Treatments
Dr. Boody's practice covers the full range, from injections to complex revision and deformity surgery. That range is the point: when every option is on the table, the recommendation can be the one that fits your problem rather than the one a surgeon happens to offer. Each treatment below explains what it does, what it is for, and what it cannot fix.
Non-surgical first
Disc herniations shrink, inflamed nerves calm down, and strained backs heal. The job of the first weeks is to control pain and protect function while that happens. Surgery is for the problems that do not resolve, and for a short list that should not wait.
Targeted exercise to take load off the painful structure, restore motion, and build the strength that keeps the problem from returning. For nerve pain, therapy is about positions and movement that give the nerve room. It is the foundation of non-surgical care and of recovery after surgery.
Anti-inflammatories for pain from an irritated disc or joint, nerve-pain medications for radiating symptoms, and a short course of oral steroids in some acute cases. Medication treats the pain while the body heals; it does not change what the MRI shows, and long-term opioids are not a treatment for spine pain.
Epidural steroid injections put anti-inflammatory medication next to an irritated nerve root. Facet and sacroiliac joint injections treat, and help diagnose, pain from a specific joint. Relief may last weeks to months, which can be enough for the underlying problem to settle, and a good response confirms which structure is responsible.
Surgical procedures
Most cervical surgery is done from the front of the neck, through a small incision beside the windpipe. The disc pressing on the nerve or cord is removed, and the space is either fused or replaced with a moving implant. Which one is the decision Dr. Boody has studied longest.
Images are simplified teaching models. Each full guide takes a closer look.
Relieves nerve or spinal cord pressure, then joins the treated vertebrae together.
The disc and any bone spurs pressing on the nerve or cord are removed from the front of the neck, and the space is filled with a bone graft or cage held by a small plate so the two vertebrae grow together. It relieves nerve and cord compression reliably and is the standard operation for cervical radiculopathy and myelopathy. The trade-off is that the fused level no longer moves, which places slightly more work on the levels next to it.
Relieves pressure with an artificial disc designed to preserve motion at the treated level.
The same decompression as an ACDF, but the disc is replaced with an implant that lets the level keep moving instead of fusing it. The aim is to protect the neighboring levels from the extra load a fusion places on them. It suits patients with good bone, well-preserved facet joints, and disease at one or two levels; it is not the right choice for every neck. Dr. Boody co-authored twenty-year outcomes from a randomized trial of this operation.
Creates more room for the spinal cord, using the approach that fits the source of pressure.
Any operation whose purpose is to take pressure off the spinal cord, in the neck or the mid-back. Depending on where the compression comes from and how many levels are involved, it is done from the front (removing discs or a vertebral body), from the back (laminectomy or laminoplasty, which opens or hinges the roof of the canal), or both. It is the treatment for myelopathy, OPLL, and cord compression from fracture or tumor. Its goal is to stop the cord from getting worse; recovery of function already lost is possible but not guaranteed.
Surgical procedures
The lumbar question is usually whether the nerve needs to be freed, or whether the level also needs to be held still. Decompression alone is a smaller operation; fusion is added when the spine is unstable or slipping.
Reaches a disc fragment outside the nerve tunnel through an approach from the side.
A microdiscectomy removes the fragment of disc pressing on a nerve root through a small incision, using a microscope. When the fragment sits out beyond the edge of the canal, where the nerve has already exited, a standard approach cannot reach it without removing part of the facet joint. The far lateral approach comes in from the side, reaches the nerve directly, and leaves the joint intact. Dr. Boody has published on the technique.
Combines nerve decompression with support for a level that needs to heal together.
A fusion of one or more lumbar levels done from the back. The worn disc is removed through the opening the nerve exits from, a cage with bone graft is placed in the disc space to restore its height and alignment, and screws hold the level still while the bone heals into a single unit. It is the usual operation for spondylolisthesis and for stenosis at an unstable level, and it can be done through small incisions with tubular retractors.
Targets the joint between the spine and pelvis to help evaluate and relieve pain.
The sacroiliac joints connect the base of the spine to the pelvis, and they are a frequently missed source of low back and buttock pain, including after a lumbar fusion. An injection of anesthetic and steroid into the joint under X-ray guidance does two things: it relieves the pain for a period, and if it does, it confirms the joint as the source. That answer determines what comes next, and it is a reason not to operate on a disc that was never the problem.
Surgical procedures
Minimally invasive methods change how an operation is done, not what it accomplishes. Revision and deformity surgery are the other end of the range: larger operations for problems that a smaller one cannot fix.
Uses a smaller muscle corridor to carry out a decompression or fusion.
Doing the same decompression or fusion through small incisions, with tubular retractors that spread the muscle rather than cutting it, and X-ray or navigation guiding the instruments. Less muscle damage generally means less pain after surgery and a faster return to activity. It is a way of operating, not a separate operation, and it is used when it can accomplish the full goal; when it cannot, a larger incision is the safer choice.
Places screws and rods through small incisions to support a fusion or stabilize a fracture.
Pedicle screws anchor a fusion or stabilize a fracture. Placing them percutaneously means each screw goes in through a small stab incision guided by X-ray or navigation, with rods threaded beneath the skin to connect them, instead of exposing the whole back of the spine. It is often used to stabilize a thoracolumbar fracture and as the fixation for a minimally invasive TLIF. Dr. Boody has studied how surgeons learn to place these screws safely.
Addresses a specific problem at or near a level that has already had surgery.
Surgery on a spine that has already been operated on: a fusion that did not heal, a level wearing out next to a fusion, hardware that has loosened or was placed in the wrong spot, or a problem the first operation did not fully address. Revision is harder than a first operation because of scar tissue and changed anatomy, and it starts with an honest diagnosis of why the first surgery did not work. Dr. Boody takes revision cases from his own practice and from surgery done elsewhere.
Treats spinal curves or imbalance when the alignment itself is causing the problem.
Surgery to straighten a scoliosis curve or restore the side-view alignment that keeps the head balanced over the pelvis, using screws and rods across multiple levels, sometimes with bone cuts (osteotomies) to allow the correction. In adolescents it stops a large curve from progressing; in adults it treats pain and nerve symptoms caused by the alignment itself. It is the largest operation in spine surgery, and the decision to do it is made only after conservative care, and only when the deformity is clearly the cause.
Appointments
The visit does not assume an operation at the end of it. Bring your imaging and what you have already tried, and you will leave with the options ranked and explained.
