:
- Spinal fusion takes around 6 months to fully heal.
- A laminectomy or discectomy takes around 12 weeks to heal.
- Herniated disc surgery takes around 6 weeks to heal.
With any spine surgery you’ll be in the hospital for 1-3 days, longer with spinal fusion. You may start physical therapy as soon as 24 hours after surgery, focusing on range-of-motion exercises. Walking is important, but you’ll use a walker at first, transitioning to a cane when you’re ready.
When home, don’t lay on the couch for hours. You’re better to sit upright in a chair, keeping your back straight. Be careful not to twist your spine. This will need to be your mindset, even when you start driving (driving includes a lot of turning your head, so be patient getting back to it) and when you return to work (get a swiveling office chair, if need be). You won’t be able to lift anything more than a gallon of milk for at least 6 weeks.
We’ll see you for follow-up appointments at varying intervals, again depending on your procedure. Often these may include imaging to view the progress of your healing.
Risks of Spine Surgery
Risks vary somewhat with the type of surgery, i.e. laminectomy versus fusion. The biggest risk with any type of spine surgery is not being sure the surgery will successfully alleviate your pain. Spinal surgery complications are rare, but you should be informed.
Here are some specific risks:
- Nerve root damage or bowel/bladder incontinence — This is extremely rare.
- Cerebrospinal fluid leak — If the dural sac is breached, cerebrospinal fluid may leak, but this can seal itself if the patient lies down for 24 hours.
- Unsuccessful fusion — This can occur, especially with people who smoke, but fusion is approximately 95 percent successful.
- Hardware problems — If screws and rods are used to further stabilize the fused vertebrae, screws may break or loosen, requiring further surgery.
- Problems with cages or grafts — Again, very rare, but grafts may not take and inserted cages in fusion may migrate.
- Instability — Removing bone to relieve pressure on the nerve can lead to instability in the future.
- Bleeding — Bleeding is rare, as there are no major blood vessels in the area.
Reaction to anesthesia
Schedule a Consultation
Our top expert spine surgeon, Dr. John Lipani, is capable of providing you with the advice, recommendations, and spine surgery procedures to assist you in living a full and comfortable life again. For more information about Dr. John Lipani or to learn more about our spine surgery procedures, call one of our New Jersey locations!
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