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Your spine is critical to your overall health and well-being. Not only does it provide stability and flexibility for standing and bending but it also houses your spinal cord, which is a bundle of nerves that carry messages back and forth from your brain to your muscles and other soft tissues. Surrounding the spinal cord is a stack of backbones called vertebrae, cushioned by a gel-like material called discs. If disease or injury occurs anywhere along the spine, immediate treatment is necessary.
Dr. Goldberg is an expert in the treatment of spine conditions. When surgery is deemed necessary, he takes a in minimally invasive approach using the most advanced technology to achieve optimal results. Some of his areas of specialty include:
Dr. Goldberg is a recognized leader in the treatment of degenerative spine conditions, which are typically caused by age-related wear and tear.
Degenerative changes can occur almost anywhere along the spine and can affect the structures of the spine, including:
Discs – The soft, gel-like pads located between the vertebrae and function as shock absorbers when you flex, rotate, or bend your back or neck.
Vertebrae – The hard bones of the spine are called vertebrae and house and protect the spinal column and nerves.
Ligaments, Tendons, and Cartilage – These structures connect the bones of the spine and aid in joint stability.
Degenerative Disc Disease
As we age, the discs may thin to the point where there is insufficient padding between vertebrae. At the same time, the outer layer of the spine can develop cracks, which gradually worsen. The discs may also develop herniated areas, which is where the central portion of the disc protrudes through the outer layer. Symptoms include pain, tingling, numbness, or weakness in the neck, arms, hands, back, hips, or legs, depending on where along the spine the disc degeneration occurs.
Myelopathy
Myelopathy is the undue pressure on your spine due to compression of the spinal cord. As a person ages, several things can start to happen:
Due to a combination of these factors, the spinal canal narrows, eventually leading to pressure on the spinal cord and myelopathy. Symptoms include pain, tingling, or numbness in the arms or legs; difficulties with coordination, walking, and fine motor skills; a feeling of heaviness in the extremities.
Radiculopathy
Radiculopathy occurs when a nerve root along the spine becomes inflamed or damaged, causing pain and other symptoms in the arm/shoulder/hand area or the buttock/leg/foot area. Radiculopathy most commonly results from degenerative changes to the spine over long periods of time but can also occur due to acute injury or illness. Symptoms can include pain, numbness, weakness, tingling, and altered reflexes.
Stenosis
Spinal stenosis is the thickening of the ligaments, formation of bone spurs, and deterioration of the disc material. As a result, the spinal canal narrows and pinches the nerve. The bone spurs may also press on the spinal cord. Symptoms can include pain in the back or neck, radiating pain into the legs or arms, and difficulty standing or walking.
Many people with degenerative spine disease respond well to conservative, non-surgical treatment. This conservative treatment typically includes anti-inflammatory medication and pain relievers. Physical therapy can help to manage your symptoms and may include manual therapy, heat and other pain-relieving methods, stretching, strengthening exercises and education to help you manage your condition.
For a small group of people who don’t respond to conservative treatment, surgery may be necessary, particularly if there are signs and symptoms of nerve compression or joint instability. There is a wide range of surgical techniques that can be used, depending on the extent, location, and exact nature of the degeneration. Dr. Goldberg will make sure you understand your surgical options and will work with you to develop an individualized treatment plan.
The term herniated disc refers to a problem with one of the rubbery, gel-like cushions between the vertebrae of the spine. Disc herniation occurs when the interior “jelly” of the disc pushes through the tougher exterior and irritates nearby nerves, resulting in pain that ranges from mild to severe.
When a disc is herniated, it may bulge and the jelly-like interior could leak out through a tear, or the bulge may press against or pinch a nerve.
Symptoms caused by a herniated disc depend on where it is located.
Cervical (Neck):
Lumbar (Lower Back):
Pain is caused by inflammatory chemicals that are released around the injured area, and the injured disc can also put pressure on the nerve roots as they travel through the adjoining tunnel to and from the spinal cord. This can cause pain, pins and needles and numbness into your leg and also lead to significant muscular weakness.
Most people with mild disc herniation will improve on their own in about six to eight weeks. For other people, the pain will be more intense and persistent and physical therapy may be indicated to help alleviate symptoms. Anti-inflammatory medication and pain relievers may also be necessary.
In a small group of people, symptoms don’t respond to conservative measures or time. When this is the case, Dr. Goldberg may recommend surgery, particularly if there is persistent pain or weakness in the arms or legs. When surgery is indicated, it is usually aimed at reducing the pressure from the herniated disc on surrounding tissues and is especially focused on relieving any pressure on the nerve roots as they exit from the spinal cord. This should relieve any symptoms of pain or sensation traveling down into the arms or legs.
There are several different types of surgical procedures for herniated discs, depending on where it is located. Dr. Goldberg will discuss these procedures with you and together you will choose the one that is most suitable for you.
Radiculopathy is the clinical term that describes a nerve root in the lumbar spine area becoming inflamed or damaged and causing pain and other symptoms in the buttock/leg/foot area. Also commonly known as sciatica, lumbar radiculopathy most commonly results from degenerative changes to the lumbar spine over long periods of time but can also occur due to acute injury or illness.
Radiculopathy is the clinical term that describes a nerve root in the lumbar spine area becoming inflamed or damaged and causing pain and other symptoms in the buttock/leg/foot area. Also commonly known as sciatica, lumbar radiculopathy most commonly results from degenerative changes to the lumbar spine over long periods of time but can also occur due to acute injury or illness.
Radiculopathy of the back can be treated in a number of different ways, both surgical and non-surgical. Non-surgical treatments are typically the first line of treatment and can include:
If non-surgical treatments don’t provide the pain relief you are looking for, surgery could be the next step.
There are a number of different surgical solutions, depending on the cause of the lumbar radiculopathy, and typically focus on decompressing the nerve and/or stabilizing the spine.
With cervical radiculopathy, pain can radiate from the neck to anywhere along the arm area, including the shoulder, hand, and fingers.
Other symptoms in this area can include:
Cervical radiculopathy can be treated in a number of different ways, both surgical and non-surgical. Non-surgical treatments are typically the first line of treatment and can include:
If non-surgical treatments don’t provide the pain relief you are looking for, surgery could be the next step. The most common surgery performed for cervical radiculopathy is anterior cervical discectomy and fusion (ACDF) in which Dr. Goldberg makes a small incision in the front of the deck to remove any disc herniation and then fuses the discs.
Unfortunately, not all back surgeries result in complete pain relief. A small percentage of patients will discover they still have back pain as they recover or find they have new pain. Failed back syndrome is the general term used to describe this condition.
Failed back syndrome doesn’t necessarily mean your surgery truly “failed” in the medical sense; it may have been that the surgery uncovered unknown issues that resulted in more pain.
For patients who have failed back syndrome, treatment starts with a complete diagnosis that utilizes high tech imaging as well as a thorough exam. Once Dr. Goldberg has determined the cause of the continued pain, he will develop a treatment plan that may include nonsurgical or surgical methods.
Nonsurgical
It is possible to treat some forms of failed back syndrome with nonsurgical methods such as medication and physical therapy. If this is possible, this will be the first line of defense.
Surgical
If surgery is required, it may include hardware removal or replacement, specific fusions, or a number of other different procedures that are designed to ease your pain.
Do you suffer from pain in your lower back, buttocks, or legs? You might be experiencing sciatica. Sciatica pain can be quite debilitating and can interfere with your daily routine. In this article, we will talk about what sciatica is, its causes, its symptoms, and how to diagnose it.
Symptoms of sciatica include pain, weakness, numbness, and tingling in the leg. The L5 nerve root compression may cause pain that extends to the foot and big toes. The patient may report burning, lancinating or stabbing pain in the leg due to the pressure on the nerve.
Additionally, L4 nerve root compression may result in weakness while straightening the leg and a diminished knee-jerk reflex. An MRI scan can confirm the diagnosis of nerve root compression.
A spine specialist can help diagnose the cause of sciatica and provide an individualized treatment plan to help reduce pain and improve function. Treatment options may include physical therapy, medication management, and in some cases, surgery to decompress the nerve root.
Sciatica pain can severely hinder an individual’s lifestyle, and it is essential to get it treated to prevent it from worsening.
Sciatica treatments vary widely, and professionals recommend conservative methods first. Medications, physical therapy, and exercise help to ease the symptoms of mild to moderate sciatica. For unresponsive or chronic cases, more invasive approaches such as corticosteroid injections or surgery may be required.
A spine specialist may use manipulative therapies or injections to relieve pain and inflammation. Treatment will vary depending on the individual case, the age of the person, and the underlying cause of sciatica. For younger adults, herniated disks might cause sciatica, and in older adults, bone spurs and arthritis may be the cause.
