Frequently Asked Questions about Spinal Conditions and Treatment Options
1. What is your advice to patients considering spine surgery or going to see a spine surgeon for the first time?
Surgery is sometimes an option after most other treatments have been tried to eliminate pain and increase mobility in a patient. It is very important to find a surgeon who has trained and is experienced in the type of surgery you require.
Find a surgeon who will take the time to listen to you and answer any questions you may have about the operation and discuss with you what you can expect afterwards.
2. Is surgery always the right option? What alternatives are available and how effective are they?
Surgery is not always the right option. Physical therapy, change in diet, exercise, and other changes in daily activities may help improve your condition, delaying the necessity of surgery. In your initial visit and evaluations with a surgeon, alternatives will be discussed and explained so the patient can make the right decision.
3. What is Dr. Paré's experience as a brain and spine surgeon?
Paré has 14 years of surgical experience including specialty training in the latest techniques for minimal access for brain and spine surgical procedures. Dr. Paré is continually attending and conducting training sessions on new technology for brain and spine surgeries. She also trains neurosurgery residents at the University of California, Irvine.
4. What does it mean that a neurosurgeon is board certified?
A neurosurgeon who has been certified by the AMERICAN BOARD OF NEUROLOGICAL SURGERY (ABNS) has completed an approved educational training program and an evaluation process, including written and oral examinations, designed to assess the knowledge, skills, and experience necessary to provide quality patient care in neurological surgery.
Board certified neurosurgeons have performed a number of surgeries, passed several rigorous tests and have successfully proven to have favorable patient outcomes in order to gain certification. Board certification is an important indicator of the level of competence of a neurosurgeon.
5. How does Dr. Paré relate to patients and how does she advise patients on the risks and benefits of surgical treatment?
Dr. Paré listens intently to each patient about the factors contributing to the medical issue. She reviews all the diagnostic and medical charts provided to her by the patient’s family physician or emergency room physician.
6. What is Dr. Paré’s primary area of expertise?
The majority of patients she treats are patients who have been in accidents or are suffering from severe forms of brain or spine diseases. The conditions are severe enough that surgery is being considered to solve the problem.
7. What is CyberKnife surgery?
The CyberKnife® Robotic Radiosurgery System was cleared by the U.S. Food and Drug Administration in 2001 to treat tumors anywhere in the body, including the spine. Despite its name, the CyberKnife System is not a surgical procedure. In fact, there is no cutting involved. Instead, the CyberKnife System delivers high doses of radiation directly to spine tumors. The CyberKnife System offers patients who cannot undergo spine cancer surgery due to their medical condition, or who refuse surgery, a minimally invasive alternative treatment for spine cancer. CyberKnife spine cancer treatments are typically performed on an outpatient basis over a period of one to five days, requiring no overnight hospital stays. Most patients experience minimal to no side effects with a quick recovery time. Source: Accuray, Inc.
8. What kinds of spine surgery does Dr. Paré perform?
General categories of spinal surgeries include:
Minimally invasive spine surgery
Spinal reconstruction for infection, trauma, deformity or tumor
Degenerative spinal disorders
Spinal tumors, benign and malignant
Open spinal surgeries include:
Anterior cervical discectomy and fusion (ACDF)
Cervical disc replacement (arthroplasty)
Cervical laminectomy
Cervical foraminotomy
Cervical instrumentation and fusion
Cervical fracture reduction and fusion
Cervical spinal cord tumors
Lumbar discectomy
Lumbar laminectomy and foraminotomy
Lumbar instrumentation and fusion
Anterior lumbar interbody fusion (ALIF)
Lumbar spinal cord tumors
Microdiscectomy
Spinal shunts
Syringomyelia
Thoracic laminectomy
Thoracic spinal cord tumor
Thoracic instrumentation and fusion
Thoracic fracture reduction and fusion
Minimally invasive spine procedures include:
AxiaLIF
Cervical foraminotomy
Cyberknife stereotactic radiosurgery for spinal tumors
Da Vinci Robotic-assisted tumor resection
DLIF (direct lumbar interbody fusion)
Kyphoplasty
Lumbar discectomy
Lumbar laminotomies
Pedicle screw fixation and fusion
TLIF (transformainal interbody fusion)
Vertebroplasty
XLIF (extreme lateral interbody fusion)
9. What kinds of brain surgery does Dr. Paré perform?
Brain tumor needle biopsy
Brain tumor removal (craniotomy)
Brain trauma
Intracranial hemorrhage
Brain shunts
Intracranial aneurysms
Endoscopic resection of pituitary adenomas
10. What is normal pressure hydrocephalus?
Hydrocephalus is a condition in which there is too much CSF in a person's ventricles. This occurs when the natural system for draining and absorbing extra CSF does not function properly. The ventricles enlarge to accommodate the extra fluid and then press on different parts of the brain, causing a number of different symptoms. Hydrocephalus has many different causes. Some people are born with the condition, while others develop it later on.
Normal pressure hydrocephalus (NPH) is a type of hydrocephalus that occurs in adults, usually older adults. The average person diagnosed with NPH is older than 60 years. NPH is different than other types of hydrocephalus in that it develops slowly over time. The drainage of CSF is blocked gradually, and the excess fluid builds up slowly. The slow enlargement of the ventricles means that the fluid pressure in the brain may not be as high as in other types of hydrocephalus. However, the enlarged ventricles still press on the brain and can cause symptoms. (The term "normal pressure" is somewhat misleading.)
11. How do I choose a neurosurgeon?
Review your health plan to ensure the neurosurgeon is within your plan’s network of physicians. If you choose to go to a neurosurgeon not in your health plan, contact their office prior to scheduling a visit and find out their policy regarding out of network patients.
Consult with your family’s physician and other health care professionals. Once you identify a neurosurgeon with experience and training in spine and brain surgery, schedule a visit and pass the necessary information on to the practice. After your visit and evaluation with the neurosurgeon, you make the decision about progressing with the course of a treatment/surgery. If you feel you would like a second or third opinion, contact their office.
(1) What should I bring to my first appointment or consultation?
(2) Proper picture identification and health plan information.
(3) Complete patient forms from UCI office.
(4) X-Rays, CT scans, MRI scans, and any other medical information from your family medicine physician or radiology provider.
(5) What is the difference between a neurosurgeon and orthopedic surgeon?
Neurosurgeons spend seven years training in the diagnosis and treatment of adults and children with neurological disorders of the brain, spinal cord, nerves, skull, and spine. About half of their training is in spine disorders and half of their training is in brain disorders. After the satisfactory completion of formal residency training, a neurosurgeon is able to perform all but the most specialized brain and spinal surgeries. In fact, most spine surgery in the US is performed by neurosurgeons.
Orthopedic surgical training focuses on all the bones in the body (except the skull). Most orthopedic spine surgeons require additional fellowship training in order to be qualified to do certain types of spinal surgery.
12. Are there patients who do not qualify for surgery? How do I know if I am one of them?
The surgeon evaluates all patients prior to surgery to ensure there is limited risk to the patient’s health. Many health factors are assessed and if a patient does not meet the expectations then surgery is not scheduled.
More information about Spinal Conditions, and Spinal Treatment options
neurosurgery, cranial surgery, degenerative spine , scoliosis, spinal stenosis, disc fusion, corpectomy, lamenictormy, microdiscectomy, surgeon, spine, minimally invasive surgery, back pain, medications, anterior cervical discectomy, anterior cervical discectomy with fusion, cervical corpectomy, cervical foraminotomy, cervical laminectomy, cervical laminoplasty, minimally invasive cervical discectomy, brain anatomy, chiari malformation, aneurysms, arteriovenous malformations, cavernous malformations, carotid oclusive disease, stroke, brain tumors, skull base tumors/acoustic , pituitary tumors, meningiomas, trigeminal neuralgia, hemifacial spasm, hydrocephalus, epilepsy, head trauma