Are Epidural Steroid Injections Right For You?

If you suffer from lumbar spinal stenosis, you are probably familiar with the pain that radiates down your legs. This pain can make it difficult to walk and even harder to just stand still. Stenosis is what happens when an enlarged facet joint or a bone spur compresses a spinal nerve or nerves. The pressure on the nerve sends pain signals to the leg or the part of your body that this particular nerve operates.
man with lower back pain
Some patients with spinal stenosis who visit us at the Spine Institute Northwest in Bothell, WA, are able to deal with their pain using conservative treatments such as exercise, behavior modifications, massage, and other techniques. Other people, though, end up requiring a stronger type of intervention so they can get on with their lives without constant pain interfering.

Lumbar spinal stenosis causes pain on the lower portion of the back. It can also cause leg cramps and pain when standing for long periods of time. Certain bending movements or sitting down may decrease your pain, but not for long.

Epidural Steroid Injections

Although these types of injections are minimally invasive, they are considered to be a conservative therapy for managing stenosis pain. A physician may inject a corticosteroid, which is an anti-inflammatory medication, into your disc area along with a local anesthetic. This combination injection can reduce pain and inflammation at the area where the nerves are being compressed. This solution may just be short-term for some patients, perhaps just a few weeks in time.

A study published in the New England Journal of Medicine in 2014 found no significant difference in self-reported pain relief between patients getting this injection combining steroids with pain relievers and others who were just injected with a pain medication alone. An epidural injection can be used to help diagnose issues in addition to relieving pain in the short-term. A physician like Dr. Solomon Kamson, MD, PhD, at the Spine Institute Northwest, will administer the epidural steroid injection guided by fluoroscopy based on your MRI imaging. If the patient’s pain is relieved, even if for less than a month, the prognosis may be good if minimally invasive surgery is chosen to relieve the nerve pressure.

If you are experiencing symptoms associated with spinal stenosis and lumbar pain, you may wish to find out whether an epidural injection is right for you, or if a minimally invasive surgical procedure, such as an endoscopically guided spinal decompression, is a good option. Contact Dr. Kamson at the Spine Institute today to make an appointment for your consultation by calling one of our patient advocates at (208) 496-0630.

How a Microdisectomy Can Get You Up to Speed Again

golf back painAfter professional golfer Tiger Woods underwent a minimally invasive microdisectomy in 2014 for a pinched nerve near his spinal cord, he was back on the golf course a few months later to play in the Quicken Loans National in Bethesda, Maryland.

Tiger Woods had been in constant agony prior to undergoing this surgery, one that is often performed by Dr. Solomon Kamson, MD, PhD, at the Spine Institute Northwest. Woods could no longer perform normal, everyday activities, leading him to get advice from other athletes, such as Tony Romo of the Dallas Cowboys, who had successfully undergone an endoscopically-assisted procedure for a herniated disc.

If you are suffering from numbness, weakness, and/or pain in your back or leg, you may be a candidate for a minimally invasive microdisectomy. A pinched nerve is also commonly referred to as a herniated disc. When you have a herniated disc, as Tiger Woods did, your pain may begin in the spine and then radiate down one or both of your legs. You can also experience a decrease of feeling in your leg, have tingling sensations, or feel weakness in your muscles. After getting up from a prone position, your pain may become worsened.

Dr. Kamson may advise patients who are experiencing this type of pain from a herniated disc to undergo a minimally invasive procedure called a microdisectomy. This procedure is often performed when your pain is stemming from nerve damage in the lumbar spine. The microdisectomy takes the pressure off the nerves in this area to relieve your pain.

During a microdisectomy, Dr. Sol Kamson will use an endoscope guided by a needle and Laser and Radiofrequency (RF) technology to repair the bulging disc from inside your body with just a small incision necessary to insert the scope. Tiny amounts of soft tissue and bone that are compressing the nerve and causing pain are extracted during the procedure. The entire surgery takes about 90 minutes for each vertebrae level being worked on. Although most patients opt for local anesthesia for this minimally invasive procedure, general anesthesia is needed for cervical decompression surgery.

For active patients who participate in sports regularly and are dealing with spinal and other sports-related issues, the Sports Medicine Clinic at the Spine Institute Northwest in Bothell, WA, also offers patients innovative treatment options. Contact Dr. Kamson today to schedule a consultation and learn more about how a microdisectomy can get you back in the game.

Get Relief from Back Pain and Sciatica – Part III

Dr. Solomon Kamson, MD, understands that persistent back pain has a huge negative impact on your quality of life. He takes the time to help you choose the best minimally invasive treatment for pain relief. Sol Kamson is highly skilled at performing the most modern treatment procedures now available to relieve pain without resorting to invasive surgery.

The procedures that have been discussed for relieving various types of back pain include endoscopic decompression, facet fixation, interbody fusion, radio frequency neurotomy, and endoscopic nerve excision. Dr. Kamson can also treat your chronic back pain using a pain pump or spinal cord stimulators.

Pain Pump Implants

Some people can effectively treat their back pain with oral medications, but these often have undesirable side effects. Medications may also need to be increased in dosage in order to achieve higher levels of pain relief as your body becomes used to certain types of drugs.

A pain pump delivers medicine straight to the pain’s source. This delivery method requires a lesser medication dosage, as the drug will not have to pass throughout your entire body, but rather it will be delivered directly to the spinal fluid for quick, strong pain relief.

Solomon Kamson at Spine Institute Northwest will surgically implant a pain pump beneath the skin of your abdomen. From there, a tiny catheter runs the medicine from the pump to your spinal column. This minimally invasive treatment is especially suitable for those who suffer from chronic, severe back pain when other treatment modalities have not worked well enough or the side effects of oral medications are too severe.
A pain pump is installed in two steps. First, the doctor inserts a temporary catheter to determine its effectiveness on relieving your pain. If the first step is successful, Dr. Kamson will then schedule the surgery to insert a pain pump. This outpatient procedure takes about two hours to perform. Every few months, the doctor will refill the pump, which only takes a few moments and requires no surgery.

Spinal Cord Stimulator Implants

Electrical signals delivered to the spinal nerves can relieve back pain, though inserting a spinal cord stimulator is an invasive procedure. For certain patients, however, this technique can work wonders as an analgesic. When other avenues of pain relief have failed to work, spinal cord stimulators may be the answer to solving chronic back pain issues. Dr. Kamson can place a tiny stimulator beneath the skin of your lower back or buttocks.  There is a thin wire attached which travels from the stimulator to the area of pain. When the device is turned on, patients may feel a tingling when the electrical current stimulates the nerves. Before Dr. Kamson inserts a spinal cord stimulator, he will test your body’s response to the low electrical current to ensure the effect is not uncomfortable.

If you’d like to get  more information, please schedule an appointment with one of our patient advocates by contacting the Spine Institute Northwest in Bothell, WA, today.

Get Relief from Back Pain and Sciatica – Part II

If you suffer from back pain and/or sciatica, you’ll be happy to know that Sol Kamson, MD, at the Spine Institute Northwest, is always on the lookout for the most up-to-date ways to offer patients relief. Dr. Kamson is a skilled surgeon who utilizes minimally invasive surgical procedures to relieve your discomfort and have you back to performing your normal everyday routines in a short period of time. Aside from procedures such as endoscopic decompression, interbody fusion and facet fixation, Solomon Kamson at the Spine Institute Northwest, offers other treatment modalities that can help you feel better without having to undergo invasive surgery.

Ease Nerve Pain with Radio Frequency Neurotomy

This minimally invasive procedure works to deaden the nerve that is causing your pain. A radio frequency neurotomy can provide you with pain relief for months, and some patients report having no painful symptoms for a year or even longer.

Using a fluoroscopy, a kind of X-ray showing live images as he works, Dr. Kamson can guide radio frequency needles to the area from which pain is originating. When the needles are in the exact spots they needs to be, Dr. Kamson then applies thermal energy. In this way, the radio waves interrupt the nerve impulses that tell the brain to feel pain.

This is a quick procedure that can be completed in less than an hour. A radio frequency neurotomy is done in the outpatient surgical center, with a short recovery period before you are then sent home. Some patients of Sol Kamson will need a second treatment after six months or up to a year later, while others experience relief for longer than a year.

After Dr. Kamson performs this procedure, you will likely feel soreness at the insertion site of the needle and heat energy infusion. Patients are advised to rest for the next 24-48 hours, after which they may go back to their normal routines in most cases.

Relief Using Endoscopic Nerve Excision

Dr. Kamson also performs endoscopic nerve excision, which is similar to radio frequency neurotomy, with the difference being the use of an endoscope to help in removing the nerve rather than just deadening it. The main cause of your pain, such as a bulging disc, will not be removed, but the nerve that is causing you to feel painful symptoms will be excised in order to halt discomfort.

The soreness and recovery time period for undergoing endoscopic nerve excision is just a few day’s rest longer than what you would need following a radio frequency neurotomy.

These two procedures may be very helping in relieving the pain associated with a facet disease. Call Solomon Kamson MD at Spine Institute Northwest in Bothell, WA, to schedule your appointment for a consultation. There is no need to live with chronic pain, as Dr. Kamson can provide you with many alternative treatments so you can live an active life once again.

Work-Related Back Pain in Heavy Equipment Operators and Delivery Drivers

Dr. Solomon Kamson of Spine Institute Northwest (SINW) in Bothell, Washington frequently treats patients who have suffered back injuries from performing work that taxes the body, especially the lower back. These workers, which include delivery drivers and heavy equipment operators, are exposed to more risk factors that may lead to back pain and musculoskeletal disorders such as extended hours sitting in awkward positions, exposure to vibration, and being in non-natural positions for hours at a time. Work-related injuries (such as back disorders) are seen as more common in the construction industry for these exact reasons. The National Institute for Occupational Safety has conducted studies to assess the impact of risk factors for workers operating heavy equipment. Traditional open back surgery, while effective at treating injuries, would mean extremely complicated procedures requiring extended recovery times. Using state-of-the-art minimally invasive techniques, the Spine Institute Northwest can significantly reduce patient downtime after their procedures. Minimally invasive back surgery requires only very small incisions and can be performed in outpatient settings, not requiring extended hospital stays.

Read these testimonials of five different cases where minimally invasive surgery helped them get their lives back when traditional back treatments could not.

Heavy Equipment Operator Penny Schwegel Gets Relief From Sciatic Pain

Penny, who operates the largest excavator for a mining firm in Alaska, believes her sciatica, which had been giving her trouble for nearly a decade, was made worse by the constant vibration from sitting in the machine for more than 12 hours at a time.

Cortisone shots were effective at managing the pain at first, but over time their efficacy wore off. A lumbar fusion procedure at SINW in December 2016 finally gave her the relief she was looking for.

Truck Driver Braun Hudson’s Battle With Paralyzing Back Pain

Braun, a truck driver from Washington who worked 6-days a week doing deliveries, finally felt the effects of his job on his body one day in 2015 when he found that he could not move his legs at all.

Being very skeptical of the merits of continuing pain medications just to manage his pain and traditional open back surgery, he opted for treatment at the SINW instead where Doctor Kamson recognized the gravity of his situation immediately.

“Dr. Kamson was surprised how I was even walking,” Braun recalls. After a lumbar decompression, the pressure on the nerves of his spine was relieved which completely addressed the pain.

Daniel Schamlzried: Herniated Disc Fixed

Years of working tough jobs including logging ,ranching, labor work, mining and truck driving took a heavy toll on Daniel’s back.  Told by doctors that open back surgery was not even a option for him at his age, he did some research on laser spine surgery instead. Diagnosed at SINW with degenerated disc that was causing his pain, a spinal fusion was performed on Daniel’s back.

Against the odds and against the outcomes predicted by other physicians, Daniel was able to find lasting pain relief for his back problems thanks to minimally invasive surgery.

Darrel Lewis – Sciatic Nerve Problem

Repetitive motions from his driving and delivery job such as lifting, pulling, and just getting off and on the truck, coupled with sciatica gradually made Darrel’s pain worse and worse. It got to a certain point where Darrel knew he had to do something, as the pain was affecting his relationship with his family and his ability to be effective at work.

This prompted Darrel to reach out to Spine Institute Northwest where he underwent a minimally invasive procedure for his back. Much to his surprise, the procedure only required a very small incision.

Chris Catron – Years of Intensive Labor Wrecked My Back

Doing heavy labor work while young and supporting a family ate away at Chris’ quality of life. Like many of the other patients at Spine Institute, Chris Catron ignored his back pain until it was too late. And as with other patients, he tried to address the pain through painkillers and physical therapy. His search for a permanent solution led him to Spine Institute Northwest and minimally invasive surgery where Dr. Kamson was able to fix his back through minimally invasive surgery.

Mark Tidball: Two Decades of Pain

Mark had been dealing with pain for almost 20 years prior to his procedure at SINW. His back pain he attributes to a job he held long ago that required some heavy lifting. Having witnessed the good work that Dr. Kamson had performed on his wife, Mark set up an appointment to have his own back looked at.

The source of Mark’s problems turned out to be a collapse of the discs in his lower back – essentially his vertebrae were grinding against each other (bone on bone). A lumbar decompression procedure at SINW addressed his back pain. Of the outcome of his procedure Mark says, “My pain is pretty much non-existent now.”


What is Minimally Invasive Surgery?

The term minimally invasive is used frequently when discussing surgery, especially when it involves the neck or back. However, “minimally invasive” can sometimes confuse patients. What exactly does minimally invasive mean? What does it mean in terms of recovery? While these general rules will apply to any minimally invasive surgery, it can help to speak to a spine and neck surgeon such as Dr. Solomon Kamson of the Spine Institute Northwest to determine what minimally invasive means for a specific type of surgery.

Dr. Kamson during surgery

What Does Minimally Invasive Mean?
In an open surgery, a surgeon will usually make an incision that is 5 to 6 inches long. Then, the surgeon pulls the muscle in this area aside to reach the area they are performing surgery on. This has a higher risk of damaging muscle tissue, which can increase postoperative pain and recovery time, in comparison to minimally invasive surgery.

In contrast, minimally invasive surgery requires only a small incision to be made by the surgeon. Advancements in medical technology allow the entire surgery to be performed through this small incision. Once the incision has been made, the surgeon uses special operating tools and guiding technology, such as an endoscope or microscopic camera. In some cases, the incisions are as small as 2 centimeters.

Minimally invasive surgeries are approved for use treating many back and neck conditions. These include degenerative disc disease, lumbar spinal stenosis, spinal deformities and infections, vertebral compression fractures, herniated discs, spinal tumors, and more.

What are the Benefits of Minimally Invasive Surgery?
There are many benefits to minimally invasive surgery, including better cosmetic results (less scarring), less surgical blood loss, faster recovery, less rehabilitation, and reduced risk of muscle damage, infection, and postoperative pain. Minimally invasive surgery allows for better cosmetic results because incisions are smaller and take less time to heal, so that there is not a large scar. Additionally, minimally invasive surgery reduces the trauma to muscles and soft tissue because it requires little to no cutting of this area. This causes all the other benefits.

Another possible benefit to minimally invasive surgery is a shorter operating time, and the possibility of not needing anesthesia. Many minimally invasive surgeries can be performed as outpatient procedures. These are performed with only a local anesthetic. The patient does not have to be put under, and can have their surgery completed in a short amount of time.

How Fast Does a Patient Recover from Minimally Invasive Surgery?
The recovery time for minimally invasive surgery varies depending on the particular surgery and the patient involved. The procedures for minimally invasive surgery require little to no muscle to be cut. This significantly reduces the amount of recovery time, in comparison to open surgery methods. In addition to less recovery time, the physical therapy process will also be shorter.

What are the Risks Associated with Minimally Invasive Surgery?
Similarly to any other surgical procedure, there are potential risks associated with minimally invasive surgery. These include adverse reaction to the anesthetic, unexpected blood loss, and localized infections. While the likelihood of adverse reaction to the anesthetic is the same as any other type of surgery, other risks are reduced. Minimally invasive surgery reduces the risk of unexpected blood loss and localized infections.

Advantages and Disadvantages of Laser Back Surgery

Laser back surgery was first introduced as an alternative to traditional back surgery in the 1980s. Since then, it has come into wider and wider use, as people seeking relief from back pain look for ways to obtain relief without having to undergo an extensive procedure. If you are considering having laser back surgery, go to experts like the doctors at the Spine Institute Northwest. Founded by Dr. Solomon Kamson, the Spine Institute Northwest specializes in minimally invasive spine surgery. The doctors there have experience with laser spine surgery and can help you understand the risks and benefits of the procedures.

The Process of Laser Back Surgery
Laser back surgery is performed using a focused beam of light, which is also known as a laser. This differs from traditional back surgery because the incision is small, and there are no cutting tools used to remove bones or cartilage. Lasers can be used to remove the ends of painful nerves and decrease the size of discs in a process known as ablation. A laminectomy, a procedure where part of a disc is removed to relieve pressure on the spine, is a common type of laser back surgery.

Advantages of Laser Back Surgery
Outpatient clinics that offer laser spine surgery provide hope for people suffering from debilitating back pain. The procedure involves smaller incisions, so the recovery time is not as long. Rather than having to endure a multi-day hospital stay, these minimally invasive procedures are generally performed on an outpatient basis. The surgeon does not have to disrupt as much muscle as in traditional open back surgery, so there is usually less pain after surgery.

Disadvantages of Laser Back Surgery
Because laser back surgery is still so new, limited research is available on its efficacy. You can, however, do research online to find out about different doctors and clinics, as well as find testimonials from patients who talk about their experiences with laser back surgery. Another disadvantage of laser back surgery is that it is rarely covered by insurers, meaning that patients have to pay out of pocket. However, because of the shorter recovery time, this cost must also be weighed against the potential costs of lost activity, whether it is working at your job or simply enjoying everyday life.

In the end, it is up to you as the patient to do your homework and find an experienced back specialist who can help you explore your pain management options, both surgical and nonsurgical. Dr. Kamson and the Spine Institute Northwest focus on early intervention and accurate diagnosis, trying to help people avoid missing out on life due to disability from chronic pain.