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Donald Corenman, MD Spine Surgeon
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The XLIF or DLIF is a procedure designed to have access to the front of the upper and mid levels of the lumbar spine (L1-5) similar to an ALIF without the dangers of an approach through the belly. The L5-S1 level cannot be approached using this technique.
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This article discuses an example of what can happen when the spine becomes unstable after a simple laminectomy in the cervical spine. When normal, the cervical spine sits in a backwards curve called a lordosis. This curve allows gravity to “push” the vertebra backwards to align each vertebra properly. As the discs degenerate as these structures will to some degree in all of us, this curve can be lost and the spine “falls forward”.
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Artificial disc replacements (ADRs) are mechanical devices that are designed to preserve movement when a spinal disc segment needs surgical attention. This surgery is normally due to a disc herniation that compresses a nerve but there are other disorders that can have indications for an ADR (bone spurs or mild degeneration). These artificial disc replacements are simple mechanical devices that can wear out or fail like any other mechanical devices. Failure can occur from wear of the bearing surfaces or failure of the bonding between the metal and bone of the vertebra.
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Cervical radiculopathy (also referred to as a pinched nerve in the neck) is a condition where the nerve root in the neck is compressed either by a herniated disc or by a bone spur. Many individuals sometimes refer to a compressed nerve as a “pinched nerve in the neck”. These are common reasons for ongoing neck pain.
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Anterior lumbar interbody fusion (ALIF) is a fusion in the front of the spine from an approach through the abdominal wall and the belly. The advantage of the ALIF is that the entire disc can be visualized when cleared. This is valuable especially when there was a previous attempt at fusion that was unsuccessful, particularly a TLIF failure.
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This article discuses an example of what can happen when the spine becomes unstable after a simple laminectomy in the cervical spine. When normal, the cervical spine sits in a backwards curve called a lordosis. This curve allows gravity to “push” the vertebra backwards to align each vertebra properly. As the discs degenerate as these structures will to some degree in all of us, this curve can be lost and the spine “falls forward”.
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Looking for a second opinion? We would be happy to give a separate opinion regarding your diagnosis or suggested treatment. Hopefully, we will reach the same conclusion as your specialty doctor but differences of opinion do occur. If you have been told, “there is nothing more that can be done”, this may not be true. We will educate you regarding the reason our opinions may differ.
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A large majority of individuals will have surgery of the spine and have success following their surgery. In fact, the overall success rate associated with spine related surgeries is around 90%. Unfortunately, there are a small percentage of spine surgeries that can fail. This is often referred to as failed spine surgery syndrome-neck area.
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New content from Dr. Corenman! The atlanto-occipital joint (O-C1) is formed by the occipital condyles and the upper articular facets of C1. These paired joints each look like a saddle and both are stabilized by multiple ligaments and the articular capsules of O-C1. The O-C1 joint is responsible for the most flexion/extension of any vertebral segment with 25 degrees of motion. There is a small amount of rotation (5 degrees) that also occurs here.
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The SI joint does not act as a typical joint like a hip or knee. There are no “gliding surfaces” like you would expect but a solid interlocking interface between these two bony surfaces. Unlike any other synovial joint in the body, global SI joint function is designed to bond the pelvis together at the rear to make the pelvis a relatively rigid ring. This joint has about 1-2 degrees of total motion (in comparison to the knee joint which has 120 degrees of motion).
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