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Conditions of Back and Spine

Herniated Disc

This is when a fragment of the center of the disc, the nucleus palposous, breaks through the outer layer of the disc, the annulus fibrosis. A painful condition can result if this herniated disc fragment is pressing up against spinal nerves.

Neck Pain

Many of the same conditions affecting the lower back also affect the neck.


This is a condition where a joint in the spine, called the facet joint, loses its ability to support the spine, causing one vertebral body to slip forward in relation to another. This can cause severe back pain, muscle spasms, and pinch nerves, causing pain to radiation down one or both legs.
[Watch Explaination Video Here]

[Watch Correction Video Here]

Degenerative Scoliosis

Is the development of abnormal curvature of the spine that is the result of severe degenerative processes. This curve is in the coronal plain (side to side). Having scoliosis does not mean that it is causing pain, or that it requires surgery. A trained spinal surgeon can help you determine if the scoliosis is the source of your pain.
[Watch Demonstration Video Here]

Cervical Stenosis and Cervical Myelopathy

This is a condition where the spinal cord is being compressed and injured by bone spurs and/or herniated discs. This can often be a painless condition, or associated with only minor neck pain. The classic symptoms are numbness in the hands, loss of hand dexterity, and loss of balance.
[Watch Demonstration Video Here]

Degenerative Disc Disease (DDD)

This is a condition of aging and “wear and tear” on the spine that can result in low back or neck pain. It is not necessarily categorized as a disease, as everyone experiences this to some degree. The discs, or cushions between spinal vertebrae lose their hydration, elasticity, and shape over time. The rate and severity of this process is the result of a combination of lifestyle, and genetics. Also, the degree of symptoms is quite variable from person to person.

Spinal Stenosis

This is when the boney canal that surrounds and protects the spinal cord and nerves slowly narrows over time due to the development bone spurs, disc bulges and thickened ligaments. This can cause problems with sensation, strength, balance and the ability to walk.
[Watch Demonstration Video Here]

Compression Fractures

Are “stable fractures” meaning surgery is not required for proper healing. They are most commonly the result of osteoporosis, or a loss in the density and strength of the bone. They may or may not be associated with trauma. Although surgery is not required for healing, the fractures can be very painful. Minimally invasive procedures such as vertebroplasty and kyphoplasty are available to treat the pain.
[Watch Demonstration Video Here]


This is a painful condition of the sacro-iliac joint. This joint connects the sacrum, the bottom bone of the spine, to the pelvis. It can mimic back pain, and often has no abnormalities visible on imaging studies. This makes the diagnosis difficult , and it is often overlooked by physicians. This can be the cause of chronic back pain in situations where someone’s back appears perfectly normal on imaging studies.

Sagittal Imbalance and Flat Back Syndrome

Sagittal imbalance is an abnormal curvature in the front to back plane. Problems with sagittal balance often result in someone looking tipped forward or looking hunched over all the time. This can be a very disabling condition. The most common cause of this is improperly planned fusion surgery. The principles of sagittal balance have only recently been strongly connected to back pain, and many surgeons have not educated themselves of these principles. Make sure your surgeon has an advanced understanding of these principles before considering surgery.
[Link To: SpineUniverse]

Chronic Pain Syndromes

There are situations where a surgeon determines that there is no structural problem with the spine that a fusion or decompression surgery can help with, or the risks of surgery for a person with health problems may be too great. In these situations we may decided to treat the symptom of pain with a spinal cord simulator.
[Watch Demonstration Video Here]

Brain Conditions

Brain Tumors

Brain tumors can be benign, meaning surgery can be curative, or malignant, meaning there is a high rate of recurrence and chemotherapy and/or radiation therapy will be required to treat them. Brain tumors are most commonly the result of cancer spreading from other parts of the body, such as lung cancer spreading to the brain. Meningiomas, Gliomas, and metastatic tumors are some of the most common types of brain tumors.

Pseudotumor Cerebri

This is a condition where the pressure in someone’s skull and brain is elevated for unclear reasons. It can result in headache and vision loss. Often treated with a cerebrospinal fluid shunt.


The brain constantly bathes itself and the spinal cord in a fluid call cerebrospinal fluid. This fluid provides protection and nutrients for the brain and spinal cord. If this fluid begins to accumulate with being properly drained, hydrocephalus can result. There are many types of hydrocephalus such as obstruction hydrocephalus, and normal pressure hydrocephalus. Neurosurgeons help to diagnosis and treat these conditions. Hydrocephalus is frequently treated with cerebrospinal fluid shunts.

Chiari Malformation

This is a condition that is the result in the protrusion of a part of the cerebellum, called the cerebellar tonsils, through a hole in the base of the skull called the foramen magnum. This protrusion can put pression on the parts of the brain and spinal cord. Symptoms can be including headaches, numbness in the arms and legs, and loss of balance.

Peripheral Nerve Conditions

Cubital Tunnel Syndrome (Ulnar Nerve)

This is compression of the ulnar nerve at the elbow. This nerve is often referred to as the "funny bone".

Lateral Femoral Cutaneous Nerve Intrapment (Meralgia Parensthetica)

This happens when the nerve that provided sensation to your thighs becomes compressed by a ligament.

Carpal Tunnel Syndrome (Medial Nerve)

This the most common compressive neuropathy. It is caused the compression of the median nerve by and inflamed or enlarged median carpal Iigament and can cause symptoms in the hand and forearm.

Reflex Sympathetic Dystrophy

Reflex sympathetic dystrophy (RSD) is a condition that often features symptoms of pain, tenderness, and swelling, warmth and/or coolness, flushing, discoloration, and shiny skin. RSD is also referred to as "complex regional pain syndrome," "the shoulder-hand syndrome," and "causalgia." This is sometimes addressed surgically with spinal cord stimulation.
[Watch Demonstration Video Here]

Below are some surgical treatment options, including minimally invasive techniques:

Treatment for a neurological disorders:

Some of the main treatment techniques include Laminectomy, Fusion, Arthroplasty or a combination of these.


This procedure involves removing the damaged disc and replacing with a bone graft or substitute allowing the vertebrae to fuse.


During this procedure the damaged disc is replaced with an artificial disc.


The physician creates space by removing a piece of the bone, relieving the pressure on the spinal cord.

“Dr. Ayer is very informative and precise. I feel very comfortable knowing he is in charge of my surgery.”

Patient Review,