If you have spine damage, the Spine Program at Corona Regional Medical Center offers non-surgical and surgical treatment options to help you return to an active life.
Surgeons at Corona Regional Medical Center can evaluate your condition and recommend a treatment program that may include rehabilitation, exercise or other therapies to help relieve your pain and increase your function. If surgery is required, minimally invasive procedures are available that can offer a shorter hospital stay and a quicker recovery with fewer complications.
Listen in as Dr. Sean Armin discusses the advantages of minimally invasive spine surgery so that you can return to your active life sooner.
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Minimally Invasive Spine Surgery
Featured Speaker:
Fellowship trained in advanced spinal surgery, Dr. Armin has been published in numerous books, abstracts, posters and studies. He has extensive research experience, studying under some of the most prestigious medical experts in the nation. He has received several prominent awards and honors throughout his training in addition to holding leadership positions with nearly every professional organization with which he has been affiliated.
Dr. Armin received his medical degree from UCLA School of Medicine. He completed a residency in neurological surgery from Loma Linda University. Following his residency, he completed a Fellowship in advanced spinal surgery with concentration in minimally invasive techniques from UCLA’s Department of Neurosugery in Los Angeles.
Sean Armin, MD
A highly accredited neurosurgeon, Dr. Sean Armin has extensive training and expertise in neurological surgery, advanced spinal surgery with concentration in minimally invasive techniques and interventional neuroradiology.Fellowship trained in advanced spinal surgery, Dr. Armin has been published in numerous books, abstracts, posters and studies. He has extensive research experience, studying under some of the most prestigious medical experts in the nation. He has received several prominent awards and honors throughout his training in addition to holding leadership positions with nearly every professional organization with which he has been affiliated.
Dr. Armin received his medical degree from UCLA School of Medicine. He completed a residency in neurological surgery from Loma Linda University. Following his residency, he completed a Fellowship in advanced spinal surgery with concentration in minimally invasive techniques from UCLA’s Department of Neurosugery in Los Angeles.
Transcription:
Minimally Invasive Spine Surgery
Melanie Cole (Host): Spine surgery has traditionally been done as open surgery, but in recent years, however, technological advances have allowed more back and neck conditions to be treated with a minimally invasive surgical technique. My guest today is Dr. Sean Armin. He is a neurosurgeon and a member of the medical staff at Corona Regional Medical Center. Welcome to the show, Dr. Armin. Tell us about the need for back and neck issues. What are you seeing today as the most common conditions that require some sort of intervention?
Dr. Sean Armin (Guest): Well, I wanted to first say that back and neck issues, specifically involving pain, is one of the most common complains that any patient has to any physician. There are some statistics out there that say it is actually the top reason of adult U.S. residents missing work after the common cold. So, it a very fairly common cause of loss of work time and a lot of mobility difficulty. This is a very common complaint that I have with patients presenting to my clinic. As a neurosurgeon, I treat patients with all types of disorders involving the nervous system, whether it has to do with the brain, the spine or even the peripheral nerve. But by far, the most common complaint involves patients presenting with issues involving their lumbar spine, which is the lower back and the cervical spine which is the neck.
Melanie: So, what are the first lines of defense? If someone comes to you with a pain in their lumbar spine or their cervical spine? What do you do for them first?
Dr. Armin: In general, by the time a patient comes to see me, most of the time they have already been to another physician. In general, it involves their primary care physician. At times, they have seen their chiropractor or a physical therapist and, most of the time, these patients have already had some type of a conservative management. By conservative management, we are referring more to observation which is giving them time to get better. They have had physical therapy. They have had various types of medications, including the anti-inflammatory and other types of pain medication. In order for a patient to really be fully evaluated by a neurosurgeon and a spine specialist, they would definitely need to have some type of imaging of their spine. Nowadays, in modern times, that involves with a gold standard being an MRI of the cervical or the lumbar spine, and, of course, this has to be combined together with a physical examination and a very thorough set of questionnaires and interviewing the patient to make sure that their signs and symptoms match and correlate with the findings on the MRI.
Melanie: So, once you've diagnosed somebody and determined that maybe surgical intervention is necessary. What are you doing? Let's speak about the lumbar discs, first and that type of minimally invasive surgery. What are you doing for people?
Dr. Armin: Before I answer that question, it's always very important in my line of work, for patients to have various options. Not every patient should receive a surgery. There are many times when patients can be treated further with conservative management. This also involves, in addition to physical therapy, interventional pain management, which involves various types of injections. Now assuming these patients are no longer improving or getting better with the standard observation and conservative management, then we start talking about various types of surgical interventions that can help these patients. There are, in general, three different types of surgeries that we do for the neck and the low back. One operation would involve mainly decompression which, basically, means removal of pressure over the neuro element, the nerve roots and all the neuro structure that go to the arms and legs. The other type of surgery involves a fusion type of surgery which, in general, involves the decompression together with some type of a stabilization of the spine. And, the third type of surgery, which is a relatively more recent type of an operation, involves artificial disc replacement, also known as disc arthroplasty, where we are able to preserve a motion in the cervical and lumbar spine. And, really, only a spine specialist can help determine the appropriate type of procedure that would help a patient.
Melanie: So, what are the benefits now to the patient for these minimal invasive types of surgery? Is it less recovery, less pain? Tell us about the benefits for the patient.
Dr. Armin: The basic concept of minimally invasive spine surgery has to do with, as they say, minimally invasive and maximally effective. So, what it refers to is causing a minimal amount of injury and trauma to the soft tissue that surrounds the spinal structure. As various studies have shown, what really causes post-operative pain and agony has to do with amount of trauma that the musculature and the soft tissue endorse during an operation. With minimally invasive spine surgery, we do whatever we can to minimize injury to the soft tissue but, at the same time, we don't want to be taking short cuts or doing less of the actual operation for the sake of doing a minimally invasive surgery. So, with all the advances in spine surgery nowadays, we can effectively do what used to be done via the traditional open operation and get the entire job done while, at the same time, minimizing soft tissue injury. And, what that can end up helping the patient with is minimize the length of hospital stay, it can minimize blood loss during the operation, it can also decrease the amount of post-operative pain. Also, usually the size of the incision is smaller, there is less scar tissue that can form and, overall, patients tend to be much happier.
Melanie: Is there any difference in range of motion in what's preserved for the patient and their back afterwards?
Dr. Armin: Well, if patients have less pain, in general, their backs and necks are more mobile. Almost with any type of neck or low back surgery, patients end up getting muscle spasm which tends to tense up their neck and back and the less spasm and less pain that they have, they also tend to have more mobility. And this is often the case with minimally invasive spine surgery.
Melanie: Is this done robotically, Dr. Armin?
Dr. Armin: There are some robotic systems that are being tried out. Most of the systems are not ready for prime time yet but that is just around the corner and we are probably looking at may be a year or two away, but nowadays it is not done robotically. We use various types of neuro-navigation and image guidance systems during the surgery to help improve the precision and accuracy of the operation. That is now being done routinely in many hospitals including Corona Regional Medical Center, but the robotics are not here yet.
Melanie: In just the last few minutes, Dr. Armin; what should people with back issues and back pain and, as you said, this is one of the number one causes for people to miss work and come to see a doctor. What should they think about when seeking care?
Dr. Armin: One very important issue is, number one, for them not to ignore their symptoms, mainly including pain, and even more importantly, having numbness or weakness. Many times, I encounter patients who have ignored their symptoms for quite a while, they come to me with sometimes obvious weakness, difficulty walking, lack of balance. Sometimes I see patients with frozen shoulder where the muscle has atrophied, they are no longer able to move their arm, they are no longer able to bring their foot up, they have various other symptoms such as a foot drop. Some of these can sometimes become irreversible and you may not even be able to fix even with operative intervention. So I think it's very important for them to seek the right specialist which, in this case, would be a neurosurgeon, a spine specialist, soon and not ignore their symptoms. Number two is for them to have a complete evaluation which involves the imaging studies that we briefly mentioned, including the MRI. One other thing that I just wanted to mention since we talked about minimally invasive spine surgery and its benefits, minimally invasive spine surgery is even a better option for the elderly patients. A very large portion of my patients nowadays because of the aging population are elderly. The minimally invasive spine surgery allows these patients to leave the hospital quicker and get back on their feet a lot faster. And, also for obese patients. Many patients with low back pain, especially, because they become less mobile, they tend to put on a lot of weight. Obese patients in general are an excellent candidate for the minimally invasive spine surgery and also there are patients who, for various reasons such as religious reasons, patients being Jehovah's witnesses, they do not even want to receive blood transfusions. Because of the less blood loss that we would expect on these operations, these types of patients would even be better candidates for minimally invasive spine surgery.
Melanie: And, why should they come to Corona Regional Medical Center for their care?
Dr. Armin: At Corona Regional Medical Center, there's a multidisciplinary approach to treatment of patients with spinal disorders. They do have all the surgical equipment that are advanced and they are fully equipped to treat patients with spinal disorders, whether it has to do with the cervical spine, the low back, the mid back and all the various types of surgeries we discussed, including minimally invasive spine surgery, whether it be a decompression operation or a fusion surgery, and whether we are talking about artificial disc replacement. All these types of surgeries can be done very effectively and safely at Corona Regional Medical Center. And, also the use of navigation, using computers and image guidance, during surgery can be done readily at Corona Regional Medical Center.
Melanie: Thank you so much for such great information, Dr. Armin. You're listening to Corona Regional Radio with Corona Regional Medical Center. For more information, you can go to coronaregional.com. That's coronaregional.com. Physicians are independent practitioners who are not employees or agents of Corona Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.
Minimally Invasive Spine Surgery
Melanie Cole (Host): Spine surgery has traditionally been done as open surgery, but in recent years, however, technological advances have allowed more back and neck conditions to be treated with a minimally invasive surgical technique. My guest today is Dr. Sean Armin. He is a neurosurgeon and a member of the medical staff at Corona Regional Medical Center. Welcome to the show, Dr. Armin. Tell us about the need for back and neck issues. What are you seeing today as the most common conditions that require some sort of intervention?
Dr. Sean Armin (Guest): Well, I wanted to first say that back and neck issues, specifically involving pain, is one of the most common complains that any patient has to any physician. There are some statistics out there that say it is actually the top reason of adult U.S. residents missing work after the common cold. So, it a very fairly common cause of loss of work time and a lot of mobility difficulty. This is a very common complaint that I have with patients presenting to my clinic. As a neurosurgeon, I treat patients with all types of disorders involving the nervous system, whether it has to do with the brain, the spine or even the peripheral nerve. But by far, the most common complaint involves patients presenting with issues involving their lumbar spine, which is the lower back and the cervical spine which is the neck.
Melanie: So, what are the first lines of defense? If someone comes to you with a pain in their lumbar spine or their cervical spine? What do you do for them first?
Dr. Armin: In general, by the time a patient comes to see me, most of the time they have already been to another physician. In general, it involves their primary care physician. At times, they have seen their chiropractor or a physical therapist and, most of the time, these patients have already had some type of a conservative management. By conservative management, we are referring more to observation which is giving them time to get better. They have had physical therapy. They have had various types of medications, including the anti-inflammatory and other types of pain medication. In order for a patient to really be fully evaluated by a neurosurgeon and a spine specialist, they would definitely need to have some type of imaging of their spine. Nowadays, in modern times, that involves with a gold standard being an MRI of the cervical or the lumbar spine, and, of course, this has to be combined together with a physical examination and a very thorough set of questionnaires and interviewing the patient to make sure that their signs and symptoms match and correlate with the findings on the MRI.
Melanie: So, once you've diagnosed somebody and determined that maybe surgical intervention is necessary. What are you doing? Let's speak about the lumbar discs, first and that type of minimally invasive surgery. What are you doing for people?
Dr. Armin: Before I answer that question, it's always very important in my line of work, for patients to have various options. Not every patient should receive a surgery. There are many times when patients can be treated further with conservative management. This also involves, in addition to physical therapy, interventional pain management, which involves various types of injections. Now assuming these patients are no longer improving or getting better with the standard observation and conservative management, then we start talking about various types of surgical interventions that can help these patients. There are, in general, three different types of surgeries that we do for the neck and the low back. One operation would involve mainly decompression which, basically, means removal of pressure over the neuro element, the nerve roots and all the neuro structure that go to the arms and legs. The other type of surgery involves a fusion type of surgery which, in general, involves the decompression together with some type of a stabilization of the spine. And, the third type of surgery, which is a relatively more recent type of an operation, involves artificial disc replacement, also known as disc arthroplasty, where we are able to preserve a motion in the cervical and lumbar spine. And, really, only a spine specialist can help determine the appropriate type of procedure that would help a patient.
Melanie: So, what are the benefits now to the patient for these minimal invasive types of surgery? Is it less recovery, less pain? Tell us about the benefits for the patient.
Dr. Armin: The basic concept of minimally invasive spine surgery has to do with, as they say, minimally invasive and maximally effective. So, what it refers to is causing a minimal amount of injury and trauma to the soft tissue that surrounds the spinal structure. As various studies have shown, what really causes post-operative pain and agony has to do with amount of trauma that the musculature and the soft tissue endorse during an operation. With minimally invasive spine surgery, we do whatever we can to minimize injury to the soft tissue but, at the same time, we don't want to be taking short cuts or doing less of the actual operation for the sake of doing a minimally invasive surgery. So, with all the advances in spine surgery nowadays, we can effectively do what used to be done via the traditional open operation and get the entire job done while, at the same time, minimizing soft tissue injury. And, what that can end up helping the patient with is minimize the length of hospital stay, it can minimize blood loss during the operation, it can also decrease the amount of post-operative pain. Also, usually the size of the incision is smaller, there is less scar tissue that can form and, overall, patients tend to be much happier.
Melanie: Is there any difference in range of motion in what's preserved for the patient and their back afterwards?
Dr. Armin: Well, if patients have less pain, in general, their backs and necks are more mobile. Almost with any type of neck or low back surgery, patients end up getting muscle spasm which tends to tense up their neck and back and the less spasm and less pain that they have, they also tend to have more mobility. And this is often the case with minimally invasive spine surgery.
Melanie: Is this done robotically, Dr. Armin?
Dr. Armin: There are some robotic systems that are being tried out. Most of the systems are not ready for prime time yet but that is just around the corner and we are probably looking at may be a year or two away, but nowadays it is not done robotically. We use various types of neuro-navigation and image guidance systems during the surgery to help improve the precision and accuracy of the operation. That is now being done routinely in many hospitals including Corona Regional Medical Center, but the robotics are not here yet.
Melanie: In just the last few minutes, Dr. Armin; what should people with back issues and back pain and, as you said, this is one of the number one causes for people to miss work and come to see a doctor. What should they think about when seeking care?
Dr. Armin: One very important issue is, number one, for them not to ignore their symptoms, mainly including pain, and even more importantly, having numbness or weakness. Many times, I encounter patients who have ignored their symptoms for quite a while, they come to me with sometimes obvious weakness, difficulty walking, lack of balance. Sometimes I see patients with frozen shoulder where the muscle has atrophied, they are no longer able to move their arm, they are no longer able to bring their foot up, they have various other symptoms such as a foot drop. Some of these can sometimes become irreversible and you may not even be able to fix even with operative intervention. So I think it's very important for them to seek the right specialist which, in this case, would be a neurosurgeon, a spine specialist, soon and not ignore their symptoms. Number two is for them to have a complete evaluation which involves the imaging studies that we briefly mentioned, including the MRI. One other thing that I just wanted to mention since we talked about minimally invasive spine surgery and its benefits, minimally invasive spine surgery is even a better option for the elderly patients. A very large portion of my patients nowadays because of the aging population are elderly. The minimally invasive spine surgery allows these patients to leave the hospital quicker and get back on their feet a lot faster. And, also for obese patients. Many patients with low back pain, especially, because they become less mobile, they tend to put on a lot of weight. Obese patients in general are an excellent candidate for the minimally invasive spine surgery and also there are patients who, for various reasons such as religious reasons, patients being Jehovah's witnesses, they do not even want to receive blood transfusions. Because of the less blood loss that we would expect on these operations, these types of patients would even be better candidates for minimally invasive spine surgery.
Melanie: And, why should they come to Corona Regional Medical Center for their care?
Dr. Armin: At Corona Regional Medical Center, there's a multidisciplinary approach to treatment of patients with spinal disorders. They do have all the surgical equipment that are advanced and they are fully equipped to treat patients with spinal disorders, whether it has to do with the cervical spine, the low back, the mid back and all the various types of surgeries we discussed, including minimally invasive spine surgery, whether it be a decompression operation or a fusion surgery, and whether we are talking about artificial disc replacement. All these types of surgeries can be done very effectively and safely at Corona Regional Medical Center. And, also the use of navigation, using computers and image guidance, during surgery can be done readily at Corona Regional Medical Center.
Melanie: Thank you so much for such great information, Dr. Armin. You're listening to Corona Regional Radio with Corona Regional Medical Center. For more information, you can go to coronaregional.com. That's coronaregional.com. Physicians are independent practitioners who are not employees or agents of Corona Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.