The Spine & Back Blog

We are thrilled to share our exciting news. NSSC Spine Clinic is expanding its services to include physical therapy!

Physical Therapy Services - NSSC Spine Clinic (Gastonia, NC)As part of our commitment to comprehensive patient care, Dr. William D. Hunter and our esteemed team of healthcare providers are pleased to announce the integration of physical therapy services into our practice, complementing our distinguished neurosurgical expertise. This addition aligns with our mission to provide holistic and personalized care to our valued patients. 

Physical therapy can play a crucial role in enhancing recovery, improving mobility, and promoting overall well-being, complementing the neurosurgical treatments we are known for.

Key Benefits of Our New Physical Therapy Services:

  • Integrated Care: Our physical therapy services are seamlessly integrated into the neurosurgical practice at the NSSC Spine Clinic, ensuring a coordinated and comprehensive approach to your treatment.
  • Expert Therapists: Our team of experienced and highly trained physical therapists is dedicated to working collaboratively with our providers to optimize your rehabilitation and recovery.
  • Customized Treatment Plans: Each patient is unique, and so are their needs. Our physical therapists will develop personalized treatment plans tailored to your specific condition, ensuring optimal outcomes.
  • Convenience: By offering physical therapy within our practice, we aim to enhance your convenience by providing comprehensive care under one roof.

Whether you are recovering from surgery, managing a chronic condition, or seeking preventive care, our physical therapy services are designed to support your journey to better health.

Physical Therapy In Gastonia, NC

To schedule a physical therapy appointment or learn more about how these services can benefit you, please call us at 704-864-5550 or reach out via our contact page.


WARLICK FAMILY YMCA TRICK OR TRAIL 5K RUNJoin Dr. William Hunter and staff as we participate in the Warlick Family YMCA Trick or Trail Run at the Warlick Family YMCA on Saturday, October 28th

Warlick Family YMCA
2221 Robinwood Road
Gastonia, NC US 28054

As the title sponsor, all of us at the Neuroscience & Spine Center of the Carolinas would love to see you come out, have a great time, and support a wonderful organization.

Warlick Family YMCA

The Trick or Trail Run supports the Warlick Family YMCA, a non-profit organization committed to helping members of our community live a balanced, healthy life in spirit, mind, and body. The YMCA makes a positive impact in the Gaston County community by encouraging wellness and family on their beautiful 118-acre campus.


5K and 1-mile Fun Run on the Sytz Trail
at the Warlick Family YMCA

  • 8:00am 5K begins
  • 9:00am Fun Run begins
  • 9:30-11:30am After Party

What does the 5K Trail Look Like? 
Both the 5K race and 1 Mile Fun Run courses are on the Sytz Trail System at the Warlick Family YMCA.
View a map of the Sytz Trail System.

Can I dress up in costume?
Please do! It makes the race even more fun! Plus, the after-race party will include prizes for best costume and performance. Dogs included!

Register Now

Visit the Warlick Family YMCA Trick or Trail Run website to register now.


When conservative treatments fail to alleviate severe back pain caused by conditions like degenerative disc disease or spinal instability, surgical intervention may be necessary. Transforaminal Lumbar Interbody Fusion (TLIF) surgery is a procedure commonly performed to address these spinal conditions. Below we’ll explore what TLIF surgery entails, discuss the benefits it offers, and identify the individuals who can benefit the most from this surgical approach.

What Is TLIF Surgery?

Transforaminal Lumbar Interbody Fusion (TLIF) surgery is a spinal fusion procedure that focuses on stabilizing the lumbar spine, specifically the lower back. It involves accessing the spine from a posterior approach, typically through a small incision in the lower back. During the procedure, the damaged disc or bone material is removed, and bone grafts or implants are inserted to promote fusion between adjacent vertebrae. This fusion helps alleviate pain, restore stability, and improve the overall functionality of the spine.

Benefits of Transforaminal Lumbar Interbody Fusion (TLIF) Surgery:

a. Pain Relief: TLIF surgery is highly effective in reducing back and leg pain caused by conditions like herniated discs, spinal stenosis, or spondylolisthesis. By decompressing nerve roots and stabilizing the affected area, the surgery alleviates pressure on nerves, resulting in significant pain relief.

BENEFITS OF TRANSFORAMINAL LUMBAR INTERBODY FUSION (TLIF) SURGERYb. Spinal Stability: One of the key benefits of TLIF surgery is the restoration of spinal stability. The fusion between vertebrae eliminates abnormal movement and instability in the affected segment of the spine. This stability helps prevent further degeneration and reduces the likelihood of future complications.

c. Improved Functionality: Individuals who undergo TLIF surgery often experience an improvement in their ability to perform daily activities. By addressing the underlying cause of pain and instability, the surgery enables patients to regain mobility, flexibility, and overall functionality.

d. Reduced Dependency on Medication: Chronic back pain often requires long-term medication use, which can have side effects and limitations. TLIF surgery offers the potential for a significant reduction in pain, allowing patients to rely less on pain medication and potentially improving their overall quality of life.

e. Faster Recovery: While recovery times can vary, TLIF surgery generally offers a faster recovery compared to traditional open spinal surgeries. The minimally invasive nature of TLIF, with smaller incisions and reduced muscle trauma, contributes to a quicker return to daily activities and work.

Who Can Benefit Most From TLIF Surgery?

a. Spinal Instability: Individuals with spinal instability resulting from degenerative disc disease, spondylolisthesis, or spinal trauma can benefit greatly from TLIF surgery. The fusion procedure stabilizes the affected segment, reducing pain and preventing further degeneration.

Benefits of Transforaminal Lumbar Interbody Fusion (TLIF) Surgeryb. Disc Herniation: TLIF surgery is effective in addressing herniated discs that cause significant pain, nerve compression, and functional limitations. The procedure removes the damaged disc material and provides stability, relieving pressure on the affected nerves.

c. Spinal Stenosis: TLIF surgery can benefit individuals with spinal stenosis, a condition characterized by the narrowing of the spinal canal. By decompressing the nerves and stabilizing the spine, the surgery relieves pain and restores functionality.

d. Failed Conservative Treatments: Patients who have exhausted non-surgical treatment options, such as physical therapy, medication, and injections, without experiencing sufficient relief may be suitable candidates for TLIF surgery.

The NSSC Spine Clinic Can Help Determine The Best Approach For You

If you are experiencing chronic back pain, transforaminal lumbar interbody fusion (TLIF) surgery is a highly effective and minimally invasive procedure to consider. It is recommended for treating various spinal conditions that cause severe back pain and instability. That said, it is only one of your many options for reducing your pain and improving your quality of life.

To better understand treatment options, and what is best for your circumstances, please contact the NSSC Spine Clinic in Gastonia, NC today to schedule a consultation with Dr. Hunter. Dr. William Hunter is a board-certified neurosurgeon and spine specialist with over two decades of experience offering various treatments for back pain relief, including spine surgery, as well as minimally invasive techniques, and regenerative medical treatments.

XLIF® procedure: Placing the femoral nerve from anterior to posterior position

Dr. William D. Hunter of Gastonia, N.C., performs an XLIF® procedure. The nerve featured here was found to be in the anterior position. It is safer to have the nerve placed posteriorly. The video demonstrates a technique used to safely place the nerve in the posterior position. Once the nerve’s position is altered, the XLIF® procedure can continue – the disk can be removed and the graft can be placed.



Hello, this is a video to describe how to move the femoral nerve posteriorly safely when performing an XLIF procedure. After making the skin incision, you can see there’s a fat plane which we dissect through. Once the fat plane is identified we can then identify the fascial plane which is above the muscle area. We clearly can see the muscle plane, and you need to clearly identify the muscle region. Taking the fascial plane away from the muscle is important. This then allows us to enter into the retroperitoneal space using a single finger dissection. Once in the retroperitoneal space, we can then place our initial dilator. The black dilator then goes on top of the psoas muscle, and then using the neural monitoring system, we can traverse through the psoas muscle. This is going to help identify where the nerve is located - whether it’s anterior, superior, inferior, or posterior - using the white mark. At this point in time we notice that the initial dilating, monitoring system is telling us that the nerve in anterior. Instead of taking the whole dilator out and starting all over again. We proceed with placing the k-wire and then the additional dilators into the region. We do know that the nerve is anterior to our dissection. We will be able to move the nerve posteriorly; however, we need to have better visualization. In doing so, we then place the additional dilators: the purple and then also the blue dilator. Again, this is telling us that the nerve is anterior. We then place the retractor system using AP and lateral x-rays, we fully identify the location of how the retractor system is set. Having the k-wire then placed, we take all the retractor systems out and initial dilators out. Then we use the neural monitoring system, noting that there is a nerve anterior. Below the suction, and right where the monitoring system was noted. At this point in time, we try to see whether we can fully identify the nerve itself. Sometimes we may need to have to adjust the retractor system, and clearly between these two instruments you can see the large femoral nerve. What we now want to do is try to establish an area interior to this nerve; therefore, we’ll continue to dissect the region and identify an anterior region for placement of the k-wire. With this dissection, we can clearly see that there is a disc anterior to the anterior part of that nerve. Because of the micro-bleeding, we will go ahead and proceed with the bipolars to bipolar the micro bleeding in the region closest to the posterior fade. Once this has been completed, we then can take the k-wire, which is currently posterior to the nerve, and place anterior to the nerve. The critical component is doing this under direct visualization. At this stage, you can see that the k-wire will now be removed and placed anteriorly. Once the k-wire is placed anteriorly, we then place the initial black dilator. Now, we subsequently remove the retractor system. Once the retractor system is removed, we then place the second dilator and then the last balloon dilator, noting that the nerve is now posterior. We then proceed in placing the retractor system again using a neuro-monitoring system, we know that the nerve is posterior to the blade. We then open the retractor system, and we can now see that there is muscle - small muscle bands above the disk material. Prior to doing anything with that muscle, it is imperative that we use the neuro monitoring system again to make sure that the nerve is posterior. Once we know that the nerve is posterior to the posterior blade, we are now in the safe zone. We use x-rays - AP and lateral - to help identify the location of the disc with regard to our retractor system. Once we feel we are in the safe zone - after using the monitoring system again to fully identify that the nerve is posterior to the posterior blade, and that the muscle is off of the disc - we place the shim, which will then help secure the retractor system in place. Then use an identifier to help note that we are in the safe zone, and that we have plenty of room to perform our discectomy, and then once the discectomy is performed, to place our graft and perform a fusion. This is the technique to place the nerve posterior to the posterior blade.