Providing Comprehensive Spine Care at

The world of spine surgery continues to rapidly evolve as minimally invasive techniques provide relief for patients while providing significantly reduced recovery time. Surgeries that used to require the cutting of muscle and months of recovery can now be performed on an outpatient basis with incisions as smal as one inch. Minimally invasive spine procedures performed by Carolina Neurosurgery & Spine Associates includes:

• Cervical Microendoscopic Discectomy (MED) - Developed by a practice neurosurgeon
• Lumbar Microendoscopic Discectomy (MED)
• Thoracoscopic Spine Surgery
• Minimally Invasive Posterior Lumbar Interbody Fusion (PLIF)

Microendoscopic Discectomy (MED)

Herniated discs are the most common, and most painful, back ailment. At Carolina Neurosurgery & Spine Associates, patients with cervical disc herniations have a minimally invasive treatment option. In 1997, one of our spine surgeons, Tim Adamson, MD, modified technology designed for lumbar surgery and developed an innovative solution for the cervical spine. Microendoscopic discectomy (MED), requires only a one-half inch incision in the back of the neck, allowing muscles to be merely separated. There is significantly less pain for the patient, thus resulting in a much shorter recovery time.

Posterior Lumbar Interbody Fusion (PLIF)

The Traditional Procedure
Posterior Lumbar Interbody Fusion (PLIF) is a surgical technique for relieving compression of nerves and placing bone graft between adjacent vertebrae to achieve a fusion. Typically, screws and rods or other types of spinal instrumentation are used to hold the spine in position while the bone heals. Indications for a PLIF may include leg pain and back pain secondary to degenerative disc disease, spondylolisthesis, or recurrent herniated discs.

As with most minimally invasive procedures, the primary advantage is faster recovery for the patient. With traditional spinal fusion, a hospital stay of up to five days is needed, and recovery can take up to three months.

The Minimally Invasive Technique
Minimally invasive PLIF is an alternative to traditional, open spinal decompression and fusion. Minimally invasive PLIF achieves the same goals and objectives as the open surgery while minimizing trauma to the patient. 

The procedure is performed through two one-inch incisions on either side of the lower back. The paraspinous muscles do not need to be stripped from the spine, there is less tissue retraction, and blood loss is minimized compared to the open procedure. Bone removal, a discectomy, an interbody fusion, and pedicle screw insertion can all be performed through the same small incisions. Therefore, tissue trauma and post-operative pain are reduced, hospital stays are shorter, and patients can recover more quickly.

Physiatry

Physiatrists are physicians who specialize in the diagnosis and treatment of musculoskeletal injuries and pain syndromes, and rehabilitation of patients with severe impairments. At Carolina Neurosurgery & Spine Associates, our board-certified physiatrists allow us to offer an even more comprehensive level of nonsurgical care. From assessing and treating spine disorders, to providing post-operative management of disabilities related to brain injuries and disorders, these specialists deliver a holistic approach where they try to avoid surgery and minimize medications.


Spine-Related Services

• Management of nonsurgical spine treatment including:
• Physical therapy
• Appropriate complementary medicine referrals
• Spinal manipulative therapy
• Limited but necessary medications
• EMG/NCV to evaluate for nerve & muscle disorders
• Therapeutic & diagnostic spinal injections
• Management of workers' compensation injuries
• Surgical referrals as needed
  
  

Brain Injury & Disorder Rehabilitation

• Disability management
• Post-concussion syndrome management
• Spasticity/dystonia management
• Sports-related concussion management
• EMG/NCV to evaluate for nerve & muscle disorders
• Behavior management

The on-site physical therapy services at our Ballantyne, Baldwin, Concord, Huntersville, Matthews and Rock Hill offices focus on improving patient recovery and rehabilitation. Our team of licensed physical therapists work together with our physiatrists and neurosurgeons to review patient progress, develop treatment plans, and share insight for optimal patient care.

Through one-on-one sessions with our physical therapists, patients receive the maximum benefit from their treatment. There is also an emphasis on patient education and injury prevention. For added convenience, patients may schedule physician and physical therapy appointments at or near the same time and in the same office.

Physical Therapy Services Include:

• State-of-the-art functional exercise equipment and modality treatments
• Individualized in-clinic and at-home exercise programs
• Skilled manual therapy and massage
• Spinal decompressive traction (both cervical and lumbar)
• Evaluation of individual motion impairments
• Training specific to sport or hobby-related needs
• Rehabilitation of golf-related spine injuries (www.golfrehabandfitness.com)
• Evaluations for returning to sports after surgery
• Treatment of carpal tunnel using traction device (Carpal Trac)
• Patient education
• Orthotics (fitting of devices that support or correct musculoskeletal disorders)
• Future injury prevention
• Pilates, yoga and senior exercise classes (Ballantyne location only)

Frequently Asked Questions

Why would a patient choose to utilize physical therapy?
The purpose of physical therapy is to educate patients about stretching, strengthening, reducing pain, preventing future occurrences of pain, and correcting posture and body mechanics. Our therapists work to restore, maintain and promote patients’ overall fitness and health, and design individual programs of treatment.

Which patients benefit most from physical therapy?
We help many different types of patients with our in-house physical therapy services. Patients complaining of back pain often benefit from physical therapy, depending on their condition, allowing them to avoid surgery. In addition to spine care, we treat a wide variety of orthopedic injuries to the shoulders, knees, hips and feet. Physical therapy is also utilized to help patients recover from spine or brain surgery. We offer specialized sports evaluations and training, including treatment of pain and injuries related to running, tennis and golf.

What takes place during a therapy session?
During a therapy session, a Physical Therapist (PT) or Physical Therapist Assistant (PTA) educates patients, reduces pain with different modalities (ice, heat, manual therapy traction or electrical stimulation). Patients are taught how to perform exercises with our on-site exercise equipment, including pulleys, bands, weights and bikes/treadmills. As recovery progresses, treatment may include dynamic training for flexibility, strength, endurance, posture and core training. Our PTs also provide patients with individualized home exercise programs.

How can physical therapy prevent future injuries?
Patients learn proper lifting techniques to use during cleaning and gardening to decrease low back pain and prevent injury. They may also learn exercises to perform at their desk during the workday to decrease neck pain (such as doing shoulder rolls, squeezing shoulder blades together and/or neck bends to shoulder).

What is manual therapy?
Manual therapy is a collection of techniques in which hand movements are skillfully applied to mobilize joints and soft tissues. These techniques may be used to alleviate pain, improve mobility, induce relaxation, reduce edema and improve pulmonary and musculoskeletal function. The use of manual therapy is considered by many PTs to be an important component of evaluation and treatment of spinal disorders.

Is physical therapy available at all practice offices?
Currently, on-site physical therapy is available at our Charlotte, Ballantyne, Concord, Huntersville, Matthews and Rock Hill offices.

Do you offer other ongoing services to help maintain or improve a patient’s health?
Pilates, yoga and senior exercise classes are also available at our Ballantyne location to help improve strength and flexibility. Please call 800-344-6716 to learn about specific classes and scheduled times.

Online Spine Animation Library
Click on any of the spine conditions or procedures below to see a detailed video animation. You can also print quick-reference brochures about each topic.