Spinal Solutions

April 02, 2014

Suffering from excruciating lower back pain and leg numbness, 49-year-old Robby Halaby hated watching life from the sidelines. “He would drop me and the kids off outside the mall then just sit outside and wait,” says Robby’s wife, Hadia.

Robby languished through unsuccessful treatments until a co-worker referred him to Providence Tarzana Medical Center. “I was scared and desperate,” Robby says, “but I had to do something because after five minutes of standing, my legs would get numb and I would lose my balance.”

In December of last year, Greg Khounganian, M.D., an orthopedic spine surgeon on staff at Providence Tarzana, performed a lumbar fusion to stabilize Robby’s spine. Today he is back on his feet—and back to his family. “Now I have my husband back and my kids have their dad back,” Hadia says.

Robby’s story is one example of how Providence’s orthopedic and neurosurgery experts offer a full repertoire of inpatient and outpatient spine services to help patients get moving again.

The Problem of Pain

Your spine is made up of 24 vertebrae that create a canal to protect the spinal cord. But problems—such as compression, injury or arthritis—with the spine’s complex network of bones, muscles, nerves and discs can cause severe pain.

Low back pain is the biggest problem. In fact, the American Academy of Orthopedic Surgeons estimates that as much as 80 percent of the population will experience low back pain.

“Spine surgery and spine problems are very complicated,” says Tiffany Rogers, M.D., an orthopedic spine surgeon at Providence Little Company of Mary Medical Center Torrance. “You can have arthritis pain, instability and compression— and sometimes all three.”

Common Treatments

Providence offers an array of procedures to help heal your pain, including:

Discectomy

Disc herniation results from an injury to the pads between the vertebrae. Improvement is expected with conservative treatment including medication, physical therapy and injections, on occasion. “ Out of 100 people I see, 99 do not need surgery,” says Dr. Rogers, who was a physical therapist before she became a spine surgeon. Providence performs microdiscectomy and discectomy—the surgical removal of the herniated disc—for patients who do require surgery.

Nerve decompression surgery

Providence offers laminectomy and laminotomy for patients with lumbar spinal stenosis, a condition in which the spinal canal is narrowed, causing pressure on the nerves. “If the spine is being compressed by thickened joints or bone, we give the spine room to breathe by removing bone around the nerve root,” says Elijah Wogu, M.D., a neurosurgeon at Providence Holy Cross Medical Center.

X-STOP Spacer

Providence hospitals also offer the X-STOP Spacer, an implant that can relieve the pain from spinal stenosis by lifting a vertebra to “unpinch” a pinched nerve. “The device simply opens up the spine a little more,” Dr. Wogu says.

Spinal fusion: Sometimes a “welding process” called spinal fusion is performed to keep the spine stable by joining vertebrae. “The top reasons for this are degenerative disease or arthritic disease with instability,” says Melvin Snyder, M.D., FACS, a neurosurgeon at Providence Little Company of Mary Medical Center San Pedro. Other reasons may include scoliosis, a tumor or a fracture.

Advanced Treatments

As technology evolves, Providence hospitals in the San Fernando Valley and the South Bay continue to redefine spine care.

At Providence Little Company of Mary San Pedro, spinal fusions are conducted using 3-D fluoroscopy integrated with BrainLab neuronavigation, a visualization and navigation tandem that Dr. Snyder likens to using GPS for better precision during surgery.

And at Providence Saint Joseph Medical Center, neurosurgeon Nouzhan Sehati, M.D., is on the forefront of artificial disc replacement, a relatively new FDA-approved technique that down the road, this may become the preferred alternative to fusion. “By replacing damaged discs, we’re allowing the vertebrae to move rather than fusing them. The goal is to have more mobility,” Dr. Sehati says. “A few years down the road, this may become the preferred alternative to fusion.”

In the end, whether you’re suffering from years of wear and tear or something unexpected like a tumor or an injury, it’s important to see a neurosurgeon or orthopedic spine surgeon to receive the right diagnosis. Robby, for one, is so glad he did. “I told Dr. Khounganian in the office before the surgery that I was in hell. Now I’m in heaven,” he says. “I wish I would have met him way back. I wouldn’t have had to go through all the suffering.”