Aware State surgery is routinely practiced for back pain or sciaitca at the Spinal Foundation because it takes the guess work out of diagnosis and provides improved diagnosis and pain source precision location without the need for General Anaesthesia. The resulting definitive treatment offers encouraging outcomes.
No longer does the surgeon need to rely upon deductions reliant upon:
Patterns of pain considered to relate to nerve pathways (Dermatomes)
These patterns are derived from dissections of cadavers and are more reliable when the nerve is so compressed that function is impaired with loss of power and sensation. However such concepts fail to take in to account the anomalies of nerve structural formation. In the lumbar spine for instance this is abnormal in 13% of patients.
X-rays - unloaded
At the Spinal Foundation we have used weight bearing X-rays since 1990 but we also amplify these with studies in flexion and extension with the patient standing and sitting.
CAT Scans - unloaded
These demonstrate bony problems such as bone spurs and overgrowth of the facet joints, but do not indicate definitively which pathology is causal of the pain or those which have been present but asymptomatic for years
MRI scans - unloaded
These show multiple sites of pathology but do not indicate definitively which pathology is causal of the pain or those which have been present but asymptomatic for years.
These diagnostic studies are all inert and clinically distant from the pain source. In most cases of degenerate disc disease there are several sites of degeneration and the source of pain may be multifactorial and multi-level in origin.
In the accompanying pages please explore the use of Spinal Probing & Discography, Differential Discography, in the refinement of the diagnostic pathway led by the patient and the available techniques of Endoscopic Minimal Invasive Spinal Surgery which can be used to seek out and precisely relieve the pain sources in a wide spectrum of patients and a wide spectrum of pathologies in the lumbar and cervical spines.