Conditions We Treat

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At the Spine Institute of Arizona, we specialize in diagnosing and treating a wide range of spine and nerve conditions that cause back pain, neck pain, and mobility issues. Our team of board-certified spine surgeons, pain management specialists, and rehabilitation experts provide comprehensive care — from non-surgical treatments and pain management to advanced minimally invasive spine surgery.

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Our physicians are equipped to treat the following conditions:

  • Herniated discs-cervical, thoracic, lumbar

  • Lumbar spondylolisthesis

  • Lumbar spondylosis

  • Peripheral nerve injuries

  • Scoliosis and spinal disorders

  • Spinal stenosis

  • Cervical and lumbar degenerative disc disease

  • Musculoskeletal pain syndromes

  • Spinal fractures

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Radiculopathy

  • Radiculopathy refers to irritation or compression of the spinal nerve root, resulting in pain, numbness, tingling, or weakness along the nerve distribution. It is a mechanical and inflammatory problem affecting a specific nerve root, most often caused by a herniated disc, bone spur, or a foraminal narrowing. The location of the nerve determines the symptoms: cervical radiculopathy causes neck and arm symptoms, while, lumbar radiculopathy/ sciatica causes back and leg symptoms.

  • Treatment can be conservative with activity modification, physical therapy, medications, and epidural steroid injections; however, if appropriate conservative treatment fails, and neurological symptoms persist or worsen, common treatments include microdiscectomy, foraminotomy, spinal fusion, or disc replacement.

Lumbar Spinal Stenosis

  • Lumbar Spinal Stenosis (LSS) is a condition in which the spaces within the spine narrow, putting pressure on the spinal canal and nerves. The narrowing can be due to various factors such as disc degeneration, bulging discs, arthritic facet joints, bone spurs, or thickening of ligaments, which can lead to compression of the nerve roots or spinal cord itself. Symptoms are often described as the gradual onset of low back pain that may radiate into the buttocks or legs, leg pain and tingling or numbness, worse with standing (neurogenic claudication) and relief with sitting or forward bending, leg weakness after walking, and in severe cases, difficulty with balance and bowel/bladder changes (rare and urgent treatment is needed).

  • Medication, PT for stretching and strengthening the muscles around the spine, posture training, aerobic exercise to improve circulation, and spinal stabilization exercises to improve core strength. Epidural steroid injections can provide temporary relief of pain and inflammation around the nerves.

  • When conservative treatments fail to provide relief or if the symptoms are severe, surgery may be considered. Including Minimally Invasive Lumbar Laminectomy, decompression surgery, and spinal fusion surgery.

  • There are many ways to address lumbar spinal stenosis. When a trained surgeon is available and it is determined to be anatomically feasible, minimally invasive lumbar laminectomy is the preferred surgical option due to its lower risk and quicker recovery time compared to traditional surgery.

Lumbar Spondylolisthesis

  • This is the forward slippage of one vertebra over the one below. This creates a mechanical instability of the spinal segment which can cause back pain, nerve compression, and poor spinal alignment. The condition can range from mild to more advanced cases with resultant nerve impingement and progressive deformity. 

  • Low back pain, typically mechanical, worsened by standing, walking, or lumbar extension. Leg pain, numbness, or weakness can occur from nerve root compression. Neurogenic claudication or pain with walking, relieved by sitting or bending forward, hamstring tightness, and, in severe cases, difficulty standing upright.

  • Made with x-rays, lateral and flexion-extension views, MRI, and CT scan. The amount of slippage is then graded based on the percentage of vertebral body slip.

  • Activity modification, NSAIDS or oral steroids (hyperlink to our site for medications), PT, epidural steroid injections

    Caveat: Patients with low-grade or stable slips can improve with appropriate conservative care.

  • when neurological deficits persist, and the degree of slip is high, and spinal stenosis or deformity is causing nerve compression, surgical interventions include decompression (laminectomy or foraminotomy, spinal fusion,or in select cases, minimally invasive fusion, or interbody fusion (TLIF/PLIF/ALIF) 

  • Spondylolisthesis represents a mechanical failure of the spinal motion. Differentiating stable slips and unstable or symptomatic cases is key to determining the treatment.

Herniated Discs (cervical, thoracic, and lumbar discs)

  • Also known as a disc prolapse or disc extrusion, occurs when the soft inner nucleus of the intervertebral disc (nucleus pulposus, for flexibility and cushion) pushes through a tear or weakened area in the tougher outer layer (annulus fibrosis, for structure and containment). This often results in pain, numbness, and weakness along the distribution of the affected nerve root. This can occur anywhere along the spine, but the neck and lumbar spine are most common. Changes in the spinal discs (degenerative or injury) can lead to loss of hydration and elasticity, and their shock absorption and motion capabilities weaken, such that nerve roots become irritated, and inflammation is triggered.

  • Low back pain, often radiating to the leg (sciatica), sharp, shooting, or burning pain that follows a dermatomal pattern, numbness, tingling, or weakness to the affected leg or foot, and pain worsened by sitting, bending, or coughing.

  • Neck pain radiating to the shoulder, arm, or hand. Sensory changes or weakness in the upper limb, reduced neck mobility

  • Localized mid-back pain or band-like chest-wall discomfort

  • Based on MRI, CT myelography, as well as electrodiagnostic studies   (EMG/NCS)

  • PT, medications, ESI

  • If appropriate conservative treatment fails to relieve symptoms, discectomy 

Lumbar Spondylosis

  • Spondylosis is the degenerative changes to the lumbar spine that occur with age: it’s the spinal equivalent of osteoarthritis, and affects intervertebral discs (shock absorption), facet joints, and surrounding ligaments. The degenerative cascade of disc desiccation (dryness), joint arthritis, ligament thickening (overgrowth), and osteophyte growth narrows the spinal canal and causes lumbar spondylosis.

  • Stiffness, mechanical back pain, and occasionally nerve compression and neurologic impairment. 

  • X-rays, MRI, and CT scan all correlated to clinical symptoms

  • activity modification and ergonomic correction, lifestyle measures, for example, weight loss, regular low-impact exercise, smoking cessation, PT, medications, facet joint injections, medial branch blocks, epidural steroid injections, Intracept

  • Only in cases when pain is disabling and unresponsive to conservative care, significant nerve compression causing radiculopathy or claudication, spinal instability, or deformity. Common surgical procedures are decompression (laminectomy or foraminotomy) and a fusion procedure when instability is present or severe facet degeneration.

Cervical and Lumbar Degenerative Disc Disease

  • Cervical and lumbar degenerative disc disease refers to the gradual deterioration of the intervertebral discs in the cervical (neck) and lumbar (lower back) regions of the spine, often resulting in pain, stiffness, and reduced mobility. This condition is typically caused by age-related wear and tear, leading to disc dehydration, loss of elasticity, and potential herniation.

  • Include physical therapy, pain management through medications such as NSAIDs, corticosteroid injections, and lifestyle modifications like weight management and exercise to strengthen supporting muscles. In cases where conservative measures fail to provide relief,

  • Item descriptionoptions may be considered, such as discectomy (removal of the damaged disc), spinal fusion (joining adjacent vertebrae), or artificial disc replacement, which aims to alleviate pain and restore function while addressing the underlying structural issues.

Peripheral Nerve Injuries

  • This is damage to the nerve outside of the brain and spinal cord, commonly involving spinal nerve roots, plexuses, or distal peripheral branches, and leading to disruption of motor, sensory, or autonomic function. In the context of spine care, these injuries can result from compression, traction, or direct trauma to the nerve during degenerative, traumatic, or surgical processes.

Myelopathy


  • Myelopathy refers to dysfunction of the spinal cord caused by compression, injury, or disease, and represents a progressive neurological disorder. It is most common in the cervical spine. It differs from radiculopathy, which affects a single nerve root. Myelopathy can lead to widespread motor, sensory, and coordination problems below the level of the compression. Chronic and gradual compression can result in ischemia and demyelination, leading to loss of function. Non-surgical management can be simply observation in mild cases, PT, NSAIDS, and neuropathic medications.  Surgical treatment is indicated in progressive cases and includes anterior cervical discectomy and fusion (ACDF), cervical corpectomy, posterior cervical laminectomy or laminoplasty, and thoracic lumbar decompression.

Scoliosis and Spinal Cord Deformities

  • can be described as a “curved spine”; however, it is a complex structural three-dimensional deformity that involves the lateral curvature of the spine as seen on an X-ray, the rotation of the vertebrae as the spine twists with curvature, and changes in the sagittal alignment, or the front-to-back curves of the spine. Classification depends on the age of onset, the curve pattern of the spine, and the region of the deformity. Not all scoliosis requires surgery: factors include nerve and spinal cord compression, pain, pulmonary function, balance due to spinal misalignment or posture, prevention of future progression or deformity, cosmetic appearance, and self-esteem.

SI Joint Dysfunction

  •  Sacroiliac (SI) joint dysfunction is a condition that involves abnormal movement or inflammation of the sacroiliac joint, which connects the spine to the pelvis. It typically presents as lower back or buttock pain, often radiating to the hips or legs, with symptoms worsening with prolonged standing, sitting, or certain movements like bending or twisting.

  • SI joint dysfunction is typically diagnosed through a combination of patient history, physical examination, and imaging. Tests such as the provocative maneuvers (e.g., FABER, Fortin's, and AP Compression test) and diagnostic injections (e.g., corticosteroid and/or anesthetic injections into the SI joint) help confirm the diagnosis by relieving the painful area. Imaging studies, such as X-rays, MRI, or CT scans, may be used to rule out other conditions.

  • Physical Therapy helps strengthen the core and pelvic muscles, improving posture, and correcting movement patterns to reduce stress on the SI joint. Diagnostic injections, local anesthesia, can help determine the source of the pain. Therapeutic injections with corticosteroids can provide relief from inflammation or pain, although relief is temporary. Lastly, if conservative treatment fails to resolve the pain, percutaneous SI joint fusion can be considered.

Compression Fractures

  •    This is the collapse or crushing of a vertebra, most common in the thoracic and lumbar spine. They can cause sudden back pain, loss of height, and changes in posture (bending forward, kyphosis). Causes are osteoporosis, trauma, or cancer and tumors. While X-rays can detect these fractures, MRI and CT scans are more useful in assessing the fracture age, severity, and compression of the spinal cord or nerves. See vertebroplasty and kyphoplasty

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