Dr. Marc S. Cohen, MD

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United States
Delray Beach, FL
Dr. Marc S. Cohen, MD

Interventional pain clinic

11/04/2022

Completed a Minuteman procedure (Direct lateral interbody fusion aka DLIF) today! This is a minimally invasive way to achieve the same effect that more invasive procedures aim to do. This patient had excellent relief from an L4/5 transforaminal epidural however after two attempts the effect did not last long. It was noted on MRI that the patient had significant central canal stenosis as this level as well as foraminal stenosis due to grade 1 listhesis. Given patient’s age she was not a good candidate for a typical fusion due to surgical risk factors. The placement of this device clearly corrects the listhesis causing her pain at l4/5 if you look at before and after, and even though she also has slippage at L5/S1 this was not a clinically significant pain generator as proven by diagnostic epidural. The device is also seeded with factors to promote bone growth and eventually, the bone in this area will fuse together. This is an excellent minimally invasive alternative to traditional fusion for people who may not be good candidates due to surgical risk or just don’t want a large procedure performed.

07/01/2022

Very challenging case. This patient had low back pain for years. Finally diagnosed with Sacroiliac dysfunction & sacroillitis. Responded well to SI joint injections but only lasted for 3-4 weeks. We also proceeded with SI radiofrequency ablation with less than ideal results. At this point we decided to proceed with a minimally invasive SI fusion procedure. The patient was considering a full SI joint fusion with a surgeon, however this has much more morbidity given this patient’s medical problems. This procedure took 30 minutes, the patient did very well. The first picture shows a pin used to access the joint, followed by a working port that inserts into the joint. The final two images show the dark radio density which represents the bone dowel that we placed into the joint in order to fuse it with the addition of a growth factor. Consider this before doing a full surgery!

04/05/2022

MILD (minimally invasive lumbar decompression) is a procedure used to treat spinal stenosis. Spinal stenosis means that the space where the spine travels is too tight and can cause serious pain. There are many causes for this issue, of which one of the more common causes is ligamentum flavum hypertrophy which is present in about 80% of cases of spinal stenosis often presenting with other causes of spinal stenosis at the same time. It occurs in degenerative disease where one of the connecting structures in the spinal canal thickens to the point the space can be too tight. One way to fix this is to do a full lumbar decompression which is a significant surgical procedure. The other way is with MILD. The picture above shows a blue line, above this is contrast injected into the epidural space. You can see how the black tapers off i.e. a very tight space. Second picture shows the working port that allows me to place a device that removes a small amount of bone and tissue opening up the space. This case represents one of the most difficult MILD procedures I have ever done in a patient who would have otherwise needed surgery.

$This patient had a traumatic fall and landed on her back suffering a compression fracture of her L1 vertebra. People who...$

03/24/2022

This patient had a traumatic fall and landed on her back suffering a compression fracture of her L1 vertebra. People who have this condition typically have poor bone density as in the case of osteoporosis. This type of fracture occurs when the vertebra collapses on itself which can cause nerve compression, and severe chronic pain. It is the same injury that is associated with height loss in older age patients. This particular patient was deemed non-operable by a surgical team. After careful review of the MRI we thought she would be a challenging case but a doable case. This was a unipedicular approach meaning we were able to use only one needle as opposed to two for the classic approach. The first picture shows us lifting the fracture with a high pressure balloon using roughly 250 psi and the other two pictures show the vertebra stabilized after injection of cement. The patient came off the table feeling significantly better. Kyphoplasties help give immediate relief to some of our most challenging patients!

08/06/2020

Thank you to for featuring me on your weekly podcast! Search for 'Absolutely Danielle' to hear our approach to treating pain on her most recent addition! Making the NJ Housewives healthy and pain free!

07/08/2020

Interesting graphic originally posted by the Texas Medical Association COVID19 task force. It's a great time for New York where we've enjoyed a relative peaceful phase as we've passed the peak but we should still exercise caution. Unfortunately, I think this statistic has lead to a false sense of security around the rest of the country. Many places e.g. Florida and LA think the worst has passed when really these areas and most of the country have not yet reached critical mass. This is not the time to let your guard down. Hopefully this graphic can allow you to assess your risk as we continue to grapple with

04/22/2020

A little snippet from CBS12 about my work on the front lines! Thanks for doing such a great job!

04/08/2020

On the front lines with one my closest friends. Stay safe everyone. Chag sameach!

03/31/2020

This is an update to give you the latest news of changes to our practice related to COVID19.

1) We are currently seeing urgent cases and have modified our hours to half days.

2) We have closed down our Joralemon and Manhattan offices temporarily, we are still seeing patients in our Midwood/Flatbush office on Newkirk Ave Brooklyn, Queens, and New Jersey.

3) We recommend only coming in if you are healthy, with no pre-existing medical issues, and are under the age of 60 years. Only in severe cases do we recommend coming in if any of the aforementioned criteria apply to you.

4) Appointments can be done by Telemedicine, we are working with the ZOOM app to do our cases over video to minimize risk.

Please call one of my coordinators at 718-759-6100 or email me directly marcscohenpainmd@gmail.com

Please stay safe, exercise social distancing, and isolate, we all have a responsibility to keep each other safe.

Dr. Cohen

03/30/2020

In such a challenging time, it's nice to hear support for the healthcare workers putting themselves in harms way to take care of this nightmare. May you and your families all be safe. 🙏🙏🙏 My practice has slowed its hours down in light of the COVID pandemic in the city, but we're still seeing urgent cases in low risk groups and Telemedicine. In my free time, if an opportunity presents itself, I may contribute my anesthesia skills to the front lines, however what I am really hoping for is that we return to our normal lives and have some fun this spring!

Address

5258 Linton Boulevard
Delray Beach, FL
33484

Telephone

+19549431133

Website

https://www.ipwcbroward.com/

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