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How Neck and Back Pain Are Treated

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Whenever possible, non-surgical treatments are initially offered to patients coming to the Spine Centers at NewYork-Presbyterian Hospital. Examples include physical therapy, physiatry, and pain management techniques. When these methods are not sufficient to relieve a patient's symptoms, surgery may be necessary. Whenever appropriate, our spine surgeons employ minimally invasive procedures using small incisions, enabling patients to recover more quickly and return to their normal activities sooner.


Alfred T. Ogden, M.D., M.P.H., the Director of Minimally Invasive Spine Surgery at The Spine Center of NewYork-Presbyterian/Columbia University Medical Center, discusses surgical procedures to treat lumbar disc herniation.

Examples of our treatments for spinal disorders include:

  • Spinal disc degeneration/herniation: Herniated (ruptured) spinal discs are among the more common spinal disorders of the neck and low back, and result from the natural aging process. Symptoms may result from the degenerative process itself or because of nerve compression caused by displacement of the disc contents. Patients often experience pain in the spine that radiates into an extremity (such as an arm or leg), commonly referred to as "sciatica." More severe compression can lead to weakness or numbness of the arms or legs and requires more immediate surgical attention. Patients with disc degeneration or herniation may be offered surgery when physical therapy and other nonsurgical approaches, such as epidural steroid (anti-inflammatory) injections and nerve blocks, are not effective. Treatments include "minimally invasive microdiscectomy" to remove the herniated portions of a disc compressing a spinal nerve; fusion of affected vertebrae to stabilize a degenerated segment and limit pain and instability; or, in some cases, implantation of an artificial disc.
  • Spinal stenosis: Spinal stenosis is a narrowing of the spinal canal in the neck (cervical) or lower back (lumbar spine) that places increased pressure on the spinal cord or nerves. In the neck, stenosis can lead to pain in an arm or leg, or wider dysfunction if the spinal cord is involved, leading to weakness, numbness, imbalance, or bowel/bladder problems. In the lower back, stenosis commonly leads to activity related back or leg pain, causing difficulty walking and standing for long periods. Often, stenosis cannot be effectively treated with nonsurgical therapies; in some cases, spinal stenosis can be treated using minimally invasive means to relieve the pressure. Complicated cases may require a more extensive treatment involving insertion of implants to stabilize the degenerated spinal segments.
  • Vertebral fractures: Fractures of the vertebrae, such as those caused by osteoporosis or spinal tumors, may be treated using vertebroplasty or kyphoplasty: the injection of a biological cement via a needle through the skin, which provides stability in a vertebra as it hardens. With balloon kyphoplasty, the surgeon inserts a balloon into a fractured vertebra, inflates it to create space and restore alignment, and then removes it and fills the space with bone cement. More complicated fractures that result from aggressive tumors or trauma often require major surgical reconstruction.
  • Scoliosis: Scoliosis and kyphosis (abnormal curvature of the spine) may be diagnosed during childhood, secondary to neuromuscular imbalance, or later in life as a result of advanced degenerative changes. The abnormal curvature of the spine interferes with spinal movement and can cause pain or pressure on the spinal cord and/or nerves. Patients suffering with a scoliosis may experience pain, poor posture, nerve problems, or (under severe circumstances) difficulty breathing. When rehabilitation and nonsurgical therapies are not effective, surgery is often needed to improve the alignment of the spine, reduce pain, and restore function. NewYork-Presbyterian's spine surgeons are world-renowned for treating patients with the most challenging degrees of scoliosis.
  • Spinal trauma: People who have suffered a spinal injury require immediate treatment to prevent further damage to the spinal cord. NewYork-Presbyterian Hospital's neurocritical care and neurosurgery teams work quickly to stabilize patients with spinal injuries to avoid further trauma. Immediate surgery may be necessary to evaluate the state of the spinal cord, stabilize fractured vertebrae, release pressure from the injured area, and treat injuries to other parts of the body. Rehabilitation is initiated within days of stabilization whenever possible.
  • Spinal tumors: Primary and metastatic spinal tumors require a multidisciplinary approach such as that used at NewYork-Presbyterian Hospital, combining surgery, chemotherapy, and/or radiation therapy as indicated. Our surgeons may use spinal stabilization techniques to treat metastatic spinal tumors, preserving spinal nerve function and improving patients' quality of life.

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