Our Services / Spine Surgery

When might I need spine surgery?

Any spine condition that causes chronic pain, limited mobility, disability, or nerve damage may ultimately need spine surgery. However, the team at Ali H. Mesiwala, MD, FAANS, first performs a thorough exam and comprehensive diagnostics to determine the cause of your pain. 

Then your first line of treatment begins with nonsurgical options such as physical therapy and medications.

If your symptoms fail to improve with nonsurgical treatments or your diagnostic tests show serious nerve damage, the next step is surgery to repair the underlying problem.

Dr. Mesiwala treats a wide range of conditions that cause pain in your cervical spine (neck), thoracic spine (mid-back), and lumbar spine (lower back), including:

• Herniated disc
• Sciatica
• Kyphosis
• Scoliosis
• Spinal stenosis
• Spinal infections
• Spinal tumors
• Nerve impingement
• Brachial plexus injury
• Spondylolisthesis (slipped vertebra)
• Degenerative disc disease
• Degenerative joint disease 
• Facet joint syndrome (arthritis)
• Compression fractures
• Failed back and neck syndrome
• Radiculopathy (pinched nerve)

In 15-30% of people with chronic lower back pain, the problem lies in their sacroiliac (SI) joint, another condition Dr. Mesiwala frequently treats.

What symptoms indicate I need spine surgery?

Neck and back pain are the most common symptoms. However, most people also have difficulty moving their spine. You may also have headaches and struggle to move your head when the problem lies in your neck.

Pinched nerves (nerve impingement) cause symptoms that radiate along the nerve. As a result, you develop symptoms that travel down your arms or legs, including sharp, stabbing pain, tingling, and a burning sensation. You may also lose feeling and develop muscle weakness in the affected limb.

What type of spine surgery will I need?

In most cases, Dr. Mesiwala performs minimally invasive spine surgery. This procedure relies on small incisions and offers advantages such as less bleeding, a faster recovery, and being able to go home the same day (for most people).

Dr. Mesiwala has years of experience performing spine surgeries, such as:

Microdiscectomy 

A microdiscectomy is a procedure to repair a herniated disc and decompress nerves. During the procedure, Dr. Mesiwala removes the damaged, protruding portion of the disc

Artificial Disc Replacement

During a discectomy, Dr. Mesiwala removes the entire disc. Then he replaces the old, damaged disc with an artificial disc, a procedure called disc replacement surgery. The new disc preserves your spinal movement and restores spinal stability.

Laminectomy, laminotomy, and foraminotomy

These are all procedures to decompress spinal nerves. During each one, Dr. Mesiwala removes a specific part of the vertebra to create more space for the nerves. He may also remove other tissues pinching the nerves, such as thickened ligaments.

Spinal fusion surgery 

After a decompression procedure, the loss of bone creates instability in that segment of the spine. Dr. Mesiwala solves the problem by fusing two vertebrae together most often with an intervertebral cage and sometimes screws and rods (if necessary). He removes the disc between the adjoining bones and inserts a bone graft in the space. The graft promotes bone growth, so the adjoining vertebrae grow together to form one strong bone.

If you struggle with ongoing back or neck pain, call Ali H. Mesiwala, MD, FAANS, or book an appointment online today.

What Is A Fusion?

Fusions in the spine are generally performed in situations that require reconstructing the spine or dealing with instability that results from trauma, tumors, or removal of bone, disc, ligament, or joints in the spine. In many instances, fusions are the gold standard surgery, especially when fractures or deformities, such as scoliosis or kyphosis, are being addressed.

Fusions, when combined with procedures that remove disc or bone that is pinching or placing pressure on the nerves or spinal cord, can eliminate pain, reestablish proper alignment, and provide structural stability to the spine. The disadvantages of spinal fusion, however, include loss of movement in the spine, added stress and strain on the discs and joints above and below the fusion, development of chronic pain, and commonly the need for additional surgery in the future.

Spinal fusions will require either a hard cervical collar or a back brace to ensure success of the surgery for at least 3 months.

Why We Prefer TDA

A rigid fusion with screws and rods will limit a patient’s range of motion of their spine. Whereas a disc replacement will preserve motion. If we can allow the patient to keep their full mobility, this is preferred!

Also, frequently a patient’s neck or low back disc is collapsed and their motion is impaired at this level. A disc replacement can then improve their range of motion at this level. 30% of the time, a patient who has a previous fusion will require additional surgery at the levels above or below the fusion construct.

Whereas, a disc replacement will not lead to adjacent level degeneration and therefore reduces the risk for additional surgery in the future. Many of our cervical and lumbar disc replacements can be done in an outpatient surgery center, allowing the patient to go home the same day. Therefore, a disc replacement allows for fewer hospital stays and reduces healthcare costs as well.

A TDA only requires a soft cervical collar for 2 weeks or no bracing at all for the lumbar spine. A disc arthroplasty also has less risk for hardware malfunction, again decreasing the risk of further surgery.