Spine Center

Our experienced caring team of specialized spine doctors and support personnel work hand in hand to deliver the best in patient-centered, evidence-based care. We bring together a highly experienced team that includes neurosurgeons, orthopaedic surgeons, experts in musculoskeletal imaging, and rehabilitation specialists.

Our goal is to deliver the right care and achieve the best outcome for each person. We partner with our patients in their care, get them back to health as soon as possible, and help them achieve the best outcomes.

For new patients, appointments may be requested by completing an online form or contacting the clinic directly. Staff will ask a series of questions to determine who would be best to see you in the Spine Clinic. 

We also accept direct referrals from treating providers that may specify which specialist the patient may see.

• Anti-inflammation drugs
• Biofeedback
• Cortisone injections
• Physical therapy

Minimally invasive spine surgery is an alternative to traditional open surgery for select patients who require spine surgery for conditions of the back, neck, and spine. This surgical approach involves only small incisions, so patients experience fewer complications -- less pain, tissue damage, and blood loss -- and recover more quickly than those who undergo open spine surgery.

Because minimally invasive spine surgery is not the best option for everyone who needs back surgery, UT Southwestern’s spine specialists thoroughly evaluate all patients and work with them to determine the course of treatment likely to lead to the best outcome.

During a spinal fusion we are changing the architecture of the spine to promote better function: reduction of pain, improvement in sensation, gains in strength, etc.  Often spinal nerves, or the spinal cord, are under pressure from external elements (cysts, overgrown arthritic bone, ligaments, discs, tumors) are decompressed (released from the pressure upon them) prior to reshaping the bony elements.  The reshaping is achieved with metallic constructs such as screws into the bone, cages between the bones in the intervertebral spaces (or larger voids surgically created), and rods or plates that take away abnormal movement.  The rods and plates can also serve to hold the spine in a more physiologic curvature as the bones heal.

The act of remodeling the surface cortex of the bone during surgery is called decortication.  Once we have remodeled the bone as needed for the goals of the surgery we often repurpose parts of the bone if removed (termed autograft) or use synthetic materials versus cadaveric bone called allografts to create bone forming bridges spanning the prepared fusion surfaces.  In time the fusion surfaces, autograft, and allograft unite to become a fusion mass which will add stability to a segment and take away movement of that segment.

We do not think of the metallic elements as fusion.  As the bones we remodel heal, they anneal in a new manner, and fuse together spanning the construct.  This is what is meant by arthrodesis and fusion.

Herniated discs are known by many names, such as slipped, ruptured, bulging, compressed, or prolapsed discs. The condition occurs when one of the cushioned discs between the 26 vertebrae of the spine ruptures, allowing the jelly-like substance it contains to leak, possibly impinging on the nearby spinal cord or nerves. Disc problems can cause sciatica, back pain, and weakness.

Treatment for a herniated disc depends on several factors that will be evaluated by your physician. Some options for treatment include anti-inflammation drugs, biofeedback, cortisone injections, physical therapy, and surgery.

Artificial discs are an alternative to fusion for some patients meeting strict criteria (age < 50 years, minimal spondylosis, no abnormal alignment such as kyphosis for example).  For patients that are symptomatic from disc protrusion/herniation or degeneration of the disc with minimal spondylosis (arthritic type bone changes) when the bad disc is removed an artificial disc may be used to span the void to preserve motion instead of creating a fusion that would ultimately lessen the movement at that segment.  They are commonly employed in the treatment of radiculopathy and “discogenic pain”.  Less commonly they can be used for treatment of myelopathy or cases of traumatic spinal cord impingement; these indications are more controversial.   The approved devices for this purpose mostly are FDA approved to treat disease at a single spinal level.  One device is FDA approved for multiple cervical levels.  The rationale is to use the artificial disc to preserve as much normal mobility as possible and potentially stress shield nearby spinal segments.

Sciatica refers to pain in a distribution associated with the sciatic nerve.  In addition to pain some patients may experience numbness, tingling or weakness.   The distribution is from the low back to the buttock, posterior thigh and may even cross to the foot.  Associated risk factors include age, obesity, trauma, repetitive use, prolonged sitting.  Symptoms persisting greater than six weeks that fail to respond to conservative medical management (rest, NSAIDs, oral steroids, physical therapy) indicate additional imaging is requisite.  An initial diagnostic study would be an MRI of the lumbar spine without contrast.  If an imaging correlate finds a structural abnormality impinging upon the components of the sciatic nerve (L4, L5, S1, S2) surgery may be indicated.  Sciatica is most commonly caused by lumbar disk disease.  It is also associated with spondylolisthesis, spinal stenosis, piriformis syndrome and intrinsic nerve pathology (tumors, cysts, trauma).

We envision surgeries of mild to moderate complexity being completed at our Frisco location. These would include simple decompressions, discectomies, one to two level fusions for example. Cases needing multiple surgeons, high level technical complexity or with multiple patient comorbidities portending higher level of perioperative care would be best served at UT Southwestern Clements University Hospital in Dallas.

We feel that in meeting our patients and providers in the community together we can determine a rationale for treatment inclusive of best practices to ensure optimal outcome and patient safety.  We are also growing a practice for complex spine surgery at the Texas Health Dallas location as well.