Building 2, Suite 210
Walnut Creek, CA 94598
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.
If you develop new or quickly worsening neurologic symptoms please contact our office. If you cannot reach our office please present to an emergency room for evaluation.
We thank you for your understanding as we respond to these unusual circumstances.
Max Merkow M.D. and Matt Piazza M.D.
Dr. Merkow addresses the philosophy behind modern spine procedures that are commonly classified as “minimally invasive.” The tenets of these surgeries include minimizing tissue injury, utilizing neuronavigation (computer/imaging guidance), and maintaining normal spine motion. Examples include tubular retractor systems, artificial disc replacement, and lateral approaches to the spine. These surgeries shorten traditional recovery times. Dr. Merkow believes, when used appropriately, minimally invasive spine surgery improves clinical outcomes by decreasing pain, increasing strength, and raising one’s overall quality of life. East Bay Brain & Spine surgeons couple the latest in surgical technology with sound clinical judgment to better the lives of their patients.
East Bay Brain & Spine Medical Group is proud to announce that Ehsan Ejaz, PA-C, has joined our practice. He is a board-certified physician assistant with a passion for neurophysiology and neurosurgery. Ehsan received his B.S. in Neurobiology, Physiology, and Behavior at UC Davis where he conducted extensive research at the Medical Investigation of Neurodevelopmental Disorders (M.I.N.D.) Institute at UC Davis and the Institute for Pediatric Regenerative Medicine at Shriners Hospital. Ehsan began gaining experience as a surgical neurophysiologist at Yale New-Haven Hospital. He has conducted over 2000 intraoperative neuromonitoring consultations on a wide variety of cases. Keen to further his passion for neurosurgery and patient care, Ehsan then completed his Masters in Physician Assistant Studies at Samuel Merritt University. Ehsan’s philosophy for patient care involves empowering patients as equal members of their health care team, as patients are their own best advocates. Ehsan practices evidence-based medicine. He stays abreast of the latest developments and research by reviewing medical and neurosurgical literature as well as attending conferences. When he is not at the bedside or in the operating room, Ehsan can be found traveling to new places, hiking California’s expansive state parks, or capturing the perfect Milky Way photograph.
East Bay Brain & Spine Medical Group is proud to announce that Dr. Matthew Piazza has joined our practice. Dr. Matthew Piazza is a neurosurgeon who specializes in the surgical treatment of neurologic conditions affecting the spine, brain, and peripheral nerves. He treats a breadth of spine conditions including cervical, thoracic, and lumbar spine degenerative disease, adult degenerative spinal deformity, spine trauma, and spinal tumors. Dr. Piazza’s primary goal is to provide patients with the maximum benefit with the smallest intervention using the latest surgical techniques and evidenced-based management. He believes that the patient–surgeon relationship is a partnership, and he strives to work with his patients to achieve the best outcome from both surgical and non-surgical treatments.
After graduating from Princeton University, Dr. Piazza received his medical degree at Columbia University College of Physicians and Surgeons. He completed his neurosurgical training at the University of Pennsylvania. While at the University of Pennsylvania, he served as an internal fellow in spine surgery during which time he received specialized training in the surgical management of complex spinal disorders including degenerative spinal disease, adult degenerative spinal deformity, spinal oncology, and spine trauma. His post-doctoral research focused on quality improvement in peri-operative neurosurgical care and the development of animal models for studying spinal disc regenerative therapies.
Dr. Piazza practices in Walnut Creek and has privileges at John Muir Medical Center’s Walnut Creek Campus.
Sponsored by the John Muir Health Neurosciences Institute Dr. Merkow spoke about, “What is Minimally Invasive Spine Surgery? Does it Work?” on June 6, 2019. The talk was geared towards primary care physicians, pain management physicians, neurologists, and kinesiologists in attendance. Dr. Merkow explained how tubular retractor systems help relieve nerve pressure while preserving important spinal ligaments. He also discussed the role of artificial disc replacement in the cervical spine and minimally invasive hardware placement using intraoperative navigation. The lecture addressed the benefits of oblique lateral lumbar interbody fusion and why Dr. Merkow prefers this approach versus lumbar fusion techniques.
Although more technically demanding, the less invasive spinal surgery approaches commonly lead to shorter recovery times and the preservation of normal spine motion/biomechanics.