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Articles of Interest

Disc surgery leads to better improvement than non-operative treatment in recent New England Journal of Medicine study.

By Articles of Interest

Best management of sciatica (leg pain, numbness, tingling, or weakness) caused by a herniated disc in the lumbar spine is challenging. We spine surgeons incorporate several factors into our decision-making: severity and duration of symptoms as well as imaging findings just to name a few. At East Bay Brain & Spine/BASS Neurosurgery we aim to avoid surgery when a patient will likely improve with physical therapy and other “conservative” treatments. On the other hand, we perform surgery when discectomy will improve a patient’s pain, numbness/tingling, and strength outcome.

This recent study from the New England Journal of Medicine studies patients (a randomized trial) who have sciatica from a herniated disc and do not undergo surgery right away. When these patients do undergo discectomy surgery four to twelve months from when the leg symptoms began, their sciatica, back pain, and level of disability improve as compared to others who were assigned physical therapy, epidural steroids, or other non-surgical treatments. 

This study provides further evidence that surgery for persistent sciatica and herniated disc in the low back is better than non-operative treatment.

Dr. Merkow interviewed for JMH Newsletter: Minimally invasive spine surgery, deep brain stimulation, and laser thermal ablation

By Articles of Interest, Featured, Practice News No Comments

Dr. Merkow was featured in the “Neurosciences 2018 Spotlight” of the John Muir Health newsletter. He discusses several areas of his practice including less invasive spine procedures, deep brain stimulation for Parkinson’s Disease and essential tremor, and laser thermal ablation for brain tumor treatment.

Read the newsletter excerpt.

Evidence for avoiding fusion in lumbar burst fractures

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In the November Journal of Neurosurgery: Spine issue, our neurosurgery colleagues publish a meta-analysis describing data that support internal fixation rather than fusion for common types of spinal fractures (lumbar burst fractures). This provides evidence for a less invasive means of treating spine fractures and maintaining good long-term outcomes. Read the abstract here.