Beverly Hills Orthopedist

Case Highlights

Deformity/Ankylosing spondylitis:

M.H. is a 63 year old gentleman with a history of ankylosing spondylitis causing his entire spine to be fused in a bent forward position (kyphosis). This position was making it very difficult for him to look up from the ground to talk to other people. It was also impossible for him to sit upright normally in a chair and he was unable to walk for more than a few minutes before his back muscles become very tired and painful.

After a lengthy discussion about the potential risks of a major deformity correction (“realignment”) surgery we decided to proceed with the surgery. We then spent a significant amount of time together planning the surgery. We ended up performing two osteotomies known as pedicle subtraction osteotomies (PSOs) at L1 and L3 with pedicle screws and rods from T11 to L5. The surgery was successful and he woke up without neurologic deficits, was up walking in the hospital two days later, and left the hospital on post-op day 6. He went home after spending a week in an inpatient rehab center. Mark is very happy with his new position. He has a comment in the patient testimonial section and his case has also been presented on SpineUniverse.

Ankylosing spondylitis

Two level Cervical disc replacement:

S.W. is a 45 year old woman with several years of worsening neck pain that radiated into her shoulders. She was developing some finger numbness. She spends a lot of time working on her laptop with her neck in a bent forward position. XRAYs and CT scan demonstrated a loss of her normal alignment. She is an example of what we have termed "text neck". MRI shows disc degeneration and disc herniations at C5-6 and C6-7causing some spinal cord and nerve root compression. Non-surgical treatments including physical therapy, NSAIDs, stretching and acupuncture failed to improve her pain. We therefore decided to proceed with a two-level artificial disc replacement.

Pre-surgery XRAYs, CT and MRI:

Two level Cervical disc replacement photo 1 Two level Cervical disc replacement photo 2 Two level Cervical disc replacement photo 3 Two level Cervical disc replacement photo 4 Two level Cervical disc replacement photo 5

Post-operative XRAYs after two level artificial disc replacements:

Two level Cervical disc replacement photo 6 Two level Cervical disc replacement photo 7 Two level Cervical disc replacement photo 8 Two level Cervical disc replacement photo 9 Two level Cervical disc replacement photo 10 Two level Cervical disc replacement photo 11 Two level Cervical disc replacement photo 12

Her neck pain is now improved, she no longer has radiating pain and her neck alignment has improved.

One level Cervical disc replacement:

J.H. is a 27 year old gentleman over a year of neck pain and severe left arm pain that radiated into his middle finger. He has tried non-surgical treatments for over a year without improvement. XRAYs and CT demonstrated some mild degenerative collapse at C6-7. MRI demonstrated a disc herniation at C6-7 that was causing left C7 nerve root compression. Since he had not improved after over a year of non-surgical treatment and the nerve compression shown on MRI correlated with his pain, we decided to proceed with surgical treatment. We made the decision together to perform an artificial disc replacement to remove the diseased disc while maintaining motion by avoiding a fusion.

Pre-surgical XRAY, CT and MRI showing disc herniation at C6-7 with nerve root compression:

Pre-surgical XRAY Pre-surgical CT Pre-surgical MRI

Post-surgical XRAY:

Post-surgical XRAY

After surgery he went back to work the following week, his neck and radiating arm pain are now completely gone.

One level lumbar disc replacement:

N.D. is a 44 year old gentleman with several years of low back pain, intermittent back spasms and more recently bilateral buttock pain. He exercises regularly and the pain has interfered with his exercise and with his job. XRAY demonstrated some collapse at L5-S1 and MRI demonstrated degenerative disc disease with disc bulging causing bilateral narrowing of the exiting space for the nerves. After long-standing pain and failure of non-surgical treatments we elected to proceed with an anterior lumbar discectomy and artificial disc replacement. He went home from the hospital the day after surgery. He began physical therapy 6 weeks after surgery and his low back pain and buttock pain are greatly improved.

One level lumbar disc replacement

Post-surgical XRAYs showing artificial disc replacement:

Pre-surgical XRAYs Post-surgical XRAYs 2 Post-surgical XRAYs 3 Post-surgical XRAYs 4

Two level cervical disc replacement:

51 year old gentleman who works as a massage therapist with progressively worsening neck pain radiating into his right shoulder. He began to develop weakness in his right arm which made it difficult to perform his job as a therapist. Pre-surgical imaging demonstrated two levels of cervical degenerative disc disease with nerve compression. We elected to proceed with a two-level artificial disc replacement. He returned to work within two weeks, his neck pain and range of motion are greatly improved and his right arm pain and strength also improved.

Pre-surgical XRAYs and CAT scan:

Pre-surgical XRAYs Post-surgical XRAYs 2 Post-surgical XRAYs 3 Post-surgical XRAYs 4

Post-surgical XRAYs including forward bending (flexion), backward bending (extension) and side bending views show good range of motion of the artificial discs.

Post-surgical XRAYs Post-surgical XRAYs 2 Post-surgical XRAYs 3 Post-surgical XRAYs 5 Post-surgical XRAYs 6 Post-surgical XRAYs 7

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450 N. Roxbury Drive
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Beverly Hills, CA 90210
Phone: (310) 803-9407

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