Dr Michael R Wheeler MD

11/30/2022

Patient Testimonials & Reviews -

11/28/2022

What is Cervical Disc Replacement?

Discs in the cervical spine (or neck) can degenerate over time or herniate, causing pressure on the spinal cord or the exiting nerve roots. This can lead to neck pain and/or pain, weakness, numbness, or tingling of the shoulder, arm, or hand on the affected side. Cervical disc replacement is a surgical procedure used to take the pressure off affected nerves by removing the herniated or degenerated disc of the cervical spine and replacing the diseased disc with a new artificial disc.

During this procedure, an incision is made in the front of the neck to remove the diseased disc. Depending on the number of problematic discs, one or more discs may be removed. Once the disc(s) is removed, an artificial disc is placed in the space between the vertebrae. This is a motion-preserving procedure and is an alternative to a fusion.

For more Information - https://michaelwheelermd.com/cervical-disc-replacement/

11/25/2022

Dr. Michael Wheeler explains lumbar spinal stenosis -

11/23/2022

Patient Testimonials & Reviews -

https://michaelwheelermd.com/

Dallas Orthopedic Spine Surgeon, Dr Michael Wheeler MD focuses on treating his patients with care.

11/21/2022

What is Anterior Cervical Discectomy and Fusion (ACDF) ?

Discs in the cervical spine (or neck) can degenerate over time or herniate, causing pressure on the spinal cord or the exiting nerve roots. This can lead to neck pain and/or pain, weakness, numbness, or tingling of the shoulder, arm, or hand on the affected side. ACDF is a surgical procedure used to take the pressure off affected nerves by removing the herniated or degenerated disc of the cervical spine. During this procedure, an incision is made in the front of the neck to remove the disc. Depending on the number of problematic discs, one or more discs may be removed. Once the disc(s) is removed, a cage filled with bone graft is inserted into the space to fuse the bones above and below. A small metal plate is usually placed to hold everything in position. For more info see: https://michaelwheelermd.com/anterior-cervical-discectomy-and-fusion-acdf/

Dr. Michael Wheeler explains lumbar disc herniations - https://youtu.be/pWmRakWDSa0

Dallas Orthopedic Spine Surgeon, Dr Michael Wheeler MD focuses on treating his patients with care.

11/18/2022

Michael R Wheeler MD
Orthopaedic Spine Surgeon

For more Information - https://michaelwheelermd.com/

11/16/2022

Typical Back & Neck Conditions

- Cervical Disc Herniation
- Cervical Myelopathy
- Cervical Radiculopathy
- Lumbar Spinal Stenosis
- Lumbar Disc Herniation
- Lumbar Spondylolisthesis
- Scoliosis
- Compression Fractures
- Neck or Back Pain

For more Information - https://michaelwheelermd.com/

11/14/2022

Patient Testimonials & Reviews

https://michaelwheelermd.com/

11/11/2022

Michael R Wheeler MD

Dallas Orthopaedic Spine Surgeon, Dr Michael R Wheeler, MD is a committed, compassionate surgeon who takes the care and time to educate his patients as to the best options available to them.

For more Information - https://michaelwheelermd.com/about/

11/09/2022

What Is Lumbar 360?

When it comes to spine fusion, there are different techniques and multiple ways to fuse the spine. The spine can be fused from the front, the back, or both. “Lumbar 360” is a term used to describe the circumferential fusion of the lumbar spine. The spine can be fused using different approaches, and each of them has their different indications, advantages and disadvantages.

For more Information - https://michaelwheelermd.com/lumbar-360/

11/07/2022

Neck or Back Pain

Although some causes of neck and back pain are structural, meaning there is an identifiable problem, many sources of neck or back pain do not have an easily identifiable cause. Overuse, muscle strain, poor posture, or other conditions can lead to severe pain in the neck or back. By using a combination of non-surgical techniques, both neck and back pain can be managed effectively.

For more Information - https://michaelwheelermd.com/posterior-cervical-fusion/

Dallas Orthopedic Spine Surgeon, Dr Michael Wheeler MD focuses on treating his patients with care.

11/04/2022

Compression Fractures

Compression fractures are a common cause of acute and chronic back pain. The most common type is an osteoporotic compression fracture, in which the weakened bone the collapses on itself. Compression fractures are commonly caused by ground level falls in the elderly. They are a sign of osteoporosis and warrant treatment with bone strengthening medications.

For more Information - https://michaelwheelermd.com/ #

11/02/2022

Scoliosis

Scoliosis is an abnormal curvature of the spine. Adult scoliosis has many causes and is a common cause of back pain. As the spine goes through natural wear and tear process, it sometimes does this asymmetrically, leading to abnormal curvature. This can lead to problems with posture, balance, and performing activities of daily living.

For more Information - https://michaelwheelermd.com/scoliosis/

10/31/2022

Lumbar Spondylolisthesis

Spondylolistheis (sliding spine) refers to spinal instability that occurs when one vertebrae develops extra motion compared to the vertebrae below it. The abnormal motion between the bones results in accelerated wear of the disc. The worn-out disc and resulting instability causes severe back pain. Additionally, the nerve caught between the sliding spine causes radiating pain through the hip and leg.

10/28/2022

Lumbar Disc Herniation

Lumbar disc herniation occurs when the inner contents of the disc of the lumbar spine ruptures outwards. When this occurs in the lower back, the ruptured disc material puts pressure on the nerves that are leaving the spine to the legs. This often presents as severe back pain, back spasm, with or without radiating pain down the leg. Patients may notice weakness, numbness, or tingling in the leg.

Dallas Orthopedic Spine Surgeon, Dr Michael Wheeler MD focuses on treating his patients with care.

10/26/2022

Lumbar Spinal Stenosis

Lumbar spinal stenosis is a degenerative condition in which the narrowed spinal canal puts external pressure on the nerves of the lumbar spine. A combination of degenerated discs, worn out facet joints, and thickened ligament contribute to the compression. Spinal stenosis typically presents as back pain and/or leg pain that is worse with physical activity (standing / walking) and improves with rest.

10/24/2022

Cervical Radiculopathy (Shoulder / Arm Pain)

Cervical radiculopathy refers to the discomfort caused by a pinched nerve in the neck. Both acute disc herniation and long-term wear and tear / disc collapse can cause cervical radiculopathy. Patients will often feel pain along the shoulder blade that may radiate down the arm(s). Other symptoms associated with cervical radiculopathy include weakness, numbness, or tingling on the affected side.

As an Orthopedic spine surgeon in Dallas, Dr Michael Wheeler has dedicated himself and his practice to helping those with issues related their spine, including specialist spine procedures, and medical conditions such as disc herniation, radiculopathy, myelopathy and more.

10/21/2022

Cervical Myelopathy

Cervical myelopathy is a condition caused by compression of the spinal cord in the neck. Patients often experience neck pain, numbness or weakness in their arms, and fine motor difficulty in their hands and fingers. Cervical myelopathy can also cause problems with balance, and when severe, problems with control of bowel or bladder function.

10/19/2022

[Cervical Disc Herniation]

👤 Patient presents with:
- Severe neck pain and left arm pain

🩻 Imaging:
- MRI demonstrates large disc herniation at C5-6 causing compression of the spinal cord and exiting nerve root on left side

👨🏼‍⚕️ Diagnosis:
- Large cervical disc herniation at C5-C6

💉 Link in bio to read about treatment options for cervical disc herniation

📖 Cervical disc herniation occurs when the inner contents of a disc in the neck ruptures outwards. The ruptured disc material puts pressure on the nerves that are exiting the spine. This often presents as severe neck pain, neck muscle spasm, and/or significant pain in the arm. Patients often notice weakness, numbness, or tingling on the side of the herniated disc.

10/19/2022

Cervical Disc Herniation

Cervical disc herniation occurs when the inner contents of a disc in the neck ruptures outwards. The ruptured disc material puts pressure on the nerves that are exiting the spine. This often presents as severe neck pain, neck muscle spasm, and/or significant pain in the arm. Patients often notice weakness, numbness, or tingling on the side of the herniated disc.

10/18/2022

What is a cage?

A cage is the device that is inserted into the empty disc space after all the disc has been removed during an or . The placement of the cage allows for restoration of disc height, improved stability, and spinal alignment. The cage serves as scaffolding for bone growth and ultimately, a spinal fusion.

Cages come in different materials, this one is a 3D printed titanium cage used in lateral fusion. You can appreciate the metal lattice work here that increases the surface area for bone growth. These cages, or wedges, are packed with bone graft prior to insertion between the vertebra to help with fusion.

10/17/2022

Office Work-Related Back Pain

Some tips that can help prevent back pain while working in an office include:

Invest in a standing desk
A standing desk helps keep your back in optimal alignment as you work. This desk keeps the computer at the same level as your eyes – avoiding look down and ultimately straining your neck and back. With a standing desk, you can place your forearms on top of the desk. This improves your posture and places less tension on your lower back.
Practice good posture
Daily exercise is important to promoting healthy posture. Yoga, stability cushions, strength training, and sitting on a yoga ball are all great ways to strengthen your core and develop healthy posture habits. Keep the computer screen at eye level and focus on keeping your shoulders down and back. Avoid rounding your upper back.
Set up the office chair correctly
If you cannot work while standing, setting up the office chair correctly can help maintain good posture. Make sure you sit close to the desk and keep your upper arms parallel to your hands and spine. Look for a chair with an armrest. If you are tall, you should raise your work surface. Also, as you sit, press the buttocks against the back of the chair. This prevents you from slouching and placing unnecessary stress on your lower back.
Stretch regularly
Sitting at a desk for long hours may cause tight muscles and strain on the lower back. Try to remember to move or stretch every hour or so. Taking breaks to refill your coffee, visit the restroom, or speak to your colleague in person rather than sending an email are a few practical ways to ‘take breaks’ while at work.
Wear comfortable shoes
Supportive shoes are critical to reducing strain on the lower back. High heels can change the center of gravity of your body, creating strain on the lower back. If you wear high heels to work, consider having a pair of shoes at your desk that you change into when not walking around or in meetings.
It can be tough to remember to take care of your back while at work. By implementing a few of the tips above, you can help prevent or improve lower back pain caused by long days in the office.

https://michaelwheelermd.com/office-back-pain/

10/17/2022

💥Happy World Day 2022

10/14/2022

Common back injuries related to sports:

3. Spondylolysis and Spondylolisthesis

Spondylolysis is a common condition in teenage athletes who take part in sports that perform frequent hyperextension of the lumbar spine. Such sports include football, pole-vaulting, and gymnastics. Weightlifters are also prone to the disorder because of exerting excessive stress on the lumbar spine. Spondylolysis will not always have noticeable symptoms, but chronic low back pain is usually the hallmark symptom. The pain can emanate from compressive (pressure on nerves) or structural (mechanical) pain. In the beginning, conservative treatment is recommended.

Spondylolisthesis (sliding spine) is a condition closely associated with spondylolysis, which occurs when the weakness caused by spondylolysis makes one vertebra slip forward on top of the one below it.

Spondylolisthesis does not always cause problems, often, patients are asymptomatic and it can be found incidentally. However, the slipped vertebra can sometimes press into the spinal canal, and stretch the nerve roots resulting in pain. The resulting neural pressure may cause low back, leg, and buttock pain, including numbness in the foot. Severe cases may require surgery.

For more information: https://michaelwheelermd.com/sports-related-back-injuries/

10/12/2022

Common back injuries related to sports:

2. Herniated Nucleus Pulposus

The nucleus pulposus is the soft, gelatinous material inside the body of the discs of our back. A herniated disc occurs when this jelly-like material herniates (ruptures) out the back of the disc. This occurs when the pressure to the annulus (disc’s outer fibers) is so high that it rips, leading to rupturing the nucleus out of its usual space. The herniated disc ruptures into space that nerves or the spinal cord lie, putting increased pressure on nerve roots or the spinal cord. This pressure on the nerves is what causes back pain and leg pain associated with a disc herniation.

Herniated discs are commonly seen in the lower spine as it supports more pressure compared to the cervical (upper) or thoracic (middle) parts of the spine. Lumbar disc herniation can cause ‘sciatica’, or pain and numbness down the leg and foot on the affected side. The symptoms caused by a herniated disc will be felt in a predictable pattern, determined by which level the disc herniated on.

90% of herniated discs will resolve on their own and do not require surgery. Treatment of a herniated disc usually starts with more conservative measures of rest, physical therapy, and oral anti-inflammatory medication. Sometimes targeted steroid injections are used to help provide relief of symptoms. If conservative measures fail to resolve symptoms, surgery may be indicated. In rare situations, the herniated disc can fill the entire spinal canal, which exerts massive pressure on the nerves. This may lead to paralysis of muscles in your legs and you may lose control of your bladder and bowels – however this is extremely uncommon.

10/10/2022

Back Injuries related to sports:

1. Musculoligamentous Strain
A common back strain that involves the lower spine’s soft tissue. Soft tissues of the spine are the blood vessels, tendons, ligaments, nerves, and muscles. Back strain is possibly the most prevalent sports injury. The injuries are diagnosed through exclusion, meaning the diagnosis is made once all other reasons for the pain are ruled out. Back strain injuries are typically self-limiting and will resolve on their own. They usually heal with time when combined with rest. Usually complete healing of the strain occurs without receiving specific treatment for the affected area. In general, treatment of lower back strain consists of rest and focuses on avoidance of future strains through a suitable warm-up, proper conditioning, and if needed, changes in the activity.

Recommended Reading
https://michaelwheelermd.com/sports-related-back-injuries/

10/07/2022

Sports Related Back Injuries

Around 80% of the population experience back pain at least once in their lifetime. However, some people are more predisposed to acute and chronic back pain due to injuries because of their lifestyle. Athletes have an increased risk of sustaining a lower (lumbar) spine injury due to the amount of time spent participating in strenuous activity. During sports such as tennis, golf, running, soccer, ice skating, football, basketball, and skiing, the spine endures a lot of stress. Turning, twisting, absorption of pressure, and bodily impact are all movements that can lead to lumbar injury and pain.

Repeated strenuous activities can strain your back and may cause injury even to the fittest and elite athletes. Although the entire spine is used when participating in sports, it is estimated that 1-% of all sports-related injuries involve the lower spine. Most of these cases are traceable to particular trauma or event, while others occur due to repetitive minor injuries resulting in micro-traumas.

Dallas Orthopedic Spine Surgeon, Dr Michael Wheeler MD focuses on treating his patients with care.

10/05/2022

Lateral Lumbar Interbody Fusion (LLIF)

Risks and complications associated with LLIF

In general, the risks associated with LLIF are rare. However, patients should be aware of all risks involved and will discuss the following prior to surgery with the surgeon:

1) Damage to Large Blood Vessels

Lateral lumbar interbody fusion is done near large blood vessels. There is a risk of damage to these vessels, leading to bleeding and blood clots. However, this complication is rare.

2) Damage to Abdominal Organs

The surgical path of lateral lumbar interbody fusion is close to the abdominal organs such as the bladder, kidneys, colon, and ureter. There is a small risk of damage to these organs.

3) Migration of the cage

In rare cases, the cage placed between the bones can move. This can lead to problems with healing and may require revision surgery. With modern technique, the risk of this is nearly eliminated.

4) Leg pain

Sometimes, the nerves can be irritated in the psoas muscle causing pain on the side of the incision. This pain is usually transient and often resolves in days to weeks.

More information at

Lateral Lumbar Interbody Fusion (LLIF) Introduction Lateral lumbar interbody fusion (LLIF) is a surgical procedure to relieve pain in the lower back and legs. The procedure involves fusing adjacent vertebrae in the lower back. This helps to stabilize the spine and relieves pressure off the nerves. T...

10/05/2022

Lateral Lumbar Interbody Fusion {LLIF}

is a procedure used to treat multiple content of the spine that cause back and leg pain.

LLIF is a procedure done through a small incision in the left flank that restores alignment + disc height ➡️ taking pressure off the nerves

👨🏼‍⚕️For more info: https://michaelwheelermd.com/lateral-interbody-fusion-llif/

10/03/2022

Lateral Lumbar Interbody Fusion (LLIF)

Procedure

LLIF accesses the spine from the side of the patient. The first portion of the surgery involves getting access to the front of the spine, which is accessed via an incision on the left flank.

As the surgeon approaches the spine, neuromonitoring technology is used to ensure none of the nerves are damaged during the surgery. Once the spine is able to visualized, the LLIF is completed using the following steps:

Step 1: Removal of the disc and cartilage

The disc between the affected levels is carefully removed in its entirety. The cartilage on the top and bottom of the vertebrae is scraped off, preparing the bones for optimal fusion.

Step 2: Trials of different sized spacers

Different sizes of spacers (cages) are placed into the disc space until the correct size is determined. An x-ray machine is used during this portion of the surgery to ensure the best fit of spacer for each individual patient.

Step 3: Placing the cage

Spacers can be made of different materials, but often are a 3D printed titanium cage. Prior to placement in the patient, the cage is filled with bone graft. The cage is then carefully placed in between the vertebrae. X-rays are taken to ensure satisfactory placement of the cage.

Step 4: Incision is closed

The incision on the patient’s flank is then closed with absorbable suture and a dressing is placed.


LLIF surgery typically takes two to three hours to complete. The patient will be given general anesthesia and asleep during the surgery. After the surgery is completed, the patient will be taken to a recovery room, where they will be closely monitored. Most patients stay in the hospital for one to two days after surgery. Almost always, this surgery is paired with a posterior instrumentation and fusion, which will be discussed separately.

For more information - https://michaelwheelermd.com/lateral-interbody-fusion-llif/