© 2019 by Randolph Health Orthopedics & Sports Medicine / 503 N. Fayetteville Street, Asheboro, NC 27203 / P 336-626-2688  F 336-626-4100

Spine Care

Back and neck problems trouble nearly 80 percent of people 30 years and older, and low back pain is one of the main causes for missed work. Luckily, spine care is no longer a world away – in fact it’s offered right here in Asheboro.

The Human Motion Institute at Randolph Health offers a comprehensive spine care program which uses the latest techniques for patients suffering from back and neck conditions. Dr. Shakeel Durrani with Randolph Health Orthopedics & Sports Medicine, is a fellowship-trained spine specialist who incorporates conservative treatments as well as innovative surgical techniques to best meet the needs of each patient. Dr. Durrani and his team of professionals have developed a program that delivers quality spine services close to home.

To schedule an appointment with Dr. Durrani, call Randolph Health Orthopedics & Sports Medicine at 336-626-2688.

We provide comprehensive spine care treatment including:

 

  • Conservative Approaches to Spine Care

  • Surgical Procedures for Spine Care


Procedures performed by:

Shakeel Durrani, MD

Spine, Trauma and Adult Reconstruction

 

 

Conservative Approaches to Spine Care

The back is a complicated structure of bones, joints, ligaments and muscles. You can sprain ligaments, strain muscles, rupture discs and irritate joints, all of which can lead to back and neck pain. While sports injuries or accidents can cause back and neck pain, sometimes very simple movements can have painful results. Additionally, arthritis, poor posture, obesity and psychological stress can cause back and neck pain.

A patient’s condition will determine if conservative or surgical approaches are appropriate.

The Human Motion Institute at Randolph Health offers a full array of non-surgical services including:

Physical Therapy (a unique program to assess and increase function and reduce pain)

Orthopedic Rehabilitation is essential to restore your lifestyle after an injury or surgery. Orthopedic patients typically have deficiencies and weaknesses which could be eliminated or alleviated via specific targeted workouts. A physical therapist will provide instruction and  the appropriate workouts designed to restore and enhance function. Orthopedic clinicians are educated about surgical procedures and are able to adapt and adjust their knowledge to treat each individual patient.

Orthopedic rehabilitation programs and treatments include but are not limited to:

 

  • Stretching exercises

  • Strengthening exercises

  • Passive stretching and joint mobilizations

  • Balance/proprioception

  • Other techniques to decrease swelling and increase circulation and healing times


Kyphoplasty (a minimally invasive procedure designed to stop the pain caused by a spinal fracture, to stabilize the spine bone and to restore some or all of the lost vertebral body height due to a compression fracture)

Kyphoplasty is a minimally invasive spinal procedure used to treat painful fractures or injuries to vertebra, or the small bones that make up the spinal column. When a vertebra fractures, the usual rectangular shape of the bone becomes compressed and distorted, causing pain. These compression fractures, which may involve the collapse of one more vertebrae in the spine, are a common symptom and result of osteoporosis

A patient undergoing Kyphoplasty lies face down. The physician advances a thin tube into the fractured vertebra from an incision in the back. Through the tube, the physician drills a small hole through the hard, outer part of the bone and into its softer center. This provides a pathway for the physician to insert the balloon into the interior of the vertebra, which is then inflated. This pushes apart the caps, or end plates, of the fractured vertebra, and restores the vertebra to its original shape as much as possible.

The balloon is then deflated and removed, leaving a cavity that the physician fills with bone cement. This procedure is done with local anesthesia. After the procedure, patients lie flat on their backs for a period of time while the cement hardens.

Vertebroplasty (a technique used for the treatment of vertebral compression fractures)

Vertebroplasty is a minimally invasive spinal procedure used to treat painful fractures or injuries to vertebra, or the small bones that make up the spinal column. When a vertebra fractures, the usual rectangular shape of the bone becomes compressed and distorted, causing pain. These compression fractures, which may involve the collapse of one more vertebrae in the spine, are a common symptom and result of osteoporosis.

Vertebroplasty involves injecting a special cement mixture into the small holes in weakened vertebrae to strengthen the spinal bones making them less likely to fracture again and providing pain relief. Through a small incision and guided by a fluoroscope, a hollow needle passes through the spinal muscles and into the fractured vertebra. Cameras guide the needle to the correct position and then bone cement is injected through the needle into the vertebra. After the procedure, patients lie flat on their backs for a period of time while the cement hardens. They are then discharged and can resume normal activity. The majority of patients have significant pain relief within a few days.

Epidural Steroid Injections (to treat muscle spasms and soft tissue problems associated with headaches, neck pain and low back pain)

Spinal Injections are often referred to as “spinal blocks.” Medications are injected into spinal structures such as the epidural space, intervertebral space, nerve root or facet joint. During the procedure anesthetics are put into the specific area to relieve pain. Many times a steroid is also administered to reduce swelling and inflammation. Once administered, the medication moves freely along the spine to coat the nerve roots and the lining of the facet joints. This begins to numb and relieve the patient’s pain.

While many spinal procedures can leave a patient sore or stationary for weeks, spinal injection procedures take less recovery time. Your physician determines the number of injections and an exercise routine often is included in treatment plans.

Nerve Blocks (a pain relief method that is performed by injecting medication into or around a nerve, or into the spine)

A nerve block is a pain relief method that is performed by injecting medication into or around a nerve, or into the spine. The block actually changes how pain signals are sent to your brain.

If you suffer from back or neck pain, you may benefit from a nerve block injection to achieve temporary pain relief. Nerve block injections can allow an irritated nerve to rest, relieving you of symptoms. Often times the nerve block can provide diagnostic information to the doctor. By performing a nerve block and then monitoring how you respond to the injection, the doctor can often use this information to help determine the cause or source of the pain.

Radiofrequency Ablation (a type of heat applied as a method of pain relief to destroy tissue that includes pain nerves)

Radiofrequency Energy is a type of heat that is created by a specific type of generator. This heat can be precisely delivered to nerves that carry pain signals. This heat can be used as a method of pain relief by destroying the tissue area that can include pain carrying nerves. Radiofrequency ablation is also called RFA.

Radiofrequency ablation can be used in patients who need longer term pain relief than is often provided by nerve blocks or injections. Because this treatment can actually destroy the nerves that carry pain impulses, the pain relief can last from a few months up to year.

Once you have undergone thorough examination by your physician, he or she will decide if you would be better served by one of the other injections or if Radiofrequency Ablation is the right treatment for you.

Facet Joint Injections (a method of pain relief in which steroid medication is injected to provide stability and guide motion in your spine)

Facets are tiny joints located in your neck, upper back, and lower back; their purpose is to provide stability and guide motion in your spine. These joints can become painful because of arthritis, an injury, or mechanical stress and in turn can cause pain in your lower back, hip, buttock, or leg.

Injecting a steroid medication into the facet joint can anesthetize the area and block the pain, often times providing long-term pain relief. The injection can also help confirm or deny the joint as the source of your pain. In other words, if you experience total relief of your symptoms while the facet joint is numb, then this joint is likely the source of your pain and future treatments can be directed towards the facet.

Implants of Spinal Cord Stimulator Trials

Medial Branch Blocks (an injection that interrupts the pain signal that is being carried to the facet joint)

Medial branch nerves are the nerve supply to the individual facet joints. At times, a facet joint injection doesn’t work and the injection must be placed directly on the medial branch of the nerve.

This injection interrupts the pain signal that is being carried to the facet joint. If the patient has the appropriate duration of pain relief after the medial branch nerve block other treatments may be investigated to gain lasting relief.

To schedule an appointment call Randolph Health Orthopedics & Sports Medicine at 336-626-2688.

Innovative Surgical Procedures for Spine Care

Often times, patients suffering from acute or chronic back or neck pain are able to manage their pain through conservative methods of treatment including: physical therapy or epideral steroid injections. Additionally, we strongly suggests lifestyle changes like weight reduction and exercise in order to help prevent and also manage back and neck pain.

For patients who have tried conservative treatment options and have not had satisfactory results, Dr. Durrani is highly skilled in several back and neck surgical procedures.

Dr. Durrani specializes in the following:

Cervical and Lumbar Laminectomies (surgical procedure that decreases the pressure on the nerve by removing a small piece of bone)

A laminectomy is removal or trimming of the lamina (roof) of the vertebrae to create more space for nerves. A laminectomy is performed when the space in the spinal canal is too small to accommodate all of the nerve roots. Part of the lamina is removed to create more space.

Laminectomies can be used in cases of herniated disc or spinal stenosis. Many physicians will perform a laminectomy when the patient complains of more leg pain than back pain. Leg pain indicates that there is a problem with the nerves such as pressure, causing radiating pain down the leg.

Cervical and Lumber Discectomies (surgical procedure that decreases the pressure on the nerve by removing a disc)

When a disc herniation occurs, a fragment of the normal spinal disc is dislodged. This fragment may press against the spinal cord or the nerves that surround the spinal cord. This pressure causes the symptoms that are characteristic of herniated discs.

The surgical treatment of a herniated disc is to remove the fragment of spinal disc that is causing the pressure on the nerve. This procedure is called a discectomy.

Fusion Procedures

 

A fusion can be defined as uniting together two or more of the small bones in the spine (vertebrae) so that no motion occurs between them. The concept of a fusion is similar to that of welding in industry; however, spinal fusion surgery does not weld the vertebrae during surgery. Instead, bone grafts are placed around the spine. The body then heals the grafts over several months, similar to healing a fracture, which joins or “welds,” the vertebrae together.

The ultimate goal of fusion is to obtain a solid union between two or more vertebrae. Fusion may or may not involve use of supplemental hardware such as plates, screws, and cages.

Smoking, medications for other conditions, and overall health can affect the rate of healing and fusion.

Microdiscectomy

Microlaminotomy and Foraminotomy

Adult and Pediatric Scoliosis Surgery

X-Stop Procedure

This is a system used to relieve symptoms of lumbar spinal stenosis. The surgeon uses a spacer to fit between the spinous processes (the bony prominences that you feel when palpating your “spine”) of the lower lumbar spine. This is a decompressive surgery and it is the only surgical treatment available for symptomatic lumbar spinal stenosis. While clinical results may be satisfactory, patients require a long period of recovery and the surgery can result in a high rate of perioperative and postoperative complications.

Revision Back Surgery

Anterior Lumbar Interbody Fusion

Spinal fusion is a surgical procedure used to correct problems with the small bones in the spine (vertebrae). It is essentially a “welding” process. The basic idea is to fuse together the painful vertebrae so that they heal into a single, solid bone.

An interbody fusion involves removing the disk that lies between the two vertebrae. When the disk space has been cleared out, a metal, plastic, or bone spacer is implanted between the two adjoining vertebrae. These spacers, or “cages”, usually contain bone graft material. This promotes bone healing and facilitates the fusion. After the cage is placed into the space, surgeons often use metal screws, plates, and rods to further stabilize the spine.

An interbody fusion can be performed using a variety of different approaches.In an anterior lumbar interbody fusion (ALIF), the procedure is performed from the front. With this approach, the organ and blood vessels must be moved to the side. This allows your surgeon to access the spine without moving the nerves.

Posterior Lumbar Interbody Fusion

Transforaminal Lumbar Interbody Fusion

Posterior Lateral Fusion of the Cervical, Thoracic and Lumbar Spine

Anterior Cervical Discectomy and Fusion

Cervical Artificial Disc Replacement

Lumbar Artificial Disc Replacement

Vertebral Corpectomy

A corpectomy is a surgical procedure that involves removing part of the vertebral body. It is usually performed as a way to decompress the spinal cord and nerves. Corpectomy is often performed in association with some form of discectomy.

Thoracic Discectomy

Minimally Invasive Spine Surgery

Removal and Repair of Failed Fusions and Spinal Hardware

To schedule an appointment call Randolph Health Orthopedics & Sports Medicine at 336-626-2688.