What Is a Standalone ALIF? Anterior lumbar interbody fusion (ALIF) is a surgical procedure performed through the front of the body to fuse vertebrae in the lower spine. In select patients, a “standalone” ALIF — meaning no additional surgery from the back of the spine is needed — can be an excellent, less invasive option…

Cervical total disc replacement or disc arthroplasty is becoming an increasingly popular procedure. Now, the cervical disc replacements are even approved for doing 2 levels, as in this recent case that I performed. Is it right for you? Many things are possible in spine surgery but only a few things are most appropriate for you…

Here is a case that shows why spinal fusion is often needed along with laminectomy (decompression) surgery. It also illustrates the importance of having a thorough evaluation done by your doctor. What makes a thorough evaluation is having a complete history and proper X-rays. Image 1: This patient had spinal stenosis at L4-5 on MRI that…

Meet Lin Sanders—a true inspiration of resilience and determination! Part 1 Lin underwent a complex two-level lumbar fusion at Texas Neuro-Spine Surgery. The procedure involved an anterior lumbar interbody fusion (ALIF) at L3-4 and L4-5, followed by laminectomies and pedicle screw instrumentation at the same levels. These surgeries were performed to help address her back…

Patients may be surprised to find out that neurosurgeons spend a lot of time on the phone trying to convince insurance companies that patients need MRI scans. Insurance companies usually don’t approve scans for patients who are only having low back pain. While serious problems like tumors are rare occurrences, sometimes they present with symptoms…

Lumbar stenosis is one of the most common problems that neurosurgeons see in the office. Patients usually have back pain that travels down their legs, which can get worse with walking. Many patients are surprised at the number of ways there are to treat this common problem. Options include: physical therapy, injections, minimally invasive surgery,…

Some surgeries are a long time in the making. This patient in her 70s recently came to me to have surgery for lumbar spinal stenosis. She also said, ”By the way, I was shot in the back more than 50 years ago in Chicago, can you remove the bullet?” I told her that I don’t…

Many patients come to me and want to have the very latest technologies used for their surgery, such as an artificial cervical disc, which is a great operation for many people. Occasionally, patients are disappointed because I counsel them not to have artificial disc surgery because it will not treat their problem adequately. In every…

As a Neurosurgeon, spinal fractures of the neck from diving accidents are things that I see way too often. This young man dove from a boat into shallow water. He presented with some numbness in his arm and hand. He had a fracture with the instability of his cervical spine at C5, requiring anterior and…

Cervical disc disease can be painful and debilitating and, in severe cases, can even be disabling. Successful surgery depends on many factors including selecting the best procedures for the individual patient. Posterior Microforaminotomy (minimally invasive microsurgery), one level anterior fusion, multiple level anterior fusion and artificial disc surgery are all good options in the right…

👉 Spinal deformities / Anterior-posterior (front-back) Spinal Fusion — At Texas NeuroSpine Surgery, our goal is to always find the least invasive approaches for the best surgical outcome. However, some cases require more extensive approaches, as in this case of an L4-5 deformity in a patient with rheumatoid arthritis and years of debilitating low back…

“This 53-year-old patient had a collapsed L5-S1 disc, retrolisthesis and foraminal stenosis contributing to severe low back pain. She had tried years of conservative (non-operative) treatment including physical therapy and injections without relief. At Texas NeuroSpine Surgery, we will always continue make every effort to treat your low back pain from a collapsed disc without…

“A Chiari malformation results when a patient has too little room for their cerebellum in the back part of the skull. The cerebellar tonsils get forced down into the spinal canal. The result can be a syrinx or fluid filled cavity within the spinal cord that can cause pain, weakness and numbness. The Chiari malformation…

“Taking a call at a Level 1 trauma center is stressful and takes time away from family and a neurosurgeon’s precious free time. I was reminded recently why I still feel passionate about taking a Level 1 trauma call when I met this simply miraculous 89-year-old woman. She was involved in a motor vehicle collision…

Surgery for cancer that has spread to the spine is extensive and recovery can be long. It is always appropriate to carefully consider all options including surgery and other treatments because many patients with metastatic spine cancer have a limited lifespan. The most important reason to do surgery is that some patients will beat the…

Here is a recent case that shows why spinal fusion is often needed along with laminectomy (decompression) surgery. It also illustrates the importance of having a thorough evaluation done by your doctor. What makes a thorough evaluation is having a complete history and proper X-rays. Image 1: This patient had spinal stenosis at L4-5 on…

Here is an example of another cervical spine case: MRI and CT scans show a 54 year-old male who had a cervical fracture dislocation at C5-6 after diving forward into shallow water and striking his head. He was fortunate not to be paralyzed. The patient also had chronic conditions in his cervical spine that put…

Cervical refers to the neck while myelopathy is a disorder of the spinal cord. Thus, cervical myelopathy is a spinal cord compression in the neck. Myelopathy can cause the following symptoms: Neck pain or stiffness, tingling, weakness, or numbness in arms, fingers, hands, Balance issues that could affect walking, and trouble with fine motor skills…

Here is a picture from another recent case of trigeminal neuralgia cured with microsurgical intervention. The patient is a 60-year-old female who had severe, debilitating pain along her left jaw that would not respond to medication or other treatments. The picture shows a nice intraoperative view of the Fourth (blue arrow) cranial nerve and Fifth…

Lumbar microdiscectomy surgery for a left L4-5 herniated disc in a patient with severe left leg pain and ankle weakness. ⠀ ⠀ The First picture shows the swollen, compressed L5 nerve root before discectomy (arrow). ⠀ ⠀ The Second picture shows the herniated disc material during removal from below the L5 nerve root. ⠀ ⠀…

Brain metastasis is a growth that appears in the brain from cancer that originates elsewhere in the body. A brain metastasis is not the same thing as a primary brain tumor because those begin in the brain. While any cancer can spread to the brain, the most common cancers that cause metastases are lung, breast,…

Sometimes the very best technology that we have is not the newest. Awake craniotomies have been performed safely for decades and maybe even centuries (if you count trephinations). Awake craniotomy is a simple and elegant procedure that has become even better with modern pharmacology. The core principles of the procedure have remained the same since…

Also known as tic douloureux, trigeminal neuralgia is a chronic condition affecting the trigeminal nerve. The nerve provides sensations in the face including the forehead, eyes, mouth, sinus cavities, and jaw. The condition occurs when a blood vessel compresses on the nerve. It causes pain during face-related activities such as teeth brushing, face washing, eating…

The cervical spine refers to the neck region of the spine that supports the body. In a relaxed position, the typical cervical spine has a “C” shaped curve called lordosis. The opening of the curve goes toward the back of the neck. Kyphosis is the opposite of lordosis. Cervical means relating to the neck. While…