When spine surgery makes sense and when it doesn’t

Mushlin Harry Mushlin, MD
Neurosurgeon
Director, Complex Spine and Deformity
Stony Brook Neurosurgery Spine Center
Stony Brook Neurosciences Institute
Stony Brook Medicine

Spine surgeons help patients with problems from their neck to their lower back. These conditions can include trauma, bone degeneration and cancer. Dr. Harry Mushlin, a fellowship-trained spine surgeon who specializes in complex spine conditions and deformities of the spine, explains why he and his colleagues take a conservative approach when it comes to recommending spine surgery to their patients.

When is spine surgery needed?
Dr. Mushlin: Spine surgery should be the last resort for a person with a neck or back condition, after they’ve undergone non-operative care including physical therapy and steroid shots. While surgery is a powerful tool, it’s not always the first answer. Surgery is aimed at aligning and stabilizing the spine and decompressing nerves. Discussing your symptoms, lifestyle and expectations should be included in the decision-making process with your spine doctor to determine the cause of your problem and the best treatment plan. Determining the best action course often means getting the proper imaging of your spine and undergoing a complete physical exam and thorough medical history.

What are common problems that require spine surgery?
Dr. Mushlin: The spine is made of lots of joints, bones, ligaments and soft tissue called discs. It’s common to have to fuse joints of the spine, shave away bone and remove discs when necessary. For example, when someone has a “herniated disc” that can mean that the nerves in the back are being irritated and require removal of the “disc” to feel better. When the spine causes disabling pain and weakness, surgery can be an important tool to help lessen these symptoms.

What is complex and deformity spine surgery?
Dr. Mushlin: There are certain spine conditions that are difficult to manage and require additional expertise. My fellowship in complex spine and deformity prepared me to deal with these kind of issues. I have expertise in dealing with unusual anatomy (body structure), revision spine surgery (to correct problems resulting from an earlier surgery), and fixing spines that have unusual curvatures and shapes. I often perform these surgeries using minimally invasive techniques.

What are the benefits of minimally invasive surgery?
Dr. Mushlin: Minimally invasive spine (MIS) surgery leads to smaller incisions, less muscle damage and less blood loss. We can use these techniques for more common procedures such as a removal of discs. I also have additional fellowship training in advanced MIS techniques in the treatment of scoliosis and spinal deformity. These can lead to improved outcomes and shorter hospital stays.

Why choose Stony Brook?
Dr. Mushlin: Whether your needs are complex or routine, our team of exceptional neurosurgeons, physiatrists and physician assistants at the Stony Brook Neurosurgery Spine Center work together from your initial consultation to surgery or non-surgical care and follow up — every step of the way of an optimal therapeutic plan. We offer the following approaches to provide you with safe, proven care:

• Medical therapies
• Customized physical therapy programs
• Spinal injections
• Latest minimally invasive and open surgical techniques
• Other advanced surgical interventions

Our areas of specialty spine surgery include:
• Adult spine surgery
• Peripheral nerve disorders
• Pediatric neurosurgery

As an academic medical center that offers advanced levels of medicine that are highly specialized and not widely accessible, it’s also comforting to know that we serve as a referral hospital throughout the community for physicians whose patients have complicated spine conditions.

For an appointment or more information, call (631) 444-1213 or visit neuro.stonybrookmedicine.edu/spine.