Common questions patients ask about the operations I do most often at HSS at NCH in Naples.

ACDF

What is ACDF surgery?

ACDF is surgery from the front of the neck to remove a damaged disc and fuse the segment so a nerve or the spinal cord is no longer compressed. It is one of the most common operations I do for arm pain or myelopathy when nonoperative care has failed.

How long is recovery after ACDF?

Most patients go home the same day or after one night and walk early. Soft-collar comfort is common; driving usually waits until you are off narcotics and at least two weeks out.

MIS-TLIF

What is MIS-TLIF?

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.

Who is a candidate for robotic MIS-TLIF?

Patients with leg pain or stenosis plus instability or spondylolisthesis who need both decompression and fusion. I use the robot to place hardware accurately when a planned corridor and precision both matter.

Cervical disc replacement

How is disc replacement different from ACDF?

Disc replacement removes the diseased disc and places a motion device instead of fusing the level. I choose it when the level is a good candidate for motion preservation and the rest of the neck will tolerate it; otherwise ACDF is often the safer mechanical choice.

Do I need NSAIDs after disc replacement?

Yes, for about the first 7 days in my practice to help prevent unwanted bone formation around the device. Other activity rules are otherwise similar to ACDF.

Robotic spine surgery

Does the robot do the surgery?

No. The robot helps plan and guide accurate hardware placement through a smaller corridor. I still perform the decompression and make every surgical decision.