Patient Information: Common spinal conditions and interventions
Disorders of the spine can be distressing and scary for many sufferers. There is much fear, misinformation and mystique about any surgery on the spine with some of this being historically poor performance and some of this being well meaning friends passing on their experiences - both generalisations should be set aside for the assessment of the individual and their condition.
Put simply, however, a very large majority of patients who develop pain and mild symptoms and signs of spinal conditions do not require any surgery for their spinal conditions in the short term.
It is difficult for patients to believe that they will ever get better and that their condition is considered to likely be self-limiting. The emphasis here is on diagnostics to identify and characterise the problem then a prescription of exercise and rehabilitation based optimisation of the patient, sometimes medications and neutroceuticals and in some instances minor non-surgical procedures such as injections.
While there is a huge array of both evidence-based and non evidence-based interventions for spinal conditions, Dr Zotti is an advocate for a strong, healthy and flexible spine promoted by weight management, a positive psychological approach, resistance training and aerobic exercise.
Dr. Zotti is trained to identify, via a combination of patient assessment and diagnostic techniques, and clarify patient values and goals to broadly group patients into:
patients that are recommended to have surgery (often owing to imminent or present nerve dysfunction or threat to vital functions or life)
patients that are likely to benefit from surgery based on their condition, health and risk / benefit balance
patients that do not require surgery, whose condition is unsuitable for surgery or who have health conditions rendering them unacceptably high risk for surgery. Some of these patients may potentially be 'worse off' after surgery if incorrectly assessed
While patients with urgent and dramatic presentations often are recommended to have surgery, most patients presenting with chronic conditions will fall under the latter two scenarios
Left - Muscle wasting and disc prolapse; Right - following surgery and successful rehabilitation growth and recovery of the back muscles
Interventions for spinal and nerve pain
Lumbar fusion - Anterior, lateral and posterior including robotic approaches
Lumbar disc replacement
Lumbar spine discectomy and decompression
Correction of deformity - scoliosis (twisted/curved) and kyphosis (stooped forward)
Sacroiliac joint denervation and fusion including robotic
Radiofrequency facet ablation, Basivertebral nerve ablation and nerve pulsing
Lumbar Disc Biacuplasty / intrathermal annuloplasty
Injections for leg pain - radiofrequency pulsing, epidural and nerve root blocks
Coccyx excision - Coccygectomy
Cervical decompression and laminoplasty
Cervical disc replacement
Keyhole foraminotomy decompression - cervical and lumbar
Nerve entrapment releases
(carpal tunnel, cubital tunnel, peroneal nerve)
General Orthopaedic fractures
Nerve and spinal cord modulation and stimulation
Nerve testing - nerve conduction and EMG electromyogram
Quantitative Bone Densitometry for bone density
Strength, and physical and psychological scoring