Treating a range of neck and back conditions
Treating a range of neck and back conditions
The spine surgeons at Scripps treat many types of back injuries, neck pain and spine conditions, including lower back pain, sciatica, scoliosis, herniated disc and spinal stenosis.
Neck and back conditions treated at Scripps
- Ankylosing spondylitis — a chronic inflammatory condition that can affect the spine and ultimately result in nonsurgical fusion of vertebrae.
- Back pain and lower back pain — can be chronic or acute and are caused by rheumatoid arthritis, osteoarthritis, muscle strains, traumatic injury or degeneration of intervertebral discs, spinal stenosis and other conditions, such as compression fractures or ligament tears.
- Cauda equine syndrome — a rare disorder that affects the bundle of nerve roots in the lower back and can impair bladder and bowel control.
- Cervical radiculopathy (pinched nerve) — when intervertebral discs in the neck lose their height and vertebrae grow bone spurs to compensate.
- Cervical spondylotic myelopathy — also called spinal cord compression — can be caused by an injury or prolonged wear and tear of spinal discs in the neck.
- Chordoma — a slow-growing tumor that can be found in the spine and base of the skull.
- Degenerative disc disease — the progressive deterioration of intervertebral discs caused by wear and tear that accompanies aging.
- Failed spinal surgery — can result in persistent pain after back surgery. There are many reasons a surgery may not relieve pain. The most common reason is that the lesion operated on was not the cause of the patient's pain.
- Fractures of the spine — include the cervical spine (neck), thoracic spine (middle back) and lumbar spine (lower back).
- Herniated disc (slipped disc, ruptured disc or bulging disc) — when one of the intervertebral discs weakens or ruptures, losing its original shape and putting pressure on nerves that can lead to pain, numbness and/or weakness in the neck, back, legs, feet, arms and fingers.
- Kyphosis — forward curvature of the spine that can produce a bowed back.
- Myelopathy — damage to the spinal cord in the neck region of the spine caused by a herniated intervertebral disc, bone spurs, dislocation, fracture, injury or autoimmune disease.
- Neck sprain (“stinger”) — the stretching of a nerve root or brachial plexus can occur from trauma caused by a football tackle involving the player’s head and neck.
- Osteoarthritis, which is the most common type of arthritis and involves degeneration of cartilage in the lower back.
- Sciatica, in which pain, weakness or numbing sensations are felt in the buttocks, hip, legs and feet due to nerve compression along the lower back (lumbar spine).
- Scoliosis, which is a sideway curvature of the spine that can affect children and teens, but can also be experienced by adults as “de novo” degenerative scoliosis due to disc degeneration.
- Spondylosis, which is caused by chronic wear on the cervical spine in the neck and is associated with osteoarthritis.
- Spondylolisthesis, which occurs when a bone in the back (vertebra) slips out of alignment due to a fracture, abnormal wear from arthritis, bone disease or injury.
- Stenosis, which is a narrowing of the spinal column that can put pressure on the spinal nerves and cause pain.
- Spinal cord tumors, which can be benign or malignant and may interfere with spinal and bodily functions.
Spine surgery options
Scripps hospitals, doctors and sports and physical rehabilitation facilities deliver advanced spinal care. Treatments for the neck and back include non-surgical and surgical approaches for spinal decompression, spinal stabilization and pain relief.
Common types of spine surgical procedures include:
- Minimally invasive spine procedures
- Spinal fusion
- Spinal reconstruction or revision
- Artificial disc replacement
Types of spine surgery offered at Scripps
- Anterior cervical discectomy and fusion (ACDF) — a procedure where a damaged disc is removed through an incision in the front of the neck, replaced with a bone graft and stabilized with a metal plate and screws.
- Anterior lumbar interbody fusion (ALIF) — a procedure where a damaged disc in the lower back is removed through an incision in the abdomen and replaced with a plastic spacer or metal cage, as well as a bone graft or morphogenic bone protein (BMP), before two vertebrae are stabilized with screws, plates and rods.
- Artificial disc replacement — a procedure where a damaged disc in the lower spine is removed and replaced with an artificial mechanical disc. The goal is to restore range of motion between two bones in the spine (called vertebrae). Learn more about artificial disc replacement.
- Axial lumbar interbody fusion (XLIF) — a minimally invasive surgery for spinal fusion in the lowest portion of the lower back (L4-L5 and L5-S1) and is performed through the side of the body.
- Discectomy — a procedure where surgeons remove all or part of a damaged disc by accessing the spine through an incision in the back or neck.
- Foraminotomy — a procedure where spinal bone is shaved or removed to widen the area through which nerve roots pass to exit the spinal canal.
- Kyphoplasty/vertebroplasty — a procedure where a balloon-like device is inserted into the spine and inflated to open up space that is filled with bone cement to relieve nerve compression.
- Laminoplasty — a procedure where an incision in the back of the neck to make cuts in lamina bone and insert small bone grafts that are stabilized with screws to open up space for the spinal cord and compressed nerves.
- Laminectomy — a procedure where part or all of the lamina, the back part of the vertebra that covers the spinal canal, is removed to allow more space for compressed spinal nerves.
- Microdiscectomy — a minimally invasive surgery that removes portions of a herniated disc through a small incision.
- Microlaminectomy — a minimally invasive surgery through a small incision to remove bone spurs that are pressing on spinal nerves.
- Minimally invasive lumbar decompression (MILD) — a procedure where surgeons make a small incision to remove parts of tissue that are pressing on spinal nerves.
- Minimally invasive spinal fusion,— performed through small incisions using an operating microscope, X-ray guidance and special surgical instruments.
- Pediatric spine surgery — highly specialized spinal care for children and teens, including treatment for scoliosis, kyphosis, congenital spinal abnormalities, spinal tumors and traumatic spine injuries. Learn more about pediatric spine surgery.
- Robotic spine surgery — uses 3D software modeling, planning and guided placement of surgical implants. Learn more about robotic spine surgery.
- Spine surgery revision — performed for certain patients to correct issues of a previous spine surgery. Revision surgery may be recommended in patients with continued chronic pain following surgery.
Alternatives to spine surgery
Spine surgery is not an option without a diagnosis based on imaging and a physical exam. Some people with serious health problems may not be suitable candidates for surgery.
Health insurance providers have different requirements before they will approve a spine procedure. Usually, non-surgical treatments are required before any surgery would be scheduled.
Nonsurgical back pain relief
Because not all injuries or conditions require surgery, Scripps clinicians can help you explore lifestyle changes and non-invasive approaches that may offer significant neck and back pain relief. Our spine specialists along with our pain medicine specialists can help you determine alternative treatments to back surgery may be right for you.
- Medication — includes prescriptions to address muscles spasms, chronic neck pain, chronic back pain or inflammation.
- Physical therapy and conditioning — can include personalized strengthening, range of motion exercises and stretches to treat pain and prevent future neck or back problems. Scripps offers several physical therapy options in San Diego with facilities in North County, South Bay, Central San Diego and La Jolla. Our team of experts uses the latest techniques and technologies to help people regain strength and mobility. Talk to your doctor about getting a referral to a specially trained Scripps rehabilitation specialist.
- Injections— can include anti-inflammatory drugs delivered to the spinal area and include facet joint injections, nerve root blocks, sacroiliac (SI) joint injections and coccyx (tailbone) injections.
- Massage therapy — to address tight or tense muscles that are causing neck or back pain. Various massage therapy techniques help, such as Swedish, trigger point or deep tissue massage, may help relax your muscles and release tension.
- Chiropractic treatment — can help relieve back pain symptoms caused by vertebrae that are out of position and putting stress on surrounding muscles.
- Acupuncture — involves tiny needles inserted into specific points on the body to stimulate energy flow, promote self-healing and potentially relieve pain.
Advances in care for neck and back conditions
Scripps orthopedic surgeons and neurosurgeons participate in research and clinical trials for new devices and procedures to improve treatments for patients with disc degeneration, including the use of artificial discs, bone morphogenic proteins (BMP) and other innovative therapies.
Support services and resources
As leaders in orthopedic care, we know what it takes to keep joints healthy. That’s why we equip our patients with support services and resources to help them achieve their best possible outcome. From connecting you with rehab services to empowering you with educational resources, Scripps offers a comprehensive lineup to help you along every step of your journey.
We are here for you — not only as your orthopedic surgeons, but as a team of experts who understands that your joint health is about much more than your medical treatment. Specifically, Scripps offers a variety of patient support services to ensure your physical and emotional well-being, as well as resources for dealing with the logistical aspects of your care.
Our services include:
- Home health care when you require skilled intermittent care in the comfort of your home.
- Nutrition and weight-maintenance services with registered dietitians of Scripps Center for Weight Management and Scripps Center for Integrative Medicine to help you plan meals that align with your health goals.
- Physical rehabilitation and occupational therapy to help you get back on your feet following an injury, illness or surgery.
- Visiting patient services if you reside beyond San Diego and want help arranging appointments or learning more about short-term lodging.
For more offerings, please visit our patient resources section.
Glossary and other resources
Also, patient education is an important part of understanding your joint condition and treatment plan. To stay informed, we encourage our orthopedic patients to:
- Bookmark the Scripps glossary of orthopedic terms for easy referencing.
- Watch the pre- and post-surgery videos your doctor recommends.
- Consult your orthopedic team for educational materials and a list of trusted online sources beyond the Scripps site.
Always check with your orthopedic surgeon first to ensure that you have the most accurate information for your particular medical condition or need.