Ezriel (Ed) Kornel, MD, FACS
Q: How common is back pain?
A. Around 65 million people suffer from back pain. Yet many of them suffer needlessly because they don’t realize that there are plenty of effective solutions, which range from simple stretches to incredibly effective minimally invasive surgery.
Q: What should I do if I have back pain?
A. Go see an expert as soon as the pain starts to impinge on your daily activities. I recommend starting with a physiatrist who specializes in the spine: These doctors provide treatment options that manage the pain without surgery. Other good options include physical therapists and chiropractors. Your goal is to learn proper body mechanics, stretches, and exercises that can take pressure off your spine. With the proper treatment and judicious use of over-the-counter painkillers like ibuprofen or naproxen, the majority of back pain will resolve after a few days or weeks. But if your pain persists for longer, you may need to seek the advice of a spine surgeon. A board-certified surgeon can diagnose non-responsive back troubles and help you decide if surgery is appropriate for you or whether other treatments may be effective.
Q: What are my options if surgery is recommended?
A. You’ll be relieved to hear that most back problems that may benefit from surgery can now be addressed with new minimally invasive procedures. Your surgeon will use imaging to help determine which procedure will work best. The good news is that surgery has improved immensely. Today’s minimally invasive procedures offer far better alternatives and outcomes.
One new surgery, endoscopic lumbar microdiscectomy, requires only one incision less than half an inch long. A tube is guided to the problem area and under high magnification, the extruded disc plucked out through the tube. Additionally, a lumbar fusion can now be performed with two small incisions using intraoperative CAT scans and a computer guidance system to direct the placement of hardware with millimeter accuracy. The visuals from the CAT scan are fed into a computer and it indicates exactly where to put the screws and disc spacer. The computer-guided system greatly reduces damage and trauma to the surrounding tissues. Patients undergoing an endoscopic microlumbar discectomy generally go home the same day and many patients undergoing a minimally invasive lumbar fusion are able to leave the hospital much sooner than with the standard procedure, and at their two-week post-op visit, they’re most often able to walk without a walker or a cane.
An even newer surgical option is extreme lateral interbody fusion—using the same technology, the surgeon approaches the spine from the side instead of from the back. That allows us to avoid the nerves altogether. The disc is removed and a structure like a cage is put in place of the disc and is filled with biological materials that spur bone growth. We lock the cage down with screws, and we’re all done. The patient often is able to go home the same day.
Northern Westchester Hospital
Director at Large
Orthopedic and Spine Institute
Learn More About Dr. Kornel
â€‹Watch an animated video on spine surgery
More from Dr. Kornel: Whiplash and Traumatic Brain Injury
â€‹Northern Westchester Hospital is a proud member of Northwell Health (formerly North Shore-LIJ Health System).