The Spine & Back Blog

TOTEventImageJoin Dr. William Hunter and staff as we participate in the Warlick Family YMCA Trick or Trail Run at the Warlick Family YMCA (2221 Robinwood Road, Gastonia, NC 28054) on Saturday, October 23rd. 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 through encouraging wellness and family on their beautiful 118 acre campus.

Register Now

Download our event brochure or visit the Warlick Family YMCA Trick or Trail Run website to register now.

TOTThankYouSponsorPenny

 

Join Dr. William Hunter and staff as they participate in the Gaston County Walk for Wellness at Gaston Christian School on the 26th of June. Supporting the fighters, admiring the survivors, and honoring the taken. As an annual event, the Walk for Wellness to benefit Cancer Services of Gaston County, but the overall mental and physical health of their participants. 

Walk for WellnessDr. Hunter has been a long-time supporter of Cancer Services of Gaston County. Cancer Services aids clients within the community with education and support for cancer patients, family members, as well as caregivers. 

The fair is free to participate! Invite your friends, neighbors, family members, and bring your pets. Enjoy a morning walk to benefit cancer, and invite your friends and family to sponsor a donation or make a contribution in memory of a loved one. Music and refreshments are provided. Come join us for a fun Saturday morning 9am - 12pm, June 26, 2021.  

www.myersmemorialumc.org/walk

Female with back pain speaking with neurosurgeonBack and neck pain affects thousands of people. Sometimes, the pain is acute; sometimes it chronic back and neck pain. People manage this type of pain in many different ways. Sometimes they rely on non-surgical treatments for back pain like medication--both prescription and over the counter or non pharmacological treatment for pain like heating and cold solutions or stretching. If back pain continues, however, it's important to have it investigated by a physician who specializes in back and neck issues. In fact, your primary care doctor is likely to refer you to a spine specialist if your back pain continues unabated. If you're coping with back pain that will not subside, it's important to visit a spine specialist for help.

Getting to the Root of Neck & Back Pain

Often, people can pinpoint when and why their back and neck pain began. They may have suffered a back muscle sprain or strain after performing yard work or moving furniture. This type of back injury may clear up on its own after a few days or, in some cases, a few weeks. When back pain persists, over-the-counter medications can often be used to treat the issue during the healing process.

Chronic neck and back pain is another type of problem altogether. Your physician may have told you that if your back or neck pain persists for more than 12 weeks, you likely need a different sort of treatment or medical intervention. In many cases, your physician will refer you to a spine specialist like a neurosurgeon who can diagnose the problem and prescribe a remedy.

Your neurosurgeon is likely to discuss the various causes for your back or neck pain such as:

There may be other causes that your spine specialist can point to depending on your specific circumstances.

How Can a Neurosurgeon Help?

A neurosurgeon will review x rays and other tests in order to help with diagnosing back pain. Non-surgical treatments, like physical therapy, acupuncture, traction, and massage, to provide back pain relief are always considered first. Your spine specialist might recommend weight loss or lifestyle changes to help you combat pain and address the root cause of your back pain. If a surgical procedure is indicated to treat your back pain, your neurosurgeon will discuss minimally invasive procedures, stem cell injections, and spine surgery with you.

Dr. William Hunter, back and spine specialist

If you are concerned about back or neck pain you've been experiencing, make an appointment with Dr. William Hunter, spine specialist and neurosurgeon at NSSC Spine Clinic. He has the experience and expertise needed to treat all types of back pain. The NSSC Spine Clinic has been serving Gastonia and the broader Charlotte, NC area including Belmont, Mount Holly, Gaston County, Meckleburg County, and portions of South Carolina for over 20 years.

Ready to Make An Appointment With A Spine Specialist?

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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.

FIRST ENTRY

Transcript:

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.