Lumbar Disc Herniation, neck pain and stenosis are a few conditions that may lead to spinal surgery.
Should you see an Orthopedist or a Neurosurgeon? Will you loose mobility? Does all spinal surgery involve fusions? These questions and more are answered here on VPH Med.
Graham Mouw, MD , board-certified neurosurgeon, gives you the latest up to date information on spinal surgery that will give you the mobility you are hoping for with the best outcomes.
Selected Podcast
Spinal Surgery Without Losing Mobility
Featured Speaker:
Graham Mouw, MD
An outpatient clinic of Valley Presbyterian Hospital, The Neurospine Surgery Center was founded by Graham Mouw, MD, FAANS, FACS. A board-certified neurosurgeon, Dr. Mouw employs advanced, minimally invasive tools and techniques to resolve conditions in all areas of the spine. Dr. Mouw graduated from the University of Southern California Keck School of Medicine and conducted his surgery and neurosurgery residencies at Case Western Reserve University. He completed a complex spinal neurosurgery fellowship at the University of California, San Francisco before practicing at Cedars-Sinai Medical Center, Kaiser Permanente Medical Group, Cleveland Clinic and now Valley Presbyterian Hospital. Dr. Mouw was also Florida Sports Team Consultant for professional athletes while at Cleveland Clinic. Transcription:
Spinal Surgery Without Losing Mobility
Melanie Cole (Host): Your health and safety is the top priority of Valley Presbyterian Hospital, and those factors are especially important in the operating room. Many procedures performed at VPH involve minimally invasive techniques with smaller incisions which can help minimize pain and speed your recovery time. We’re talking today with board-certified neurosurgeon with VPH, Dr. Graham Mouw. Welcome to the show, Dr. Mouw. Tell us a little bit about spinal surgery. What conditions would require somebody to seek out a neurosurgeon and say, “I think I have some issues with my back, and it’s pretty severe”?
Dr. Graham Mouw (Guest): Hi, nice to speak with you. The conditions that I normally treat involve people who have either a pain in their arms or hands or numbness in their arms or hands or sometimes weakness in their arms or hands. Similar symptoms with legs, the pain shooting down a leg or any numbness and/or possible weakness. I even treat people who have difficulty walking which is stemming from the nerves from the spinal cord.
Melanie: If people are experiencing these symptoms and they come to see you, is there something you do with them first? Do you try medications? Or at this point, have medications already been tried and now it’s time to discuss procedures?
Dr. Mouw: Well, I think the most important part of the analysis is that a patient has to start off with the MRI imaging, most likely, depending if it’s up the neck or the lower back. I think that’s usually a good start. Usually by the time people come to see me, they’ve had some sort of imaging study.Aand if they haven’t, then certainly that’s something that I can order for them.
Melanie: Okay. Once they’ve gotten that and you’ve looked at it and you’ve said, “Okay, this is the situation,” whether you’ve got stenosis or severe arthritis or some cervical issue, then what? What kinds of procedures are we talking about that can not work on reducing mobility and that are not fusion involved?
Dr. Mouw: One should always take a conservative approach to the spine, and sometimes we use medications or sometimes I’ll send them to a pain specialist. Very often, surgery is actually needed, and we’re moving into the realm of very high success rates with spinal surgery. I think a lot of that success is coming from what I call motion-sparing surgery, surgery where you maintain the normal motion of the spine as well as what I also call less invasive surgery, which is surgery that doesn’t require a long hospital stay and people can return very quickly to their normal function of life. The success rates are very high today with these newer techniques that are available.
Melanie: People always want to know. I myself am an exercise physiologist and people ask me this question all the time, Dr. Mouw. Do you go to an orthopedist when you’ve got a back issue, or do you go see a neurosurgeon?
Dr. Mouw: Well, that’s an excellent question. I’m a board-certified neurosurgeon with fairly extensive experience with spinal surgery. I come from the Cleveland Clinic and have come to Valley Presbyterian because of the excellent services that are offered. The advantage of a neurosurgeon is oftentimes you can get smaller surgeries. My particular expertise is in motion sparing. I’ve helped develop some techniques, particularly in the neck, that allow a patient to have a surgery and not have what we call spinal fusion, where the bones are fused together. That’s a very common procedure at America. But in other parts of the world, there are procedures that have been developed that allow full motion of the spine. I’ve developed those techniques in my practice, and that’s something that’s now available at Valley Presbyterian Hospital.
Melanie: People get very afraid of anything having to do with their neck, Dr. Mouw, and even for their spine. What is recovery like? Are they able to start physical therapy pretty quickly? How soon can they resume some activity?
Dr. Mouw: That’s the really nice thing about motion sparing surgeries is that people can resume activity very quickly and have a very normal and natural feeling to their neck because it’s motion sparing. Just to give you an idea, the two types of a motion sparing surgery, one is disk replacement surgery in the neck. In that particular case, people usually go home the next morning and can usually within a week have a fairly normal activity level. The other procedure that I’m an expert at probably more than just about anybody in the United States is what we call cervical laminoplasty, where I actually reconstruct the back of the spine, what we call the lamina, and I expand it, I make it wider. Those people similarly can return to fairly normal activity level usually within two to three weeks, and by about four to six weeks, there are really no restrictions at all. I’ve performed that procedure on NFL players. I’ve also performed that procedure on a wide range of people ranging from 40 to 80 years old, and that’s an incredibly successful surgery.
Melanie: Are there certain people that are not candidates for the cervical laminoplasty?
Dr. Mouw: The most important thing when you have the symptoms that we talked about at the beginning of the interview, symptoms down the arms or hands, weakness, numbness or symptoms in the legs, is to meet with a spine surgeon who can perform most, if not all, aspects of spinal surgery. There’s absolutely certain indications where I would choose, for instance, to do a disk replacement or a patient who I would choose to do a laminoplasty. That’s for the neck. In the lower back, there’s also a less invasive procedure similarly, where I could decide to do a micro nerve root decompression versus a standard open laminectomy, where you remove the whole lamina of the back part of the spine. I can do a very selective surgery called nerve root decompression. These are almost outpatient procedures where people certainly would be home by the next morning. There’s also procedures in the back where I can preserve motion where there’s some weakness in the back, some devices that are available. But really, in order to be able to tell what is the best option from you, you need to meet with a surgeon such as myself who is trained in all of these procedures and even pioneered some of these procedures so that you get the exact procedure or the best fit for you and your spine. Very often a surgeon may only know how to, for instance, do a fusion and you’re going to go meet with them and that’s what you’re going to be offered. A surgeon you meet with such as myself should be able to do just about everything so that you get the best fit for you.
Melanie: That’s great information. In the last few minutes, if you would, Dr. Mouw, please give us your best advice for people suffering from cervical or spinal pain and what you really want them to know about this type of pain and what procedures and help there is out there for them.
Dr. Mouw: Well, I think that as we are all experiencing these sorts of symptoms at some point in our life, I think people need to know that spinal surgery has improved significantly, and relief is certainly quite possible now. I quote people very, very high success rates, well over 90 percent for the relief of these symptoms. However, it’s very important to seek out a surgeon who has specialized training, such as a neurosurgeon with spinal fellowship training such as myself and somebody who can try and do the least invasive surgery and always try and preserving the motion of the spine. What I can tell people is that they don’t need to suffer and that certainly, if you’re a good candidate for surgery, the surgical success rates today in the right hands are extremely high. I quote people, like I said, well over 90 percent success rate if I sign them up for surgery.
Melanie: Thank you so much. That’s absolutely fascinating and gives hope to a lot of people who are suffering from cervical and spinal pain. You are listening to VPH Med with Valley Presbyterian Hospital. For more information, you can go to valleypres.org. That’s valleypres.org. This is Melanie Cole. Thanks so much for listening.
Spinal Surgery Without Losing Mobility
Melanie Cole (Host): Your health and safety is the top priority of Valley Presbyterian Hospital, and those factors are especially important in the operating room. Many procedures performed at VPH involve minimally invasive techniques with smaller incisions which can help minimize pain and speed your recovery time. We’re talking today with board-certified neurosurgeon with VPH, Dr. Graham Mouw. Welcome to the show, Dr. Mouw. Tell us a little bit about spinal surgery. What conditions would require somebody to seek out a neurosurgeon and say, “I think I have some issues with my back, and it’s pretty severe”?
Dr. Graham Mouw (Guest): Hi, nice to speak with you. The conditions that I normally treat involve people who have either a pain in their arms or hands or numbness in their arms or hands or sometimes weakness in their arms or hands. Similar symptoms with legs, the pain shooting down a leg or any numbness and/or possible weakness. I even treat people who have difficulty walking which is stemming from the nerves from the spinal cord.
Melanie: If people are experiencing these symptoms and they come to see you, is there something you do with them first? Do you try medications? Or at this point, have medications already been tried and now it’s time to discuss procedures?
Dr. Mouw: Well, I think the most important part of the analysis is that a patient has to start off with the MRI imaging, most likely, depending if it’s up the neck or the lower back. I think that’s usually a good start. Usually by the time people come to see me, they’ve had some sort of imaging study.Aand if they haven’t, then certainly that’s something that I can order for them.
Melanie: Okay. Once they’ve gotten that and you’ve looked at it and you’ve said, “Okay, this is the situation,” whether you’ve got stenosis or severe arthritis or some cervical issue, then what? What kinds of procedures are we talking about that can not work on reducing mobility and that are not fusion involved?
Dr. Mouw: One should always take a conservative approach to the spine, and sometimes we use medications or sometimes I’ll send them to a pain specialist. Very often, surgery is actually needed, and we’re moving into the realm of very high success rates with spinal surgery. I think a lot of that success is coming from what I call motion-sparing surgery, surgery where you maintain the normal motion of the spine as well as what I also call less invasive surgery, which is surgery that doesn’t require a long hospital stay and people can return very quickly to their normal function of life. The success rates are very high today with these newer techniques that are available.
Melanie: People always want to know. I myself am an exercise physiologist and people ask me this question all the time, Dr. Mouw. Do you go to an orthopedist when you’ve got a back issue, or do you go see a neurosurgeon?
Dr. Mouw: Well, that’s an excellent question. I’m a board-certified neurosurgeon with fairly extensive experience with spinal surgery. I come from the Cleveland Clinic and have come to Valley Presbyterian because of the excellent services that are offered. The advantage of a neurosurgeon is oftentimes you can get smaller surgeries. My particular expertise is in motion sparing. I’ve helped develop some techniques, particularly in the neck, that allow a patient to have a surgery and not have what we call spinal fusion, where the bones are fused together. That’s a very common procedure at America. But in other parts of the world, there are procedures that have been developed that allow full motion of the spine. I’ve developed those techniques in my practice, and that’s something that’s now available at Valley Presbyterian Hospital.
Melanie: People get very afraid of anything having to do with their neck, Dr. Mouw, and even for their spine. What is recovery like? Are they able to start physical therapy pretty quickly? How soon can they resume some activity?
Dr. Mouw: That’s the really nice thing about motion sparing surgeries is that people can resume activity very quickly and have a very normal and natural feeling to their neck because it’s motion sparing. Just to give you an idea, the two types of a motion sparing surgery, one is disk replacement surgery in the neck. In that particular case, people usually go home the next morning and can usually within a week have a fairly normal activity level. The other procedure that I’m an expert at probably more than just about anybody in the United States is what we call cervical laminoplasty, where I actually reconstruct the back of the spine, what we call the lamina, and I expand it, I make it wider. Those people similarly can return to fairly normal activity level usually within two to three weeks, and by about four to six weeks, there are really no restrictions at all. I’ve performed that procedure on NFL players. I’ve also performed that procedure on a wide range of people ranging from 40 to 80 years old, and that’s an incredibly successful surgery.
Melanie: Are there certain people that are not candidates for the cervical laminoplasty?
Dr. Mouw: The most important thing when you have the symptoms that we talked about at the beginning of the interview, symptoms down the arms or hands, weakness, numbness or symptoms in the legs, is to meet with a spine surgeon who can perform most, if not all, aspects of spinal surgery. There’s absolutely certain indications where I would choose, for instance, to do a disk replacement or a patient who I would choose to do a laminoplasty. That’s for the neck. In the lower back, there’s also a less invasive procedure similarly, where I could decide to do a micro nerve root decompression versus a standard open laminectomy, where you remove the whole lamina of the back part of the spine. I can do a very selective surgery called nerve root decompression. These are almost outpatient procedures where people certainly would be home by the next morning. There’s also procedures in the back where I can preserve motion where there’s some weakness in the back, some devices that are available. But really, in order to be able to tell what is the best option from you, you need to meet with a surgeon such as myself who is trained in all of these procedures and even pioneered some of these procedures so that you get the exact procedure or the best fit for you and your spine. Very often a surgeon may only know how to, for instance, do a fusion and you’re going to go meet with them and that’s what you’re going to be offered. A surgeon you meet with such as myself should be able to do just about everything so that you get the best fit for you.
Melanie: That’s great information. In the last few minutes, if you would, Dr. Mouw, please give us your best advice for people suffering from cervical or spinal pain and what you really want them to know about this type of pain and what procedures and help there is out there for them.
Dr. Mouw: Well, I think that as we are all experiencing these sorts of symptoms at some point in our life, I think people need to know that spinal surgery has improved significantly, and relief is certainly quite possible now. I quote people very, very high success rates, well over 90 percent for the relief of these symptoms. However, it’s very important to seek out a surgeon who has specialized training, such as a neurosurgeon with spinal fellowship training such as myself and somebody who can try and do the least invasive surgery and always try and preserving the motion of the spine. What I can tell people is that they don’t need to suffer and that certainly, if you’re a good candidate for surgery, the surgical success rates today in the right hands are extremely high. I quote people, like I said, well over 90 percent success rate if I sign them up for surgery.
Melanie: Thank you so much. That’s absolutely fascinating and gives hope to a lot of people who are suffering from cervical and spinal pain. You are listening to VPH Med with Valley Presbyterian Hospital. For more information, you can go to valleypres.org. That’s valleypres.org. This is Melanie Cole. Thanks so much for listening.