About Our PracticeAbout Our Practice

Our doctors are all highly experienced and renowned in the field of orthopaedic medicine and surgery.

We offer:

  • Board Certification in Orthopaedic Surgery
  • Board Certification in Anesthesiology
  • Board Certification in Pain Medicine
  • Decades in practice helping patients

In the News!

A Second Chance by Dr. Lospinuso

Freedom To Move by Dr. Bhatnager


The following doctors have been named Jersey Choice Top Doctors 2014 by New Jersey Monthly


  • Dr. Ramil Bhatnagar, MD FAAOS
  • Michael F. Lospinuso, MD FACS
NJ Monthly Top Doctor 2014
About Our Practice
Dr. Bhatnagar's Congratulations Letter
Dr. Lospinuso's Congratulations Letter
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Common Diagnoses

Myelopathy Treatment

Myelopathy takes place when there is compression of the spinal cord and resulting damage of the spinal nerves. This interrupts the nerve transmissions and impairs their function. It frequently occurs in the cervical (neck) region and becomes more common as we age.

There are numerous causes for myelopathy. Some of the most common are trauma, autoimmune or inflammatory disorders, tumors and degenerative diseases such as herniated disks and spondylosis. Anything that can result in spinal stenosis, a narrowing of the spinal canal, can bring about myelopathy.

Symptoms

The symptoms experienced by people with myelopathy may differ based on what part of the spinal cord is being compressed. The progression of symptoms can also vary widely from person to person. If the arms are affected, the patient may have weakness, clumsiness or unsteadiness in their hands. If the legs are affected, the patient may experience weakness or numbness while walking. Abnormal reflexes and muscle spasms may be present. Less commonly, loss of bowel or bladder control takes place.

Diagnosis

To diagnose degenerative disc disease, your doctor will perform a physical evaluation and review your medical history. The physical examination typically entails inspecting the affected area for tenderness, changes in range of motion, neurologic deficit as well as other potential conditions, such as infection or fractures. In some cases, x-rays and/or MRI may also be used to obtain a better view of the discs

Sometimes a myelogram, in which dye is injected around the spinal cord or nerve roots, and CT scans are performed to visualize the injured area.

Treatment

The most effective treatment for myelopathy is usually surgery. That is the only way to decompress the spinal canal, prevent further progression of the myelopathy and provide some relief from the symptoms. There are several procedures that are used to treat myelopathy, depending upon its location, the alignment of the spine, and other considerations.

Some of the options are:

  • Laminectomy: In this procedure, a small section of bone that covers the back of the spinal cord, called the lamina, is removed to relieve the compression. It is most commonly performed on the vertebra in either the neck or the lower back.
  • Laminoplasty: This surgery expands the spinal canal by removing any thickened ligament and elevating the lamina. The lamina are typically maintained in a more open position using titanium plates to hold them in place.
  • Discectomy: A procedure in which a herniated disk is removed to relieve pressure on the nerves, a discectomy also involves a laminectomy to allow access to the troublesome disk. Microdiscectomy is a variation of this employing microscopes to magnify the section of spine and allow for a smaller incision and less damage to the rest of the area.
  • Corpectomy: When corpectomy is performed, the damaged part of the vertebra and adjacent discs are removed from the spinal column. A bone graft and sometimes titanium plates and screws are incorporated into the spine to enhance support.

Contact our office to learn more about myelopathy or to schedule a consultation.

Radiculopathy Treatment

Radiculopathy is the term for any mechanical problem or disease that affects the spinal nerve roots. These spinal nerves connect the spinal cord with the rest of the body. Often called a "pinched nerve," radiculopathy can be caused by a herniated disk, bone spur, an injury to the spine or osteoarthritis. It may involve any part of the spine, but it is most frequently found in the neck (cervical region) or lower back (lumbar region). Those considered at the highest risk are older individuals and younger people who play contact sports or perform manual labor.

Symptoms

Radiculopathy can result in pain near where the injured nerve is located. In addition, some sufferers feel a tingling, numbness and weakness in the area or a nearby extremity. So if the radiculopathy occurs in the neck, pain and discomfort may radiate down one or both arms and if it occurs in the lower back, it may radiate down one or both legs. When it affects the legs, it is also known as sciatica. Movements that pull on the affected part of the body, such as a quick reach, may sharpen the pain.

Diagnosis

Your physician will take a complete medical history, which includes asking numerous questions about your symptoms. He or she will examine the affected area and check on your strength, reflexes and sensation of feeling. Additional tests may be required as well. These can include X-rays to view spinal alignment and disks and an MRI to more clearly visualize the spinal cord and nerve roots. CT scans may also be used to obtain detailed views of the spinal bones and electromyelography, which helps the physician to study the electrical activity along the nerve.

Treatment

Conservative treatments are always the first options considered for radiculopathy. This will limit the range of motion in your neck and rest the muscles. Physical therapy may be able to strengthen the muscles in the problem area, maximize flexibility with stretching exercises and take some pressure off of the injured nerve roots.

There are medications that can help as well. Anti-inflammatories and oral corticosteroids can reduce pain and swelling. Steroid injections in the spine are sometimes used to decrease swelling too, allowing for healing to take place. In severe cases when pain does not respond, stronger prescription pain medications may be incorporated into the care plan.

If these treatments cannot provide the patient with relief or symptoms are worsening, surgery will often be required. There are several types of procedures that can be used to correct radiculopathy, depending on the reason for your nerve problem and its location. Discectomy with fusion is the most common and it can restore the alignment of the spine, reduce the compression on the nerves and support the affected area of spine. A laminoforaminotomy may be used to remove the segments of bone that are compressing the nerves. If the radiculopathy is caused by a degenerated disk, artificial disk replacement may be the best surgical option to remove the worn disk, relieve pressure on the nerves and restore height between the vertebrae.

Contact our office to learn more about radiculopathy or to schedule a consultation.

Common Diagnoses
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