I’m a 77 year old retired physician. For 1 year I had severe sciatic pain radiating from my right lower back to my right lower leg. I couldn’t walk more than 50 feet before the pain became severe. Dr. Georgiy Brusovanik performed surgery at Doctors hospital in Coral Gables replacing all the disk in my lumbar spine because the degeneration was severe.Procedure was done in two stages.The surgery was very successful.My recovery each time was shorter than i expected.I am now able to walk my dogs up to 12 city blocks per day.I am very pleased with the care i received and feel that Dr. Brusovanik expertise and kind manor helped me to achieve the success i had.

Dr. Burton Silver, MD
Dermatologic Surgeon
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Adult scoliosis or bending and curving of the spine, happens frequently. With time disks become shorter. Sometimes we notice this change as our grandparents age and lose height. Spinal disks are between each of the spinal vertebrae. They provide space for nerves that are leaving the spinal column between those vertebrae. As you can imagine, if the spacer wears out, nerves may get squeezed. The process is usually very slow. First, the nerves become swollen and inflamed and one may feel pain in the distribution of the nerve that is affected. For example down one’s thigh, buttock or leg. If the compression gets worse, patients start to feel numbness and weakness in the legs. If the spine has a curve, or scoliosis, the disks become shorter asymmetrically. In that case nerves on one side of the spine become compressed sooner then the nerves on the other side. Also, as the vertebrae bend and curve away from each other, the channels between the vertebrae become very narrow. As the compression progresses, patients feel more pain, numbness and weakness in their legs. In most severe cases of scoliosis, which are not common, patients may lose control of urine or bowel and become unable to walk even short distances. Most commonly, patients complain of back pain and limited walking distance due to thigh and leg pain.

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ScoliosisAbout two percent of people are affected by this deformation of the spine, which causes the normally straight spine to curve.

In early stages of degenerative scoliosis, we can make swollen, irritated nerves better with medicines and injections. Using simple x-ray, we can place a single drop of medicine right on the red and inflamed nerve. This can help with the pain going down the leg and back pain as well. Braces and Physical Therapy do help in selected cases of scoliosis as well. When all else fails, one can think about surgery.

Traditionally, we could straighten the spine with a long surgery on the back. The main goal is to create a solid, immobile segment from painful few vertebrae that shift and bend out of order. The muscles are injured to expose the bone. There is usually a lot of blood loss. Newer techniques allow surgeons to accomplish the same goals with less injury to the body. For example, screws can be placed through tiny poke holes instead of using a large open wound. Fusion can be accomplished in front of the spine where bone is more abundant and hence the operation is more reliable. Finally, such fusion is done through thin tubular devices that minimize injury to muscle and other important structures and allow decreased blood loss and faster recovery. Only the patients can decide when the risks of surgery are worth taking to get rid of pain. Surgery for scoliosis is done to relieve pain and improve quality of life.

In early stages of degenerative scoliosis, we can make swollen, irritated nerves better with medicines and injections. Using simple x-ray, we can place a single drop of medicine right on the red and inflamed nerve. This can help with the pain going down the leg and back pain as well. Braces and Physical Therapy do help in selected cases of scoliosis as well. When all else fails, one can think about surgery.

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XLIF: Lateral Lumbar Interbody FusionUnlike traditional back surgery, XLIF is performed through the patient’s side. By entering this way, major muscles of the back are avoided. This minimally-invasive procedure is generally used to treat leg or back pain caused by degenerative disc disease. It can be performed on an outpatient basis.

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Lumbar pedicle screw fixation (CD HORIZONS Sextant)This minimally-invasive procedure uses special guides and fluoroscopic imaging to allow a surgeon to precisely implant stabilizing screws and rods in the spine while minimizing damage to muscles, tendons and other soft tissue in the back.

In the hospital, Nurses will provide you with medicine for whatever ails you. At first, we will make it really easy to obtain pain medicine. We place a button that delivers IV pain medicine right into your hand. Over a day, we will transition you to pain pills until you will no longer feel pain from surgery itself. You will be able to resume a normal diet. A physical therapist will help you out of bed. Normally after surgery, patients just need to walk. However, if patients feel week, physical therapy at home and at an inpatient rehab facility can be provided.

There are very few guarantees in surgery. If someone offers you a therapy that is 100% effective, please do yourself a favor and run. Scoliosis is a complex mechanical problem and in about 90% of patients, surveys report significant pain relief. Please use the attached literature. Please see the attached scientific articles that were written by people who do their best to abstain from bias and financial incentive. Thank you for your attention.

• Scoliosis Article 1 [ Download PDF ]
• Scoliosis Article 2 [ Download PDF ]

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