Common Types of Incomplete Spinal Cord

A resident of Denton, Texas, Dr. Jamie Gottlieb received his medical degree from Cornell University Medical College and subsequently completed a Spine Surgery Fellowship at the Texas Back Institute. Dr. Jamie Gottlieb practices at Orthopedic Specialists North, I-Spine Institute, and GBS Spinal Associates as a spine surgeon where he treats patients with spinal cord injuries (SCIs).

SCIs are classified as either complete or incomplete. Complete injuries prevent the brain from being able to transmit signals below the area of the spinal cord that has been injured, whereas incomplete injuries reduce signaling below the damaged area.

Incomplete SCIs can involve different areas of the spine and are referred to by different names. For example, an anterior cord syndrome involves injury to the front of the spine, which leads to interference with sensation and motor function. Central cord syndrome involves injury to the middle of the cord and the associated nerves, thus leading to arm paralysis and partial paralysis of the legs. This type of injury may also cause bowel and bladder problems and loss of sexual function. Brown-Sequard syndrome involves damage to only one side of the spinal cord causing a loss of movement on one side but not the other.

Types of Knee Injections & Benefits

For more than 20 years, Dr. Jamie Gottlieb has been practicing medicine. He is the CEO and a spine surgeon at I-Spine Institute and GBS Spinal Associates, and he also serves as a spine surgeon at Orthopedic Specialists North Texas in Denton, TX. Dr. Jamie Gottlieb has written an article on intra-articular knee injections.

Knee injections are often necessary in sports medicine, general practice, and rheumatology to treat various conditions and reduce the impact of lifestyle-limiting knee injuries. Most commonly, intra-articular knee injections use corticosteroids, which relieve inflammation and pain in knee joints and address osteoarthritis pain. However, people who have psoriatic arthritis, pseudogout, rheumatoid arthritis, or juvenile idiopathic arthritis also may benefit from intra-articular corticosteroid injections.

Doctors also use other agents in knee injections, including hyaluronic acid and infliximab. Infliximab treats refractory knee synovitis or monoarthritis in patients who have rheumatoid arthritis or Behcet's disease. Typically, these patients have not had success with systemic treatment. Hyaluronic acid benefits patients who have osteoarthritis in the knees.  

An Overview of Ankylosing Spondylitis

Spine surgeon Dr. Jamie Gottlieb is experienced in treating a wide range of conditions of the spine, from back injuries to spinal tumors. Dr. Jamie Gottlieb is based in Denton, Texas, where treats a variety of conditions with innovative procedures and technologies.

A condition of the spine that currently has no cure is ankylosing spondylitis, an inflammatory disease that can lead to the fusion of some of the vertebrae, reducing the flexibility of the spine and causing pain and stiffness, usually in the lower back and hips. The pain is more common to occur in the morning or after periods of inactivity.

The areas affected are usually, though not only, the joint between the spine and pelvis, the lower back, hip, and shoulder joints. While the causes of ankylosing spondylitis are not certain, it appears that genetics can have an impact as people with the HLA-B27 gene are more likely to develop the condition. Furthermore, men appear to be more at risk of developing the condition, which usually occurs between late adolescence and early adulthood.

The diagnosis can be done through an X-ray or an MRI. X-rays are only able to detect the visible signs of the condition, that are often not present in the early stages. An MRI (magnetic resonance imaging) can detect evidence of ankylosing spondylitis also in the earlier stages.

While there is no cure for ankylosing spondylitis, there are treatments meant to help alleviate the pain and even slow down the progression of the condition. The treatment often consists of medication and physical therapy, mainly range-of-motion and stretching exercises. Surgery may only be necessary in the case of severe pain or joint damage, but it’s quite rare.

Yoga for Chronic Back Pain

A spine surgeon based in Denton, TX, Dr. Jamie Gottlieb treats spine conditions such as arthritis of the neck, back injuries, chronic back pain, herniated disc, osteoporosis, rheumatoid arthritis, and more. A member of several medical associations such as the American Medical Association, the American Academy of Orthopedic Surgery, and the North American Spine Society, Dr. Jamie Gottlieb aims to help his patients increase their quality of life by providing personalized treatment and advice.

While medication or even surgery can be necessary to treat back pain, exercise can often be enough to alleviate moderate and even severe chronic back pain. Yoga, in particular, is a form of exercise that has proven effective in alleviating back pain, as long as it is performed carefully and even better under the guidance of a trained instructor.

A 2017 research found that specific yoga classes for low back pain can be as effective as physical therapy in reducing pain and improving function, while also leading to lowering the use of medicine. The same findings were found in a 2020 systematic review and meta-analysis of 18 randomized controlled trials. Furthermore, it won’t come as a surprise that practicing yoga has proven more effective in reducing pain than not performing any type of exercise.

 

Causes of Pain in the Cervical Spine Region

A Texas-based spine surgeon, Dr. Jamie Gottlieb works at Orthopedic Specialist North Texas in Denton. Dr. Jamie Gottlieb draws on over a decade of experience in the treatment of spine injuries including pain-causing cervical spine traumas.

When there is a problem in the cervical region of the spine, a variety of symptoms can occur. Neck pain, which represents the majority of the symptoms, is the most definitive and direct consequence of a defect in the cervical region of the spine. According to studies, as many as 43 percent of neck pains resolve without specific treatments. About one-third of patients with neck pain however continue to suffer from moderate to severe symptoms.

Cervical or neck pain can be classified into three major categories as recommended by the Agency for Health Care Policy for Research. These are:

1. Pain from potentially serious conditions such as severe trauma to the spine or tumor.

2. Radicular pain that results from nerve root compromise.

3. All other pain syndromes that fall out of the aforementioned categories, including traumatic injury of musculoskeletal and discogenic nature.

 

Postoperative Recovery after Lumbar Spinal Fusion Surgery

An accomplished spine surgeon, Dr. Jamie Gottlieb works at Orthopedic Specialists North Texas in Denton, TX. Dr. Jamie Gottlieb is a member of the American Academy of Orthopedic Surgery. He has written extensively on lumbar spinal fusion surgery.

While spinal fusion surgery has successfully made it possible for the majority of patients to resume their normal activities and lifestyle after a traumatic or atraumatic spine injury, different factors play important roles in how quickly patients recover from the surgery.

Spinal fusion surgery involves placing a bone graft in between two adjacent vertebral bones to facilitate bone growth which comes to completion when the graft material and surrounding vertebral bones fuse together to appear like a single bone. This process may take up to 6 months. During recovery, it is critical that the operated area is left in place by avoiding or minimizing activities that require movement in the area which is why some patients wear braces.

On average, patients return home from the hospital or health care facility where the surgery is performed around 2 to 4 days after the surgery is done. How quickly a patient can resume activity depends on the level of physical effort the activity requires. For instance, less strenuous activities like driving and an office or sedentary job can be resumed safely a couple of weeks after the surgery (typically about 4 to 6 weeks).

If the fusion is performed on a single level in the spine, recovery is always faster in contrast to those that involve more than 2 vertebrae which may require extra weeks. Single-level lumbar fusion surgery recipients can return to all activities (including vigorous ones) 6 months after surgery.

Depression, smoking, obesity, osteoporosis, chronic illness, and long-standing opioid use before surgery can prolong recovery.

 

Lumbar Fusion Surgery - Preparing Home for Post-operative Convenience

An accomplished spine specialist, Dr. Jamie Gottlieb is a spine surgeon with Orthopedic Specialists North Texas in Denton, Texas. Dr. Jamie Gottlieb draws from nearly two decades of experience in spine surgery with a special dedication to perform a lumbar fusion surgery.

Lumbar fusion surgery is a common surgical procedure for low back pain. By stopping motion, the procedure stabilizes the segment of the lower spine region where abnormal movement is causing pain.

To hasten recovery from lumbar fusion surgery, patients must avoid bending or performing rigorous tasks as much as possible during the first few days after the surgery. Before going to the hospital for the surgery, patients should put the things that they use more regularly at home in heights where they can reach them without bending over. These include shoes, clothing, toiletries, kitchen utensils, and telephone. They should also identify a person who can assist them at home with chores. 

Current Sports Medicine Reports - Official ACSM Clinical Journal

An experienced physician and spine surgeon, Dr. Jamie Gottlieb serves Denton, TX, residents at the Orthopedic Specialists North Texas clinic. Nearly a decade ago, Dr. Jamie Gottlieb wrote “Return to Play Decisions after Cervical Spine Injuries,” an article that was published in the 6th edition of the Current Sports Medicine Reports journal.

Current Sports Medicine Reports is the official clinical journal of the American College of Sports Medicine (ACSM) that focuses exclusively on the sports medicine subspecialty's clinical features. As a peer-reviewed journal, Current Sports Medicine Reports presents relevant articles that promote and review advances in the field. With this information, physicians in sports medicine can improve their practice and provide better care for their patients.

The journal divides research in the sports medicine subspecialty into 12 sections, including General Medical Conditions, Exercise is Medicine, Nutrition & Ergogenic Aids, and Head, Neck, and Spine. Each division is supervised by an experienced physician editor, who is knowledgeable about the section for which they are responsible.

Each issue of the Current Sports Medicine Reports journal includes a Pearls & Pitfalls section, where hot topics developing in the field are discussed, and a Web Alert feature focused on keeping readers updated on popular sports medicine websites. Each issue also features an ACSM Clinician Profile section, where a prominent ACSM physician member shares their perspective on the present and future of the sports medicine field.. 

Benefits of Lateral Lumbar Interbody Fusion

A member of the North American Spine Society, Dr. Jamie Gottlieb currently works as a spine surgeon at Orthopedic Specialists of North Texas. In his work with the Denton, TX, practice, Dr. Jamie Gottlieb draws on over a decade of experience in the surgical treatment of various spine diseases and injuries. He is proficient in innovative surgical techniques, including lateral lumbar interbody fusion, a recently developed, minimally invasive technique to fuse bones in the lower back region of the spine.

Lateral interbody fusion involves a tiny incision at the side of the patient's waist. Through the incision, a defective disc is removed from the spine and replaced by a bone graft, called a spacer graft, to facilitate fusion while restoring the height between two vertebrae.

Used when conservative techniques have failed to result in improvement, this procedure efficiently treats lower back and leg pain that results from a degenerative disc or abnormal forward flip of a vertebra, known as spondylolisthesis. It also can help correct mild sideways curvature of the spine, known as scoliosis.

Benefits of lateral interbody fusion, as compared to traditional lumbar fusion procedures, include less blood loss and scarring, shorter duration of surgery, decreased post-operative pain, and faster recovery. Patients often are able to walk the same day they had the surgery, and may only be required to spend a single night at the hospital.

What Is Failed Back Surgery Syndrome?

Denton, TX-based spine surgeon Dr. Jamie Gottlieb delivers orthopedic care at clinics in Indiana and Texas. Working closely with patients to prevent postsurgical complications, Dr. Jamie Gottlieb also treats patients who experience failed back surgery syndrome (FBSS).

Despite the condition’s name, FBSS is not always caused by surgery. Several risk factors can increase the likelihood of post-surgical complications. For example, patients with existing chronic back pain cannot benefit from a spinal surgery. To avoid this, surgeons review every patient’s medical history to ensure that invasive surgery is the best solution.

Other patient-related risk factors include smoking and obesity. Sometimes, symptoms return after surgery because of postsurgical conditions. For instance, a build-up of scar tissue or infection may result in symptoms such as radiating pain or weakness.

FBSS is usually addressed with a holistic treatment approach designed specifically for each patient. This includes physical therapy, pain management, and possibly, additional surgery. 

Sacroiliac Joint Dysfunction Causes and Treatments

Dr. Jamie Gottlieb is a spine surgeon who meets the needs of patients in the Denton, TX, community. Committed to personalized treatment, Dr. Jamie Gottlieb has an extensive background in assessing and correcting complex conditions such as sacroiliac joint (SIJ) dysfunction.

Located at the base of the spine, the sacroiliac joints are firm and provide stability when a person engages in activities such as walking. Characterized by a limited range of motion, they absorb impact and serve to redistribute the weight of the upper body in the lower body.

SIJ hypermobility involves too much joint movement, which is associated with pain and instability in the hip and lower back. SIJ that become irritated and inflamed are known as sacroiliitis. Relatively common, SIJ dysfunction has a variety of other causes, including pregnancy, which involves a combination of extra weight and stretching of the ligaments, such that the pelvis can widen. Another common cause is forceful impact, such as a car accident, sports injury, or a direct fall on the buttocks. In addition, arthritis and other degenerative joint diseases may result in SIJ deterioration.

There are several therapeutic pathways, such as physical therapy, SIJ injections, and oral anti-inflammatory medications. In addition, a surgical fusion of the SIJ can be undertaken to relieve pain.

 

XLIF Lateral Lumbar Interbody Fusion Basics

A graduate of Cornell University Medical College, Dr. Jamie Gottlieb has worked at several high-profile institutes and clinics. Currently, he is the principal spine surgeon at i-Spine Institute in Denton, TX. One of the procedures Dr. Jamie Gottlieb performs at the institute is extreme lateral interbody fusion (XLIF).

While the standard ALIF (anterior lumbar interbody fusion) procedure uses anterior access, the XLIF procedure accesses the spine from the patient’s side, avoiding major muscle groups in the back. Typically, patients with a spinal tumor, scoliosis, kyphosis, or degenerative disc disease undergo the latter.

Surgeons performing the procedure test the spinal nerves with a probe. They use fluoroscopic X-ray images to guide them to avoid injuring nerves. When they locate the problem, surgeons move the back muscles aside with a retraction device to reach the spine.

After that, surgeons remove the degenerated disc and insert a bone graft-filled implant in its place. If needed, surgeons may also apply bone morphogenetic protein to speed the recovery.