Neck & Spine Specialities
Dr. Nourian has an enviable record of successfully treating the full spectrum of neck and spine problems.
Arthritis
Bulging/Herniated Discs
Disease & Disorders
Degeneration
Fractures
Infections
Injuries
Sciatica
Scoliosis
Spinal Stenosis
Stiff Neck
Tumors
Conditions
Cervical Radiculopathy
This condition is an irritation or compression of one or more nerve roots in the cervical spine. Because these nerves travel to the shoulders, arms and hands, an injury in the cervical spine can cause symptoms in these areas. Cervical radiculopathy may result from a variety of problems with the bones and tissues of the cervical spinal column.
Compression Fractures of the Spine
This is a collapse of vertebral bone. It can affect one or more vertebrae. Compression fractures typically develop in your mid or lower back. This can change the shape of your spine.
Herniated Disc
Between the vertebrae of your spine are soft discs. They let your spine twist and bend. They absorb shocks. But if damaged, the disc’s soft center can push through the disc wall. That’s a herniated disc. This bulge presses against nerves in your spine.
Kyphosis
This condition is a deformity of the spine. With it, your vertebrae change from a cylindrical shape to a wedge shape. Your spine may begin to curve forward. Eventually, this gives your upper back a rounded appearance.
Lumbar Radiculopathy (Sciatica)
This condition is an irritation or compression of one or more nerve roots in the lumbar spine. Because these nerves travel to the hips, buttocks, legs and feet, an injury in the lumbar spine can cause symptoms in these areas. Sciatica may result from a variety of problems with the bones and tissues of the lumbar spinal column.
Scoliosis
This condition is an abnormal curvature of the spine. It most often develops in early childhood, just before a child reaches puberty.
Spinal Stenosis
Your spinal nerves travel through your spinal canal and exit through openings we call “foramen.” If any of these spaces are too narrow, your nerves become compressed. We say you have “spinal stenosis.” It’s a problem that most often happens in the neck and lower back.
Spinal Stenosis (Cervical)
This problem affects the spinal nerves in your neck. It’s a narrowing of the spinal canal. That’s the space your spinal nerves travel through. In a healthy spine, the spinal canal protects these nerves. It keeps them free from injury. But with spinal stenosis, the spinal canal is too narrow, and your nerves get compressed.
Spinal Stenosis (Thoracic)
This condition affects the thoracic spine between the neck and the lower back. It is a narrowing of the spinal canal that results from degeneration of bones in the spine, disc herniation, or thickening of the tissues that surround the spinal cord.
Spondylolisthesis
This condition occurs when a lumbar vertebra slips out of place. It slides forward, distorting the shape of your spine. This may compress the nerves in the spinal canal. The nerves that exit the foramen (open spaces on the sides of your vertebrae) may also be compressed. These compressed nerves can cause pain and other problems.
Where Lower Back Pain Begins
Lower back pain is a common problem that severely impacts the quality of your life. It can limit your ability to be active. It can cause you to miss work. Many different causes may lead to pain in your lower back.
Where Neck Pain Begins
Neck pain is a common problem that severely impacts the quality of your life. It can limit your ability to be active. It can cause you to miss work. Many different causes may lead to pain in your neck.
Surgical Care and Management
ALIF: Anterior Lumbar Interbody Fusion
ALIF is generally used to treat back or leg pain caused by degenerative disc disease. The surgeon will stabilize the spine by fusing vertebrae together with bone graft material.
Anterior Cervical Discectomy and Fusion (ACDF)
This surgery removes a herniated or degenerative vertebral disc in your neck and replaces it with a bone graft. This can relieve painful pressure on spinal nerves.
Artificial Cervical Disc Replacement
This procedure replaces a degenerative or damaged spinal disc with an implant designed to preserve motion in your neck. This procedure can relieve the pain of compressed nerves in the cervical spine.
Cervical Posterior Foraminotomy
This surgery creates more space for a compressed spinal nerve in your neck. The procedure relieves painful pressure caused by a herniated or degenerative disc.
Kyphoplasty (Balloon Vertebroplasty)
This minimally-invasive procedure repairs a vertebral compression fracture. It helps restore the spine’s natural shape. Some patients experience rapid pain relief after the procedure
Laminectomy
This procedure relieves pressure on the nerve roots in the spine. It is most commonly performed to relieve the pain of stenosis. This is a narrowing of the spinal canal that is often caused by the formation of bony growths that can press against the nerve roots. The surgeon may treat one or more vertebrae.
Lumbar Discoscopic Discectomy
This minimally-invasive procedure is designed to relieve pain caused by herniated discs pressing on nerve roots. This surgery is performed through a small tubular device under local or epidural anesthesia, allowing the patient to leave the hospital the same day.
Spinal Fusion (Lumbar)
In many spinal surgeries, two or more vertebral bones are permanently joined with a technique called “spinal fusion.” A fusion creates a solid mass of bone. It stabilizes your spine.
Superion® InterSpinous Spacer (Vertiflex)
This is an implant that lifts and separates your vertebrae. It’s used to treat lumbar spinal stenosis. That’s a narrowing of the space around your spinal nerves in your lower back. The Superion implant makes more room for these nerves, relieving painful compression.
Vertebroplasty
This minimally-invasive procedure is an injection of bone cement into a vertebra. It stabilizes a compression fracture of the spine. One or more vertebrae may need to be treated.
Lumbar Disc Replacements
Lumbar disk replacement involves replacing a worn or degenerated disk in the lower part of your spine with an artificial disk made of metal or a combination of metal and plastic.
Lumbar disk replacement is generally seen as an alternative to the more common spinal fusion surgery.
Spinal Cord Stimulators
Spinal cord stimulators consist of thin wires (the electrodes) and a small, pacemaker-like battery pack (the generator). The electrodes are placed between the spinal cord and the vertebrae (the epidural space), and the generator is placed under the skin, usually near the buttocks or abdomen.
Xlif
The XLIF (eXtreme Lateral Interbody Fusion) is an approach to spinal fusion in which the surgeon accesses the intervertebral disc space and fuses the lumbar spine (low back) using a surgical approach from the side (lateral) rather than from the front (anterior) or the back (posterior).
Stem Cell Therapy
Stem-cell therapy is the use of stem cells to treat or prevent a disease or condition. As of 2016, the only established therapy using stem cells is hematopoietic stem cell transplantation (HSCT). This usually takes the form of a bone marrow transplantation, but the cells can also be derived from umbilical cord blood.
PRP
Platelet-rich plasma, or PRP, is a substance that’s thought to promote healing when injected. Plasma is a component of your blood that contains special “factors,” or proteins, that help your blood to clot. It also contains proteins that support cell growth. Researchers have produced PRP by isolating plasma from blood and concentrating it.
Epidural Injections
Epidural steroid injections (ESIs) are a common treatment option for many forms of low back pain and leg pain. They have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an epidural steroid injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.
Facet Injections
A facet joint injection is a relatively simple, straightforward procedure, and is usually performed in an office-based procedure suite or in an ambulatory surgical center.
As with many spinal injections, facet joint injections are best performed using fluoroscopy (live X-ray) for guidance to properly target and place the needle (and to help avoid nerve injury or other injuries).
Non-Surgical Care and Management
MRI (Magnetic Resonance Imaging)
This scan lets doctors see inside your body without using radiation. Instead, MRIs use magnets and radio waves. An MRI shows clear views of your soft tissues. It can show cancer and other problems.
PRP Therapy (Overview)
Platelet rich plasma therapy can help injured joints and other problems. It uses parts of your own blood to reduce pain and speed up healing
Professional Affiliations
Dr. Nourian is affiliated with American Academy of Orthopedic Surgeons, American Board of Orthopedic Surgery, California Medical Association, North American Spine Society, Ventura County Medical Association.
