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style="--container-background:initial;--container-box-shadow:initial;--container-border-left:initial;--container-border-right:initial;--container-border-top:initial;--container-border-bottom:initial;--container-border-radius:initial;--item-background:initial;--item-hover-background:initial;--item-selected-background:initial;--item-font:initial;--item-color:initial;--item-hover-color:initial;--item-selected-color:initial;--item-text-decoration:initial;--item-hover-text-decoration:initial;--item-selected-text-decoration:initial;--item-text-transform:initial;--item-text-outline:initial;--item-hover-text-outline:initial;--item-selected-text-outline:initial;--item-text-highlight:initial;--item-hover-text-highlight:initial;--item-selected-text-highlight:initial;--item-letter-spacing:initial;--item-line-height:initial;--item-text-shadow:initial;--item-hover-text-shadow:initial;--item-selected-text-shadow:initial;--item-border-left:initial;--item-hover-border-left:initial;--item-selected-border-left:initial;--item-border-right:initial;--item-hover-border-right:initial;--item-selected-border-right:initial;--item-border-top:initial;--item-hover-border-top:initial;--item-selected-border-top:initial;--item-border-bottom:initial;--item-hover-border-bottom:initial;--item-selected-border-bottom:initial;--item-border-radius:initial;--item-hover-border-radius:initial;--item-selected-border-radius:initial;--item-box-shadow:initial;--item-hover-box-shadow:initial;--item-selected-box-shadow:initial;--sub-item-background:initial;--sub-item-hover-background:initial;--sub-item-selected-background:initial;--sub-item-font:initial;--sub-item-color:initial;--sub-item-hover-color:initial;--sub-item-selected-color:initial;--sub-item-text-decoration:initial;--sub-item-hover-text-decoration:initial;--sub-item-selected-text-decoration:initial;--sub-item-text-transform:initial;--sub-item-text-outline:initial;--sub-item-hover-text-outline:initial;--sub-item-selected-text-outline:initial;--sub-item-text-highlight:initial;--sub-item-hover-text-highlight:initial;--sub-item-selected-text-highlight:initial;--sub-item-letter-spacing:initial;--sub-item-line-height:initial;--sub-item-text-shadow:initial;--sub-item-hover-text-shadow:initial;--sub-item-selected-text-shadow:initial;--sub-item-border-left:initial;--sub-item-hover-border-left:initial;--sub-item-selected-border-left:initial;--sub-item-border-right:initial;--sub-item-hover-border-right:initial;--sub-item-selected-border-right:initial;--sub-item-border-top:initial;--sub-item-hover-border-top:initial;--sub-item-selected-border-top:initial;--sub-item-border-bottom:initial;--sub-item-hover-border-bottom:initial;--sub-item-selected-border-bottom:initial;--sub-item-border-radius:initial;--sub-item-hover-border-radius:initial;--sub-item-selected-border-radius:initial;--sub-item-box-shadow:initial;--sub-item-hover-box-shadow:initial;--sub-item-selected-box-shadow:initial;--item-hover-font:initial;--item-selected-font:initial;--item-hover-text-transform:initial;--item-selected-text-transform:initial;--item-hover-letter-spacing:initial;--item-selected-letter-spacing:initial;--item-hover-line-height:initial;--item-selected-line-height:initial;--sub-item-hover-font:initial;--sub-item-selected-font:initial;--sub-item-hover-text-transform:initial;--sub-item-selected-text-transform:initial;--sub-item-hover-letter-spacing:initial;--sub-item-selected-letter-spacing:initial;--sub-item-hover-line-height:initial;--sub-item-selected-line-height:initial;--item-vertical-padding:initial;--item-horizontal-padding:initial;--item-padding-top:initial;--item-padding-right:initial;--item-padding-bottom:initial;--item-padding-left:initial;--container-vertical-padding:initial;--container-horizontal-padding:initial;--container-padding-top:initial;--container-padding-right:initial;--container-padding-bottom:initial;--container-padding-left:initial;--item-vertical-spacing:initial;--item-horizontal-spacing:initial;--sub-items-vertical-spacing-before:initial;--sub-items-vertical-spacing-between:initial;--sub-item-vertical-padding:initial;--sub-item-horizontal-padding:initial;--sub-item-padding-top:initial;--sub-item-padding-right:initial;--sub-item-padding-bottom:initial;--sub-item-padding-left:initial;--columns-number:initial;--align:initial;--item-align:initial;--sub-item-align:initial;--submenu-direction:initial;--submenu-item-direction:initial;--submenu-sub-item-direction:initial"><div id="dataItem-mgpjp7za-dropdown" class="t_wvYI " role="group" aria-label="About" data-part="dropdown-container"><div class="cNddzb OOc2NG Nk9NbA G4Bkwp wixui-dropdown-container" data-animation-name="none"><div data-testid="responsive-container-content" class="dataItem-mgpjp7za-container"><div id="dataItem-mgpjp7za-submenu" class="toi7Rj x0UOau" data-hook="submenu"><ul class="sbxaYn x0UOau wixui-dropdown-menu" style="--items-number:2"><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/about" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Nicholas Clark, MD</span></a><ul class="SjbYta x0UOau" style="--items-number:4"><li class="P3tBK7" data-item-depth="2"><a data-testid="linkElement" data-anchor="anchors-meki4qan" data-part="dropdown-subitem" 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wixui-dropdown-menu__subitem-label" data-part="dropdown-subitem-label" data-testid="submenu-sub-item-label">Presentations</span></a></li><li class="P3tBK7" data-item-depth="2"><a data-testid="linkElement" data-anchor="anchors-mfcstbra" data-part="dropdown-subitem" href="https://www.nicholasjclarkmd.com/publications" target="_self" class="B2qCAf _3mA1c x0UOau wixui-dropdown-menu__subitem has-inner-focus-ring"><span class="UCVF7R wixui-dropdown-menu__subitem-label" data-part="dropdown-subitem-label" data-testid="submenu-sub-item-label">Book Chapters</span></a></li></ul></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/jorge-monje" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Jorge Monje, APRN</span></a></li></ul></div></div></div></div></div></div><span class="BDrALc"></span></li><li class="NxO5nt" data-part="menu-item" data-animation-name="none" data-item-depth="0"><div class="fYThT1"><div class="FBAIyH QFOPOz wixui-horizontal-menu__item wixui-menu__item cVnJ7u" data-part="menu-item-content" data-interactive="true"><a data-testid="linkElement" data-part="menu-item-link" href="https://www.nicholasjclarkmd.com/minimally-invasive-spine-surgery" target="_self" class=""><div class="ijO_Jr wixui-horizontal-menu__item-label wixui-menu__item-label GPIJZi" data-part="label">MIS Surgery</div></a><button aria-label="More MIS Surgery pages" class="RXCM8H" aria-expanded="false" data-part="dropdown-button"><svg width="16" height="11" viewBox="0 0 16 11" fill="none" xmlns="http://www.w3.org/2000/svg" data-part="dropdown-icon" class="kbbiAh wixui-menu__item-icon"><path d="M8 10.5L16 1.86193L14.7387 0.5L8 7.77613L1.26133 0.499999L-5.95321e-08 1.86193L8 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class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Robotics/Navigation</span></a></li></ul></div></div></div></div></div><div class="lmsYvh"><div style="--container-background:initial;--container-box-shadow:initial;--container-border-left:initial;--container-border-right:initial;--container-border-top:initial;--container-border-bottom:initial;--container-border-radius:initial;--item-background:initial;--item-hover-background:initial;--item-selected-background:initial;--item-font:initial;--item-color:initial;--item-hover-color:initial;--item-selected-color:initial;--item-text-decoration:initial;--item-hover-text-decoration:initial;--item-selected-text-decoration:initial;--item-text-transform:initial;--item-text-outline:initial;--item-hover-text-outline:initial;--item-selected-text-outline:initial;--item-text-highlight:initial;--item-hover-text-highlight:initial;--item-selected-text-highlight:initial;--item-letter-spacing:initial;--item-line-height:initial;--item-text-shadow:initial;--item-hover-text-shadow:initial;--item-selected-text-shadow:initial;--item-border-left:initial;--item-hover-border-left:initial;--item-selected-border-left:initial;--item-border-right:initial;--item-hover-border-right:initial;--item-selected-border-right:initial;--item-border-top:initial;--item-hover-border-top:initial;--item-selected-border-top:initial;--item-border-bottom:initial;--item-hover-border-bottom:initial;--item-selected-border-bottom:initial;--item-border-radius:initial;--item-hover-border-radius:initial;--item-selected-border-radius:initial;--item-box-shadow:initial;--item-hover-box-shadow:initial;--item-selected-box-shadow:initial;--sub-item-background:initial;--sub-item-hover-background:initial;--sub-item-selected-background:initial;--sub-item-font:initial;--sub-item-color:initial;--sub-item-hover-color:initial;--sub-item-selected-color:initial;--sub-item-text-decoration:initial;--sub-item-hover-text-decoration:initial;--sub-item-selected-text-decoration:initial;--sub-item-text-transform:initial;--sub-item-text-outline:initial;--sub-item-hover-text-outline:initial;--sub-item-selected-text-outline:initial;--sub-item-text-highlight:initial;--sub-item-hover-text-highlight:initial;--sub-item-selected-text-highlight:initial;--sub-item-letter-spacing:initial;--sub-item-line-height:initial;--sub-item-text-shadow:initial;--sub-item-hover-text-shadow:initial;--sub-item-selected-text-shadow:initial;--sub-item-border-left:initial;--sub-item-hover-border-left:initial;--sub-item-selected-border-left:initial;--sub-item-border-right:initial;--sub-item-hover-border-right:initial;--sub-item-selected-border-right:initial;--sub-item-border-top:initial;--sub-item-hover-border-top:initial;--sub-item-selected-border-top:initial;--sub-item-border-bottom:initial;--sub-item-hover-border-bottom:initial;--sub-item-selected-border-bottom:initial;--sub-item-border-radius:initial;--sub-item-hover-border-radius:initial;--sub-item-selected-border-radius:initial;--sub-item-box-shadow:initial;--sub-item-hover-box-shadow:initial;--sub-item-selected-box-shadow:initial;--item-hover-font:initial;--item-selected-font:initial;--item-hover-text-transform:initial;--item-selected-text-transform:initial;--item-hover-letter-spacing:initial;--item-selected-letter-spacing:initial;--item-hover-line-height:initial;--item-selected-line-height:initial;--sub-item-hover-font:initial;--sub-item-selected-font:initial;--sub-item-hover-text-transform:initial;--sub-item-selected-text-transform:initial;--sub-item-hover-letter-spacing:initial;--sub-item-selected-letter-spacing:initial;--sub-item-hover-line-height:initial;--sub-item-selected-line-height:initial;--item-vertical-padding:initial;--item-horizontal-padding:initial;--item-padding-top:initial;--item-padding-right:initial;--item-padding-bottom:initial;--item-padding-left:initial;--container-vertical-padding:initial;--container-horizontal-padding:initial;--container-padding-top:initial;--container-padding-right:initial;--container-padding-bottom:initial;--container-padding-left:initial;--item-vertical-spacing:initial;--item-horizontal-spacing:initial;--sub-items-vertical-spacing-before:initial;--sub-items-vertical-spacing-between:initial;--sub-item-vertical-padding:initial;--sub-item-horizontal-padding:initial;--sub-item-padding-top:initial;--sub-item-padding-right:initial;--sub-item-padding-bottom:initial;--sub-item-padding-left:initial;--columns-number:initial;--align:initial;--item-align:initial;--sub-item-align:initial;--submenu-direction:initial;--submenu-item-direction:initial;--submenu-sub-item-direction:initial"><div id="dataItem-mgpk95eq-dropdown" class="t_wvYI " role="group" aria-label="MIS Surgery" data-part="dropdown-container"><div class="cNddzb OOc2NG Nk9NbA G4Bkwp wixui-dropdown-container" data-animation-name="none"><div data-testid="responsive-container-content" class="dataItem-mgpk95eq-container"><div id="dataItem-mgpk95eq-submenu" class="toi7Rj x0UOau" data-hook="submenu"><ul class="sbxaYn x0UOau wixui-dropdown-menu" style="--items-number:3"><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/minimally-invasive-spine-surgery" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">About Minimally Invasive Spine (MIS) Surgery</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-anchor="anchors-mgr0o1ox" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/minimally-invasive-spine-surgery" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">How is MIS accomplished?</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-anchor="anchors-mgr0ob2t" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/minimally-invasive-spine-surgery" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Robotics/Navigation</span></a></li></ul></div></div></div></div></div></div><span class="BDrALc"></span></li><li class="NxO5nt" data-part="menu-item" data-animation-name="none" data-item-depth="0"><div class="fYThT1"><div class="FBAIyH QFOPOz wixui-horizontal-menu__item 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data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/degenerative-disc-disease" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Degenerative Disc Disease</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/herniated-disc-sciatica" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Herniated Disc (Sciatica)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/myelopathy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Myelopathy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/neck-and-back-pain" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Neck and Back Pain</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/radiculopathy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Radiculopathy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/spinal-stenosis" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Spinal Stenosis</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/spondylolisthesis-and-spondylolysis" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Spondylolisthesis and Spondylolysis</span></a></li></ul></div></div></div></div></div><div class="lmsYvh"><div style="--container-background:initial;--container-box-shadow:initial;--container-border-left:initial;--container-border-right:initial;--container-border-top:initial;--container-border-bottom:initial;--container-border-radius:initial;--item-background:initial;--item-hover-background:initial;--item-selected-background:initial;--item-font:initial;--item-color:initial;--item-hover-color:initial;--item-selected-color:initial;--item-text-decoration:initial;--item-hover-text-decoration:initial;--item-selected-text-decoration:initial;--item-text-transform:initial;--item-text-outline:initial;--item-hover-text-outline:initial;--item-selected-text-outline:initial;--item-text-highlight:initial;--item-hover-text-highlight:initial;--item-selected-text-highlight:initial;--item-letter-spacing:initial;--item-line-height:initial;--item-text-shadow:initial;--item-hover-text-shadow:initial;--item-selected-text-shadow:initial;--item-border-left:initial;--item-hover-border-left:initial;--item-selected-border-left:initial;--item-border-right:initial;--item-hover-border-right:initial;--item-selected-border-right:initial;--item-border-top:initial;--item-hover-border-top:initial;--item-selected-border-top:initial;--item-border-bottom:initial;--item-hover-border-bottom:initial;--item-selected-border-bottom:initial;--item-border-radius:initial;--item-hover-border-radius:initial;--item-selected-border-radius:initial;--item-box-shadow:initial;--item-hover-box-shadow:initial;--item-selected-box-shadow:initial;--sub-item-background:initial;--sub-item-hover-background:initial;--sub-item-selected-background:initial;--sub-item-font:initial;--sub-item-color:initial;--sub-item-hover-color:initial;--sub-item-selected-color:initial;--sub-item-text-decoration:initial;--sub-item-hover-text-decoration:initial;--sub-item-selected-text-decoration:initial;--sub-item-text-transform:initial;--sub-item-text-outline:initial;--sub-item-hover-text-outline:initial;--sub-item-selected-text-outline:initial;--sub-item-text-highlight:initial;--sub-item-hover-text-highlight:initial;--sub-item-selected-text-highlight:initial;--sub-item-letter-spacing:initial;--sub-item-line-height:initial;--sub-item-text-shadow:initial;--sub-item-hover-text-shadow:initial;--sub-item-selected-text-shadow:initial;--sub-item-border-left:initial;--sub-item-hover-border-left:initial;--sub-item-selected-border-left:initial;--sub-item-border-right:initial;--sub-item-hover-border-right:initial;--sub-item-selected-border-right:initial;--sub-item-border-top:initial;--sub-item-hover-border-top:initial;--sub-item-selected-border-top:initial;--sub-item-border-bottom:initial;--sub-item-hover-border-bottom:initial;--sub-item-selected-border-bottom:initial;--sub-item-border-radius:initial;--sub-item-hover-border-radius:initial;--sub-item-selected-border-radius:initial;--sub-item-box-shadow:initial;--sub-item-hover-box-shadow:initial;--sub-item-selected-box-shadow:initial;--item-hover-font:initial;--item-selected-font:initial;--item-hover-text-transform:initial;--item-selected-text-transform:initial;--item-hover-letter-spacing:initial;--item-selected-letter-spacing:initial;--item-hover-line-height:initial;--item-selected-line-height:initial;--sub-item-hover-font:initial;--sub-item-selected-font:initial;--sub-item-hover-text-transform:initial;--sub-item-selected-text-transform:initial;--sub-item-hover-letter-spacing:initial;--sub-item-selected-letter-spacing:initial;--sub-item-hover-line-height:initial;--sub-item-selected-line-height:initial;--item-vertical-padding:initial;--item-horizontal-padding:initial;--item-padding-top:initial;--item-padding-right:initial;--item-padding-bottom:initial;--item-padding-left:initial;--container-vertical-padding:initial;--container-horizontal-padding:initial;--container-padding-top:initial;--container-padding-right:initial;--container-padding-bottom:initial;--container-padding-left:initial;--item-vertical-spacing:initial;--item-horizontal-spacing:initial;--sub-items-vertical-spacing-before:initial;--sub-items-vertical-spacing-between:initial;--sub-item-vertical-padding:initial;--sub-item-horizontal-padding:initial;--sub-item-padding-top:initial;--sub-item-padding-right:initial;--sub-item-padding-bottom:initial;--sub-item-padding-left:initial;--columns-number:initial;--align:initial;--item-align:initial;--sub-item-align:initial;--submenu-direction:initial;--submenu-item-direction:initial;--submenu-sub-item-direction:initial"><div 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target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Degenerative Disc Disease</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/herniated-disc-sciatica" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Herniated Disc (Sciatica)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/myelopathy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Myelopathy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/neck-and-back-pain" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Neck and Back Pain</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/radiculopathy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Radiculopathy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/spinal-stenosis" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Spinal Stenosis</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/spondylolisthesis-and-spondylolysis" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Spondylolisthesis and Spondylolysis</span></a></li></ul></div></div></div></div></div></div><span class="BDrALc"></span></li><li class="NxO5nt" data-part="menu-item" data-animation-name="none" data-item-depth="0"><div class="fYThT1"><div class="FBAIyH QFOPOz wixui-horizontal-menu__item wixui-menu__item 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Discectomy and Fusion (ACDF)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-microdiscectomy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS Microdiscectomy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-decompression" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS Decompression/ Laminectomy
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href="https://www.nicholasjclarkmd.com/treatments/mis-llif-lateral-lumbar-interbody-fusion" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS LLIF (Lateral Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-alif-anterior-lumbar-interbody-fusion" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS ALIF (Anterior Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/cervical-total-disc-replacement" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Cervical Total Disc Replacement</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/pars-repair" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Pars repair</span></a></li></ul></div></div></div></div></div><div class="lmsYvh"><div 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Discectomy and Fusion (ACDF)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-microdiscectomy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS Microdiscectomy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-decompression" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS Decompression/ Laminectomy
</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-tlif" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS TLIF (Transforaminal Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/synovial-cyst-excision" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Synovial Cyst Excision</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-llif-lateral-lumbar-interbody-fusion" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS LLIF (Lateral Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-alif-anterior-lumbar-interbody-fusion" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS ALIF (Anterior Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/cervical-total-disc-replacement" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Cervical Total Disc Replacement</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/pars-repair" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Pars repair</span></a></li></ul></div></div></div></div></div><div class="lmsYvh"><div style="--container-background:initial;--container-box-shadow:initial;--container-border-left:initial;--container-border-right:initial;--container-border-top:initial;--container-border-bottom:initial;--container-border-radius:initial;--item-background:initial;--item-hover-background:initial;--item-selected-background:initial;--item-font:initial;--item-color:initial;--item-hover-color:initial;--item-selected-color:initial;--item-text-decoration:initial;--item-hover-text-decoration:initial;--item-selected-text-decoration:initial;--item-text-transform:initial;--item-text-outline:initial;--item-hover-text-outline:initial;--item-selected-text-outline:initial;--item-text-highlight:initial;--item-hover-text-highlight:initial;--item-selected-text-highlight:initial;--item-letter-spacing:initial;--item-line-height:initial;--item-text-shadow:initial;--item-hover-text-shadow:initial;--item-selected-text-shadow:initial;--item-border-left:initial;--item-hover-border-left:initial;--item-selected-border-left:initial;--item-border-right:initial;--item-hover-border-right:initial;--item-selected-border-right:initial;--item-border-top:initial;--item-hover-border-top:initial;--item-selected-border-top:initial;--item-border-bottom:initial;--item-hover-border-bottom:initial;--item-selected-border-bottom:initial;--item-border-radius:initial;--item-hover-border-radius:initial;--item-selected-border-radius:initial;--item-box-shadow:initial;--item-hover-box-shadow:initial;--item-selected-box-shadow:initial;--sub-item-background:initial;--sub-item-hover-background:initial;--sub-item-selected-background:initial;--sub-item-font:initial;--sub-item-color:initial;--sub-item-hover-color:initial;--sub-item-selected-color:initial;--sub-item-text-decoration:initial;--sub-item-hover-text-decoration:initial;--sub-item-selected-text-decoration:initial;--sub-item-text-transform:initial;--sub-item-text-outline:initial;--sub-item-hover-text-outline:initial;--sub-item-selected-text-outline:initial;--sub-item-text-highlight:initial;--sub-item-hover-text-highlight:initial;--sub-item-selected-text-highlight:initial;--sub-item-letter-spacing:initial;--sub-item-line-height:initial;--sub-item-text-shadow:initial;--sub-item-hover-text-shadow:initial;--sub-item-selected-text-shadow:initial;--sub-item-border-left:initial;--sub-item-hover-border-left:initial;--sub-item-selected-border-left:initial;--sub-item-border-right:initial;--sub-item-hover-border-right:initial;--sub-item-selected-border-right:initial;--sub-item-border-top:initial;--sub-item-hover-border-top:initial;--sub-item-selected-border-top:initial;--sub-item-border-bottom:initial;--sub-item-hover-border-bottom:initial;--sub-item-selected-border-bottom:initial;--sub-item-border-radius:initial;--sub-item-hover-border-radius:initial;--sub-item-selected-border-radius:initial;--sub-item-box-shadow:initial;--sub-item-hover-box-shadow:initial;--sub-item-selected-box-shadow:initial;--item-hover-font:initial;--item-selected-font:initial;--item-hover-text-transform:initial;--item-selected-text-transform:initial;--item-hover-letter-spacing:initial;--item-selected-letter-spacing:initial;--item-hover-line-height:initial;--item-selected-line-height:initial;--sub-item-hover-font:initial;--sub-item-selected-font:initial;--sub-item-hover-text-transform:initial;--sub-item-selected-text-transform:initial;--sub-item-hover-letter-spacing:initial;--sub-item-selected-letter-spacing:initial;--sub-item-hover-line-height:initial;--sub-item-selected-line-height:initial;--item-vertical-padding:initial;--item-horizontal-padding:initial;--item-padding-top:initial;--item-padding-right:initial;--item-padding-bottom:initial;--item-padding-left:initial;--container-vertical-padding:initial;--container-horizontal-padding:initial;--container-padding-top:initial;--container-padding-right:initial;--container-padding-bottom:initial;--container-padding-left:initial;--item-vertical-spacing:initial;--item-horizontal-spacing:initial;--sub-items-vertical-spacing-before:initial;--sub-items-vertical-spacing-between:initial;--sub-item-vertical-padding:initial;--sub-item-horizontal-padding:initial;--sub-item-padding-top:initial;--sub-item-padding-right:initial;--sub-item-padding-bottom:initial;--sub-item-padding-left:initial;--columns-number:initial;--align:initial;--item-align:initial;--sub-item-align:initial;--submenu-direction:initial;--submenu-item-direction:initial;--submenu-sub-item-direction:initial"><div id="dataItem-melo0pa1-dropdown" class="t_wvYI " role="group" aria-label="Treatments" data-part="dropdown-container"><div class="cNddzb OOc2NG Nk9NbA G4Bkwp wixui-dropdown-container" data-animation-name="none"><div data-testid="responsive-container-content" class="dataItem-melo0pa1-container"><div id="dataItem-melo0pa1-submenu" class="toi7Rj x0UOau" data-hook="submenu"><ul class="sbxaYn x0UOau wixui-dropdown-menu" style="--items-number:9"><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/anterior-cervical-discectomy-and-fusion-acdf" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Anterior Cervical Discectomy and Fusion (ACDF)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-microdiscectomy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS Microdiscectomy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-decompression" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS Decompression/ Laminectomy
</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-tlif" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS TLIF (Transforaminal Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/synovial-cyst-excision" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Synovial Cyst Excision</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" 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href="https://www.nicholasjclarkmd.com/minimally-invasive-spine-surgery" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">How is MIS accomplished?</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-anchor="anchors-mgr0ob2t" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/minimally-invasive-spine-surgery" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Robotics/Navigation</span></a></li></ul></div></div></div></div></div></div><span class="BDrALc"></span></li><li class="NxO5nt" data-part="menu-item" data-animation-name="none" data-item-depth="0"><div class="fYThT1"><div class="FBAIyH QFOPOz wixui-horizontal-menu__item 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style="--container-background:initial;--container-box-shadow:initial;--container-border-left:initial;--container-border-right:initial;--container-border-top:initial;--container-border-bottom:initial;--container-border-radius:initial;--item-background:initial;--item-hover-background:initial;--item-selected-background:initial;--item-font:initial;--item-color:initial;--item-hover-color:initial;--item-selected-color:initial;--item-text-decoration:initial;--item-hover-text-decoration:initial;--item-selected-text-decoration:initial;--item-text-transform:initial;--item-text-outline:initial;--item-hover-text-outline:initial;--item-selected-text-outline:initial;--item-text-highlight:initial;--item-hover-text-highlight:initial;--item-selected-text-highlight:initial;--item-letter-spacing:initial;--item-line-height:initial;--item-text-shadow:initial;--item-hover-text-shadow:initial;--item-selected-text-shadow:initial;--item-border-left:initial;--item-hover-border-left:initial;--item-selected-border-left:initial;--item-border-right:initial;--item-hover-border-right:initial;--item-selected-border-right:initial;--item-border-top:initial;--item-hover-border-top:initial;--item-selected-border-top:initial;--item-border-bottom:initial;--item-hover-border-bottom:initial;--item-selected-border-bottom:initial;--item-border-radius:initial;--item-hover-border-radius:initial;--item-selected-border-radius:initial;--item-box-shadow:initial;--item-hover-box-shadow:initial;--item-selected-box-shadow:initial;--sub-item-background:initial;--sub-item-hover-background:initial;--sub-item-selected-background:initial;--sub-item-font:initial;--sub-item-color:initial;--sub-item-hover-color:initial;--sub-item-selected-color:initial;--sub-item-text-decoration:initial;--sub-item-hover-text-decoration:initial;--sub-item-selected-text-decoration:initial;--sub-item-text-transform:initial;--sub-item-text-outline:initial;--sub-item-hover-text-outline:initial;--sub-item-selected-text-outline:initial;--sub-item-text-highlight:initial;--sub-item-hover-text-highlight:initial;--sub-item-selected-text-highlight:initial;--sub-item-letter-spacing:initial;--sub-item-line-height:initial;--sub-item-text-shadow:initial;--sub-item-hover-text-shadow:initial;--sub-item-selected-text-shadow:initial;--sub-item-border-left:initial;--sub-item-hover-border-left:initial;--sub-item-selected-border-left:initial;--sub-item-border-right:initial;--sub-item-hover-border-right:initial;--sub-item-selected-border-right:initial;--sub-item-border-top:initial;--sub-item-hover-border-top:initial;--sub-item-selected-border-top:initial;--sub-item-border-bottom:initial;--sub-item-hover-border-bottom:initial;--sub-item-selected-border-bottom:initial;--sub-item-border-radius:initial;--sub-item-hover-border-radius:initial;--sub-item-selected-border-radius:initial;--sub-item-box-shadow:initial;--sub-item-hover-box-shadow:initial;--sub-item-selected-box-shadow:initial;--item-hover-font:initial;--item-selected-font:initial;--item-hover-text-transform:initial;--item-selected-text-transform:initial;--item-hover-letter-spacing:initial;--item-selected-letter-spacing:initial;--item-hover-line-height:initial;--item-selected-line-height:initial;--sub-item-hover-font:initial;--sub-item-selected-font:initial;--sub-item-hover-text-transform:initial;--sub-item-selected-text-transform:initial;--sub-item-hover-letter-spacing:initial;--sub-item-selected-letter-spacing:initial;--sub-item-hover-line-height:initial;--sub-item-selected-line-height:initial;--item-vertical-padding:initial;--item-horizontal-padding:initial;--item-padding-top:initial;--item-padding-right:initial;--item-padding-bottom:initial;--item-padding-left:initial;--container-vertical-padding:initial;--container-horizontal-padding:initial;--container-padding-top:initial;--container-padding-right:initial;--container-padding-bottom:initial;--container-padding-left:initial;--item-vertical-spacing:initial;--item-horizontal-spacing:initial;--sub-items-vertical-spacing-before:initial;--sub-items-vertical-spacing-between:initial;--sub-item-vertical-padding:initial;--sub-item-horizontal-padding:initial;--sub-item-padding-top:initial;--sub-item-padding-right:initial;--sub-item-padding-bottom:initial;--sub-item-padding-left:initial;--columns-number:initial;--align:initial;--item-align:initial;--sub-item-align:initial;--submenu-direction:initial;--submenu-item-direction:initial;--submenu-sub-item-direction:initial"><div id="dataItem-mgpjp7zo-dropdown" class="t_wvYI " role="group" aria-label="Conditions" data-part="dropdown-container"><div class="cNddzb OOc2NG Nk9NbA G4Bkwp wixui-dropdown-container" data-animation-name="none"><div data-testid="responsive-container-content" class="dataItem-mgpjp7zo-container"><div id="dataItem-mgpjp7zo-submenu" class="toi7Rj x0UOau" data-hook="submenu"><ul class="sbxaYn x0UOau wixui-dropdown-menu" style="--items-number:8"><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/arthritis" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Arthritis</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/degenerative-disc-disease" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Degenerative Disc Disease</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/herniated-disc-sciatica" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Herniated Disc (Sciatica)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/myelopathy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Myelopathy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/neck-and-back-pain" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Neck and Back Pain</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/radiculopathy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Radiculopathy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/spinal-stenosis" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Spinal Stenosis</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/conditions/spondylolisthesis-and-spondylolysis" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Spondylolisthesis and Spondylolysis</span></a></li></ul></div></div></div></div></div></div><span class="BDrALc"></span></li><li class="NxO5nt" data-part="menu-item" data-animation-name="none" data-item-depth="0"><div class="fYThT1"><div class="FBAIyH QFOPOz wixui-horizontal-menu__item wixui-menu__item 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Discectomy and Fusion (ACDF)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-microdiscectomy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS Microdiscectomy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-decompression" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS Decompression/ Laminectomy
</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-tlif" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS TLIF (Transforaminal Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/synovial-cyst-excision" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Synovial Cyst Excision</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-llif-lateral-lumbar-interbody-fusion" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS LLIF (Lateral Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-alif-anterior-lumbar-interbody-fusion" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS ALIF (Anterior Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/cervical-total-disc-replacement" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Cervical Total Disc Replacement</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/pars-repair" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Pars repair</span></a></li></ul></div></div></div></div></div><div class="lmsYvh"><div style="--container-background:initial;--container-box-shadow:initial;--container-border-left:initial;--container-border-right:initial;--container-border-top:initial;--container-border-bottom:initial;--container-border-radius:initial;--item-background:initial;--item-hover-background:initial;--item-selected-background:initial;--item-font:initial;--item-color:initial;--item-hover-color:initial;--item-selected-color:initial;--item-text-decoration:initial;--item-hover-text-decoration:initial;--item-selected-text-decoration:initial;--item-text-transform:initial;--item-text-outline:initial;--item-hover-text-outline:initial;--item-selected-text-outline:initial;--item-text-highlight:initial;--item-hover-text-highlight:initial;--item-selected-text-highlight:initial;--item-letter-spacing:initial;--item-line-height:initial;--item-text-shadow:initial;--item-hover-text-shadow:initial;--item-selected-text-shadow:initial;--item-border-left:initial;--item-hover-border-left:initial;--item-selected-border-left:initial;--item-border-right:initial;--item-hover-border-right:initial;--item-selected-border-right:initial;--item-border-top:initial;--item-hover-border-top:initial;--item-selected-border-top:initial;--item-border-bottom:initial;--item-hover-border-bottom:initial;--item-selected-border-bottom:initial;--item-border-radius:initial;--item-hover-border-radius:initial;--item-selected-border-radius:initial;--item-box-shadow:initial;--item-hover-box-shadow:initial;--item-selected-box-shadow:initial;--sub-item-background:initial;--sub-item-hover-background:initial;--sub-item-selected-background:initial;--sub-item-font:initial;--sub-item-color:initial;--sub-item-hover-color:initial;--sub-item-selected-color:initial;--sub-item-text-decoration:initial;--sub-item-hover-text-decoration:initial;--sub-item-selected-text-decoration:initial;--sub-item-text-transform:initial;--sub-item-text-outline:initial;--sub-item-hover-text-outline:initial;--sub-item-selected-text-outline:initial;--sub-item-text-highlight:initial;--sub-item-hover-text-highlight:initial;--sub-item-selected-text-highlight:initial;--sub-item-letter-spacing:initial;--sub-item-line-height:initial;--sub-item-text-shadow:initial;--sub-item-hover-text-shadow:initial;--sub-item-selected-text-shadow:initial;--sub-item-border-left:initial;--sub-item-hover-border-left:initial;--sub-item-selected-border-left:initial;--sub-item-border-right:initial;--sub-item-hover-border-right:initial;--sub-item-selected-border-right:initial;--sub-item-border-top:initial;--sub-item-hover-border-top:initial;--sub-item-selected-border-top:initial;--sub-item-border-bottom:initial;--sub-item-hover-border-bottom:initial;--sub-item-selected-border-bottom:initial;--sub-item-border-radius:initial;--sub-item-hover-border-radius:initial;--sub-item-selected-border-radius:initial;--sub-item-box-shadow:initial;--sub-item-hover-box-shadow:initial;--sub-item-selected-box-shadow:initial;--item-hover-font:initial;--item-selected-font:initial;--item-hover-text-transform:initial;--item-selected-text-transform:initial;--item-hover-letter-spacing:initial;--item-selected-letter-spacing:initial;--item-hover-line-height:initial;--item-selected-line-height:initial;--sub-item-hover-font:initial;--sub-item-selected-font:initial;--sub-item-hover-text-transform:initial;--sub-item-selected-text-transform:initial;--sub-item-hover-letter-spacing:initial;--sub-item-selected-letter-spacing:initial;--sub-item-hover-line-height:initial;--sub-item-selected-line-height:initial;--item-vertical-padding:initial;--item-horizontal-padding:initial;--item-padding-top:initial;--item-padding-right:initial;--item-padding-bottom:initial;--item-padding-left:initial;--container-vertical-padding:initial;--container-horizontal-padding:initial;--container-padding-top:initial;--container-padding-right:initial;--container-padding-bottom:initial;--container-padding-left:initial;--item-vertical-spacing:initial;--item-horizontal-spacing:initial;--sub-items-vertical-spacing-before:initial;--sub-items-vertical-spacing-between:initial;--sub-item-vertical-padding:initial;--sub-item-horizontal-padding:initial;--sub-item-padding-top:initial;--sub-item-padding-right:initial;--sub-item-padding-bottom:initial;--sub-item-padding-left:initial;--columns-number:initial;--align:initial;--item-align:initial;--sub-item-align:initial;--submenu-direction:initial;--submenu-item-direction:initial;--submenu-sub-item-direction:initial"><div id="dataItem-mgpjp7zt4-dropdown" class="t_wvYI " role="group" aria-label="Treatments" data-part="dropdown-container"><div class="cNddzb OOc2NG Nk9NbA G4Bkwp wixui-dropdown-container" data-animation-name="none"><div data-testid="responsive-container-content" class="dataItem-mgpjp7zt4-container"><div id="dataItem-mgpjp7zt4-submenu" class="toi7Rj x0UOau" data-hook="submenu"><ul class="sbxaYn x0UOau wixui-dropdown-menu" style="--items-number:9"><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/anterior-cervical-discectomy-and-fusion-acdf" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Anterior Cervical Discectomy and Fusion (ACDF)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-microdiscectomy" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS Microdiscectomy</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-decompression" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS Decompression/ Laminectomy
</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-tlif" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS TLIF (Transforaminal Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/synovial-cyst-excision" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Synovial Cyst Excision</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-llif-lateral-lumbar-interbody-fusion" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS LLIF (Lateral Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/mis-alif-anterior-lumbar-interbody-fusion" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">MIS ALIF (Anterior Lumbar Interbody Fusion)</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/cervical-total-disc-replacement" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Cervical Total Disc Replacement</span></a></li><li class="" data-item-depth="1"><a data-testid="linkElement" data-part="dropdown-item" href="https://www.nicholasjclarkmd.com/treatments/pars-repair" target="_self" class="ptLEUT eP1KVV x0UOau wixui-dropdown-menu__item has-inner-focus-ring"><span class="u9_aLl wixui-dropdown-menu__item-label" data-part="dropdown-item-label" data-testid="submenu-item-label">Pars repair</span></a></li></ul></div></div></div></div></div></div><span class="BDrALc"></span></li><li class="NxO5nt" data-part="menu-item" data-animation-name="none" data-item-depth="0"><div class="fYThT1"><div class="FBAIyH QFOPOz wixui-horizontal-menu__item wixui-menu__item cVnJ7u" data-part="menu-item-content" data-interactive="true"><a data-testid="linkElement" data-part="menu-item-link" 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APRN</span></a></li></ul></div></div></div></div></div></div><span class="BDrALc"></span></li><li class="NxO5nt" data-part="menu-item" data-animation-name="none" data-item-depth="0"><div class="fYThT1"><div class="FBAIyH QFOPOz wixui-horizontal-menu__item wixui-menu__item cVnJ7u" data-part="menu-item-content" data-interactive="true"><a data-testid="linkElement" data-part="menu-item-link" href="https://www.nicholasjclarkmd.com/minimally-invasive-spine-surgery" target="_self" class=""><div class="ijO_Jr wixui-horizontal-menu__item-label wixui-menu__item-label GPIJZi" data-part="label">MIS Surgery</div></a><button aria-label="More MIS Surgery pages" class="RXCM8H" aria-expanded="false" data-part="dropdown-button"><svg width="16" height="11" viewBox="0 0 16 11" fill="none" xmlns="http://www.w3.org/2000/svg" data-part="dropdown-icon" class="kbbiAh wixui-menu__item-icon"><path d="M8 10.5L16 1.86193L14.7387 0.5L8 7.77613L1.26133 0.499999L-5.95321e-08 1.86193L8 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Clark, MD: Minimally Invasive Spine Surgeon in Naples, FL</h1></div><!--/$--><!--$--><div id="comp-mdhsuv371" class="N8MGzv _v6ohL AWXfZq comp-mdhsuv371 wixui-rich-text" data-testid="richTextElement"><h2 class="font_0 wixui-rich-text__text">Orthopedic Spine Surgeon: Minimally Invasive and Robotic Surgery in Naples, FL</h2></div><!--/$--><!--$--><div id="comp-mdhsuv391" class="N8MGzv _v6ohL AWXfZq comp-mdhsuv391 wixui-rich-text" data-testid="richTextElement"><p class="font_8 wixui-rich-text__text">Fellowship-trained orthopedic spine care at HSS at NCH, including revision and motion-preserving options for Southwest Florida.</p></div><!--/$--><!--$--><div id="comp-mdhsuv3c1" role="" class="HFEOE3 NaeT1r comp-mdhsuv3c1-container comp-mdhsuv3c1 wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><!--$--><div id="comp-mdhsuv3d2" class="comp-mdhsuv3d2" data-semantic-classname="button" dir="inherit"><a data-testid="linkElement" href="https://www.nicholasjclarkmd.com/patient-registration" target="_self" class="WZxFET style-mdhsuv3f__root wixui-button OOhWpA" aria-label="Make an Appointment
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Clark MD" style="object-fit:cover;object-position:50% 50%"/></picture></wow-image></div></div></div><!--/$--></div></div><!--/$--></div></section><!--/$--><!--$--><section id="comp-mdhvz68r" tabindex="-1" data-block-level-container="Section" class="ke5pl1 comp-mdhvz68r wixui-section fwXYgt" data-testid="section-container"><div id="bgLayers_comp-mdhvz68r" data-hook="bgLayers" data-motion-part="BG_LAYER comp-mdhvz68r" class="QG9w8P"><div data-testid="colorUnderlay" class="LNYVZi ayCf9D"></div><div id="bgMedia_comp-mdhvz68r" data-motion-part="BG_MEDIA comp-mdhvz68r" class="ROWgFb"></div></div><div data-testid="responsive-container-content" role="group" class="comp-mdhvz68r-container max-width-container"><!--$--><div id="comp-mdhvz68v1" role="" class="HFEOE3 NaeT1r comp-mdhvz68v1-container comp-mdhvz68v1 wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><!--$--><div id="comp-mdx5gevf" role="" class="HFEOE3 NaeT1r comp-mdx5gevf-container comp-mdx5gevf wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><!--$--><div id="comp-mdhw0ysj" class="N8MGzv _v6ohL AWXfZq comp-mdhw0ysj wixui-rich-text" data-testid="richTextElement"><h2 class="font_0 wixui-rich-text__text">Welcome</h2></div><!--/$--><!--$--><div id="comp-mdhw0ysl1" class="N8MGzv _v6ohL AWXfZq comp-mdhw0ysl1 wixui-rich-text" data-testid="richTextElement"><h2 class="font_2 wixui-rich-text__text">About Nicholas Clark</h2></div><!--/$--><!--$--><div id="comp-mdhw0ysn" class="N8MGzv _v6ohL AWXfZq comp-mdhw0ysn wixui-rich-text" data-testid="richTextElement"><p class="font_8 wixui-rich-text__text">Dr. Nicholas J. Clark is a fellowship-trained orthopedic spine surgeon at HSS at NCH in Naples. He specializes in minimally invasive and robotic spine surgery, including revision and motion-preserving care, for patients across Southwest Florida (Naples, Estero, Bonita Springs, Fort Myers, and surrounding cities). He trained at Mayo Clinic and completed spine fellowship at Hospital for Special Surgery in New York. His goal is to relieve pain and restore function with the least invasive option that still finishes the job safely.</p></div><!--/$--><!--$--><div id="comp-mdrrq0hk" role="" class="HFEOE3 NaeT1r comp-mdrrq0hk-container comp-mdrrq0hk wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><!--$--><div id="comp-mdrrq0j6" class="comp-mdrrq0j6" data-semantic-classname="button" dir="inherit"><a data-testid="linkElement" href="https://www.nicholasjclarkmd.com/about" target="_self" class="WZxFET style-mdrrq0ja3__root wixui-button OOhWpA" aria-label="Learn More"><span class="UPWJFm"><span class="QeinDR wixui-button__label" data-testid="stylablebutton-label">Learn More</span><span class="vwUNxR wixui-button__icon" aria-hidden="true" data-testid="stylablebutton-icon"><span>
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Clark MD&quot;,&quot;name&quot;:&quot;Clark.Nicholas.Casual.jpeg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:47,&quot;y&quot;:18},&quot;scrollEffect&quot;:&quot;none&quot;},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdix2ki2" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/c771f2_85e8f613f2d247b08694aa28f5246706~mv2.jpeg/v1/fill/w_980,h_1470,al_c,q_85,usm_0.66_1.00_0.01,enc_avif,quality_auto/Clark_Nicholas_Casual.jpeg" alt="Nicholas J. 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By operating through incisions typically smaller than one inch, surgeons can target specific areas of the spine with precision. Many MIS procedures are performed in outpatient settings, allowing patients to return home the same day.</p></div><!--/$--><!--$--><div id="comp-mdrshjck" class="comp-mdrshjck" data-semantic-classname="button" dir="inherit"><a data-testid="linkElement" href="https://www.nicholasjclarkmd.com/minimally-invasive-spine-surgery" target="_self" class="WZxFET style-mdrshjct4__root wixui-button OOhWpA" aria-label="Learn More
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</span></span></span></a></div><!--/$--></div><!--/$--><!--$--><div id="comp-mdix9xz5" role="" class="HFEOE3 NaeT1r comp-mdix9xz5-container comp-mdix9xz5 wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><!--$--><div id="comp-mdixfo9p" class="ArRNfA comp-mdixfo9p wixui-repeater"><div class="comp-mdixfo9p-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="list" class="comp-mdixfo9p-container"><!--$--><div id="comp-mdixfo9y3__8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">ACDF (Anterior Cervical Discectomy and Fusion)</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/anterior-cervical-discectomy-and-fusion-acdf" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce"><wow-image id="img-comp-mdj21vk0__8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;fd2f94_bea50f455a1341d6acdafaf0d1f76336~mv2.jpg&quot;,&quot;width&quot;:1058,&quot;height&quot;:1019,&quot;alt&quot;:&quot;ACDF (anterior cervical discectomy and fusion) for cervical disc disease and nerve or cord compression, Naples FL.&quot;,&quot;name&quot;:&quot;IMG_0354_edited.jpg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/fd2f94_bea50f455a1341d6acdafaf0d1f76336~mv2.jpg/v1/fill/w_980,h_944,al_c,q_85,usm_0.66_1.00_0.01,enc_avif,quality_auto/IMG_0354_edited.jpg" alt="ACDF (anterior cervical discectomy and fusion) for cervical disc disease and nerve or cord compression, Naples FL." style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--><!--$--><div id="comp-mdixfo9y3__f0fbdc4b-416a-485b-bc44-33f0317e0e94" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__f0fbdc4b-416a-485b-bc44-33f0317e0e94" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__f0fbdc4b-416a-485b-bc44-33f0317e0e94" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">Tubular Microdiscectomy (Minimally Invasive Lumbar Discectomy)</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__f0fbdc4b-416a-485b-bc44-33f0317e0e94" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__f0fbdc4b-416a-485b-bc44-33f0317e0e94" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/mis-microdiscectomy" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__f0fbdc4b-416a-485b-bc44-33f0317e0e94"><wow-image id="img-comp-mdj21vk0__f0fbdc4b-416a-485b-bc44-33f0317e0e94" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__f0fbdc4b-416a-485b-bc44-33f0317e0e94&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;fd2f94_2dcc7bfde43b4e05bf2df32fbc8c4410~mv2.jpg&quot;,&quot;width&quot;:220,&quot;height&quot;:286,&quot;alt&quot;:&quot;Tubular microdiscectomy for herniated lumbar disc and sciatica, Naples FL.&quot;,&quot;name&quot;:&quot;MIS microdisc_edited.jpg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__f0fbdc4b-416a-485b-bc44-33f0317e0e94" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/fd2f94_2dcc7bfde43b4e05bf2df32fbc8c4410~mv2.jpg/v1/fill/w_220,h_286,al_c,q_80,enc_avif,quality_auto/MIS%20microdisc_edited.jpg" alt="Tubular microdiscectomy for herniated lumbar disc and sciatica, Naples FL." style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--><!--$--><div id="comp-mdixfo9y3__971ef3b3-d471-42ff-bb74-1b998f1dc140" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__971ef3b3-d471-42ff-bb74-1b998f1dc140" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__971ef3b3-d471-42ff-bb74-1b998f1dc140" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">ULBD Laminectomy (Unilateral Laminotomy for Bilateral Decompression)</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__971ef3b3-d471-42ff-bb74-1b998f1dc140" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__971ef3b3-d471-42ff-bb74-1b998f1dc140" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/mis-decompression" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__971ef3b3-d471-42ff-bb74-1b998f1dc140"><wow-image id="img-comp-mdj21vk0__971ef3b3-d471-42ff-bb74-1b998f1dc140" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__971ef3b3-d471-42ff-bb74-1b998f1dc140&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;c771f2_e2e66a47c3234e64af0dfea92a58cfb0~mv2.jpg&quot;,&quot;width&quot;:1920,&quot;height&quot;:1080,&quot;alt&quot;:&quot;ULBD laminectomy (unilateral laminotomy for bilateral decompression) for lumbar stenosis, Naples FL.&quot;,&quot;name&quot;:&quot;Spinal_Decompression.jpg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__971ef3b3-d471-42ff-bb74-1b998f1dc140" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/c771f2_e2e66a47c3234e64af0dfea92a58cfb0~mv2.jpg/v1/fill/w_980,h_551,al_c,q_85,usm_0.66_1.00_0.01,enc_avif,quality_auto/Spinal_Decompression.jpg" alt="ULBD laminectomy (unilateral laminotomy for bilateral decompression) for lumbar stenosis, Naples FL." style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--><!--$--><div id="comp-mdixfo9y3__c35eb063-af19-4b98-a4e2-831f25f98886" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__c35eb063-af19-4b98-a4e2-831f25f98886" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__c35eb063-af19-4b98-a4e2-831f25f98886" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">MIS-TLIF (Minimally Invasive Transforaminal Lumbar Interbody Fusion)</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__c35eb063-af19-4b98-a4e2-831f25f98886" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__c35eb063-af19-4b98-a4e2-831f25f98886" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/mis-tlif" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__c35eb063-af19-4b98-a4e2-831f25f98886"><wow-image id="img-comp-mdj21vk0__c35eb063-af19-4b98-a4e2-831f25f98886" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__c35eb063-af19-4b98-a4e2-831f25f98886&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;c771f2_1b9a6996a30844d2bd9e097c6243f3dc~mv2.jpeg&quot;,&quot;width&quot;:3750,&quot;height&quot;:5000,&quot;alt&quot;:&quot;MIS-TLIF (minimally invasive transforaminal lumbar interbody fusion) for pinched nerve and unstable lumbar segment, Naples FL&quot;,&quot;name&quot;:&quot;AdobeStock_261992123.jpeg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__c35eb063-af19-4b98-a4e2-831f25f98886" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/c771f2_1b9a6996a30844d2bd9e097c6243f3dc~mv2.jpeg/v1/fill/w_980,h_1307,al_c,q_85,usm_0.66_1.00_0.01,enc_avif,quality_auto/AdobeStock_261992123.jpeg" alt="MIS-TLIF (minimally invasive transforaminal lumbar interbody fusion) for pinched nerve and unstable lumbar segment, Naples FL" style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--><!--$--><div id="comp-mdixfo9y3__c6530a2b-1fab-4222-af98-6a32f08c1f9f" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__c6530a2b-1fab-4222-af98-6a32f08c1f9f" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__c6530a2b-1fab-4222-af98-6a32f08c1f9f" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">Synovial Cyst Excision</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__c6530a2b-1fab-4222-af98-6a32f08c1f9f" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__c6530a2b-1fab-4222-af98-6a32f08c1f9f" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/synovial-cyst-excision" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__c6530a2b-1fab-4222-af98-6a32f08c1f9f"><wow-image id="img-comp-mdj21vk0__c6530a2b-1fab-4222-af98-6a32f08c1f9f" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__c6530a2b-1fab-4222-af98-6a32f08c1f9f&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;c771f2_7cf519f3f8eb42ca9b791e5674fa60d2~mv2.jpeg&quot;,&quot;width&quot;:4096,&quot;height&quot;:4096,&quot;alt&quot;:&quot;Synovial Cyst Excision is a procedure that removes fluid-filled cysts from the spine to reduce nerve irritation and pain.&quot;,&quot;name&quot;:&quot;AdobeStock_128892904.jpeg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__c6530a2b-1fab-4222-af98-6a32f08c1f9f" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/c771f2_7cf519f3f8eb42ca9b791e5674fa60d2~mv2.jpeg/v1/fill/w_980,h_980,al_c,q_85,usm_0.66_1.00_0.01,enc_avif,quality_auto/AdobeStock_128892904.jpeg" alt="Synovial Cyst Excision is a procedure that removes fluid-filled cysts from the spine to reduce nerve irritation and pain." style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--><!--$--><div id="comp-mdixfo9y3__851ecba7-de44-4708-b6e5-48afa336d0a9" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__851ecba7-de44-4708-b6e5-48afa336d0a9" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__851ecba7-de44-4708-b6e5-48afa336d0a9" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">LLIF (Lateral Lumbar Interbody Fusion)</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__851ecba7-de44-4708-b6e5-48afa336d0a9" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__851ecba7-de44-4708-b6e5-48afa336d0a9" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/mis-llif-lateral-lumbar-interbody-fusion" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__851ecba7-de44-4708-b6e5-48afa336d0a9"><wow-image id="img-comp-mdj21vk0__851ecba7-de44-4708-b6e5-48afa336d0a9" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__851ecba7-de44-4708-b6e5-48afa336d0a9&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;fd2f94_ee550703741c4c0db00ccec661a969dc~mv2.png&quot;,&quot;width&quot;:2250,&quot;height&quot;:2773,&quot;alt&quot;:&quot;LLIF (lateral lumbar interbody fusion) side-approach lumbar fusion, Naples FL.&quot;,&quot;name&quot;:&quot;IMG_0158.heic&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__851ecba7-de44-4708-b6e5-48afa336d0a9" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/fd2f94_ee550703741c4c0db00ccec661a969dc~mv2.png/v1/fill/w_980,h_1208,al_c,q_90,usm_0.66_1.00_0.01,enc_avif,quality_auto/IMG_0158_heic.png" alt="LLIF (lateral lumbar interbody fusion) side-approach lumbar fusion, Naples FL." style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--><!--$--><div id="comp-mdixfo9y3__b76b6309-890e-47c4-9eb5-d22e89f5d71c" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__b76b6309-890e-47c4-9eb5-d22e89f5d71c" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__b76b6309-890e-47c4-9eb5-d22e89f5d71c" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">MIS ALIF (Anterior Lumbar Interbody Fusion)</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__b76b6309-890e-47c4-9eb5-d22e89f5d71c" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__b76b6309-890e-47c4-9eb5-d22e89f5d71c" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/mis-alif-anterior-lumbar-interbody-fusion" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__b76b6309-890e-47c4-9eb5-d22e89f5d71c"><wow-image id="img-comp-mdj21vk0__b76b6309-890e-47c4-9eb5-d22e89f5d71c" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__b76b6309-890e-47c4-9eb5-d22e89f5d71c&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;fd2f94_43717d8bfd5d4aaea6c48f8245bd1573~mv2.jpeg&quot;,&quot;width&quot;:810,&quot;height&quot;:810,&quot;alt&quot;:&quot;MIS ALIF (Anterior Lumbar Interbody Fusion) is a front-approach procedure that replaces a damaged disc and fuses the lumbar spine for long-term support.&quot;,&quot;name&quot;:&quot;ALIF.jpeg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__b76b6309-890e-47c4-9eb5-d22e89f5d71c" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/fd2f94_43717d8bfd5d4aaea6c48f8245bd1573~mv2.jpeg/v1/fill/w_810,h_810,al_c,q_85,enc_avif,quality_auto/ALIF.jpeg" alt="MIS ALIF (Anterior Lumbar Interbody Fusion) is a front-approach procedure that replaces a damaged disc and fuses the lumbar spine for long-term support." style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--><!--$--><div id="comp-mdixfo9y3__9fac0d3e-ca35-48fd-816e-1b81216b3fa2" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__9fac0d3e-ca35-48fd-816e-1b81216b3fa2" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__9fac0d3e-ca35-48fd-816e-1b81216b3fa2" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">Cervical Disc Replacement (CDR / TDR)</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__9fac0d3e-ca35-48fd-816e-1b81216b3fa2" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__9fac0d3e-ca35-48fd-816e-1b81216b3fa2" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/cervical-total-disc-replacement" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__9fac0d3e-ca35-48fd-816e-1b81216b3fa2"><wow-image id="img-comp-mdj21vk0__9fac0d3e-ca35-48fd-816e-1b81216b3fa2" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__9fac0d3e-ca35-48fd-816e-1b81216b3fa2&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;c771f2_06fb73eeb1c14e54a77dea6f3d231194~mv2.jpg&quot;,&quot;width&quot;:1280,&quot;height&quot;:720,&quot;alt&quot;:&quot;Cervical disc replacement (CDR / TDR) for motion-preserving treatment of cervical disc disease, Naples FL.&quot;,&quot;name&quot;:&quot;cervartificialdisc_1280.jpg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__9fac0d3e-ca35-48fd-816e-1b81216b3fa2" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/c771f2_06fb73eeb1c14e54a77dea6f3d231194~mv2.jpg/v1/fill/w_980,h_551,al_c,q_85,usm_0.66_1.00_0.01,enc_avif,quality_auto/cervartificialdisc_1280.jpg" alt="Cervical disc replacement (CDR / TDR) for motion-preserving treatment of cervical disc disease, Naples FL." style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--><!--$--><div id="comp-mdixfo9y3__60bd3159-fc08-4e46-9aba-09e6a37f4e18" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__60bd3159-fc08-4e46-9aba-09e6a37f4e18" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__60bd3159-fc08-4e46-9aba-09e6a37f4e18" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">Pars repair</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__60bd3159-fc08-4e46-9aba-09e6a37f4e18" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__60bd3159-fc08-4e46-9aba-09e6a37f4e18" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/pars-repair" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__60bd3159-fc08-4e46-9aba-09e6a37f4e18"><wow-image id="img-comp-mdj21vk0__60bd3159-fc08-4e46-9aba-09e6a37f4e18" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__60bd3159-fc08-4e46-9aba-09e6a37f4e18&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;c771f2_ab6096ee86c54f418a328fbdb8fc2322~mv2.jpeg&quot;,&quot;width&quot;:243,&quot;height&quot;:208,&quot;alt&quot;:&quot;Pars Repair is a focused surgery that treats stress fractures in the spine to restore stability and reduce pain.&quot;,&quot;name&quot;:&quot;images (2).jpeg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__60bd3159-fc08-4e46-9aba-09e6a37f4e18" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/c771f2_ab6096ee86c54f418a328fbdb8fc2322~mv2.jpeg/v1/fill/w_243,h_208,al_c,q_80,enc_avif,quality_auto/images%20(2).jpeg" alt="Pars Repair is a focused surgery that treats stress fractures in the spine to restore stability and reduce pain." style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--><!--$--><div id="comp-mdixfo9y3__e3f642c3-4c77-417f-814f-219afc836462" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__e3f642c3-4c77-417f-814f-219afc836462" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__e3f642c3-4c77-417f-814f-219afc836462" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">Revision Spine Surgery</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__e3f642c3-4c77-417f-814f-219afc836462" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__e3f642c3-4c77-417f-814f-219afc836462" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/revision-spine-surgery" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__e3f642c3-4c77-417f-814f-219afc836462"><wow-image id="img-comp-mdj21vk0__e3f642c3-4c77-417f-814f-219afc836462" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__e3f642c3-4c77-417f-814f-219afc836462&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;fd2f94_b66785bdac9b495cb1590d73dbd6c712~mv2.jpg&quot;,&quot;width&quot;:1024,&quot;height&quot;:684,&quot;alt&quot;:&quot;Dr. Clark explaining spine anatomy with a lumbar model during consultation&quot;,&quot;name&quot;:&quot;revision-spine-model-clinic.jpg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__e3f642c3-4c77-417f-814f-219afc836462" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/fd2f94_b66785bdac9b495cb1590d73dbd6c712~mv2.jpg/v1/fill/w_980,h_655,al_c,q_85,usm_0.66_1.00_0.01,enc_avif,quality_auto/revision-spine-model-clinic.jpg" alt="Dr. Clark explaining spine anatomy with a lumbar model during consultation" style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--><!--$--><div id="comp-mdixfo9y3__ec743cf3-9baa-45c7-91b9-774b24c75e00" role="listitem" class="HFEOE3 NaeT1r comp-mdixfo9y3 EtmdIW wixui-repeater__item" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-repeater__item"></div><div class="comp-mdixfo9y3-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdixfo9y3-container"><!--$--><div id="comp-mdxkwpjj__ec743cf3-9baa-45c7-91b9-774b24c75e00" role="" class="HFEOE3 NaeT1r comp-mdxkwpjj wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div data-testid="responsive-container-content" role="group" class="comp-mdxkwpjj-container"><!--$--><div id="comp-mdxknlt5__ec743cf3-9baa-45c7-91b9-774b24c75e00" class="N8MGzv _v6ohL AWXfZq comp-mdxknlt5 wixui-rich-text" data-testid="richTextElement"><h3 class="font_3 wixui-rich-text__text">Robotic Spine Surgery</h3></div><!--/$--></div></div><!--/$--><!--$--><div id="comp-mdj21vk0__ec743cf3-9baa-45c7-91b9-774b24c75e00" data-testid="imageX" class="i4P7Vt comp-mdj21vk0 wixui-image"><a data-motion-part="BG_LAYER comp-mdj21vk0__ec743cf3-9baa-45c7-91b9-774b24c75e00" data-testid="linkElement" href="https://www.nicholasjclarkmd.com/treatments/robotic-spine-surgery" target="_self" class="YX2qkL"><div class="XWKVT7" data-motion-part=""><div data-motion-part="BG_MEDIA comp-mdj21vk0__ec743cf3-9baa-45c7-91b9-774b24c75e00"><wow-image id="img-comp-mdj21vk0__ec743cf3-9baa-45c7-91b9-774b24c75e00" data-is-responsive="true" data-image-info="{&quot;containerId&quot;:&quot;comp-mdj21vk0__ec743cf3-9baa-45c7-91b9-774b24c75e00&quot;,&quot;alignType&quot;:&quot;center&quot;,&quot;parallaxSpeed&quot;:1.5,&quot;sourceSets&quot;:[],&quot;imageData&quot;:{&quot;uri&quot;:&quot;fd2f94_a27571fb91354654b96bdce599feb096~mv2.jpg&quot;,&quot;width&quot;:1500,&quot;height&quot;:2000,&quot;alt&quot;:&quot;Dr. Nicholas Clark and his NCH operating room team celebrating their 100th ExcelsiusGPS robotic spine case in Naples, FL&quot;,&quot;name&quot;:&quot;dr-nicholas-clark-100th-robotic-spine-case-nch-naples.jpg&quot;,&quot;displayMode&quot;:&quot;fill&quot;,&quot;focalPoint&quot;:{&quot;x&quot;:50,&quot;y&quot;:51},&quot;scrollEffect&quot;:&quot;none&quot;,&quot;crop&quot;:null},&quot;hasAnimation&quot;:false,&quot;encoding&quot;:&quot;AVIF&quot;,&quot;allowFullGIFTransformation&quot;:false}" data-has-ssr-src="true" data-motion-part="BG_IMG comp-mdj21vk0__ec743cf3-9baa-45c7-91b9-774b24c75e00" class="qR3Oj6"><picture><img loading="lazy" src="https://static.wixstatic.com/media/fd2f94_a27571fb91354654b96bdce599feb096~mv2.jpg/v1/fill/w_980,h_1307,al_c,q_85,usm_0.66_1.00_0.01,enc_avif,quality_auto/dr-nicholas-clark-100th-robotic-spine-case-nch-naples.jpg" alt="Dr. Nicholas Clark and his NCH operating room team celebrating their 100th ExcelsiusGPS robotic spine case in Naples, FL" style="object-fit:cover;object-position:50% 51%"/></picture></wow-image></div></div></a></div><!--/$--></div></div></div><!--/$--></div></div></div><!--/$--></div><!--/$--><!--$--><div id="comp-mg73u39r" class="comp-mg73u39r" data-semantic-classname="button" dir="inherit"><button type="button" class="WZxFET style-mg73u3a4__root wixui-button" data-testid="buttonContent" aria-label="Arthritis"><span class="UPWJFm"><span class="QeinDR wixui-button__label" data-testid="stylablebutton-label">Arthritis</span><span class="vwUNxR wixui-button__icon" aria-hidden="true" data-testid="stylablebutton-icon"><span>
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Information</h2></div><!--/$--></div><!--/$--></div></div><!--/$--></div></div><!--/$--></div></section><!--/$--><!--$--><section id="comp-mdixh5v3" tabindex="-1" data-block-level-container="Section" class="ke5pl1 comp-mdixh5v3 wixui-section fwXYgt" data-testid="section-container"><div id="bgLayers_comp-mdixh5v3" data-hook="bgLayers" data-motion-part="BG_LAYER comp-mdixh5v3" class="QG9w8P"><div data-testid="colorUnderlay" class="LNYVZi ayCf9D"></div><div id="bgMedia_comp-mdixh5v3" data-motion-part="BG_MEDIA comp-mdixh5v3" class="ROWgFb"></div></div><div data-testid="responsive-container-content" role="group" class="comp-mdixh5v3-container max-width-container"><!--$--><div id="comp-mdj4bou5" role="" class="HFEOE3 NaeT1r comp-mdj4bou5 wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><div class="comp-mdj4bou5-overflow-wrapper ku1hVK" data-testid="responsive-container-overflow"><div data-testid="responsive-container-content" tabindex="-1" role="group" class="comp-mdj4bou5-container"><!--$--><div id="comp-me0haewj" class="QrIus  "><div class="comp-me0haewj"><div style="--wix-color-29:var(--wix-color-3);--wix-color-37:var(--wix-color-5);--wix-color-38:var(--wix-color-8);--wix-color-39:var(--wix-color-8);--wix-color-40:var(--wix-color-1);--wix-color-41:var(--wix-color-8);--wix-color-42:var(--wix-color-8);--wix-color-43:var(--wix-color-1);--wix-color-44:var(--wix-color-3);--wix-color-45:var(--wix-color-3);--wix-color-46:var(--wix-color-1);--wix-color-47:var(--wix-color-1);--wix-color-48:var(--wix-color-8);--wix-color-49:var(--wix-color-8);--wix-color-50:var(--wix-color-1);--wix-color-51:var(--wix-color-8);--wix-color-52:var(--wix-color-8);--wix-color-53:var(--wix-color-1);--wix-color-54:var(--wix-color-3);--wix-color-55:var(--wix-color-3)" data-hook="tpa-components-provider"><div style="--index2490108247-shadowXOffset:0px;--index2490108247-shadowYOffset:0px;overflow:visible" class="sN4uTVR" data-hook="Form-wrapper"><div style="--wix-color-29:var(--wix-color-3);--wix-color-37:var(--wix-color-5);--wix-color-38:var(--wix-color-8);--wix-color-39:var(--wix-color-8);--wix-color-40:var(--wix-color-1);--wix-color-41:var(--wix-color-8);--wix-color-42:var(--wix-color-8);--wix-color-43:var(--wix-color-1);--wix-color-44:var(--wix-color-3);--wix-color-45:var(--wix-color-3);--wix-color-46:var(--wix-color-1);--wix-color-47:var(--wix-color-1);--wix-color-48:var(--wix-color-8);--wix-color-49:var(--wix-color-8);--wix-color-50:var(--wix-color-1);--wix-color-51:var(--wix-color-8);--wix-color-52:var(--wix-color-8);--wix-color-53:var(--wix-color-1);--wix-color-54:var(--wix-color-3);--wix-color-55:var(--wix-color-3)" data-hook="tpa-components-provider"><div><form aria-label="General Inquiry" id="form-ee9eb636-7a3a-452f-a071-fe168b17d40b" data-hook="form-ee9eb636-7a3a-452f-a071-fe168b17d40b" class=""><fieldset class="kLNiUo"><div data-hook="form-root"><div class="ckHV4G" dir=""><div><div style="display:grid;width:100%;grid-template-columns:repeat(12, 1fr);grid-auto-rows:minmax(min-content, max-content) 1fr" class="GLWhGq"><div style="grid-row:1 / span 1;grid-column:1 / span 6;display:flex;align-items:flex-end"><label id="form-field-label-fc4ecdc7-267f-47a5-f851-52c8231728c8-comp-me0haewj-" for="form-field-input-fc4ecdc7-267f-47a5-f851-52c8231728c8-comp-me0haewj-" class="shszO9W sL0Ef41 sE7EeYv">First name<span aria-hidden="true" class="sHbjjkq">*</span></label></div><div style="grid-row:2 / span 1;grid-column:1 / span 6" data-hook="form-field-first_name_f831" data-field-type="CONTACTS_FIRST_NAME"><div data-hook="text-field-root" class="skk_vnu oNTzDv_---theme-3-box oNTzDv_--newErrorMessage snZ_6f6 sL5d0Ld"><div class="slP6sMf oeM_EMx---errorAppearance-8-TextOnly sF775mU"><div class="svEXDbE srLCoTH oNTzDv_---theme-3-box" data-theme="box" data-success="false" data-error="false" data-empty-state="true"><input id="form-field-input-fc4ecdc7-267f-47a5-f851-52c8231728c8-comp-me0haewj-" data-theme="box" data-success="false" data-error="false" data-empty-state="true" aria-invalid="false" required="" placeholder="Your first name" aria-label="First name" type="text" class="s__10GFi0  has-custom-focus" value=""/></div></div></div><div class="slP6sMf oeM_EMx---errorAppearance-8-TextOnly s__0oqQvY" data-hook="field-error-first_name_f831"></div></div><div style="grid-row:1 / span 1;grid-column:7 / span 6;display:flex;align-items:flex-end"><label id="form-field-label-2dd8e8df-a749-46fe-62f6-b19a5c25e849-comp-me0haewj-" for="form-field-input-2dd8e8df-a749-46fe-62f6-b19a5c25e849-comp-me0haewj-" class="shszO9W sL0Ef41 sE7EeYv">Last name<span aria-hidden="true" class="sHbjjkq">*</span></label></div><div style="grid-row:2 / span 1;grid-column:7 / span 6" data-hook="form-field-last_name_77b8" data-field-type="CONTACTS_LAST_NAME"><div data-hook="text-field-root" class="skk_vnu oNTzDv_---theme-3-box 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id="form-field-label-644d6a1d-6e56-4ce4-1f2f-a4afff73792c-comp-me0haewj-" for="form-field-input-644d6a1d-6e56-4ce4-1f2f-a4afff73792c-comp-me0haewj-" class="shszO9W sL0Ef41 sE7EeYv">Email<span aria-hidden="true" class="sHbjjkq">*</span></label></div><div style="grid-row:2 / span 1;grid-column:1 / span 12" data-hook="form-field-email_f880" data-field-type="CONTACTS_EMAIL"><div data-hook="text-field-root" class="skk_vnu oNTzDv_---theme-3-box oNTzDv_--newErrorMessage snZ_6f6 sL5d0Ld"><div class="slP6sMf oeM_EMx---errorAppearance-8-TextOnly sF775mU"><div class="svEXDbE srLCoTH oNTzDv_---theme-3-box" data-theme="box" data-success="false" data-error="false" data-empty-state="true"><input id="form-field-input-644d6a1d-6e56-4ce4-1f2f-a4afff73792c-comp-me0haewj-" data-theme="box" data-success="false" data-error="false" data-empty-state="true" aria-invalid="false" required="" placeholder="Your email" aria-label="Email" type="email" class="s__10GFi0  has-custom-focus" value=""/></div></div></div><div class="slP6sMf oeM_EMx---errorAppearance-8-TextOnly s__0oqQvY" data-hook="field-error-email_f880"></div><div id="form-field-suggestion-644d6a1d-6e56-4ce4-1f2f-a4afff73792c-comp-me0haewj-" data-hook="email-mistype-suggestion" aria-live="polite"></div></div></div></div><div><div style="display:grid;width:100%;grid-template-columns:repeat(12, 1fr);grid-auto-rows:minmax(min-content, max-content) 1fr" class="GLWhGq"><div style="grid-row:1 / span 1;grid-column:1 / span 12;display:flex;align-items:flex-end"><label id="form-field-label-b62efd03-1fb3-4299-52c3-bc8e8041c43b-comp-me0haewj-" for="form-field-input-b62efd03-1fb3-4299-52c3-bc8e8041c43b-comp-me0haewj-" class="shszO9W sL0Ef41 sE7EeYv">Subject<span aria-hidden="true" class="sHbjjkq">*</span></label></div><div style="grid-row:2 / span 1;grid-column:1 / span 12" data-hook="form-field-subject" data-field-type="TEXT_INPUT"><div data-hook="text-field-root" class="skk_vnu oNTzDv_---theme-3-box 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for="form-field-input-428d8494-c721-43f0-ed5d-57b310a4c047-comp-me0haewj-" class="shszO9W sL0Ef41 sE7EeYv">Message<span aria-hidden="true" class="sHbjjkq">*</span></label></div><div style="grid-row:2 / span 1;grid-column:1 / span 12" data-hook="form-field-message" data-field-type="TEXT_AREA"><div class="slP6sMf oeM_EMx---errorAppearance-8-TextOnly s_71EX_ ogfZBj6---theme-3-box ogfZBj6--newErrorMessage scI_sd4 shezckr"><div data-disabled="false" data-theme="box" data-error="false" data-success="false" data-focused="false"><div class="sEJ_l9V"><textarea id="form-field-input-428d8494-c721-43f0-ed5d-57b310a4c047-comp-me0haewj-" placeholder="Your Message" class="sY5Smt1 has-custom-focus" data-hook="text-area" aria-label="Message" aria-invalid="false" required=""></textarea></div></div></div><div class="slP6sMf oeM_EMx---errorAppearance-8-TextOnly s__0oqQvY" data-hook="field-error-message"></div></div></div></div><div><div style="display:grid;width:100%;grid-template-columns:repeat(12, 1fr);grid-auto-rows:minmax(min-content, max-content) 1fr" class="GLWhGq"><div style="grid-row:1 / span 1;grid-column:1 / span 12;display:flex;align-items:flex-end"></div><div style="grid-row:2 / span 1;grid-column:1 / span 12" data-hook="form-field-874a3a72-b160-40d9-eacb-6f5dcbfb55b2" data-field-type="SUBMIT_BUTTON"><div class=""><button data-fullwidth="false" data-mobile="false" data-hook="submit-button" style="--wix-ui-tpa-button-font-size-default:16px;--wix-ui-tpa-button-line-height-default:1.5em" aria-live="assertive" type="button" class="sqaxP2l sPAw12I sKv4tNB ojaRfgA---paddingMode-16-explicitPaddings ojaRfgA--wrapContent ojaRfgA---hoverStyle-9-underline sH_TMlX oeNpDxd--upgrade sgKo7D0 sasFW9G" data-focusable-focus="false" data-focusable-focus-visible="false" tabindex="0" aria-disabled="false"><span class="s__5CjnXs se5p61l">Submit</span></button></div></div></div></div></div><div role="region" aria-live="polite"><div style="transition:opacity 350ms ease-in-out;opacity:0"></div></div></div></fieldset></form></div></div></div></div></div></div><!--/$--><!--$--><div id="comp-me0gv7hs" role="" class="HFEOE3 NaeT1r comp-me0gv7hs-container comp-me0gv7hs wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><!--$--><div id="comp-me0gv7i1" class="N8MGzv _v6ohL AWXfZq comp-me0gv7i1 wixui-rich-text" data-testid="richTextElement"><h2 class="font_0 wixui-rich-text__text">Contact</h2></div><!--/$--><!--$--><div id="comp-me0gv7i5" class="N8MGzv _v6ohL AWXfZq comp-me0gv7i5 wixui-rich-text" data-testid="richTextElement"><h2 class="font_2 wixui-rich-text__text">Talk with Dr. Clark</h2></div><!--/$--><!--$--><div id="comp-me0gv7i83" class="N8MGzv _v6ohL AWXfZq comp-me0gv7i83 wixui-rich-text" data-testid="richTextElement"><p class="font_8 wixui-rich-text__text">For questions, help scheduling an appointment, or more information about treatment options, send a message using the form or call (239) 624-0306.</p></div><!--/$--><!--$--><div id="comp-me0gv7ib" role="" class="HFEOE3 NaeT1r comp-me0gv7ib-container comp-me0gv7ib wixui-box" dir="ltr"><div aria-hidden="true" class="jdJeEr NYfD3h inner-box wixui-box"></div><!--$--><div id="comp-me0gv7ie" class="comp-me0gv7ie" data-semantic-classname="button" dir="inherit"><a data-testid="linkElement" href="https://www.nicholasjclarkmd.com/patient-registration" target="_self" class="WZxFET style-me0gv7ii2__root wixui-button OOhWpA" aria-label="Book an Appointment
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Smaller is not automatically safer; the standard is a complete, safe decompression and solid stabilization. Anatomy, prior surgery, or deformity may still require a wider approach.\\\"}},{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"What is recovery like after microdiscectomy?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"Tubular microdiscectomy is usually same-day. Early goals are short walks, wound care, and activity limits such as avoiding bending, lifting, and twisting while the disc and soft tissues settle. No fusion is performed for a typical microdiscectomy, and a brace is not usually planned. Formal therapy is not automatic; many patients recover with walking and gradual activity, with therapy added later if progress stalls. Full timelines are set by the discharge instructions and follow-up visits.\\\"}},{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"How soon can patients walk and drive after spine surgery?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"Walking starts early after most neck and lumbar operations once anesthesia has cleared and pain allows safe footing. Driving waits until narcotics are stopped and the patient can brake and turn without hesitation; for ACDF that is often at least two weeks, and lumbar cases follow the specific discharge rules. Timing is individualized; the written plan after surgery wins if it differs from general guidance.\\\"}},{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"When do patients return to work after spine surgery?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"Desk work may resume sooner than physical labor. 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Clark, MD\\\"},\\\"mainEntity\\\":[{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"What is ACDF?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"ACDF is anterior cervical discectomy and fusion: surgery from the front of the neck to remove a diseased disc pressing on a nerve root or the spinal cord, rebuild height with an implant and graft, and fuse that level so the bones grow together over months.\\\"}},{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"How is radiculopathy different from myelopathy?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"Radiculopathy is a pinched nerve root, often with arm or hand pain, numbness, tingling, or weakness in a nerve pattern. Myelopathy is pressure on the spinal cord itself: clumsy hands, unsteady walking or balance, and symptoms that can worsen over time. Some people have both. Counseling and expectations differ.\\\"}},{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"Which nerve matches which disc level?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"In the neck, a disc problem at one level usually affects the nerve root that exits at that level. A simple patient map: C3\\\\u20134 \\\\u2192 C4 (trapezius \/ neck, sometimes around the shoulder blade); C4\\\\u20135 \\\\u2192 C5 (shoulder \/ outer upper arm; deltoid and rotator cuff strength); C5\\\\u20136 \\\\u2192 C6 (thumb side of the forearm and hand; biceps and wrist extension); C6\\\\u20137 \\\\u2192 C7 (middle finger \/ back of forearm; triceps); C7\\\\u2013T1 \\\\u2192 C8 (ring and small finger; hand grip). Not every person feels every textbook spot. 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Formal PT is only needed for about 20\\\\u201330% of people after early recovery if symptoms are not improving.\\\"}},{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"Can I use nicotine or anti-inflammatory pills after fusion?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"Nicotine is a hard stop. No nicotine products after fusion surgery. No NSAIDs for 3 months after fusion unless an exception is written. Ask before taking anything new for pain.\\\"}},{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"Is the fusion done at 6 weeks?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"No. Week 6 is a check-in and activity discussion, not proof that bone has fused. 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The operation matches the mechanical problem.\\\"}},{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"Who is a candidate for ULBD laminectomy?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"Patients with walking-limiting lumbar stenosis when imaging matches the exam, the segment is stable enough for decompression without fusion, and nonoperative care is not enough. If instability is part of the problem, fusion may be discussed instead.\\\"}},{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"How long will I stay in the hospital?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"Same-day discharge is common when the patient is ready. Overnight stay is case by case.\\\"}},{\\\"@type\\\":\\\"Question\\\",\\\"name\\\":\\\"Will I need a brace?\\\",\\\"acceptedAnswer\\\":{\\\"@type\\\":\\\"Answer\\\",\\\"text\\\":\\\"Brace after ULBD \/ laminectomy is case by case, not automatic. 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This is joint pain, the same flavor as an arthritic finger, located in the spine."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"akxuc30","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"w9jeu32","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When bone spurs narrow the nerve tunnels ("},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"foraminal stenosis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"), the symptoms change. 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A spine that was once flexible gets rigid, and the rigid segments above and below work harder, which is how the process spreads."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mt87e44","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"invsu46","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How it is diagnosed"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nst7v48","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fm7tr50","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Diagnosis starts with the pattern. Pain that is worse with extension and better with flexion points at the facets. Pain that radiates into a limb points at nerve compression. The exam tests strength, reflexes, and sensation to look for a neurologic pattern."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"no3x552","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fztmw54","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"X-ray"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" shows the classic arthritic signs: narrowed facet joint spaces, bone spurs ("},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"osteophytes"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"), and thickened bone. 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"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"CT scan"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" shows bone detail better than MRI and is useful when planning surgery around heavy spurring."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hclto63","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fxtcc65","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"An honest point about imaging: arthritic spurs on a scan do not prove they are causing your pain. Plenty of people have impressively spurred spines and no symptoms. The exam and the symptom pattern have to match the pictures, or the pictures are just pictures."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bnmd067","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"e69j869","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Diagnostic injections"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" can settle the question. A facet joint injection that numbs the suspected joint and relieves the pain for a few hours confirms the facet as the pain generator. That matters because it separates joint pain from nerve pain, which get different treatments."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8revs72","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"gsutc74","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative treatment comes first"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lklvf76","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4r2zl78","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Arthritis is a wear process, not a break, so the first line is management, not repair. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Physical therapy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (core strengthening, flexibility, posture) supports the arthritic segments and keeps the rest of the spine moving. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Anti-inflammatory medications"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" calm the joint inflammation. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Activity modification"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" means avoiding the positions that load the worst joints, usually heavy extension."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"q0e8486","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hjb5288","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Injection therapy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" has a real role here. Facet joint injections and "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"medial branch blocks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" both treat and diagnose facet pain. Epidural injections calm nerve pain from spur-related stenosis. Injections do not fix the arthritis, but they can break a pain cycle long enough for therapy to work."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xo5lk93","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1krk395","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Most arthritic flares settle over weeks with consistent care. The arthritis itself does not reverse, but the pain around it is often manageable for long stretches."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"m81w797","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"sasc299","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When surgery is considered"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vqzno101","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xu3xc103","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Here is the line to draw carefully. Surgery for "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"arthritic back pain alone"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", without nerve compression or instability, is a poor bet. Fusing a painful arthritic joint sometimes helps, but the results are less predictable than surgery for a pinched nerve, and the arthritis simply moves to the neighboring levels. A good surgeon will tell you when your arthritis is the kind surgery helps and when it is not."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ppeo6107","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zo9eq109","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgery is on the table when the arthritis is causing a structural problem surgery can fix: "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"nerve compression"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" from bone spurs with persistent radiating pain or progressive weakness, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"spinal stenosis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" that limits walking despite good nonoperative care, or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"instability"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" where arthritic wear has let a vertebra shift."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6vqa7117","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"0fpmh119","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgical options"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"l2atb121","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gw30x123","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgery does not cure arthritis. It treats what the arthritis is doing to the nerves or the alignment. When bone spurs are pinching a nerve, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"decompression"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" removes the spur and opens the tunnel. When arthritic wear has made a segment unstable or collapsed, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" stops the painful motion and holds the alignment while the nerves are freed. Sometimes both are needed in the same operation. The full details, candidacy criteria, and recovery timelines are on each treatment page."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"s9isq129","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"449tz131","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Red flags: seek urgent care"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"byyox133","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 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0)"},"type":"COLOR"}],"text":"Rapidly worsening weakness"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" in an arm or leg, or new foot drop"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"scv9z153","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6j9zs154","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Clumsy hands or new balance problems in the neck, which can signal cord compression from spurs"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"itt14156","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"twyao157","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Severe neck or back pain after trauma, or pain with fever, which needs prompt evaluation for fracture or infection"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"}],"type":"BULLETED_LIST"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"u605v159","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"4sk23161","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"FAQs"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"w914k163","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nvtfj165","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Is spinal arthritis the same as degenerative disc disease?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" They are different parts of the same wear process. Degenerative disc disease is the discs drying out and collapsing. Arthritis is the facet joints wearing down and growing bone spurs. They usually coexist and worsen each other, but they cause different pain: disc collapse tends toward instability and nerve tunnel narrowing, arthritis toward joint pain and spur-related pinching. Your surgeon sorts out which one is driving your symptoms."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"o19x5168","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"87ic6170","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"My MRI says \"multilevel spondylosis.\" Do I need surgery?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Probably not based on the report alone. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Spondylosis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is the radiologist's word for age-related spinal arthritis, and it is a normal finding in middle-aged and older adults. Surgery is for a structural problem that matches your symptoms: a spur pinching a nerve, stenosis limiting your function, or instability. The report describes anatomy. Your symptoms and exam determine treatment."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sydcb175","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ackak177","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Can the bone spurs be shaved off without a fusion?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Yes, when the spur is the whole problem. If a bone spur is pinching a nerve in an otherwise stable segment, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"decompression"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" removes the spur and leaves the spine's motion intact. Fusion enters when the segment is unstable, collapsing, or so arthritic that removing the spur would destabilize it. The flexion and extension X-rays are what decide."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"yxbb5182","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ku1t4184","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will arthritis come back after surgery?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" The arthritis at the operated level is addressed, but arthritis is a spine-wide process. Neighboring levels continue to age, and a fused segment loads them slightly more. That is one reason surgeons are conservative about fusing for pure arthritic pain: the underlying process continues either way."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qwv6l187","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"69bpt189","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Do I need to stop being active?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" No, with guidance. Motion is good for arthritic joints. Low-impact activity, core strengthening, and flexibility work are the mainstays. What to limit is heavy axial loading and repetitive extension through the worst segments. A PT who understands spinal arthritis is worth more than a generic exercise sheet."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"o2a7b192","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"f8blb194","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Considering care in Naples"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"15dhd196","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tm0qz198","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Arthritic changes on imaging are normal. Pain that limits your life is not, and the difference between the two is a clinical judgment, not a radiology report. If neck or back pain, or pain radiating into an arm or leg, is keeping you from the life you want, bring your imaging and your questions to HSS at NCH in Naples."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ibdp3200","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"x88p0202","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"}]},"link-conditions-all":"\/conditions\/","title":"Arthritis"},"0693432e-bd5a-4dea-823f-add130064813":{"image":"wix:image:\/\/v1\/fd2f94_44a7e856ce2c41d494188a213fd3a1c7~mv2.jpeg\/Cervical%20stenosis%20image.jpeg#originWidth=1024&originHeight=751","_id":"0693432e-bd5a-4dea-823f-add130064813","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"Spinal cord compression leading to balance, coordination, or bowel\/bladder issues, often requiring surgical treatment.","_createdDate":{"$date":"2025-08-04T13:50:12.284Z"},"shortDescription":"Spinal cord compression leading to balance, coordination, or bowel\/bladder issues, often requiring surgical treatment.","_updatedDate":{"$date":"2026-10-04T17:04:43.892Z"},"link-conditions-title":"\/conditions\/myelopathy","PageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"q1j2k8","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Myelopathy is a term for symptoms that occur when there is a problem with the spinal cord. It can be painful or painless but can involve numbness\/weakness of the hands as well as difficulty with balance, manual dexterity\/fine motor skill deterioration (such as handwriting worsening or frequent dropping of objects) or controlling bowel\/bladder function, among other symptoms."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sj28i10","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fu9iy12","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This can occur with compression of the spinal cord in the neck or mid to upper back. Given the severity of this condition, treatment for spinal cord compression typically involves surgery."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dn2ns14","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7efoo16","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The key distinction: radiculopathy is a pinched nerve root; myelopathy is a compressed spinal cor"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"cco3c170","nodes":[],"type":"PARAGRAPH"},{"id":"l3rn8451","nodes":[],"type":"VIDEO","videoData":{"containerData":{"alignment":"CENTER","textWrap":true,"width":{"size":"CONTENT"}},"thumbnail":{"height":720,"src":{"id":"media\/c771f2_95a070b239714473b25ee284a0c6ddf2f000.jpg"},"width":1280},"title":"myelopathy_720.mp4","video":{"duration":121.002,"src":{"id":"video\/c771f2_95a070b239714473b25ee284a0c6ddf2\/720p\/mp4\/file.mp4"}}}},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ltdib459","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"d. A pinched root affects one limb's wire. A compressed cord affects everything below the compression, both sides, plus coordination itself. That is why myelopathy changes the urgency of the conversation."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"t60tu18","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"42y4t20","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Causes"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"w0t7f22","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"s75ku24","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"In adults, myelopathy almost always comes from "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"cervical stenosis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":": the canal narrows from thickened ligaments, arthritic facet joints, bulging discs, and bone spurs until the cord itself is squeezed. Less common causes include a large disc herniation, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"OPLL"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (ossification of the posterior longitudinal ligament), prior trauma, or, rarely, tumors or inflammatory conditions. The thoracic cord can be compressed too, but the neck is by far the most common site."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9vhrd30","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"e3aky32","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Symptoms"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"n8qyp34","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rqp2936","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Myelopathy often arrives quietly, which is what makes it dangerous. Early signs are easy to dismiss: handwriting gets sloppy, buttons get harder, objects get dropped, the handwriting you could once do without thinking now takes effort. Then gait changes: balance feels off, stairs feel uncertain, walking in the dark becomes difficult. Neck pain may be present or completely absent. Later signs include numbness or weakness in the hands, legs that feel stiff or heavy, and difficulty controlling bowel or bladder function."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8xut038","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"byxps40","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Because it can be painless, myelopathy is often discovered late, after months of attributing the clumsiness to aging."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"54tcg42","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"r0qit44","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How it is diagnosed"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1u3vc46","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rxczb48","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The exam looks for upper motor neuron signs: "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"hyperreflexia"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (overly brisk reflexes), "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"clonus"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (rhythmic beating of the ankle when the foot is flexed), a positive "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Hoffman's sign"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (thumb flexion when the middle finger is flicked), or a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Babinski sign"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (toes fan upward when the sole is stroked). "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"MRI"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" of the cervical spine shows the cord compression and may show "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"myelomalacia"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", a bright signal change inside the cord indicating injury. That signal change matters: it marks damage that surgery can stop from progressing but may not fully reverse."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"59sdm62","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"2viyi64","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative treatment: limited role"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gf68i66","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jzcq468","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Unlike radiculopathy, myelopathy does not have a reassuring natural history. Mild, stable cases without progression are sometimes observed closely, but there is no injection, therapy program, or medication that decompresses a cord. The honest framing: nonoperative care is watchful waiting with a low threshold to act, not a treatment plan. If symptoms progress at any point, the discussion moves to surgery without delay."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5atn670","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"s6n3b72","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When surgery is considered"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"u4cd074","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1625t76","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgery is recommended for "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"progressive myelopathy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", for significant cord compression with signal change on MRI, or when symptoms are already meaningfully impairing hand function, gait, or bowel\/bladder control. The goal is to "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"stop progression first"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"; recovery of lost function is the second goal and depends on how long and how severely the cord was compressed. Earlier decompression gives better odds of meaningful recovery, which is why progressive myelopathy should not wait."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zphk482","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"0gpzg84","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgical options"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"uwxin86","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hbc7q88","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The operation removes the compression from the cord. From the front, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ACDF"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"cervical disc replacement"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (in select cases) addresses one to three levels. Posterior approaches can also be considered in select cases, and the options are reviewed at the clinic visit. The choice depends on the number of involved levels, alignment (kyphosis favors an anterior approach), and the source of compression. The full details, candidacy criteria, and recovery timelines are on each treatment page."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hnm4k94","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"r9ohq96","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Red flags: seek urgent care"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xdgof98","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"y95zg100","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Go to the ER or call your surgeon immediately if you develop:"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wkefm102","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"bulletedListData":{"indentation":0},"id":"acx8v104","nodes":[{"id":"lybx0105","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7lg97106","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Rapidly worsening"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" hand weakness, leg weakness, or new difficulty walking"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"urxgy109","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bwu9g110","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"New "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"loss of bowel or bladder control"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", or rapidly progressing numbness below a level"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"goqps114","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"si14c115","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Myelopathy symptoms after trauma, even minor trauma in a neck already known to be stenotic"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"}],"type":"BULLETED_LIST"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"l44dw117","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"bbaor119","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"FAQs"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hlb5m121","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"26li3123","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will myelopathy get better on its own?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Essentially never. Cord compression from stenosis is structural and progressive. Symptoms may plateau for stretches, which creates a false sense of stability, but the long-term direction is worsening. This is the opposite of a herniated disc, where waiting is often rewarded."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lk9ih126","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"z9fde128","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Can I just wait and watch it?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Only if symptoms are truly mild, truly stable, and being monitored with serial exams. Once there is progression, such as worse hand function, worse gait, or new bowel or bladder symptoms, waiting stops being safe. Cord damage that becomes permanent cannot be operated back."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kcrav131","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9zvfo133","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will surgery restore what I've lost?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" It stops the progression, which is the primary goal. Recovery of hand dexterity, balance, and strength is common but incomplete when compression was severe or prolonged; the cord heals poorly compared to a nerve root. Patients decompressed earlier recover more. No surgeon can promise full reversal, and you should be skeptical of one who does."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"urej1136","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1imp4138","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Is myelopathy the same as spinal stenosis?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Stenosis is the narrowing; myelopathy is what happens when that narrowing compresses the cord itself. Cervical stenosis without cord compression causes neck pain or radiculopathy. Once the cord is involved, it is myelopathy, and the treatment calculus changes."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"avz00141","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7vphm143","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What does the bright spot on my MRI mean?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" That is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"myelomalacia"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", a signal change inside the cord indicating injury from chronic compression. It confirms the cord is suffering, not just crowded. It raises the urgency of decompression and tempers expectations for full recovery."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"z9zqy148","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sdnpa150","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"I have no pain, just clumsy hands. Can that really be my spine?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Yes, and this is the classic myelopathy story. The cord carries fine motor control; compression degrades it before pain ever appears. Painless hand clumsiness with brisk reflexes is a spine problem until proven otherwise."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sk94u153","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"jvm46155","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Considering care in Naples"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gvlh4157","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"v99e1159","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Myelopathy rewards early recognition and punishes delay. If your hands are getting clumsy, your balance is off, or your cervical MRI shows cord compression, do not watch it drift. Bring your MRI and your questions to HSS at NCH in Naples for an exam that measures exactly what the cord is doing and a plan that protects it."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"388e8161","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ivl8e163","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"}]},"link-conditions-all":"\/conditions\/","title":"Cervical stenosis (Myelopathy)"},"524b351e-bdbc-41e6-987f-8ca61c7b894b":{"image":"wix:image:\/\/v1\/c771f2_14b705ed1ef0413cbf23621f8ac5f1e0~mv2.jpg\/shutterstock_2264100023.jpg#originWidth=1000&originHeight=666","_id":"524b351e-bdbc-41e6-987f-8ca61c7b894b","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"Age-related disc wear that can lead to spinal pain and nerve compression due to loss of disc height and flexibility.","_createdDate":{"$date":"2025-08-04T13:50:12.282Z"},"shortDescription":"Age-related disc wear that can lead to spinal pain and nerve compression due to loss of disc height and flexibility.","_updatedDate":{"$date":"2026-09-22T01:08:08.729Z"},"link-conditions-title":"\/conditions\/degenerative-disc-disease","PageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tzpmj2","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Discs are the soft cushions that act as shock absorbers between your vertebrae. Over time healthy discs tend to lose water and become more brittle, transmitting more load to the adjacent bones. These changes can cause neck or back pain. As discs lose height, there can also be compression of your spinal cord\/nerves which can also cause neck or back pain as well as symptoms in your arms or legs."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tbujy4","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zy6976","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Despite the name, this is not really a disease. It is the normal aging of the spinal discs, the same way skin wrinkles and joints stiffen. Nearly everyone develops some degree of it by middle age. The term describes the MRI findings; whether those findings cause pain is a separate question."},"type":"TEXT"}],"type":"PARAGRAPH"},{"id":"la5uu294","nodes":[],"type":"VIDEO","videoData":{"containerData":{"alignment":"CENTER","textWrap":true,"width":{"size":"CONTENT"}},"thumbnail":{"height":720,"src":{"id":"media\/c771f2_8894c4680ed4421d8c32948968dc27d6f000.jpg"},"width":1280},"title":"ddd_720 (1).mp4","video":{"src":{"id":"video\/c771f2_8894c4680ed4421d8c32948968dc27d6\/720p\/mp4\/file.mp4"}}}},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"607op8","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"qyf0m10","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What happens in a degenerating disc"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"l4k1w12","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"047l114","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A healthy disc is mostly water, held in a tough outer ring. With age, the disc dries out ("},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"desiccation"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"), flattens, and loses height. The outer ring can develop small tears. The neighboring vertebrae take on more load and respond by forming bone spurs ("},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"osteophytes"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"), and the facet joints behind the disc arthritically enlarge. As the disc space collapses, the nerve exit tunnels ("},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"foramina"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":") narrow, which is how a \"disc problem\" becomes a nerve problem."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6toab22","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rfq0t24","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This process can be accelerated by genetics, smoking, heavy labor, prior injury, or prior surgery at a neighboring level, but for most people it is simply wear over time."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zlh6626","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"m6v6v28","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Symptoms"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"z9np230","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"x7ec232","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The most common symptom is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"axial pain"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":": a deep ache in the neck or low back, often worse with sitting, bending, or lifting, and eased by changing position or lying down. Morning stiffness that loosens up is typical. When height loss pinches a nerve, symptoms radiate: shooting pain, numbness, or weakness into the arm or leg. When multiple levels are involved, the pain can feel diffuse and hard to localize."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nd89v36","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3el8q38","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Many people have advanced disc degeneration on MRI with no pain at all. Pain correlates poorly with how bad the pictures look."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2o0m240","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"bcm0m42","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How it is diagnosed"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"n7p3k44","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"q8oou46","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"MRI"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" shows desiccated (dark) discs, loss of disc height, annular tears, and any nerve compression. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"X-ray"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" shows disc space narrowing, bone spurs, and alignment, and flexion\/extension views reveal instability. Diagnosis is not the MRI alone: the exam has to connect a specific disc level to the patient's pain pattern, because degenerated discs are nearly universal after a certain age and most are silent."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2ctci51","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"79jxr53","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative treatment comes first"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5vs9q55","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"i7zas57","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The standard course is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"physical therapy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (core strengthening, flexibility, posture), "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"anti-inflammatory medications"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"activity modification"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", weight management, and "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"smoking cessation"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", since nicotine accelerates disc degeneration. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Epidural or facet injections"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" can calm nerve-related pain and help identify the pain generator, though they are less durable for pure discogenic back pain than for radiating leg pain."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"77qk369","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"atfy871","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Most flare-ups settle over weeks with consistent care. The goal is a strong, flexible spine around the degenerated segments."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"cg1iq73","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"hfc3l75","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When surgery is considered"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5v50t77","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ypfzx79","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgery enters the conversation when pain is persistent and disabling despite a real course of nonoperative care, or when disc collapse causes nerve compression with progressive symptoms. An honest caveat: surgery for "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"back pain alone"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (without nerve compression or instability) has less predictable results than surgery for radiating leg or arm pain. That is why the workup focuses on identifying a specific structural problem surgery can fix, not just a degenerated-looking MRI."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6ctlh83","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"bjtae85","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgical options"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"c2bho87","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1euhy89","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When a collapsed, painful disc is the confirmed source and nonoperative care has failed, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (such as "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"MIS TLIF"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"lateral interbody fusion (LLIF)"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ALIF"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":") stops the painful motion at that segment and restores disc height, which reopens the nerve tunnels. In the neck, a select patient with a degenerated disc, preserved motion, and no instability may be a candidate for "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"cervical disc replacement"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" instead of fusion. When the main problem is nerve compression from the collapse, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"decompression"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" addresses the pinched nerve directly. The full details, candidacy criteria, and recovery timelines are on each treatment page."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"flb63103","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"8xff5105","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Red flags: seek urgent care"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"m10wt107","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 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disease?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" No, and the name misleads a lot of patients. It is age-related wear of the discs, not a progressive illness. A better name would be \"disc aging.\" The findings are expected; only the symptoms, if any, need treating."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lgjmn139","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jrk2p141","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will it keep getting worse?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" The MRI findings progress slowly with age, but symptoms often do not follow the same curve. Many people have their worst flare in their 40s or 50s and then stabilize as the segment stiffens naturally. Symptom trajectory matters more than image trajectory."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"alocd144","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ozahm146","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Can the disc rehydrate or heal?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" No. Once a disc desiccates and loses height, it does not plump back up. Treatment works around the degeneration: stronger supporting muscles, better mechanics, calmer nerves, and, when needed, surgery that addresses the structural consequence."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"c0y4m149","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"l6d1m151","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"My MRI looks terrible but I feel okay. Do I need surgery?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" No. Surgery treats symptoms and neurologic deficits, not pictures. A bad-looking MRI without matching symptoms is observed, not operated on. This is one of the most common misunderstandings in spine care."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lvqiq154","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vd3bq156","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will a fusion fix my back pain?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" It can, when a specific painful disc has been carefully identified as the source and nonoperative care has failed. But back-pain outcomes after fusion are less predictable than leg-pain outcomes after decompression, which is why the evaluation is deliberately strict. A surgeon who recommends fusion for back pain should be able to explain exactly which disc and why."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6a66g159","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rvqo3161","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Does smoking really affect my discs?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Yes. Nicotine constricts the small blood vessels that nourish the discs' outer layers and impairs healing. Smokers degenerate faster, respond worse to nonoperative care, and fuse less reliably. Quitting is one of the few things proven to change the course."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"n5x6t164","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"lw34y166","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Considering care in Naples"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7rcqj168","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7pif3170","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Degenerative disc disease is universal with age, but painful cases deserve a careful, honest evaluation: which level, what structure, and whether anything surgical would actually help. If persistent neck or back pain is limiting your life despite good nonoperative care, bring your MRI and your questions to HSS at NCH in Naples."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"msisl172","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rdjkb174","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"b31zu176","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qfqc4178","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 238)"},"type":"COLOR"},{"linkData":{"link":{"target":"BLANK","url":"https:\/\/smiss.org"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"Society for Minimally Invasive Spine Surgery | "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 238)"},"type":"COLOR"},{"linkData":{"link":{"rel":{"noreferrer":true},"target":"BLANK","url":"http:\/\/smiss.org"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"smiss.org"},"type":"TEXT"}],"type":"PARAGRAPH"}]},"link-conditions-all":"\/conditions\/","title":"Degenerative Disc Disease"},"a778b0a5-9ad3-464c-83b8-44caad3b56a5":{"image":"wix:image:\/\/v1\/fd2f94_ab9a7295339a424a8e6be44e3738d8ac~mv2.png\/Lumbar%20disc%20herniation.png#originWidth=2524&originHeight=1771","_id":"a778b0a5-9ad3-464c-83b8-44caad3b56a5","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"A ruptured disc that presses on spinal nerves, causing pain, numbness, or weakness, potentially requiring surgery if severe.","_createdDate":{"$date":"2025-08-04T13:50:12.283Z"},"shortDescription":"A ruptured disc that presses on spinal nerves, causing pain, numbness, or weakness, potentially requiring surgery if severe.","_updatedDate":{"$date":"2026-10-04T17:04:43.522Z"},"link-conditions-title":"\/conditions\/herniated-disc-sciatica","PageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ndo5420","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Disc herniations occur when there is a rupture of the outer disc covering, allowing the inner portion to squeeze out, compressing your spinal cord or nerves in and around your spinal canal."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"m291o22","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qm2hy24","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Discs are the soft cushions that act as shock absorbers between your vertebrae. They consist of a soft central portion (nucleus pulposus) and a harder outer covering (annulus fibrosis). These herniations can occur acutely from a specific event or can develop slowly over time, and can occur throughout the spine (cervical, thoracic, or lumbar)."},"type":"TEXT"}],"type":"PARAGRAPH"},{"id":"krnsk499","nodes":[],"type":"VIDEO","videoData":{"containerData":{"alignment":"CENTER","textWrap":true,"width":{"size":"CONTENT"}},"thumbnail":{"height":720,"src":{"id":"media\/c771f2_a2ed85118b774ce2a74a2a589e5d5809f000.jpg"},"width":1280},"title":"herniateddisc_720.mp4","video":{"duration":93.013,"src":{"id":"video\/c771f2_a2ed85118b774ce2a74a2a589e5d5809\/720p\/mp4\/file.mp4"}}}},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"j9qug26","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"nsyh328","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Symptoms"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"owdio30","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"j4jjp32","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Symptoms can vary from neck or back pain to shooting pain, numbness, or weakness in the arms or legs. A lumbar herniation pressing on a nerve root causes "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"sciatica"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":": sharp, burning, or aching pain that radiates from the buttock down the back or side of the leg, sometimes all the way to the foot. A cervical herniation causes similar radiating symptoms into the shoulder, arm, or hand."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jcmcs36","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"0jjnz38","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"If there is spinal cord compression, patients may experience difficulty with balance, manual dexterity, or controlling bowel or bladder function, among other symptoms."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"d4mng40","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ncie342","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Pain that stays in the back or neck without radiating into a limb is less typical of a herniation pressing on a nerve, and points toward other sources."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"0c45y44","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"34ecy46","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How it is diagnosed"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wta3048","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"uf9r650","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Diagnosis starts with history and physical exam: where the pain travels, which movements provoke it, and whether there is weakness, numbness, or reflex changes in a nerve pattern. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"MRI"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is the study that shows the disc itself, the degree of herniation, and which nerve or nerves are compressed. X-ray shows alignment and bone but not the disc. In some cases, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"EMG\/nerve conduction studies"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" help confirm which nerve root is involved, especially when symptoms and imaging do not line up cleanly."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"pvm9a56","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bmhzo58","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Not every herniation seen on MRI is the cause of pain. Many people have disc bulges or herniations on imaging with no symptoms at all. The exam has to match the picture."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"y10p360","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"vt71r62","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative treatment comes first"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"230sj64","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dewhx66","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Most herniated discs improve without surgery. The standard course is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"activity modification"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (stay moving, avoid prolonged bed rest), "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"anti-inflammatory medications"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"physical therapy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" focused on extension-based exercises and core stability, and sometimes "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"epidural steroid injections"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" to calm nerve inflammation. Many herniations shrink on their own over weeks to months as the body resorbs the extruded fragment."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"v4c1676","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bslvv78","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A reasonable expectation: noticeable improvement over 6 to 12 weeks with consistent nonoperative care. Lack of progress, worsening symptoms, or new weakness changes the plan."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"blgmt80","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"8ar8e82","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When surgery is considered"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"znjjb84","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4qxx986","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgery enters the conversation when leg or arm pain persists despite good nonoperative care, typically after 6 to 12 weeks, or sooner when there is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"progressive weakness"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", severe pain that does not respond to conservative measures, or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"cauda equina syndrome"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (see below), which is a surgical emergency."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"z11yg92","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"exxtk94","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The goal of surgery for a herniation is straightforward: remove the fragment pressing on the nerve. Fusion is usually not needed for a straightforward herniation."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6wbuo96","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"r2gdq98","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgical options"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qbg5u100","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wudz1102","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"For a lumbar herniation causing sciatica, the standard operation is a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"microdiscectomy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":": through a small incision, the herniated fragment is removed and the nerve is freed. It is a decompression, not a fusion, and most patients go home the same day."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bybj1106","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"c8851108","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"For a cervical herniation, options include "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ACDF"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (anterior cervical discectomy and fusion) or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"cervical disc replacement"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", depending on the level, the anatomy, and whether there is instability or arthritis at neighboring levels."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mblq4114","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"s0cz9116","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"These are minimally invasive or small-incision procedures in appropriate candidates. The full details, candidacy criteria, and recovery timelines are on each treatment page."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"idefq118","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"t8m4c120","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Red flags: seek urgent care"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2f2pt122","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 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own?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Often, yes. The body can resorb herniated disc material over time, and most patients improve with nonoperative care within weeks to months. \"Healed\" usually means the pain resolves and function returns, even if follow-up imaging still shows some disc abnormality."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8h2yd154","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tcd2b156","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Do I need an MRI right away?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Not always. In the first few weeks of typical sciatica without red flags, the initial treatment is the same with or without an MRI. Imaging becomes important when symptoms persist, worsen, or when surgery is being considered, so the surgeon can see exactly what is pressing on what."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4mr04159","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"k7n9p161","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Are epidural steroid injections a cure?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" They are a treatment for pain and inflammation, not a repair of the disc. For many patients they provide enough relief to get through the healing window and complete rehab. They do not change the long-term outcome compared with time and rehab alone, but they can make the wait far more tolerable."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"59935164","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"o0qlr166","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will I need a fusion for a herniated disc?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Usually not. A straightforward herniation is treated with decompression alone (microdiscectomy in the lumbar spine). Fusion enters the picture when there is instability, a recurrent herniation with back pain from a collapsed disc, or significant spondylolisthesis at the same level."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6unnt169","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dnt4b171","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Can the disc herniate again after surgery?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Yes, recurrent herniation at the same level happens in a minority of patients. The risk is higher with larger annular defects and in the early months before the annulus scars down. Activity restrictions after microdiscectomy exist largely to protect that healing."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dqynl174","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sbvor176","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What about chiropractic care or traction?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Some patients get short-term relief from manual therapy or traction. There is no strong evidence they change the natural history of a herniation. Aggressive manipulation in the presence of progressive weakness or cord compression is not advisable. If you try it and symptoms worsen, stop and get reevaluated."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"73ly3179","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"pcr18181","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Considering care in Naples"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zos0c183","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wvedx185","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A herniated disc is common, and most cases resolve without an operation. The decision for surgery is based on your symptoms, your exam, and your imaging together, not on the MRI alone. If you have persistent sciatica or arm pain that is not improving, bring your MRI and your questions to HSS at NCH in Naples. A careful exam and imaging review determine whether nonoperative care, an injection, or surgery fits your problem."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mrs5d187","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"00f8f189","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"}]},"link-conditions-all":"\/conditions\/","title":"Herniated Disc (Sciatica)"},"39a81c4f-26b7-486c-801f-2515cb619392":{"image":"wix:image:\/\/v1\/c771f2_5c263ee1f1a84430b799347736aed2ae~mv2.jpg\/Chronic-neck-pain.jpg#originWidth=1000&originHeight=667","_id":"39a81c4f-26b7-486c-801f-2515cb619392","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"Can stem from injury or long-term degeneration, with care tailored to the source and severity of the pain.","_createdDate":{"$date":"2025-08-04T13:50:12.280Z"},"shortDescription":"Can stem from injury or long-term degeneration, with care tailored to the source and severity of the pain.","_updatedDate":{"$date":"2026-09-22T01:15:52.748Z"},"link-conditions-title":"\/conditions\/neck-and-back-pain","PageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"yewh75","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Neck and back pain is the most common reason adults see a spine surgeon, and the most common thing they misunderstand. Almost everyone gets it. Most episodes are mechanical: strained muscles, irritated joints, a disc that is aging faster than you would like. The vast majority get better without surgery, often without any real treatment at all."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"u3d8o7","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ttdd99","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The hard part is not finding something on an MRI. Imaging almost always finds something, especially after age 40. Bulging discs, arthritis, bone spurs, mild stenosis: these are normal findings in people with no pain. The real question is whether there is a specific structural problem that explains your symptoms and that surgery can actually fix. That distinction is what separates pain that needs time and therapy from pain that needs a surgeon."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"r48zt11","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2ztli13","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This page covers the common patterns of neck and back pain, how a surgeon figures out what is going on, what should be tried first, and when surgery is honestly on the table."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"97o9i15","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"fcs1t17","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Symptoms"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tb0gc19","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"etvot21","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Axial pain"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is pain centered in the neck or back itself: a deep ache or stiffness, worse with sitting, bending, or lifting, often eased by movement, heat, or rest. Morning stiffness that loosens up is typical. This is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"mechanical pain"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", usually from muscles, facet joints, or discs."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8m7ib26","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5yhkb28","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Radiating pain"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" shoots from the neck into the arm or from the back into the leg. This is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"nerve pain"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", typically sharp, burning, or electric, following a path down the limb, sometimes with numbness, tingling, or weakness in a specific area. When a nerve root is pinched, it is called "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"radiculopathy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sfxgw35","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hwl1837","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"In the neck, compression of the spinal cord itself causes "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"myelopathy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":": clumsy hands, balance problems, numbness below a level. That is a different problem with different urgency."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hy91t41","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xp2qn43","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Most mechanical pain flares and settles. Nerve pain can linger for weeks. The pattern matters more than the intensity."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"thrfh45","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"extfw47","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How it is diagnosed"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"a85dd49","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2qhvr51","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Diagnosis starts with the history and the physical exam, not the MRI. When it started. What makes it worse. Whether the pain radiates. Whether there is weakness, numbness, or a change in gait. The exam tests strength, reflexes, and sensation to look for a neurologic pattern."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sn9yz53","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xtoez55","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"X-ray"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" shows alignment, disc space narrowing, bone spurs, and instability on flexion and extension views. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"MRI"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" shows discs, nerves, and the spinal cord in detail. Imaging is ordered when it will change management: persistent symptoms, a neurologic deficit, or surgical planning."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9ua8z60","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"m4ida62","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The exam has to connect the picture to the patient. A bulging disc at a level that does not match the symptoms is an incidental finding, not a diagnosis. Treating the MRI instead of the patient is how unnecessary surgery happens."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"yvr5n64","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"ma8us66","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative treatment comes first"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qff2q68","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sbjec70","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"For uncomplicated neck and back pain, the standard course is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"physical therapy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (core and postural strengthening, flexibility), "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"anti-inflammatory medications"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", activity modification, heat or ice, and time. Most acute episodes improve substantially within weeks."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"057kv76","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ezg4z78","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"For pain that persists, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"injection therapy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (epidural or facet injections) can calm symptoms and help confirm which structure is the pain generator. Chronic pain also responds to weight management, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"smoking cessation"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", and the sleep and stress habits that are boring to talk about and effective in practice."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3h1p584","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"p367v86","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The goal of nonoperative care is not just relief. It is information. What responds to therapy and what does not tells the surgeon a great deal about what will respond to surgery."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"irexf88","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"g2gmm90","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When surgery is considered"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ajx7y92","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2qo4z94","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgery is considered when a real course of nonoperative care has not produced adequate relief and the workup has identified a structural problem surgery can fix. The clearest indications are "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"nerve compression"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" with persistent radiating pain or progressive weakness, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"instability"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" seen on imaging, and "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"spinal cord compression"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" in the neck."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"knr22102","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"46l9c104","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"An honest caveat: surgery for neck or back pain alone, without nerve compression or instability, has less predictable results than surgery for radiating arm or leg pain. A good surgeon will tell you when your pain is the kind surgery fixes and when it is not."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7g23u106","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"an0lq108","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgical options"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5xn7t110","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1hjna112","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"There is no single operation for neck and back pain because neck and back pain is not one diagnosis. The operation follows the cause. A pinched nerve may need "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"decompression"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". A collapsed, unstable segment may need "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". A slip, a cyst, a cord compression each has its own operation and its own recovery. That is why the workup comes first and the operation second. The full details, candidacy criteria, and recovery timelines are on each treatment page."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"pc6oj118","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"l08hr120","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Red flags: seek urgent care"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ai9tz122","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 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Do I need surgery?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Probably not based on the report alone. Those findings are extremely common in adults with no pain at all. Surgery is for a structural problem that matches your symptoms and has not responded to nonoperative care. The report describes anatomy. Your symptoms, your exam, and what you have already tried determine treatment."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"n15ix160","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"shz7g162","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How long should I try physical therapy before seeing a surgeon?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" For uncomplicated neck or back pain without weakness or red flags, a fair trial is typically 6 to 12 weeks of consistent therapy and medication. That is not 6 to 12 weeks of waiting. It is 6 to 12 weeks of actually doing the work. If symptoms are progressing, especially weakness, do not wait out the clock."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vxo50165","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"69sg0167","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"If I wait, will my spine get worse?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" For ordinary mechanical pain, usually no. Waiting does not turn a muscle strain into a surgical problem. The exception is progressive neurologic loss: weakness that is getting worse, or myelopathy in the neck, where delay can cost function that does not come back."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"t95ae170","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zopw1172","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"I was told I have a herniated disc. 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Surgery is for persistent, disabling nerve pain despite good nonoperative care, or for progressive weakness."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nyj1f175","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4d6fu177","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What should I bring to a surgical consultation?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Bring your imaging (the actual images, not just the report), a list of what you have tried and for how long, your medications, and your questions. The most useful thing you can bring is a clear story: when it started, what it feels like, what helps, what does not."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mlcbh180","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"mr7dd182","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Considering care in Naples"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"c2bfj184","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1lljm186","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Neck and back pain is common, but your case is specific, and the answer starts with matching your symptoms to a cause rather than treating a picture. If pain is limiting your life, or you have been told you need surgery and want a straight answer about whether you actually do, bring your imaging and your questions to HSS at NCH in Naples."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jc1ms188","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gfcg4190","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"}]},"link-conditions-all":"\/conditions\/","title":"Neck and Back Pain"},"3f5462eb-1273-49f4-bc7d-f63b5e0203b0":{"image":"wix:image:\/\/v1\/c771f2_97f17bdeec504486a97ed35c89589469~mv2.jpeg\/AdobeStock_408261543.jpeg#originWidth=5744&originHeight=3822","_id":"3f5462eb-1273-49f4-bc7d-f63b5e0203b0","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"Nerve root compression causing pain, tingling, or weakness in limbs, treated with conservative or surgical methods.","_createdDate":{"$date":"2025-07-23T18:03:42.466Z"},"shortDescription":"Nerve root compression causing pain, tingling, or weakness in limbs, treated with conservative or surgical methods.","_updatedDate":{"$date":"2026-09-22T00:46:02.823Z"},"link-conditions-title":"\/conditions\/radiculopathy","PageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ays9s31","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Radiculopathy is a term for symptoms that occur with compression of your nerve roots as they leave the spinal cord."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wmox033","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9wtt235","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This can result in pain, numbness\/tingling, and or weakness in your arms\/trunk\/legs. This can occur acutely from a specific event (e.g. disc herniation) or from a more chronic process (e.g. arthritic changes of the spine)."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qghy137","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"grib639","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Think of each nerve root as a single wire carrying signals to a specific strip of skin and a specific set of muscles. When that wire gets pinched where it exits the spine, the symptoms follow the wire's path, not a vague or random pattern. That predictable pattern is what lets the exam pinpoint which level is involved, often before the MRI is even opened."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9ld2t41","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"h27f643","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Cervical Radiculopathy"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"id":"5c219506","nodes":[],"type":"VIDEO","videoData":{"containerData":{"alignment":"CENTER","textWrap":true,"width":{"size":"CONTENT"}},"thumbnail":{"height":720,"src":{"id":"media\/c771f2_96b04c76f5864479977f9f1d5b2ff8b1f000.jpg"},"width":1280},"title":"cervrad_720.mp4","video":{"duration":146.005,"src":{"id":"video\/c771f2_96b04c76f5864479977f9f1d5b2ff8b1\/720p\/mp4\/file.mp4"}}}},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bkvmc45","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"j8ljz47","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A pinched nerve in the neck sends symptoms into the shoulder, arm, and hand along a specific path. Each root has a signature: a C6 pinch typically affects the thumb and index finger and weakens the biceps; C7 affects the middle finger and weakens the triceps; C8 affects the small finger and weakens grip. Neck pain is often present but the arm symptoms are the defining feature. Certain positions, like looking up or tilting toward the affected side, typically worsen it (a positive "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Spurling's test"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":")."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"u6dqw51","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"o90jc53","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Lumbar Radiculopathy"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"id":"us9mm1125","nodes":[],"type":"VIDEO","videoData":{"containerData":{"alignment":"CENTER","textWrap":true,"width":{"size":"CONTENT"}},"thumbnail":{"height":720,"src":{"id":"media\/c771f2_478e5b50b14140a8b2c20a2e1d2d8784f000.jpg"},"width":1280},"title":"lumradsciatica_720.mp4","video":{"duration":152,"src":{"id":"video\/c771f2_478e5b50b14140a8b2c20a2e1d2d8784\/720p\/mp4\/file.mp4"}}}},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"414i755","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"h4kyy57","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A pinched nerve in the low back sends symptoms into the buttock, leg, and foot. This is what most people mean by "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"sciatica"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", though true sciatica technically refers to irritation of the sciatic nerve itself. An L5 pinch typically causes pain down the outer leg to the top of the foot and weakens foot lift; an S1 pinch runs down the back of the leg to the outer foot and weakens the calf. A "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"straight leg raise"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" that reproduces the leg pain is the classic exam finding."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"0crfr63","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ybbdl65","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Not all buttock and leg pain is radiculopathy. Hip arthritis, sacroiliac joint pain, and piriformis irritation can mimic it, which is why the pattern and the exam matter more than the complaint of \"leg pain\" alone."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"uss1767","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"20xnm69","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How it is diagnosed"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9wgcq71","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"p1buq73","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Diagnosis starts with mapping the symptoms: which fingers or toes, which movements are weak, which reflexes are diminished. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"MRI"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" confirms the compression and shows the cause (herniation, bone spur, narrowed foramen). "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"EMG\/nerve conduction studies"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" can confirm which root is involved when the picture is unclear or symptoms have been present a long time. As with disc herniations, the MRI must match the exam: asymptomatic nerve contact on imaging is common and means nothing without matching symptoms."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"0o8aj79","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"hsplm81","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative treatment comes first"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4olcd83","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"a5r1985","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Treatment varies from nonoperative to operative and depends on the severity and duration of symptoms. Most radiculopathy is treated without surgery first: "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"activity modification"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (staying mobile, avoiding the positions that provoke it), "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"anti-inflammatory medications"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"physical therapy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" for posture, mechanics, and nerve glides, and "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"epidural steroid injections"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" targeted at the affected root. Injections both relieve pain and confirm the level."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3u7w195","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vacyi97","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The natural history favors patience: the majority of acute radiculopathies improve substantially over 6 to 12 weeks as inflammation settles, even if the structural pinch persists on imaging."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kmh5999","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"3xhf2101","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When surgery is considered"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ridto103","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"crytz105","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgery enters the conversation when arm or leg pain remains severe and limiting despite a real course of nonoperative care, or when there is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"progressive weakness"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" in a muscle group, which should not wait for months. Persistent numbness alone, without weakness or intolerable pain, is usually observed rather than operated on, since numbness is the slowest symptom to recover regardless of treatment."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"53fkf109","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"22mn5111","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgical options"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gp93f113","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"uj2gw115","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The operation depends on the cause and the location. A lumbar herniation compressing a root is treated with "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"microdiscectomy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"; arthritic narrowing around the root with "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ULBD"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (decompression). In the neck, a pinched root is addressed with "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ACDF"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"cervical disc replacement"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", chosen based on the levels involved, alignment, and the condition of neighboring discs. The goal in every case is the same: free the specific nerve root shown to be the problem. The full details, candidacy criteria, and recovery timelines are on each treatment page."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gtvto125","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"zymw2127","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Red flags: seek urgent care"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"285n5129","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 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radiculopathy?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Roughly. Radiculopathy is the medical term for a pinched nerve root anywhere in the spine. Sciatica describes the symptom pattern of pain radiating down the leg, which is usually caused by lumbar radiculopathy. All sciatica-type leg pain is not radiculopathy, but most of it is."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"r7ryn161","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qdois163","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How long will this last?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Most acute episodes improve markedly within 6 to 12 weeks with nonoperative care. Numbness and tingling often linger longer than pain. If meaningful improvement has not started by 6 to 8 weeks, or weakness is progressing, that is when the conversation changes."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ra7m4166","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hjt8w168","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will the numbness go away?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Often, but it is the slowest symptom to resolve, and long-standing numbness may only partially recover even after the nerve is freed. This is one reason progressive or severe neurologic symptoms are not left to linger indefinitely."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"0czdi171","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"w4jmx173","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Do I need an MRI right away?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Not always. A first episode of classic radiculopathy with a matching exam is often treated without immediate imaging, since early management rarely changes. MRI becomes important when symptoms persist, worsen, include weakness, or when a procedure is being considered."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3jcr1176","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"b5ysw178","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Can a chiropractor or inversion table fix a pinched nerve?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" They can relieve symptoms for some patients, and many improve with manipulative or traction-based care. They cannot remove a herniated fragment or bone spur. Reasonable rule: if it helps and nothing is worsening, fine; if weakness progresses or red flags appear, stop and get evaluated."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dtp6t181","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8gn88183","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"If I have surgery, can the same nerve get pinched again?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Recurrence at the same level is possible but uncommon after a well-done decompression. What happens more often is a different level becoming symptomatic years later, since the degenerative process continues. Staying strong, flexible, and at a healthy weight is the best long-term protection."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5x8mg186","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"jo8to188","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Considering care in Naples"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3lh8p190","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kc3st192","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A pinched nerve announces itself with a pattern, and reading that pattern correctly is the whole game: right level, right cause, right treatment. If arm or leg pain, numbness, or weakness is persisting despite care, bring your MRI and your questions to HSS at NCH in Naples for an exam that connects the symptoms to the source."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"z5wl9194","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rcipt196","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"}]},"link-conditions-all":"\/conditions\/","title":"Sciatica (Radiculopathy)"},"2afda21d-2ecf-4b59-994d-c8912def2a70":{"image":"wix:image:\/\/v1\/fd2f94_a69dbce393564e6f8ab3b9948bbbf2b0~mv2.png\/MRI-of-Lumbar-Spinal-Stenosis.png#originWidth=342&originHeight=524","_id":"2afda21d-2ecf-4b59-994d-c8912def2a70","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"Narrowing of the spinal canal causing nerve symptoms or cord compression, managed through various treatment levels.","_createdDate":{"$date":"2025-07-23T18:03:42.468Z"},"shortDescription":"Narrowing of the spinal canal causing nerve symptoms or cord compression, managed through various treatment levels.","_updatedDate":{"$date":"2026-10-04T17:04:43.723Z"},"link-conditions-title":"\/conditions\/spinal-stenosis","PageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ljg3l9","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Stenosis is a term that refers to narrowing of the space where your spinal cord and nerves run. This can occur from an acute event (e.g. disc herniation) or develop from a more chronic process as with aging."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lmiiv11","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"iw4jm13","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The narrowing usually comes from a combination of wear: thickened ligaments, enlarged facet joints from arthritis, bulging discs, and sometimes a slip of one vertebra over another. 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Stenosis is a degenerative process, and the canal does not widen on its own. That said, symptoms often plateau for long stretches, and many patients manage for years with nonoperative care before surgery becomes worth discussing."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"cf360144","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"eqd9n146","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Why does bending forward help?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Flexing the spine slightly opens the spinal canal and the nerve exit tunnels, giving the crowded nerves more room. That is why sitting relieves neurogenic claudication and why leaning on a shopping cart lets people walk further. Extension (standing upright, walking downhill) does the opposite."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ws2o0149","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qttg0151","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Can exercise fix stenosis?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Exercise cannot reverse the narrowing, but it can meaningfully improve function: stronger core and hip muscles, better posture, and flexion-based routines reduce the load on the arthritic segments. PT is about working around the stenosis, not curing it."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hz65v154","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mh4ed156","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Do epidural injections cure stenosis?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" No. They reduce inflammation around the compressed nerves and can provide months of relief, which is valuable for staying active and for confirming which level is symptomatic. They do not change the underlying narrowing."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rovzm159","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hw3ww161","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will I need a fusion, or just a decompression?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" It depends on stability. Stenosis alone is treated with decompression. When there is a spondylolisthesis (slip), scoliosis, or instability on flexion\/extension X-rays, fusion is added to keep the segment from shifting after the decompressing bone is removed. This is one of the key things the surgeon evaluates before recommending a plan."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gj54b164","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"v1dkq166","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Is stenosis the same as a pinched nerve?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" A pinched nerve (radiculopathy) is one possible result of stenosis, but they are not the same thing. Stenosis is the narrowing; radiculopathy is what happens when that narrowing compresses a specific nerve root. Stenosis can also compress the whole canal (causing claudication) or the cord itself (myelopathy)."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"b1wir169","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"tzl1v171","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Considering care in Naples"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tk0c7173","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jm09l175","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Spinal stenosis is one of the most common reasons adults over 50 seek spine care, and most cases are managed without surgery for a long time. When walking distance shrinks, standing becomes a chore, or weakness progresses, it is worth a proper evaluation. Bring your MRI and your questions to HSS at NCH in Naples. A careful exam and imaging review determine whether nonoperative care is still the right call or whether decompression fits your problem."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"t9iwr177","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"08ybj179","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"}]},"link-conditions-all":"\/conditions\/","title":"Spinal Stenosis"},"050e0d27-0cba-42d5-88ec-502786fa417b":{"image":"wix:image:\/\/v1\/fd2f94_c545e6ce80a44d3bb5fd620caafe6fab~mv2.jpeg\/spondylolisthesis.jpeg#originWidth=850&originHeight=850","_id":"050e0d27-0cba-42d5-88ec-502786fa417b","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"Slippage of a vertebra that can compress nerves and cause leg or back symptoms, treated based on severity.","_createdDate":{"$date":"2025-07-23T18:03:42.469Z"},"shortDescription":"Slippage of a vertebra that can compress nerves and cause leg or back symptoms, treated based on severity.","_updatedDate":{"$date":"2026-09-22T01:16:06.047Z"},"link-conditions-title":"\/conditions\/spondylolisthesis-and-spondylolysis","PageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wguvr7","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Spondylolisthesis refers to a slip of one vertebrae on another. This can occur either forwards (anterolisthesis) or backwards (retrolisthesis) and can be due to chronic, degenerative changes with age or in younger patients with a fracture (spondylolysis)."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"26w509","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"74lzb11","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This forward slip of the vertebrae can cause narrowing of the space available for your nerves, resulting in compression and back and leg pain, as well as heaviness, numbness\/tingling, and weakness of the legs."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4gh5o13","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7yq5q15","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The two terms describe related but different things. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Spondylolysis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is a crack or stress fracture in the pars interarticularis, the small bridge of bone connecting the facet joints at the back of the vertebra. It is common in young athletes in extension sports (gymnastics, football, weightlifting). "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Spondylolisthesis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is the slip itself: one vertebra shifting forward over the one below. A spondylolysis can lead to a slip (isthmic spondylolisthesis), but many slips in older adults happen without any fracture, from years of arthritic wear (degenerative spondylolisthesis)."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vwobz21","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"2vrk523","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Symptoms"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"91ut225","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"67ss127","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Low-grade slips are often painless and found incidentally. When symptoms occur, the pattern depends on the type. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Degenerative slips"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" in older adults typically cause back pain plus leg symptoms from the accompanying stenosis: pain, heaviness, or numbness with walking or standing, eased by sitting. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Isthmic slips"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" in younger patients usually cause mechanical back pain, worse with extension (arching backward), sometimes with tight hamstrings and an altered gait in adolescents. A high-grade slip can cause visible postural changes and, rarely, nerve compression severe enough to affect bowel or bladder function."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"u2t5633","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"jdhfc35","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How it is diagnosed"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6u3ig37","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sqc9f39","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Spondylolisthesis is diagnosed utilizing X-rays with multiple views and physical examination. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Standing X-rays"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" show the slip and its grade (I through IV, by percentage of forward shift). "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Flexion and extension views"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" show whether the slip moves, which is the key finding that pushes toward fusion. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"MRI"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" shows nerve compression and disc condition. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"CT scan"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is the best study for a pars fracture itself, showing the crack the MRI can miss. Advanced imaging such as MRI or CT may be necessary depending on what the X-rays show."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rxykr49","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"51o2b51","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative treatment comes first"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"pg3wi53","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dy0q155","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Treatment depends on symptom severity and duration of symptoms. Nonoperative care, including "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"physical therapy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" to strengthen the muscles supporting the spine, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"anti-inflammatory medications"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", nerve medications, or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"injection therapy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" may be recommended. In adolescents with an acute pars fracture, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"bracing"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" and activity restriction can allow the fracture to heal. Epidural injections can calm leg symptoms from the associated stenosis. Many low-grade, stable slips are managed indefinitely without surgery."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8vu5c65","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"wdz1067","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When surgery is considered"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bwpbz69","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tpr3271","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"If nonoperative care does not provide adequate relief, surgical care may be recommended. The triggers are familiar: persistent back or leg pain that limits daily life despite good nonoperative care, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"progressive leg weakness or numbness"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", or a slip that is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"unstable"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (moves on flexion\/extension X-rays) or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"progressing"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" on serial imaging. In young patients with a pars fracture that will not heal and ongoing pain, direct repair is considered before fusion."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lrhah79","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"2q27x81","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgical options"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ohdtx83","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"25u8385","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This can involve "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"spinal fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" to stabilize the bones and relieve pressure on the nerves. For a degenerative slip with stenosis, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (such as "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"MIS TLIF"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"lateral interbody fusion (LLIF)"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ALIF"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":") stops the painful motion and holds the alignment while the nerves are decompressed. For a young patient with a spondylolysis and no significant slip, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"pars repair"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" fixes the fracture directly and preserves motion, avoiding a fusion. The choice hinges on age, slip grade, stability, and whether the nerves are compressed. The full details, candidacy criteria, and recovery timelines are on each treatment page."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ok5o497","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"20q1999","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Red flags: seek urgent care"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5qk3b101","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 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time?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Degenerative slips can progress slowly, which is why serial X-rays matter. Isthmic slips in adults usually stabilize once growth finishes; progression after skeletal maturity is uncommon. An unstable slip (one that moves on flexion\/extension views) is the one to watch."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"uags0133","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"0fg2d135","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Is this the same as a slipped disc?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" No, though patients use the terms interchangeably. A \"slipped disc\" is a herniation of disc material. Spondylolisthesis is the whole vertebra shifting position. They can coexist and both can pinch nerves, but they are different structural problems with different operations."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2n8hw138","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"seeak140","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Can I exercise with a spondylolisthesis?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Usually yes, with guidance. Core strengthening and flexion-based exercise are the mainstays; extension-heavy activities (backbends, heavy overhead lifting, high-impact twisting sports) are the ones to limit, especially with an active pars fracture. A PT who understands the condition is worth more than a generic exercise sheet."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8n05a143","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"x29ri145","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Do I need a fusion, or can the pars just be fixed?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" It depends on the slip. A pars fracture without meaningful slip in a young patient is a candidate for "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"direct pars repair"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", which preserves motion. Once there is a real slip, instability, or significant degeneration, fusion is the durable answer. This is the central decision point and it comes from the flexion\/extension X-rays."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"um4lf150","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5d63p152","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"My teenager was diagnosed with a pars fracture. Will they need surgery?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Usually not. Most adolescent spondylolysis heals with bracing, rest from extension sports, and PT, especially when caught early. Surgery enters only for fractures that will not heal with persistent pain, or slips that progress. The odds favor nonoperative care in this age group."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"d7c3a155","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"x33dx157","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will I set off alarms or need special care after fusion?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" The hardware is titanium and does not set off metal detectors. You will have standard post-fusion restrictions: no bending, lifting, or twisting for 6 weeks, no NSAIDs for 3 months while the bone heals, and no nicotine before or after surgery. The details are on the fusion treatment pages."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"r0iaj160","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"e183r162","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Considering care in Naples"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"17kd1164","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gmiqj166","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A slip is a mechanical problem, and mechanical problems need mechanical answers: is it stable, is it compressing nerves, and what will stop the pain without overtreating the spine. If back or leg pain from a spondylolisthesis is limiting your life, or your young athlete has a pars fracture that is not healing, bring your imaging and your questions to HSS at NCH in Naples."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sqp5h168","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"e330b170","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"}]},"link-conditions-all":"\/conditions\/","title":"Spondylolisthesis and Spondylolysis"}},"Items":{"8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce":{"_manualSort_85b0f783-b8d0-41c3-b2c2-3dcbeb166104":"1g","link-items-all":"\/treatments\/","image":"wix:image:\/\/v1\/fd2f94_bea50f455a1341d6acdafaf0d1f76336~mv2.jpg\/IMG_0354_edited.jpg#originWidth=1058&originHeight=1019","_id":"8dc2c7cc-9cf2-41ae-854d-0e9119ae76ce","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"ACDF (anterior cervical discectomy and fusion) for cervical disc disease and nerve or cord compression, Naples FL.","_createdDate":{"$date":"2025-08-04T20:35:12.342Z"},"shortDescription":"ACDF is surgery from the front of the neck: remove a diseased disc pressing on a nerve or the cord, rebuild height with implant and graft, and fuse the level.","_updatedDate":{"$date":"2026-10-01T01:27:41.216Z"},"seoTitle":"ACDF Surgery in Naples, FL | Dr. Nicholas Clark","_publishStatus":"PUBLISHED","link-copy-of-treatments-title":"anterior-cervical-discectomy-and-fusion-(acdf)","link-items-title":"\/treatments\/anterior-cervical-discectomy-and-fusion-acdf","title":"ACDF (Anterior Cervical Discectomy and Fusion)","seoDescription":"ACDF removes a diseased cervical disc, takes pressure off the nerve or spinal cord, and fuses the level. Dr. Nicholas Clark, HSS at NCH, Naples, FL.","pageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7vdmd2","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ACDF is surgery from the front of the neck. A diseased disc that is pressing on a nerve root or the spinal cord is removed, disc height is rebuilt with an implant and graft, and that level is fused so the space stays open and stable while bone heals over months."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"iwsen4","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zyf1n6","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The path is anterior: a small incision on the side of the neck, muscles spread rather than cut, then direct access to the disc. The goal is mechanical and clear. Take pressure off what is compressed. Hold the height. Let bone grow solid."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fn40w8","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7tqnt10","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients researching ACDF in Naples or elsewhere in Southwest Florida often find that the useful question is not only “What is ACDF?” It is whether the problem is a pinched nerve root, cord compression, or both, and whether this is the safest complete path for that anatomy. 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Myelopathy is compression of the cord itself: clumsy hands, balance or walking trouble, and symptoms that can worsen in steps over time. Some people have both. The plan follows what is driving the individual problem on exam and MRI."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"j2jq247","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ro2xl49","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"For arm-pain radiculopathy, many people try activity changes, medicines, therapy, and sometimes injections first when those have a realistic chance. 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Waiting for “it to settle” is not always safe when the cord is under pressure. Mild cases are individualized. Progressive cord compression often moves the conversation toward surgery sooner to protect function. The arm-pain improvement pattern discussed for radiculopathy does "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" apply to myelopathy counseling."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"86zdf59","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7oq8k61","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The anterior path is chosen when the job can be finished completely and safely from the front. 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It is not framed as a rare complication. It is often worse with upper levels (C3–4, C4–5) than lower levels (C5–6, C6–7), worse early, and more likely to leave a subtle long-term change when more levels are fused. Steroids are available after surgery to help swelling "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"if prescribed"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". Do not start a steroid on your own."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vchms179","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rvifo181","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This is an emergency, not “expected swallowing”:"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" inability to swallow saliva or liquids; drooling because nothing will go down; breathing that is harder, noisy, or tight; or a bulge in the front of the neck that is growing. 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The driving rule still applies."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nzc1h284","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"PT:"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" walking is the main therapy. Only about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"20–30%"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" of people need formal office PT after early recovery, usually if neck pain is not improving. Do not assume everyone gets a PT gym order. Do not assume nobody does."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"uj1b8289","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Back-of-neck ache:"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" often worst in weeks 1–4, then slowly better. It may not be gone at 6 weeks."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"78h4r292","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"oyyd1294","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nicotine is a hard stop for fusion."},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" No smoking, vaping, dip, or nicotine pouches after surgery. Nicotine can stop bone from healing. Ask for help quitting if needed. Do not hide it."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kebnk297","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"i412v299","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"No NSAIDs for 3 months after fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (ibuprofen, naproxen, Advil, Aleve, and similar). Those medicines can interfere with bone healing. Acetaminophen (Tylenol) is the usual alternative if it is allowed. Do not start leftover anti-inflammatories on your own."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3yach302","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3rfjt304","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients typically see Jorge again at about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"6 weeks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". Week 6 is often a check-in and an activity talk. It is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" sports clearance. It is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" “the fusion is done.” Hardware is a scaffold. Bone still has months of healing ahead."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"69i2x312","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"28wn9314","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Weeks 6–12"},"type":"TEXT"}],"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"igij5316","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hzyqo318","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Ease back into activities "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"slowly"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", based on what is written at or after the 6-week visit"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"aezr6322","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Keep treating the fusion as healing, not healed"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"q2krv324","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Formal PT only if ordered for continued or non-improving symptoms"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bphle326","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"pvhks328","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Fusion patients are typically seen by Dr. Clark at about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"3 months"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" and "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"6 months"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (and sometimes around a year) as the usual pathway. Bone healing is a long process. The early visits with Jorge cover wounds, swallowing, and the first activity steps. The later visits watch how the fusion is progressing."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"v6yhe334","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"n3km1336","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"FAQs"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"j6g70338","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"asmbr340","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What is ACDF?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"n9qnr342","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ox3sd344","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ACDF is anterior cervical discectomy and fusion: surgery from the front of the neck to remove a diseased disc pressing on a nerve root or the spinal cord, rebuild height with an implant and graft, and fuse that level so the bones grow together over months."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"yzeuy346","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nkwrm348","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How is radiculopathy different from myelopathy?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"q41ob350","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"o703r352","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Radiculopathy is a pinched "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"nerve root"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", often with arm or hand pain, numbness, tingling, or weakness in a nerve pattern. Myelopathy is pressure on the "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"spinal cord itself"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":": clumsy hands, unsteady walking or balance, and symptoms that can worsen over time. Some people have both. Counseling and expectations differ."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"p1262358","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gjrhb360","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Which nerve matches which disc level?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5p8ve362","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xy3n0364","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"In the neck, a disc problem at one level usually affects the nerve root that exits at that level. A simple patient map: "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"C3–4 → C4"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (trapezius \/ neck, sometimes around the shoulder blade); "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"C4–5 → C5"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (shoulder \/ outer upper arm; deltoid and rotator cuff strength); "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"C5–6 → C6"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (thumb side of the forearm and hand; biceps and wrist extension); "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"C6–7 → C7"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (middle finger \/ back of forearm; triceps); "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"C7–T1 → C8"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (ring and small finger; hand grip). Not every person feels every textbook spot. Symptoms, exam, and imaging are matched together."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ftv81376","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"uy8s2378","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Who is a candidate for ACDF?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"furnt380","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5bkcb382","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients with stubborn or progressive arm symptoms from a pinched nerve root, or with cord compression (myelopathy) that needs decompression to protect function, when imaging and exam match and nonoperative care is not enough or not the right fit. Decisions are made from the individual case, not from a webpage."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hnufk384","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1tk7r386","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How long will I stay in the hospital?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1rvwx388","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dxfab390","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Same-day for basically all 1–2 level ACDF. Generally overnight for 3–4 level ACDF (4-level is uncommon). The written plan and how the patient looks after surgery win if they differ."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"a4f83392","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"r7ffk394","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will I need a collar?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"u641n396","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"911vq398","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Yes, typically a soft collar for about the first 2 weeks. Hard collars are almost never used. Follow whatever was written if it differs."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ic0hw400","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1ij0k402","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When can I drive after ACDF?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"oj8wn404","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ir03m406","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"No driving for the first 2 weeks. After that, driving may be considered only if the patient is at least 2 weeks out "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"and"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" off all narcotics. Both required."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"cr3od410","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lx98r412","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What is the main exercise after surgery?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vvqz4414","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"yfvgy416","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Walking. Short walks early. Keep walking on even ground through the first 6 weeks while BLT and the lift limit stay in place. Formal PT is only needed for about 20–30% of people after early recovery if symptoms are not improving."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zujz0418","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"83qqs420","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Can I use nicotine or anti-inflammatory pills after fusion?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"95qdp422","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ttlcv424","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nicotine is a hard stop. No nicotine products after fusion surgery. No NSAIDs for 3 months after fusion unless an exception is written. Ask before taking anything new for pain."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"syuqe426","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"f5jwm428","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Is the fusion done at 6 weeks?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5pxts430","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1jdm6432","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"No. Week 6 is a check-in and activity discussion, not proof that bone has fused. Later visits in the fusion pathway continue as healing continues over months."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ntfor434","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mrlmp436","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What about swallowing and back-of-neck pain?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7umkn438","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1dul0440","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Trouble swallowing is expected after ACDF, worse early and often more with upper levels or more levels. Soft diet and upright sleep help. Back-of-neck ache from height restoration is common in weeks 1–4, then slowly better. Cannot swallow saliva, harder breathing, or a growing front-of-neck bulge is an emergency: call 911."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ano3b442","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"0qcpt444","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What about outcomes?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6xwba446","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"goz55448","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"For "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"radiculopathy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (pinched nerve root), counseling often describes meaningful improvement in arm pain for most patients, with weakness and numbness improving less often than pain. The operation takes pressure off the nerve. The nerve still has to heal itself. For "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"myelopathy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (cord compression), the primary goal is to stop progression. Some people stabilize; some improve partly; cord recovery is not promised. No one can promise a perfect result for any individual patient."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gvcb7454","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"b71yq456","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients dealing with arm pain from a pinched neck nerve, or with clumsy hands and walking trouble from cord compression, who have been told about ACDF are encouraged to bring imaging and questions. The conversation starts with the problem, not the incision size: what needs to be decompressed, whether the level needs to be fused or is a candidate for "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/treatments\/cervical-total-disc-replacement"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"cervical disc replacement"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", and whether an anterior path is the safest complete plan for that anatomy."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"31tam458","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"yvuyd460","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"That is the conversation Dr. Nicholas J. 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Clark, MD, orthopedic spine surgery (minimally invasive and robotic), HSS at NCH, Naples, FL."},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"},{"italicData":true,"type":"ITALIC"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"pacrg475","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"id":"nc56e477","nodes":[],"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"type":"PARAGRAPH"}]}},"f0fbdc4b-416a-485b-bc44-33f0317e0e94":{"_manualSort_85b0f783-b8d0-41c3-b2c2-3dcbeb166104":"1k","link-items-all":"\/treatments\/","image":"wix:image:\/\/v1\/fd2f94_2dcc7bfde43b4e05bf2df32fbc8c4410~mv2.jpg\/MIS%20microdisc_edited.jpg#originWidth=220&originHeight=286","_id":"f0fbdc4b-416a-485b-bc44-33f0317e0e94","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"Tubular microdiscectomy for herniated lumbar disc and sciatica, Naples FL.","_createdDate":{"$date":"2025-08-04T20:35:12.347Z"},"shortDescription":"Tubular microdiscectomy is a minimally invasive lumbar surgery to remove a herniated disc fragment compressing a nerve root, usually same-day and without fusion.","_updatedDate":{"$date":"2026-10-01T01:27:40.886Z"},"seoTitle":"Tubular Microdiscectomy in Naples, FL | Dr. Nicholas Clark","_publishStatus":"PUBLISHED","link-copy-of-treatments-title":"mis-microdiscectomy","link-items-title":"\/treatments\/mis-microdiscectomy","title":"Tubular Microdiscectomy (Minimally Invasive Lumbar Discectomy)","seoDescription":"Tubular microdiscectomy removes a herniated disc fragment pressing on a nerve, usually same-day and without fusion. Dr. Nicholas Clark, HSS at NCH, Naples.","pageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4p3m82","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Tubular microdiscectomy is a minimally invasive lumbar surgery. It is done to remove a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/conditions\/herniated-disc-sciatica"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"herniated disc fragment"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" that is compressing a nerve root and causing leg pain (sciatica), numbness, or weakness."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"k39sj4","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"554ae6","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The path through the soft tissue is narrow. The surgeon works through a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"16–18 mm"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" tubular corridor and a microscope. The goal is mechanical and clear: take the offending fragment off the nerve. This is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not a fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". No implant is placed to glue the bones together."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"t9b1g12","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jh8bi14","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients researching microdiscectomy in Naples or elsewhere in Southwest Florida often find that the useful question is not only “Is it minimally invasive?” It is whether a single disc fragment is driving the leg symptoms, and whether removing that fragment is the safest complete path. That is the conversation at HSS at NCH."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"j4ejf16","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"xvem718","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When microdiscectomy is recommended"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9nkh420","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"o5re522","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative care is preferred when it still solves the problem. Many herniations improve over weeks with activity changes, medicines, therapy, and sometimes injections."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bxo4m24","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"t4zbw26","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Microdiscectomy is typically recommended when:"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"b5w3228","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vbqji30","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients have "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"leg pain (sciatica)"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" from a herniated disc fragment pressing on a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"nerve root"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", with imaging that matches the exam"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bf96z36","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Symptoms have not settled with a realistic nonoperative trial, or strength is slipping in a way that needs the fragment removed"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"v1zqz38","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The mechanical job is to remove the offending fragment, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" to fuse the segment"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2jb3f42","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Back pain may or may not be the main issue; this is usually a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"one-nerve"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" story, different from "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/conditions\/spinal-stenosis"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"stenosis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" that crowds many nerves with walking and is often treated with "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/treatments\/mis-decompression"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"ULBD laminectomy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (though some people have both)"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6xz9v46","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gx7av48","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Common patterns include L4–5 affecting the L5 nerve (side of the leg, top of the foot, lifting the foot) and L5–S1 affecting the S1 nerve (back of the leg, outer foot, pushing down with the foot). Not every person feels every textbook spot. Symptoms, exam, and MRI are matched together."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lee7950","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zmx7y52","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Microdiscectomy is not automatic because an MRI shows a herniation. 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Week 6 is an activity talk. Many people who are progressing appropriately are "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"released from routine care at about 6 weeks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" after microdiscectomy. It is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" sports clearance unless that is written. 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It is not a fusion."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"d6vi6268","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ip8uj270","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Who is a candidate?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"v8wp1272","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qegnv274","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients with stubborn or progressive leg pain (sciatica), numbness, or weakness from a herniated fragment when imaging matches the exam and nonoperative care is not enough or not the right fit. Decisions are made from the individual case."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qxdqk276","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5odex278","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How long will I stay in the hospital?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kogcn280","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zecdq282","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Same-day discharge is usual. Overnight stay is uncommon and case by case."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dsurf284","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nhe6v286","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will I need a brace?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7yiv0288","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lg5qt290","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"No. Typical microdiscectomy does not use a brace."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"cho4z292","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7d1js294","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When can I drive?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"aup84296","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"spkjl298","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"No driving for the first 2 weeks. After that, driving may be considered only if the patient is at least 2 weeks out "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"and"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" off all narcotics. Both required."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fd8cg302","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"n5m9t304","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What is the main exercise after surgery?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"r9ucb306","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"f88d0308","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Walking. Short, limited walks in weeks 0–2. If healing is OK at the 2-week visit, unlimited walking in weeks 2–6. BLT restrictions stay for 6 weeks either way. Formal PT is only needed for about 20–30% of people after early recovery if symptoms are not improving."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"a8ivj310","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wvo0v312","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What is the biggest procedure-specific risk later?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"peu0k314","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ipeey316","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Reherniation. A disc can herniate again. Most reherniations do not need more surgery and are treated like a new herniation with a nonoperative pathway for about 6–12 weeks unless there is a reason to operate sooner."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"783w4318","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"t1o58320","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What about outcomes?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"b34z5322","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7ezgm324","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Counseling for this kind of nerve-root decompression often describes meaningful improvement in leg pain for most patients, with weakness and numbness improving less often than pain. The operation takes pressure off the nerve. The nerve still has to heal itself. No one can promise a perfect result for any individual patient."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qfn1c326","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"x9iom328","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients dealing with sciatica or leg pain from a herniated disc who have been told about microdiscectomy are encouraged to bring imaging and questions. The conversation starts with the problem, not the tube size: whether a fragment is pinching the nerve, whether nonoperative care still has a realistic chance, and whether removing that fragment through a tubular corridor is the safest complete path."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zp2wn330","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9d4n1332","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"That is the conversation Dr. Nicholas J. 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Clark, MD, orthopedic spine surgery (minimally invasive and robotic), HSS at NCH, Naples, FL."},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"},{"italicData":true,"type":"ITALIC"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xy5zk347","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"id":"sgecj349","nodes":[],"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"type":"PARAGRAPH"}]}},"971ef3b3-d471-42ff-bb74-1b998f1dc140":{"_manualSort_85b0f783-b8d0-41c3-b2c2-3dcbeb166104":"1m","link-items-all":"\/treatments\/","image":"wix:image:\/\/v1\/c771f2_e2e66a47c3234e64af0dfea92a58cfb0~mv2.jpg\/Spinal_Decompression.jpg#originWidth=1920&originHeight=1080","_id":"971ef3b3-d471-42ff-bb74-1b998f1dc140","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"ULBD laminectomy (unilateral laminotomy for bilateral decompression) for lumbar stenosis, Naples FL.","_createdDate":{"$date":"2025-08-04T20:35:12.346Z"},"shortDescription":"ULBD laminectomy is a minimally invasive lumbar decompression for spinal stenosis: through a one-sided corridor, both sides of the canal are opened without fusion when the segment is stable.","_updatedDate":{"$date":"2026-10-01T01:27:41.057Z"},"seoTitle":"ULBD Laminectomy in Naples, FL | Dr. Nicholas Clark","_publishStatus":"PUBLISHED","link-copy-of-treatments-title":"mis-decompression%2F-laminectomy-","link-items-title":"\/treatments\/mis-decompression","title":"ULBD Laminectomy (Unilateral Laminotomy for Bilateral Decompression)","seoDescription":"ULBD laminectomy opens the lumbar canal for spinal stenosis through a one-sided corridor, usually without fusion. Dr. Nicholas Clark, HSS at NCH, Naples.","pageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"oraup2","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ULBD laminectomy is a minimally invasive lumbar decompression for "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"spinal stenosis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". Through a small corridor on one side of the back, enough bone and ligament are removed to free "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"both sides"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" of the canal so the nerve roots have room again."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"c7bqf8","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kp58310","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The goal is mechanical and clear: open the crowded canal. When the segment is stable, this is usually "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not a fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". Walking distance and comfort are often the practical measures of success, not only a pain score at rest."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"pz5t614","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"unyxr16","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients researching laminectomy or ULBD in Naples or elsewhere in Southwest Florida often find that the useful question is not only “Is it minimally invasive?” It is whether stenosis is driving the walking problem, whether the segment is stable enough for decompression alone, and whether this corridor finishes the job safely. That is the conversation at HSS at NCH."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gkdpp18","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"urey920","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When ULBD laminectomy is recommended"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"32uba22","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bs22r24","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative care is preferred when it still solves the problem. Therapy, medicines, activity changes, and injections are still discussed when those have a realistic chance."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"cwgmy26","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"z8x2k28","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ULBD \/ MIS laminectomy is typically recommended when:"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dvnoc30","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"imt4z32","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients have "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/conditions\/spinal-stenosis"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"lumbar stenosis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":": legs get heavy, painful, or numb with "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"walking or standing"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", and often feel better sitting or leaning forward (the “shopping-cart” posture)"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kc6oz38","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Imaging shows canal crowding from thickened ligament, bone spurs, disc bulge, or facet arthritis that matches the walking pattern"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wvaw640","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The segment is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"stable enough for decompression without fusion"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jjjci43","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative care has not restored useful walking, or symptoms are progressing in a way that needs space for the nerves"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"oshz045","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fyjky47","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This is different from a single disc fragment shooting pain down one nerve ("},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/treatments\/mis-microdiscectomy"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"microdiscectomy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" territory), though some people have both problems. Stenosis crowds the canal; classic symptoms worsen with standing and walking and ease with flexion."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2g35o49","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wgpjk51","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ULBD is not automatic because an MRI shows stenosis. Surgery is for when the anatomy and symptoms say the canal will not finish opening on its own with nonoperative care, and the mechanical job is to give the nerves room again."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"s85li53","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1e44455","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"If instability or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/conditions\/spondylolisthesis-and-spondylolysis"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"a slip"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is part of the problem, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/treatments\/mis-tlif"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" may need to be part of the plan instead of decompression alone. That is decided from imaging and exam, not from a webpage. Complete and safe is the standard."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"b7tp157","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"i6p3o59","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What happens in surgery"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"s92rw61","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"686s963","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ULBD does one main job:"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jp2ts65","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fcyuv67","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Decompress"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" both sides of the canal through a unilateral (one-sided) laminotomy corridor"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zf0b170","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nxbvn72","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ULBD"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" means unilateral laminotomy for bilateral decompression. Through a small incision on "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"one side"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", using dilating tubes and a microscope, enough bone and ligament are removed to free "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"both sides"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" of the canal. Muscle fibers are gently split, not stripped in a long open midline strip. The working tube is often "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"16–18 mm"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vpgto81","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"if28d83","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This is usually "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not a fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" when the segment is stable. No implant is placed to glue the bones together unless the written plan says otherwise. If an in-situ or other fusion add-on is needed for that anatomy, that is said clearly before surgery."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4r4d287","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"pm3xa89","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Decompression does not “cure arthritis.”"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Back pain from facet arthritis may still be there after a decompression-only surgery. 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Week 6 is an activity talk. Many people who are progressing appropriately are "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"released from routine care at about 6 weeks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" after laminectomy \/ ULBD. It is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" sports clearance unless that is written. Return to sport is eased in weeks "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"6–12"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" based on what is written."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"il83c238","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"qq9ex240","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Weeks 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enough bone and ligament are removed to free both sides of the canal for lumbar stenosis. It is usually not a fusion when the segment is stable."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5mg7a270","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"blhpy272","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How is stenosis different from a herniated disc fragment?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"x72br274","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"so09y276","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Stenosis is canal crowding that often makes legs heavy or painful with walking or standing and better with sitting or leaning forward. A herniated fragment is more often a single-nerve sciatica story. Some people have both. The operation matches the mechanical problem."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wooqs278","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4g3y9280","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Who is a candidate for ULBD laminectomy?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"b7a3f282","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xg4kr284","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients with walking-limiting lumbar stenosis when imaging matches the exam, the segment is stable enough for decompression without fusion, and nonoperative care is not enough. If instability is part of the problem, fusion may be discussed instead."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"umcbx286","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"cd37j288","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How long will I stay in the hospital?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"m3gip290","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5qc6y292","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Same-day discharge is common when the patient is ready. Overnight stay is case by case."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8f2ga294","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"e8nxk296","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will I need a brace?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6zvi7298","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"elfl9300","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Brace after ULBD \/ laminectomy is case by case, not automatic. Wear it only if it was written."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ognej302","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"32jxz304","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When can I drive?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sjec8306","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"q2eq7308","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"No driving for the first 2 weeks. After that, driving may be considered only if the patient is at least 2 weeks out "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"and"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" off all narcotics. Both required."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"stt48312","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xavjo314","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What is the main exercise after surgery?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gr4o2316","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8l88i318","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Walking. Short walks in weeks 0–2. If healing is OK at the 2-week visit, unlimited walking in weeks 2–6. BLT stays for 6 weeks. Formal PT is only needed for about 20–30% of people after early recovery if symptoms are not improving."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ibsyw320","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"iedpo322","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will this cure my arthritis back pain?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5ma8w324","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fxuuy326","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Decompression opens space for the nerves. It does not cure facet arthritis. Back pain from arthritis may remain. The main target is leg heaviness and walking limits from stenosis."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ffcu1328","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wqzn3330","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What about outcomes?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"w1a09332","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jkmg4334","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Counseling for leg \/ nerve symptoms after decompression often describes meaningful improvement for most patients, with weakness and numbness improving less often than pain. Walking distance and comfort are often the practical measures. No one can promise a perfect result for any individual patient."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2vxi5336","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"76mz8338","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients dealing with walking-limiting leg heaviness or pain from lumbar stenosis who have been told about laminectomy or ULBD are encouraged to bring imaging and questions. The conversation starts with the problem, not the incision size: whether stenosis is driving the walking pattern, whether the segment is stable enough for decompression alone, and whether a one-sided ULBD corridor finishes the job safely."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"14ilz340","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qbkiv342","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"That is the conversation Dr. Nicholas J. Clark has with patients at HSS at NCH in Naples."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ioheq344","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"skrv9346","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/contact"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"Request an appointment"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" · "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"tel:+12396240306"}},"type":"LINK"}],"text":"(239) 624-0306"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zbk5y351","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"okqw3353","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"},{"italicData":true,"type":"ITALIC"}],"text":"Nicholas J. Clark, MD, orthopedic spine surgery (minimally invasive and robotic), HSS at NCH, Naples, FL."},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"},{"italicData":true,"type":"ITALIC"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5w7mv357","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"id":"sg5s4359","nodes":[],"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"type":"PARAGRAPH"}]}},"c35eb063-af19-4b98-a4e2-831f25f98886":{"_manualSort_85b0f783-b8d0-41c3-b2c2-3dcbeb166104":"1n","link-items-all":"\/treatments\/","image":"wix:image:\/\/v1\/c771f2_1b9a6996a30844d2bd9e097c6243f3dc~mv2.jpeg\/AdobeStock_261992123.jpeg#originWidth=3750&originHeight=5000","_id":"c35eb063-af19-4b98-a4e2-831f25f98886","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"MIS-TLIF (minimally invasive transforaminal lumbar interbody fusion) for pinched nerve and unstable lumbar segment, Naples FL","_createdDate":{"$date":"2025-08-04T20:35:12.348Z"},"shortDescription":"MIS-TLIF is a minimally invasive lumbar fusion for pinched nerves and an unstable segment: decompress the nerve, then stabilize the segment through a smaller corridor, often with robotic guidance.","_updatedDate":{"$date":"2026-10-01T01:27:40.709Z"},"seoTitle":"MIS-TLIF Lumbar Fusion in Naples, FL | Dr. Nicholas Clark","_publishStatus":"PUBLISHED","link-copy-of-treatments-title":"mis-tlif-(transforaminal-lumbar-interbody-fusion)","link-items-title":"\/treatments\/mis-tlif","title":"MIS-TLIF (Minimally Invasive Transforaminal Lumbar Interbody Fusion)","seoDescription":"MIS-TLIF frees pinched nerves and stabilizes an unstable level through a small corridor, often with robotic guidance. 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Both are required. If opioid pain medicine is still being taken at 2 weeks, do not drive yet."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"n73","nodes":[{"id":"n74","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"Work (counseling, not an employer note):"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" case by case when ready. Desk work is often "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"2-3 weeks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":", sometimes earlier. Physical work is generally out about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"6 weeks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":". Not while on narcotics. The driving rule still applies."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"n75","nodes":[{"id":"n76","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"PT:"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" walking is the main therapy. Only about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"20-30%"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" of people need formal office PT after early recovery, usually if lumbar pain is not improving. Do not assume everyone gets a PT gym order. Do not assume nobody does."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"}],"type":"LIST_ITEM"}],"type":"BULLETED_LIST"},{"id":"sp32","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n77","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"Nicotine is a hard stop for fusion."},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" No smoking, vaping, dip, or nicotine pouches after surgery. Nicotine can stop bone from healing. Ask for help quitting if needed. Do not hide it."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp33","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n78","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"No NSAIDs for 3 months after fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" (ibuprofen, naproxen, Advil, Aleve, and similar). Those medicines can interfere with bone healing. Acetaminophen (Tylenol) is the usual alternative if it is allowed. Do not start leftover anti-inflammatories on your own."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp34","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n79","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Patients typically see Jorge again at about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"6 weeks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":". Week 6 is often an x-ray (if ordered) and an activity talk. It is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" sports clearance. It is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" “the fusion is done.” Hardware is a scaffold. Bone still has months of healing ahead."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp35","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"id":"n80","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Weeks 6-12"},"type":"TEXT"}],"type":"HEADING"},{"id":"sp36","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"bulletedListData":{"indentation":0},"id":"n81","nodes":[{"id":"n82","nodes":[{"id":"n83","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Ease back into activities and return toward sport "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"slowly"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":", based on what is written at or after the 6-week visit"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"n84","nodes":[{"id":"n85","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Keep treating the fusion as healing, not healed"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"n86","nodes":[{"id":"n87","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Formal PT only if ordered for continued or non-improving symptoms"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"}],"type":"LIST_ITEM"}],"type":"BULLETED_LIST"},{"id":"sp37","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n88","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Fusion patients are typically seen by Dr. Clark at about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"3 months"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" and "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"6 months"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" (and sometimes around a year) as the usual pathway. Bone healing is a long process. The early visits with Jorge cover wounds and the first activity steps. The later visits watch how the fusion is progressing."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp38","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"id":"n89","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"FAQs"},"type":"TEXT"}],"type":"HEADING"},{"id":"sp39","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n90","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"What is MIS-TLIF?"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp40","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n91","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"MIS-TLIF is a minimally invasive lumbar fusion that decompresses pinched nerves and stabilizes an unstable segment through a smaller muscle-sparing corridor, often with robotic guidance. The goal is the same as an open fusion. The path through the soft tissue is narrower."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp41","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n92","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"Who is a candidate for robotic MIS-TLIF?"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp42","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n93","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Patients with leg pain or stenosis plus instability or spondylolisthesis who need both decompression and fusion. The robot is used to place hardware accurately when a planned corridor and precision both matter."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp43","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n94","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"Does the robot do the surgery?"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp44","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n95","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"No. The robot helps plan and guide accurate hardware placement through a smaller corridor. The surgeon still performs the decompression and makes every surgical decision."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp45","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n96","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"How long will I stay in the hospital?"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp46","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n97","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Generally overnight. Same-day discharge is case by case, not the default for MIS-TLIF."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp47","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n98","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"Will I need a brace?"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp48","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n99","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Yes, typically a short LSO after lumbar fusion. Wear it as written. Hours and weaning are adjusted at follow-up. Do not wean on your own because the incisions look small."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp49","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n100","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"When can I drive after MIS-TLIF?"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp50","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n101","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"No driving for the first 2 weeks. After that, driving may be considered only if the patient is at least 2 weeks out "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"and"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" off all narcotics. Both required."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp51","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n102","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"What is the main exercise after surgery?"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp52","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n103","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Walking. Short, limited walks in weeks 0-2. If healing is OK at the 2-week visit, unlimited walking in weeks 2-6. BLT restrictions stay for 6 weeks either way. Formal PT is only needed for about 20-30% of people after early recovery if symptoms are not improving."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp53","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n104","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"Can I use nicotine or anti-inflammatory pills after fusion?"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp54","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n105","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Nicotine is a hard stop. No nicotine products after fusion surgery. No NSAIDs for 3 months after fusion unless an exception is written. Ask before taking anything new for pain."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp55","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n106","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"Is the fusion done at 6 weeks?"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp56","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n107","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"No. Week 6 is a check-in and activity discussion, not proof that bone has fused. Later visits in the fusion pathway continue as healing continues over months."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp57","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n108","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"}],"text":"What about outcomes?"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp58","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n109","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"In counseling for this kind of lumbar decompression and fusion, meaningful improvement in leg pain is often described for most patients, with weakness and numbness improving less often than pain. The operation takes pressure off the nerve. The nerve still has to heal itself. No one can promise a perfect result for any individual patient."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp59","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n110","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Patients dealing with leg pain, stenosis, or a slip who have been told about fusion are encouraged to bring imaging and questions. The conversation starts with the problem, not the incision size: what needs to be decompressed, what needs to be stabilized, and whether a muscle-sparing MIS-TLIF corridor (with robotic hardware guidance when it fits) is the safest complete path, or whether another approach, such as "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/treatments\/mis-alif-anterior-lumbar-interbody-fusion"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"ALIF"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" or "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/treatments\/mis-llif-lateral-lumbar-interbody-fusion"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"LLIF"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":", fits better."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp60","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n111","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"That is the conversation Dr. Nicholas J. Clark has with patients at HSS at NCH in Naples."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp61","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n112","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/contact"}},"type":"LINK"}],"text":"Request an appointment"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[],"text":" · "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"linkData":{"link":{"target":"SELF","url":"tel:+12396240306"}},"type":"LINK"}],"text":"(239) 624-0306"},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp62","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n113","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"Nicholas J. Clark, MD, orthopedic spine surgery (minimally invasive and robotic), HSS at NCH, Naples, FL."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"},{"id":"sp64","nodes":[],"paragraphData":{},"type":"PARAGRAPH"},{"id":"n115","nodes":[{"id":"","nodes":[],"textData":{"decorations":[],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"paragraphData":{},"type":"PARAGRAPH"}]}},"c6530a2b-1fab-4222-af98-6a32f08c1f9f":{"_manualSort_85b0f783-b8d0-41c3-b2c2-3dcbeb166104":"1n4","link-items-all":"\/treatments\/","image":"wix:image:\/\/v1\/c771f2_7cf519f3f8eb42ca9b791e5674fa60d2~mv2.jpeg\/AdobeStock_128892904.jpeg#originWidth=4096&originHeight=4096","_id":"c6530a2b-1fab-4222-af98-6a32f08c1f9f","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"Synovial Cyst Excision is a procedure that removes fluid-filled cysts from the spine to reduce nerve irritation and pain.","_createdDate":{"$date":"2025-07-23T18:05:16.682Z"},"shortDescription":"Synovial Cyst Excision is a procedure that removes fluid-filled cysts from the spine to reduce nerve irritation and pain.","_updatedDate":{"$date":"2026-10-01T02:02:34.359Z"},"seoTitle":"Synovial Cyst Removal in Naples, FL | Dr. Nicholas Clark","_publishStatus":"PUBLISHED","link-copy-of-treatments-title":"synovial-cyst-excision","link-items-title":"\/treatments\/synovial-cyst-excision","title":"Synovial Cyst Excision","seoDescription":"Synovial cyst resection removes a lumbar facet cyst pinching a nerve, often without fusion if the level is stable. 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It typically causes low back pain plus shooting leg pain, numbness, or weakness on one side. The symptoms often mimic a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"herniated disc"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". These cysts form most often at "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"L4-L5"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", where years of "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"facet arthritis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" put the most stress on the joint lining."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"127pq18","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3wyoa20","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A synovial cyst is not a tumor or cancer. It is a mechanical problem: a pocket of joint fluid trapped under pressure, pressing on a nerve. When the cyst is the clear source of nerve compression, removing it relieves that pressure directly. Patients researching synovial cyst treatment in Naples or Southwest Florida often want to know whether the cyst can be removed without a fusion. That is the conversation at HSS at NCH."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"0ayf722","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"x47lz24","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When cyst resection is recommended"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"66l3o26","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lqidf28","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgery is not the first step. 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But "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"recurrence is common"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", and a large cyst causing real nerve compression usually does not stay gone with an injection alone. 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Early follow-up visits are usually with "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Jorge Monje, APRN"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":": wound check and symptom review."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"76237151","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qbcpq153","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Leg pain often improves quickly, sometimes immediately, once the nerve is free. 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A radiologist can try to aspirate or rupture the cyst under imaging guidance, usually with a steroid added. It helps a meaningful subset of patients, but the cyst wall remains, so "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"recurrence is common"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". 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That call is made from your MRI and standing X-rays."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gsisp311","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6cugg313","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What are the risks?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Dural tear"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" with "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"CSF leak"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (usually repaired during surgery), incomplete symptom relief, cyst "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"recurrence"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", infection, bleeding, blood clots, and, if enough facet bone was removed, postoperative "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"instability"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" that could later require fusion. Serious neurologic injury is rare."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"acohf324","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tteeq326","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How long is recovery compared with a fusion?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Meaningfully shorter: often back to desk work in 1-2 weeks and normal activity by about 6-12 weeks. 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If your operation included a fusion, expect the longer pathway."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"u6s1w331","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"c7bl2333","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will my back pain or leg pain improve more?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Leg pain"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" improves most reliably, because the operation directly removes what was pressing on the nerve. 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Confirm timing at your follow-up visit."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"o449w360","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"v0y9o362","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Can the cyst go away on its own?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Spontaneous resolution is reported but uncommon. Most symptomatic cysts causing real nerve compression do not resolve without treatment, though not every cyst needs surgery. Small cysts with mild symptoms are often simply watched."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"59fhc365","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"txyb2367","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Closing"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"w33sf369","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lgorj371","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A lumbar synovial cyst is a fixable, mechanical problem, and for the right patient, removing it through a small, muscle-sparing approach offers durable relief with a recovery measured in weeks, not months. The key questions: does the cyst match your symptoms, has conservative care had a fair trial, and does your segment need a fusion too? At HSS at NCH in Naples, that evaluation starts with your imaging and your story. 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That is the conversation at HSS at NCH."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"766v420","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"id":"9hcbk1992","nodes":[],"type":"VIDEO","videoData":{"containerData":{"alignment":"CENTER","textWrap":true,"width":{"size":"CONTENT"}},"thumbnail":{"height":720,"src":{"id":"media\/c771f2_f9fe1c76b989432db5493cca91d77c72f000.jpg"},"width":1280},"title":"xlif_720 (1).mp4","video":{"duration":130.176,"src":{"id":"video\/c771f2_f9fe1c76b989432db5493cca91d77c72\/720p\/mp4\/file.mp4"}}}},{"style":{},"id":"abtb422","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When LLIF is recommended"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"e9fjy24","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"v5lzr26","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Motion-sparing care is preferred when it still solves the problem. 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Physical work is generally out about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"6 weeks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". Not while on narcotics."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"c3634259","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"PT:"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" walking is the main therapy. Only about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"20–30%"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" of people need formal office PT after early recovery, usually if lumbar pain is not improving."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kin86264","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4i3a9266","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nicotine is a hard stop for fusion."},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" No smoking, vaping, dip, or nicotine pouches after surgery. Nicotine can stop bone from healing. If nicotine was used before surgery, urine nicotine and cotinine testing may be part of planning. No nicotine after surgery. Ask for help quitting if needed. Do not hide it."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xctvt269","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2yjdt271","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"No NSAIDs for 3 months after fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (ibuprofen, naproxen, Advil, Aleve, and similar). Those medicines can interfere with bone healing. Acetaminophen (Tylenol) is the usual alternative if it is allowed. Do not start leftover anti-inflammatories on your own."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"h4mia274","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8mpfr276","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients typically see Jorge again at about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"6 weeks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". Week 6 is often an x-ray (if ordered) and an activity talk. It is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" sports clearance. It is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" “the fusion is done.” Hardware is a scaffold. Bone still has months of healing ahead."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"timah284","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"nmoy7286","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Weeks 6–12"},"type":"TEXT"}],"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qpy0g288","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"trqic290","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Ease back into activities and return toward sport "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"slowly"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", based on what is written at or after the 6-week visit"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jvvzx294","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Keep treating the fusion as healing, not healed"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lac05296","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Formal PT only if ordered for continued or non-improving symptoms"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wkn6x298","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Approach-side thigh symptoms often continue to improve over weeks; ask at follow-up if they are not settling as expected"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6l2da300","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2ym2h302","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Fusion patients are typically seen by Dr. Clark at about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"3 months"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" and "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"6 months"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (and sometimes around a year) as the usual pathway. Bone healing is a long process. The early visits with Jorge cover wounds and the first activity steps. The later visits watch how the fusion is progressing."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xyusc308","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"us7yx310","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"FAQs"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ni6tu312","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wwd07314","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What is LLIF?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kw4ji316","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6bnuk318","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"LLIF is a lateral (side-approach) lumbar fusion. The worn disc is removed from the flank, height is rebuilt with graft and an implant to help open the foramen, and the level is stabilized so bone can heal over months."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"irn9j320","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"h1erz322","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Who is a candidate for LLIF?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zsx6p324","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"eskfs326","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients who need height restoration and fusion for problems such as foraminal stenosis or selected slips when a side approach fits the level and anatomy. Approach choice is case-specific."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ajypr328","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zfs3k330","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What are the approach-side risks?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"cvu6k332","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wzp0h334","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"On the approach side, more prominent at L3–4 and L4–5, counseling includes possible hernia, temporary quad \/ hip-flexion weakness, and thigh numbness or odd sensation. Most of these improve with time. They are separate from the leg pain the height restoration is meant to address."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"s42ra336","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qwdzz338","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How long will I stay in the hospital?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"g6rhs340","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wmc65342","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Generally overnight. Same-day discharge may be considered in selected cases, case by case, not the default."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"treh2344","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"54ur5346","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will I need a brace?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dh9ie348","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9gtxb350","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Yes, typically a short LSO after lumbar fusion. Wear it as written. Hours and weaning are adjusted at follow-up."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gx2ah352","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"55dhh354","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When can I drive after LLIF?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jssbi356","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gfvzv358","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"No driving for the first 2 weeks. After that, driving may be considered only if the patient is at least 2 weeks out "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"and"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" off all narcotics. Both required."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"88nss362","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"scs93364","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What is the main exercise after surgery?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"u1z3u366","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"pqkmn368","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Walking. Short walks in weeks 0–2. If healing is OK at the 2-week visit, unlimited walking in weeks 2–6. BLT stays for 6 weeks. Formal PT is only needed for about 20–30% of people after early recovery if symptoms are not improving."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"a45rb370","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lpxs1372","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Can I use nicotine or anti-inflammatory pills after fusion?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"i5io8374","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2wbz1376","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nicotine is a hard stop. No nicotine products after fusion surgery. No NSAIDs for 3 months after fusion unless an exception is written. Ask before taking anything new for pain."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"yn7se378","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"07iv2380","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Is the fusion done at 6 weeks?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"itucz382","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"yytry384","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"No. Week 6 is a check-in and activity discussion, not proof that bone has fused. Later visits in the fusion pathway continue as healing continues over months."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"j18i9386","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1qvvp388","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What about outcomes?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jfvm1390","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"c263p392","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When the main target is leg \/ nerve-root symptoms, counseling often describes meaningful improvement in leg pain for most patients, with weakness and numbness improving less often than pain. Approach-side thigh symptoms are counseled separately. The operation restores height and stability. The nerve still has to heal itself. No one can promise a perfect result for any individual patient."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mocpw394","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ypbhh396","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients dealing with leg pain from foraminal stenosis, disc collapse, or a slip who have been told about lateral fusion are encouraged to bring imaging and questions. The conversation starts with the problem, not the flank incision: what needs height restored, what needs to be stabilized, whether approach-side risks fit that level, and whether LLIF is the safest complete path compared with ALIF or MIS-TLIF."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zar8s398","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"c1yvz400","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"That is the conversation Dr. Nicholas J. 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Clark, MD, orthopedic spine surgery (minimally invasive and robotic), HSS at NCH, Naples, FL."},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"},{"italicData":true,"type":"ITALIC"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6p6ik415","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"id":"lhvmt417","nodes":[],"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"type":"PARAGRAPH"}]}},"b76b6309-890e-47c4-9eb5-d22e89f5d71c":{"_manualSort_85b0f783-b8d0-41c3-b2c2-3dcbeb166104":"1nc","link-items-all":"\/treatments\/","image":"wix:image:\/\/v1\/fd2f94_43717d8bfd5d4aaea6c48f8245bd1573~mv2.jpeg\/ALIF.jpeg#originWidth=810&originHeight=810","_id":"b76b6309-890e-47c4-9eb5-d22e89f5d71c","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"MIS ALIF (Anterior Lumbar Interbody Fusion) is a front-approach procedure that replaces a damaged disc and fuses the lumbar spine for long-term support.","_createdDate":{"$date":"2025-08-20T16:36:03.827Z"},"shortDescription":"MIS ALIF (Anterior Lumbar Interbody Fusion) is a front-approach procedure that replaces a damaged disc and fuses the lumbar spine for long-term support.","_updatedDate":{"$date":"2026-10-01T01:27:40.352Z"},"seoTitle":"ALIF Lumbar Fusion in Naples, FL | Dr. Nicholas Clark","_publishStatus":"PUBLISHED","link-copy-of-treatments-title":"mis-alif-(anterior-lumbar-interbody-fusion)","link-items-title":"\/treatments\/mis-alif-anterior-lumbar-interbody-fusion","title":"MIS ALIF (Anterior Lumbar Interbody Fusion)","seoDescription":"ALIF is a front-approach lumbar fusion that restores disc height and lordosis and stabilizes the level. 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Passing gas before a regular diet is the usual milestone."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Call the office or go to the ER for any of these:"},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"bulletedListData":{"indentation":0},"nodes":[{"nodes":[{"nodes":[{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"New "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"loss of bowel or bladder control"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":", or numbness in the "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"saddle"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" area (inner thighs, groin, buttocks), which can signal "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"cauda equina syndrome"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":", a surgical emergency"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"nodes":[{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Rapidly worsening leg weakness"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":": new inability to lift the foot, push off, or bear weight"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"nodes":[{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Fever"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" over 101°F that won't come down, or fever with worsening wound redness, warmth, or "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"drainage"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"nodes":[{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Calf swelling, pain, or redness"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":", or sudden shortness of breath or chest pain, which are signs of a blood clot"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"nodes":[{"nodes":[{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Severe, uncontrolled abdominal pain or a distended, rigid abdomen"},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"}],"type":"BULLETED_LIST"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Mild oozing the first day, a low-grade temperature under 100.4°F, and muscle soreness are expected."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Recovery timeline"},"type":"TEXT"}],"type":"HEADING"},{"type":"PARAGRAPH"},{"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Weeks 0-2"},"type":"TEXT"}],"type":"HEADING"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Walking is the main exercise: short, frequent walks, building gradually. "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"BLT restrictions: no bending, lifting, or twisting for 6 weeks"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":", the same as after "},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#1155CC"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/treatments\/mis-tlif"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"MIS-TLIF"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":". No lifting greater than "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"10-15 pounds"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" for the first 6 weeks. Log-roll in and out of bed. "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Showering is usually fine the day after surgery"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":". "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"No submerging the incision (baths, hot tubs, pools) for 6 weeks."},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"No driving for the first 2 weeks and not while on narcotics."},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" Stay hydrated and use the prescribed stool softener. The 2-week visit is typically with "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#1155CC"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/jorge-monje"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"Jorge Monje, APRN"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" (Spanish and English): a wound check, medicine review, and the walking decision. If healing looks appropriate, patients are often released to "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"unlimited walking"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" for weeks 2-6. Unlimited walking still means walking. It does not lift BLT. It does not mean sport, gym, swimming, or chores that bend, lift, or twist."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Weeks 2-6"},"type":"TEXT"}],"type":"HEADING"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Walking:"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" unlimited on even ground if the 2-week visit said healing is OK; if not, stay on short walks until the plan is changed in writing. Most patients are off narcotics. "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"No NSAIDs for the first 3 months after surgery."},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" Acetaminophen (Tylenol) is the usual alternative. "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Desk work can often resume around 2-3 weeks"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"; light physical work is generally about 6 weeks. Driving may be considered only once the patient is at least 2 weeks out and off all narcotics, and can turn, brake, and react comfortably. The incision may feel tight, numb, or lumpy for weeks. That is normal healing. "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Walking is the main therapy."},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" Formal office PT is not automatic; it is ordered only for continued or non-improving symptoms. An "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"LSO brace"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" is generally provided after ALIF."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Weeks 6-12"},"type":"TEXT"}],"type":"HEADING"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Restrictions ease gradually after the 6-week visit, based on what is written. Formal PT only if ordered for continued or non-improving symptoms. "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Follow-up visits are at about 2 weeks, 6 weeks, 3 months, 6 months, and 1 year, with X-ray at every visit"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":", the same pathway as MIS-TLIF. The early visits are usually with "},"type":"TEXT"},{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Jorge Monje, APRN"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"; the later visits, around 3 and 6 months, are with Dr. Clark. Fusion is confirmed on imaging over months, not weeks, so early clearance is about function, not a finished fusion. Heavier duties come later, case by case. Exercise builds back: walking, then stationary cycling and swimming once the incision is fully healed."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"No nicotine before or after surgery."},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" No smoking, vaping, or other nicotine products. Nicotine impairs bone healing."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"FAQs"},"type":"TEXT"}],"type":"HEADING"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Why go through the front instead of the back?"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" Two reasons: no back muscles are cut, and the anterior route allows the largest interbody cage of any approach. That means more graft, better disc-height restoration, and the most reliable correction of lost lordosis. The back approach stays better for some problems (severe canal stenosis needing direct decompression, prior anterior scarring)."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"What is the access surgeon's role?"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" An access surgeon, usually a vascular or general surgeon, typically assists with the abdominal exposure: the incision, the retroperitoneal corridor, and safe mobilization of the aorta, vena cava, and iliac vessels. The spine surgeon then does the disc removal, cage placement, and fusion."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"How big is the cage, and why does that matter?"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" ALIF cages are substantially larger than posterior-approach cages. They can span nearly the full width of the disc. Reopening disc height also reopens the nerve tunnels (foramina), often relieving leg symptoms without touching the nerves directly."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Will I need posterior screws too?"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" Not always. Some levels are treated with the anterior implant alone, and others also need posterior screws. Posterior screws are added when there is a slip (spondylolisthesis) or instability, placed percutaneously through small back incisions to hold the segment while fusion matures. When screws are needed, they are almost always placed the same day."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"How long is the hospital stay?"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" Some patients go home the same day, and some stay overnight."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"When can I drive, work, and exercise?"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" No driving for the first 2 weeks. After that, driving may be considered only if the patient is at least 2 weeks out and off all narcotics. Desk work is often about 2-3 weeks, and light physical work about 6 weeks. Walking starts the day of surgery and is the main therapy. Formal office PT is not automatic. Unlimited walking is typically cleared at the 2-week visit if healing looks appropriate."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Does the abdominal incision hurt more or less than a back incision?"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" Most patients describe surface-level soreness, similar to an appendectomy recovery, rather than the deep muscular ache of a back incision. Coughing, laughing, or straining will pull on it early on; the typical course is a few weeks of manageable soreness."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"What if I've had prior abdominal surgery?"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" It depends on the surgery. A prior appendectomy or C-section usually leaves low, off-to-the-side scarring and may not matter. Prior major bowel surgery, aortic or iliac vascular surgery, or abdominal\/pelvic radiation can make the corridor unsafe. That is one of the first questions the spine surgeon and the access surgeon evaluate."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"nodes":[{"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Considering ALIF in Naples"},"type":"TEXT"}],"type":"HEADING"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"ALIF is one option among several for a painful lumbar segment. It is not the default, and it is not right for everyone. The decision comes down to symptoms, imaging, anatomy, and medical history. Patients weighing fusion for a collapsed disc, lost lordosis, or foraminal stenosis are encouraged to bring their MRI and questions to HSS at NCH in Naples. A careful exam and imaging review determine whether the anterior approach fits the problem, or whether a different approach, such as "},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#1155CC"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/treatments\/mis-llif-lateral-lumbar-interbody-fusion"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"LLIF"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" or "},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#1155CC"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/treatments\/mis-tlif"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"MIS-TLIF"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":", fits better."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"That is the conversation Dr. Nicholas J. Clark has with patients at HSS at NCH in Naples."},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"colorData":{"foreground":"#1155CC"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/contact"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"Request an appointment"},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" · "},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"tel:+12396240306"}},"type":"LINK"}],"text":"(239) 624-0306"},"type":"TEXT"}],"type":"PARAGRAPH"},{"type":"PARAGRAPH"},{"nodes":[{"textData":{"decorations":[{"italicData":true,"type":"ITALIC"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"Nicholas J. Clark, MD, orthopedic spine surgery (minimally invasive and robotic), HSS at NCH, Naples, FL."},"type":"TEXT"},{"textData":{"decorations":[{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":" "},"type":"TEXT"},{"textData":{"decorations":[{"italicData":true,"type":"ITALIC"},{"colorData":{"foreground":"#000000"},"type":"COLOR"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"}]}},"9fac0d3e-ca35-48fd-816e-1b81216b3fa2":{"_manualSort_85b0f783-b8d0-41c3-b2c2-3dcbeb166104":"1ng","link-items-all":"\/treatments\/","image":"wix:image:\/\/v1\/c771f2_06fb73eeb1c14e54a77dea6f3d231194~mv2.jpg\/cervartificialdisc_1280.jpg#originWidth=1280&originHeight=720","_id":"9fac0d3e-ca35-48fd-816e-1b81216b3fa2","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"Cervical disc replacement (CDR \/ TDR) for motion-preserving treatment of cervical disc disease, Naples FL.","_createdDate":{"$date":"2025-08-20T16:36:27.722Z"},"shortDescription":"Cervical disc replacement removes a diseased disc from the front of the neck and places a motion-preserving device instead of fusion when the level is a good candidate.","_updatedDate":{"$date":"2026-10-01T01:27:40.149Z"},"seoTitle":"Cervical Disc Replacement, Naples, FL | Dr. Nicholas Clark","_publishStatus":"PUBLISHED","link-copy-of-treatments-title":"cervical-total-disc-replacement","link-items-title":"\/treatments\/cervical-total-disc-replacement","title":"Cervical Disc Replacement (CDR \/ TDR)","seoDescription":"Cervical disc replacement removes a diseased disc and places a motion device instead of fusion when the level qualifies. Dr. Nicholas Clark, HSS at NCH.","pageContent":{"documentStyle":{},"nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"41arh2","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Cervical disc replacement is surgery from the front of the neck. A diseased disc that is pressing on a nerve root or the spinal cord is removed, and a motion-preserving device is placed instead of fusing the level when that level is a good candidate for motion preservation."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wd8uk4","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"dmewe6","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The path is anterior: a small incision on the side of the neck, muscles spread rather than cut, then direct access to the disc. The mechanical goal is clear. Take pressure off what is compressed. Rebuild height. Keep controlled motion at that segment when anatomy allows."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hlm668","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mj9q610","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients researching cervical disc replacement in Naples or elsewhere in Southwest Florida often find that the useful question is not only “What is CDR?” It is whether the level is a safe motion-preservation candidate, or whether fusion ("},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/treatments\/anterior-cervical-discectomy-and-fusion-acdf"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"ACDF"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":") is the safer mechanical choice for that anatomy. That is the conversation at HSS at NCH."},"type":"TEXT"}],"type":"PARAGRAPH"},{"id":"dn8ax1012","nodes":[],"type":"VIDEO","videoData":{"containerData":{"alignment":"CENTER","textWrap":true,"width":{"size":"CONTENT"}},"thumbnail":{"height":480,"src":{"url":"https:\/\/i.ytimg.com\/vi\/kfR9WIFj_s8\/sddefault.jpg"},"width":640},"title":"Simplify Disc procedure","video":{"duration":98,"src":{"url":"https:\/\/www.youtube.com\/watch?v=kfR9WIFj_s8"}}}},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"oxti112","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"vhhc914","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When cervical disc replacement is recommended"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"juxdk16","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"d8iq318","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative care is preferred when it still solves the problem. Disc replacement is for when the diseased disc must come out, the nerve or cord needs decompression, and the level can reasonably keep motion instead of being fused."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fsf0j20","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"t52yc22","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"CDR \/ TDR is typically recommended when:"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4abj324","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8f1nq26","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients have "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/conditions\/radiculopathy"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"cervical radiculopathy"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":": arm pain, numbness, tingling, or weakness from a pinched "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"nerve root"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" that has not settled with nonoperative care, and imaging matches the exam"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ur7ka32","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Selected patients have cord or nerve compression at a level where removing the diseased disc and placing a motion device is the planned mechanical job"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"akuoh34","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The level is a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"good motion-preservation candidate"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (alignment, arthritis pattern, and neighboring levels support that choice)"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"6zo7j38","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Imaging and exam match symptoms, and the mechanical job is clear: decompress and rebuild height while keeping motion when safe"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"eijm540","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"h9cuc42","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"CDR is not automatic because someone wants to “keep motion.”"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Alignment, facet disease, prior surgery, number of levels, and how the rest of the neck will tolerate a moving implant all matter. When the level is not a good motion-preservation candidate, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"ACDF is often the safer mechanical choice"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". That decision is made from the individual case, not from a webpage."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xaaq747","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jfkgx49","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"For arm-pain radiculopathy, many people try activity changes, medicines, therapy, and sometimes injections first when those have a realistic chance. Surgery is for when the anatomy and symptoms say the mechanical problem will not finish healing on its own, or when strength is slipping."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kw00651","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rmsdq53","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The anterior path is chosen when the job can be finished completely and safely from the front. If anatomy or prior surgery needs a different approach, that is planned honestly. Complete and safe is the standard."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"c0jdb55","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"3xqwe57","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What happens in surgery"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lhizj59","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3y68r61","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Cervical disc replacement does three things:"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ut6ps63","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rqxl465","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Remove"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" the diseased disc (and bone spurs as needed) pressing on the nerve root and\/or the spinal cord"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2mjrw68","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Rebuild height"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" where the worn disc was"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mhcc171","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Place a motion device"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" so the level keeps controlled motion instead of being fused"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2bj9s74","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"80kbp76","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A small incision is made on the "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"left"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" side of the neck, about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"1.5 inches"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", oriented side to side along the natural skin lines. When a neck crease exists, the cut is placed in that crease. Muscles are spread rather than cut. The esophagus (food tube) is moved gently aside so the spine can be reached. The diseased disc is removed. An implant designed to move is placed to reconstruct height. Most cases are "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"1–2 levels"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mw1s584","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"18b4o86","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The scar is usually a small pencil line when the incision follows a crease or those side-to-side skin lines."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kdtnt88","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rm7d690","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Because height is restored, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"pain in the back of the neck"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" can happen after surgery, similar to ACDF counseling. Soft diet early and upright sleep help with swelling and swallowing the same way they do after other front-of-neck spine surgery."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1oh3s94","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hylmc96","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"If arm pain is the main story (radiculopathy)"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kf33t98","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7bsqb100","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Surgery takes pressure off the nerve root. It does "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" rebuild the nerve. The nerve has to heal itself. There is no sign during surgery that tells anyone for sure how much the nerve will recover."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"k8ly9104","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xkd2j106","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Motion preservation is the long-term goal of the implant."},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" It is not permission to stretch hard, drive early, or return to work faster than the written early rules allow. Weeks 0–2 still protect the wound, swallowing, and implant settling."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"t153k109","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"v0dqr111","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Hospital stay and the first days"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sk4tq113","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5grbk115","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Stay is often same-day for 1–2 level CDR"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" when appropriate, similar to 1–2 level ACDF. Overnight stay is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"case by case"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", not automatic."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"38rvz120","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qmieq122","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The discharge paper wins if it differs. Patients need a responsible adult to take them home. Patients should not drive themselves."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tr4dt124","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4hoxu126","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Early goals:"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2lpxr128","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"q5vu6130","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Protect airway and swallowing, and watch the front of the neck"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gmnnr132","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Control pain enough to rest and walk short distances"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8w3jq134","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Start soft-diet swallowing, wound care, and the activity rules followed at home"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jclap136","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bw0yq138","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients typically wear a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"soft collar for about the first 2 weeks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", like ACDF. Hard collars are almost never used. 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Mild, slowly changing nerve ache can happen as a nerve settles. Soft diet early helps: protein shakes, blended foods, yogurt, eggs, soup that is not steaming hot. Dry foods and large pills are often the hardest. 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Do not drive yourself."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"u51k0162","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"minp9164","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"New"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" rapidly worsening arm or leg weakness, new loss of bowel or bladder control, or chest\/calf clot warning signs are also emergencies. Call 911 or go to the ER."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"f7qgh167","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"oa50r169","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Showering is usually fine with the waterproof dressing and surgical glue. Let water run over. Do not scrub. Pat dry. 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Both are required. If opioid pain medicine is still being taken at 2 weeks, do not drive yet."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9pmj1259","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Work (counseling, not an employer note):"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" case by case when ready. 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The driving rule still applies."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3hnfv266","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"PT:"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" walking is the main therapy. Only about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"20–30%"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" of people need formal office PT after early recovery, usually if neck pain is not improving."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"lrh9w271","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"After the first-week NSAID course, follow whatever was written next. Do not invent a fusion “no NSAID for 3 months” rule for CDR unless that was written."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"349wa273","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gj2f7275","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Do not use nicotine after surgery."},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" No smoking, vaping, dip, or nicotine pouches. Ask for help quitting if needed. Do not hide it."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7fvyn278","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"van70280","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients typically see Jorge again at about "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"6 weeks"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". Week 6 is a check-in and an activity talk. It is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" sports clearance. Motion at the implant level is a long-term goal. Early weeks still protect healing tissue."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"mp98o286","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"gudok288","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Weeks 6–12"},"type":"TEXT"}],"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"7bp0o290","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qxbsg292","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Ease back into activities "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"slowly"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", based on what is written at or after the 6-week visit"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nhmyx296","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Keep treating early recovery as recovery, not “fully broken in”"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"b6w4a298","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Formal PT only if ordered for continued or non-improving symptoms"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"veer6300","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"we2j0302","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Later long-term fusion pathway visits (3 months \/ 6 months \/ 1 year with Dr. Clark) are "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" automatically copied onto every CDR pathway unless written for that patient. Early visits with Jorge cover wounds, swallowing, medicines, and the first activity steps."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"o0xy3306","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"feud8308","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"FAQs"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8bn8i310","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"79n6t312","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What is cervical disc replacement (CDR \/ TDR)?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ce6j2314","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5nvnx316","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Cervical disc replacement removes a diseased disc from the front of the neck and places a motion device instead of fusing the level when that level is a good candidate for motion preservation. The goal is to take pressure off the nerve or cord, rebuild height, and keep controlled motion at that segment."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"douq5318","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"q5fh5320","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How is disc replacement different from ACDF?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fr7az322","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jwm1s324","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Both remove the diseased disc and decompress what is pinched. ACDF rebuilds height and fuses the bones so they grow together. CDR places a motion device so the level is not meant to fuse. CDR is chosen when the level is a good motion-preservation candidate; otherwise ACDF is often the safer mechanical choice."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"srpbk326","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"k81uc328","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Who is a candidate for CDR?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"1xsk4330","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"z5u98332","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients who need the diseased disc removed and who have anatomy that can tolerate a motion device at that level. Alignment, arthritis pattern, neighboring levels, and exam all matter. Decisions are made from the individual case, not from a webpage."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hol2b334","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"8yaa8336","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"How long will I stay in the hospital?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"y4o2a338","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vpp6b340","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Same-day discharge is common for 1–2 level CDR when appropriate. Overnight stay is case by case. The written plan and how the patient looks after surgery win if they differ."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qkc7d342","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nrigw344","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will I need a collar?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5rqau346","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2fb5c348","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Yes, typically a soft collar for about the first 2 weeks, like ACDF. Hard collars are almost never used. Follow whatever was written if it differs."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rzor5350","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"h8vzp352","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Do I need NSAIDs after disc replacement?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9lzpp354","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jte3a356","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Yes, for about the first 7 days in this practice to help prevent unwanted bone formation (heterotopic ossification) around the device. That is the main medicine difference from fusion. Other activity rules are otherwise similar to ACDF."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"t284b358","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zolow360","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When can I drive after CDR?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zmlva362","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"us9tg364","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"No driving for the first 2 weeks. After that, driving may be considered only if the patient is at least 2 weeks out "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"and"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" off all narcotics. Both required."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"q6x5b368","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xtn80370","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What is the main exercise after surgery?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"au1oq372","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"vb432374","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Walking. Short walks early. Keep walking on even ground through the first 6 weeks while BLT and the lift limit stay in place. Formal PT is only needed for about 20–30% of people after early recovery if symptoms are not improving."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qclpz376","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qjc64378","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What about outcomes?"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"l3t1c380","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fo22e382","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Counseling for arm \/ nerve-root symptoms after decompression often describes meaningful improvement in arm pain for most patients, with weakness and numbness improving less often than pain. The operation takes pressure off the nerve. The nerve still has to heal itself. No one can promise a perfect result for any individual patient. CDR-specific numbers, when quoted, are discussed at the visit rather than copied from a fusion handout."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"116ne384","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"4nz1k386","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients dealing with arm pain from a pinched neck nerve who have been told about disc replacement or ACDF are encouraged to bring imaging and questions. The conversation starts with the problem, not the device: what needs to be decompressed, whether that level is a safe motion-preservation candidate, and whether CDR or fusion is the safest complete plan for that anatomy."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"23wue388","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nsj6y390","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"That is the conversation Dr. Nicholas J. Clark has with patients at HSS at NCH in Naples."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"gsygd392","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fsozp394","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(17, 85, 204)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"https:\/\/www.nicholasjclarkmd.com\/contact"}},"type":"LINK"},{"type":"UNDERLINE"}],"text":"Request an appointment"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" · "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"},{"linkData":{"link":{"target":"SELF","url":"tel:+12396240306"}},"type":"LINK"}],"text":"(239) 624-0306"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"voc81399","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"wp1qt401","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"},{"italicData":true,"type":"ITALIC"}],"text":"Nicholas J. Clark, MD, orthopedic spine surgery (minimally invasive and robotic), HSS at NCH, Naples, FL."},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"},{"italicData":true,"type":"ITALIC"}],"text":"This page is educational and not medical advice for your specific condition."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tymyd405","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"id":"t5g18407","nodes":[],"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"type":"PARAGRAPH"}]}},"60bd3159-fc08-4e46-9aba-09e6a37f4e18":{"_manualSort_85b0f783-b8d0-41c3-b2c2-3dcbeb166104":"1nh","link-items-all":"\/treatments\/","image":"wix:image:\/\/v1\/c771f2_ab6096ee86c54f418a328fbdb8fc2322~mv2.jpeg\/images%20(2).jpeg#originWidth=243&originHeight=208","_id":"60bd3159-fc08-4e46-9aba-09e6a37f4e18","_owner":"c771f2ae-0d39-4a72-901f-91e37cbd8d26","imagesAltText":"Pars Repair is a focused surgery that treats stress fractures in the spine to restore stability and reduce pain.","_createdDate":{"$date":"2025-08-20T16:37:26.090Z"},"shortDescription":"Pars Repair is a focused surgery that treats stress fractures in the spine to restore stability and reduce pain.","_updatedDate":{"$date":"2026-10-01T02:02:34.165Z"},"seoTitle":"Pars Defect Repair in Naples, FL | Dr. Nicholas Clark","_publishStatus":"PUBLISHED","link-copy-of-treatments-title":"pars-repair","link-items-title":"\/treatments\/pars-repair","title":"Pars repair","seoDescription":"Pars repair fixes a spondylolysis crack with bone graft and screws, keeping the level mobile without fusion. 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That bridge is a stress point, and in young athletes it can develop a crack, a condition called "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"spondylolysis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". A direct pars repair fixes that crack itself: the surgeon cleans out the defect, packs it with "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"bone graft"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", and places screws across it to compress and stabilize it while it heals. Because the disc and the rest of the segment are left alone, the spinal level keeps its normal motion. This is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not a fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". No disc is removed, and no vertebrae are permanently joined together."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"0c2uk16","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"erquq18","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Patients researching pars repair in Naples or Southwest Florida are usually young, active, and hoping to avoid a fusion. That is the conversation at HSS at NCH."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sb2cv20","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"9tni322","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When pars repair is recommended"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"flf3k24","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"avpt926","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This operation has narrow indications, and it is worth being honest about that up front. 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When the rest of the spinal segment is healthy, repairing the crack restores a normal, mobile vertebra. When the rest of the segment is diseased, repairing the crack does not fix the actual problem."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rodw634","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"a0jrd36","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The ideal candidate is an adolescent or young adult athlete whose low back pain has been traced to the pars defect itself. Confirmation usually comes from imaging: "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"MRI"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" shows whether the disc is healthy and whether the pars has active inflammation, a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"CT scan"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" shows the size and character of the bony defect, and sometimes a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"SPECT"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" bone scan or a targeted "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"pars injection"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is used to confirm the defect is the pain generator. Ideal candidates are younger patients in general, considered case by case, with little or no vertebral slip, a healthy disc at the level, and a small enough defect gap to close and heal (generally under about 4 mm)."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nay4446","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nqhoh48","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This operation is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"not"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" for patients with a meaningful vertebral slip, a degenerated or collapsed disc at that level, older patients whose pain comes from facet arthritis or stenosis, or back pain that cannot be traced to the pars defect. In those situations the right answer is different: sometimes a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", sometimes no surgery at all."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"etrgc54","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"51yjn56","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Nonoperative care comes first, always. Most young patients with "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"spondylolysis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" are treated with rest from sport, activity modification, bracing, physical therapy focused on core and hamstring flexibility, and sometimes injections. Many fresh pars fractures heal this way, and some established defects simply stop hurting and never need surgery. An operation is only discussed when pain persists after a genuine course of conservative treatment and the defect is confirmed as the source."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"do0uz60","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"5r8bu62","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What happens in surgery"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"n2nct64","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"r79xo66","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A pars repair is an open, motion-preserving operation. 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The general sequence:"},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9leq768","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"id":"3e03w70","nodes":[{"id":"dpfwd71","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"5ejsj72","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"General anesthesia"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", with the patient positioned face-down (prone) on the operating table."},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"k2dak75","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"hd71i76","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"midline incision"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is made over the affected level, almost always "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"L5"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (sometimes L4)."},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"ds06182","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2fd4c83","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The muscles are gently moved aside to expose the "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"pars defect"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" on one or both sides."},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"j2hqi87","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"w2ni988","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The defect is "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"cleaned and freshened"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" down to healthy, bleeding bone."},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"5mhes92","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"816yl93","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Bone graft"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (both autograft and allograft) is packed into the defect."},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"uynoa96","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"acna597","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Screws are placed across the defect"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" to compress it. The classic description, "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Buck's technique"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", is a lag screw driven across the pars; the same principle applies in modern variants (including pedicle screw and hook constructs): the hardware squeezes the defect shut so the graft can bridge it. Implants are selected for the patient's anatomy."},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"},{"id":"pkj7a102","nodes":[{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"qk397103","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The incision is closed in layers, and a dressing is applied."},"type":"TEXT"}],"type":"PARAGRAPH"}],"type":"LIST_ITEM"}],"orderedListData":{"indentation":0},"type":"ORDERED_LIST"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xgla3105","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tirv8107","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Throughout, the disc, the facet joints, and the motion of the segment are preserved. Nothing is fused."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"tums3109","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"37525111","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Why not just do a fusion?"},"type":"TEXT"}],"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"g6bfi113","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xloek115","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This is the honest question to ask, and the honest answer is about patient selection. A "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is the fallback when the disc at that level is worn out or the vertebra has slipped enough that the segment needs immobilizing. A fusion solves a broader problem but costs motion at that level. That is a meaningful tradeoff for a teenager or young athlete."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"9qalt119","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"su37t121","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"A pars repair keeps the segment mobile, which is the whole point for a young, active patient. But it only works when the rest of the segment is healthy. A repair offered to the wrong candidate (a degenerated disc, a real slip, arthritis elsewhere) is how a good procedure gets a bad reputation. Patient selection is everything here."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"jfbt1123","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"2151l125","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Hospital stay and the first days"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"pwfau127","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kr6wn129","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"This is generally "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"same-day (outpatient) surgery"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", depending on the patient. You will be walking the day of surgery. Early follow-up visits are usually with "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Jorge Monje, APRN"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":". Early walking is the main activity for the first weeks, and it also helps prevent blood clots."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"s5vtd135","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bjoxm137","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Emergency red flags after any lumbar surgery: go to the ER or call your surgeon immediately:"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" - New loss of bowel or bladder control, or numbness in the \"saddle\" area (inner thighs, groin, buttocks), which can signal "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"cauda equina syndrome"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":", a surgical emergency. - Rapidly worsening leg weakness or numbness. - Fever above about 101°F (38.3°C), increasing redness or swelling at the incision, or drainage from the wound."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kmiez142","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"4x90u144","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Recovery timeline"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"rsy6u146","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ds3yh148","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Pars repair recovery is brace-heavy and deliberately slow. The timeline is built around one biological fact: the defect has to "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"grow bone"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" across the gap, and bone does not heal faster because you feel good at six weeks."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"iugyu152","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"de0ot154","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Weeks 0-2"},"type":"TEXT"}],"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"bgzqh156","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"yaft6158","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Walking is the main exercise: short, frequent walks, building gradually. No bending, lifting, or twisting ("},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"BLT restrictions"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"): no lifting more than 10 pounds for the first 6 weeks. No driving for the first 2 weeks, and you must be off narcotic pain medication before driving. You can shower the day after surgery. You will likely be fitted for your brace before or shortly after discharge."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2ujto162","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"iyqo7164","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Weeks 2-6"},"type":"TEXT"}],"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"z12y8166","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"zj21n168","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Walking continues and lengthens. You will be wearing a rigid "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"TLSO\/LSO brace"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" for the first 3 months. No formal physical therapy for the first 6 weeks; it typically starts after that with gentle, neutral-spine work (core activation, flexibility). Do not submerge the incision (no baths, pools, or hot tubs) for 6 weeks."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"0gu99172","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"lfk4p174","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Weeks 6-12"},"type":"TEXT"}],"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2iqfk176","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kf07m178","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"The brace is weaned at 3 months. PT progresses as tolerated, still protecting the healing defect. No extension-based loading, no impact. Follow-up visits check wound healing and may include X-rays."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"u0kna180","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"4wb4o182","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Beyond 12 weeks and return to sport"},"type":"TEXT"}],"headingData":{"level":3,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"ert2q184","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fa6cx186","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Return to sport is slow by design. The standard sequence is: pain-free daily life first, then sport-specific exercises, with return to sport at 3 or 6 months depending on symptoms. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Golf"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" and other rotational sports are typically reintroduced around 3 months. You do not return until you are pain-free and your surgeon clears you. No CT is required before clearance."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"uzzlg190","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"v2jhz192","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Bone-healing rules during recovery:"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" no "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"nicotine"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" in any form before or after surgery. Smoking and vaping interfere with bone healing. No "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"NSAIDs"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" (ibuprofen, naproxen) for 3 months after surgery."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3fxvs199","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"style":{},"id":"4wugb201","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"FAQs"},"type":"TEXT"}],"headingData":{"level":2,"textStyle":{"textAlignment":"AUTO"}},"type":"HEADING"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"uzdhc203","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"nvq5x205","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What is the difference between spondylolysis and spondylolisthesis?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Spondylolysis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is the crack in the "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"pars interarticularis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" itself. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Spondylolisthesis"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" is when one vertebra slips forward over the one below it. A bilateral pars defect "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"},{"italicData":true,"type":"ITALIC"}],"text":"can"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" allow a slip to develop, but many people have the crack without any slip. A direct pars repair treats the crack; it does not treat a significant slip. That is a different operation."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"050zc216","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xevge218","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Am I too old for a pars repair?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" There is no absolute age cutoff; candidacy is considered case by case. The operation works best in younger patients. Older patients are more likely to have "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"disc degeneration"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" or arthritis that makes them better candidates for a different procedure or for nonoperative care."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"2ojy3223","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"kho22225","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Why can't the crack just heal on its own?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Sometimes it does. Fresh pars fractures in young athletes can heal with rest and bracing, especially unilateral ones. The problem is an established defect with smooth, hardened edges. It has given up trying to heal. Surgery recreates the conditions for healing by freshening the edges to bleeding bone, adding graft, and compressing the defect with screws."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xhe8z228","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"l9cqs230","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Will I set off metal detectors? Do the screws stay in?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" The screws are small and typically stay in permanently unless they cause a problem. They generally do not trigger airport metal detectors, though it is possible."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"sg5yp233","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"yeodj235","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What are the risks?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" The main risks are "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"nonunion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" of the defect (the crack fails to heal despite surgery), screw-related issues (loosening, breakage, or irritation), persistent back pain, infection, and bleeding. If the disc at that level degenerates later, further treatment (potentially a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":") could be needed down the road."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"xc5fb242","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"i33fr244","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"What if the repair doesn't heal?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" That is called a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"nonunion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" of the defect, and it is the most important thing to monitor. Follow-up imaging shows whether bone is bridging the gap. If the defect does not heal and pain persists, options include continued bracing and activity modification, or revision surgery: a repeat repair or conversion to a "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"fusion"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" at that level. Those decisions are made case by case."},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"fquvg251","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" "},"type":"TEXT"}],"type":"PARAGRAPH"},{"paragraphData":{"textStyle":{"textAlignment":"AUTO"}},"style":{},"id":"3iyxb253","nodes":[{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"When can I play sports again?"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" Plan on 3 or 6 months depending on symptoms, and only after your surgeon clears you. "},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"fontWeightValue":700,"type":"BOLD"},{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":"Golf"},"type":"TEXT"},{"id":"","nodes":[],"textData":{"decorations":[{"colorData":{"background":"transparent","foreground":"rgb(0, 0, 0)"},"type":"COLOR"}],"text":" and other rotational sports are typically reintroduced around 3 months. You do not return until you are pain-free. 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