Treating Spine Conditions

UC San Diego Health System’s orthopedic spine specialists provide both surgical and nonsurgical care for people living with spinal injuries and conditions.

 Physical Medicine and Rehabilitation

Back pain at any location along the spine can often be treated without surgery. First-line treatments include anti-inflammatory medications (over-the-counter or prescription), short-term bed rest (two to five days) and activity alteration. Using nonoperative therapeutic methods, physical medicine specialists treat musculoskeletal conditions and injuries, pain, repetitive stress injuries, and acute and chronic conditions. By tailoring physical therapy programs to patients' specific conditions, our physiatrists address low back pain, neck pain, arthritis and herniated discs, and other spinal conditions.

Spinal Injections

Physiatrists and anesthesiologists also perform minimally invasive injections of medications into certain areas of the spinal column to alleviate pain. This helps individuals who are not ready for or are not a good candidate for surgery. These injections can also help identify the cause of a person’s pain. They can include caudal epidurals and spinal nerve root and facet joint interventions, when deemed appropriate.

Minimally Invasive Spine Surgery

The field of spinal surgery is being transformed by minimally invasive surgical techniques. UC San Diego Health System is at the forefront of innovations in minimally invasive spinal surgery, providing a broad range of minimally invasive surgical therapies for spinal disorders and injuries. These procedures include kyphoplasty, endoscopic surgery for disc disease and spine motion preservation, fusion and decompressive techniques. Using specialized instruments to decrease the size of the incision and reduce injury to surrounding soft tissues, our spine surgeons can treat many spinal disorders resulting in less pain, quicker recovery and improved functioning. Patients with herniated discs, spinal stenosis, spondylolisthesis, scoliosis, kyphosis, spinal fractures, infections and tumors may be candidates for this type of treatment. Read more about minimally spinal surgery at the Spine Center at UC San Diego Health System's Neurological Institute.

Open Spine, Neck, Mid- and Low Back Surgery

Some spinal conditions require open or traditional surgery to give the surgeon appropriate access to the spine. Our surgeons treat conditions affecting areas from the neck to the lower back, including all types of spinal disorders. These conditions include degenerative osteoarthritis, fractures, scoliosis, infections and tumors. UC San Diego Health System is a referral center for adult patients who have disorders that may be too complex for their local spine surgeons to treat. Advances in computer and imaging technologies provide our surgeons with the ability to have extended vision of the patient's spine during surgery. This helps guide the surgeons to critical areas of the spine, minimizing disruption of nearby muscles, tissues, nerves and blood vessels. Technological advances include nerve monitoring to assist in identifying physiological changes during and after surgery.

Total Disc Replacement

With total disc replacement, a degenerative disc is replaced with an artificial disc. The major advantages of total disc replacement over a conventional spinal fusion are shorter recovery time and reduced postoperative discomfort. Most patients can return to normal and full motion activities within six weeks after total disc replacement, compared to three to six months after a fusion procedure. UC San Diego Health System surgeons have been involved with the development of some of these surgical techniques, as well as many FDA clinical trials. Although these procedures may be FDA-approved, currently, very few insurance companies will pay for them.

Kyphoplasty

Kyphoplasty involves injecting of polymethyl methacrylate bone cement into the vertebrae to treat spinal fractures. Using an incision approximately 1 cm in length, and real time x-ray guidance and monitoring, the surgeon guides an orthopedic balloon into the area of the collapsed vertebra. The balloon is inflated until the vertebra is moved to the correct position. The balloon is removed and the cavity is filled with bone cement to support the surrounding bone and prevent further collapse. This highly successful procedure typically takes about 45 minutes to treat each fracture and may require an overnight hospital stay. Our spine surgeons are also involved in clinical trials evaluating new devices and techniques for this type of treatment.