Frequently Asked Questions About Spinal Problems and New Jersey Spine Specialists
Q: When is surgery necessary for patients with spine problems?
Q: Is minimally invasive spine surgery safe?
Q: When is the difference between a herniated disc and a bulging disc?
Q: What is multi-level spondylitis?
Q: Do you accept insurance?
Q: What type of care will be needed after surgery?
Q: Do I need to wear a brace after surgery?
Q: What can I do to avoid surgery?
Q: Will I be in pain after my surgery?
Q: How long is the recovery time and when will I be able to resume normal activities?
Q: Will I need physical therapy after spinal surgery?
Q: What is the recovery time for a Sacroiliac Joint Fusion?
Q: Do you offer help for patients with Failed Back Surgery Syndrome?
Q: Can I benefit from laser spine surgery?
Q: What areas and locations do you serve?
A: The majority of conditions that cause neck and back pain tend to have a good prognosis and resolve without major intervention. Because of this, the treatment of most spinal conditions usually follows a pathway that starts with the least invasive and time consuming options and progresses from there to the more advanced and invasive therapies. After a thorough evaluation, many conditions are treated simply with mild rest and activity limitation. Analgesic medications including anti-inflammatory and muscle relaxing medications are often utilized during this stage. The next step in treatment usually involves a program of formalized physical therapy. If these initial treatments are not effective and patients find their symptoms very bothersome, additional workup with imaging studies such as an MRI scan is usually performed. Some patients with persistent symptoms can benefit from spinal injections such as epidural steroid injections. Other second line medications are also considered at this stage.
In most cases, spine surgery is a considered an option of last resort. When someone has persistent pain that is affecting their quality of life and they have failed to improve with non-invasive treatment, surgery is sometimes an option. This decision is based on a thorough review of a patient’s symptoms, their physical exam findings, and a detailed analysis of their imaging studies. It should be noted that there are a few conditions when surgery needs to be considered more urgently. These situations include when someone is losing nerve function in their arms or legs, has significant pressure of their spinal cord, has a spinal tumor or infection, and when someone is losing control of their bowel or bladder function.
A: The goal of all spine surgery is safety and effectiveness. In our practice, minimally invasive techniques are only utilized when it does not compromise these critical goals. For marketing reasons many surgeons and non-surgeons are using “minimally invasive” techniques that have limited track records and may place patients at increased risk. Our practice prides itself on fully educating patients about their condition and treatment options. One needs to be cautious about marketing campaigns for surgery focusing around seductive words like “laser” and “percutaneous.” When these techniques are a good option, we will let you know. When they are not, we will give you an honest answer.
A: Bulging and herniated discs represent degrees of disc injury on a spectrum. To oversimplify, a disc is shaped like a jelly donut. When the outer part of the donut has a weakness, it can bulge like a flat tire. If the outer part of the disc tears, the disc material can displace outward. This is called a disc herniation. Other words for this are disc extrusion, protrusion, prolapse, and rupture. All discs eventually show signs of aging and degenerations. Non-spine specialists tend to call almost all disc problems a “herniated disc.” Determining what exactly you are dealing with requires a careful review of your MRI scan. In our practice, we make it a priority to review your imaging studies with you so that everyone is on the same page with regards to treatment options.
A: Multi-level Spondylitis is a group of inflammatory diseases that typically affect the vertebrae, facet joints, and spinal structures, and can lead to chronic pain and discomfort. Spondylitis treatment options include exercises, physical therapy, medications, physical modalities such as heat, electrical stimulation, ultrasound, epidural cortisone injections, brace immobilization, and in severe cases, spinal surgery.
A: At The New Jersey Spine Specialists, Drs. Drzala and Reiter work with a wide range of insurance carriers for those patients who have out-of-network benefits. Please call us at 908.608.9619 to speak with one of our experienced patient advocates with any questions you may have regarding your insurance benefits.Our doctors also work with many workers’ compensation carriers and most auto insurance companies as well. Please reach out to one of our patient advocates at 908.608.9619 to see if our doctors participate with your policy. Our patient advocate will then contact your adjuster in order to determine if an appointment can be made. Drs. Reiter and Drzala DO NOT participate with Medicaid or Medicare. Dr. Hullinger is in-network with most insurance carriers. She accepts most Blue Cross Blue Shield and commercial insurance plans with the following exceptions: Advance EPO, Anthem BCBS, Aetna (no EPO), AmeriHealth (no EPO), Cigna, Great West, Health Republic NJ, Medicare, Oxford, QualCare, Tricare, and United Healthcare. Some of these may have tiers or limitations, so please contact the office first to confirm coverage eligibility at 908 376 1530. Of note, Dr. Hullinger DOES NOT participate with MagnaCare, United Healthcare Medicare Complete HMO, BCBS Advance EPO, Humana. Dr. Hullinger DOES NOT participate with Medicaid. Regardless of the doctor you see, a financial hardship program is available to those patients that meet the program’s qualifications.
A: With state of the art surgical techniques, nearly all of our patients are able to get out of bed either the same day as surgery or the next morning. Any surgical pain will be carefully controlled with medications. Postsurgical rehabilitation will be coordinated by our office and usually begins 1-2 weeks after surgery.
A: For non-fusion spinal surgery, a brace is almost never necessary. For fusion procedures, newer and more rigid internal fixation techniques have significantly decreased the need for postoperative braces. The determination as to whether a brace is required is based on multiple factors that will be discussed prior to your surgery.
A: The best things that one can do to avoid spinal surgery are to stay physically fit. This includes a program of aerobic conditioning and some core muscle strengthening. Avoiding smoking and obesity is also helpful. Unfortunately, some people are genetically predisposed to spinal disc disorders despite following the above recommendations.
A: Drs. Reiter and Drzala both feel strongly that surgical pain should be well controlled. This starts with the use of long acting systemic and local anesthetics placed during the procedure. Pain control following surgery requires a careful balance of short and long acting pain killers, anti-inflammatory medications, and careful mobilization. Managing pain is a dynamic process in which the patient and doctor work as a team to achieve their goals.
A: Each spinal condition and procedure has a different time frame for when patients are allowed to resume normal activities. We work hard to use techniques that are the least invasive so that disruption of one’s life is minimized.
A: Most patients receive physical therapy following surgery. This is done to help regain spinal range of motion and strength that is lost during the period of disability prior to surgery as well as from the procedure itself.
A: The time to fully recover from a sacroiliac fusion varies from patient to patient, but most patients have recovered fully from this minimally invasive surgery within six months. For the first 6 weeks after the sacroiliitis treatment, it’s recommended to protect weight bearing on the surgical side with the use of crutches or a walker. After that, patients are typically enrolled in a course of physical therapy under the guidance of a certified physical therapist. Physical therapy will include more passive measures for the first few weeks followed by a more active rehabilitative exercise program. Passive postoperative treatments that your therapist may choose to use include heat, ice, electrical stimulation, ultrasound, and massage. As your condition improves and you regain your strength, you will begin an active strengthening exercise program, which will allow you to increase your level of function. As your doctor and your therapist feel that you have been properly rehabilitated, you will be able to resume normal activities. Your doctor and physical therapist will be valuable contacts during your recovery and will help guide you and adjust your level of activity as necessary during this time. Ultimately, the goal is to resume a normal level of function with minimal discomfort.
A: New Jersey Spine Specialists treatment starts with properly diagnosing the cause of the continuing or new symptoms. Post-operative MRI and/or CT scans often play an important role in assessing the underlying spinal problem. Persistent symptoms of pain and discomfort following spinal surgery can have a variety of common causes. Read more about Failed Back Syndrome and optional treatment.
A: Laser spine institutes argue that laser spine surgery is more efficient, effective and gentle than traditional minimally invasive spine procedures. Laser spine institutes claim it causes a decrease in blood loss and scarring, and reduces the recovery time. However, lasers can generate harmful, excessive heat, which can be damaging to the sensitive nerves in the spine. Laser spine institutes aggressively market the term laser spine surgery because it sounds futuristic and appeals to patient. In reality, minimally invasive spine surgery can be performed as effectively, and more effectively, without a laser.
A: New Jersey Spine Specialists serve two offices in Northern New Jersey. Dr Reiter has an office in Summit, Dr Drzala has an office in Summit and Montclair New Jersey, and Dr Hullinger has office in both Summit and Montclair. This allows us to be conveniently located to our patients, who come in from all over the Northern New Jersey, and New York tri-state area. We routinely see patients from Livingston, Morristown, Hackensack, Bernardsville, Basking Ridge, Berkeley Heights, New Providence, Summit, Short Hills, Warren, Bloomfield, Westfield, Millburn, Maplewood, Millburn, Watchung, Union, Glen Ridge, Bloomfield, Nutley, Mountainside, Florham Park, and Mountain Lakes as we are convenient to get to from Union, Morris, Essex, Middlesex, and Somerset counties. With a staff of nationally recognized spine experts, we also draw patients from all over the United States, and even internationally.
To schedule an appointment, call:
Mitchell Reiter, M.D.
Mark R. Drzala, M.D.
Heidi Hullinger, M.D.