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Minimally Invasive Lumbar Spine Surgery

Whether you've injured your back playing football, or your spine is pressing on a nerve, the spine program at Palmdale Regional can help people who need minimally-invasive, same-day outpatient surgery, as well as those who may need more complex procedures that require inpatient rehabilitation.

In this segment, Dr Quang D. Ma discusses minimally invasive lumbar spine surgery and how a dedicated team of surgeons, nurses and skilled therapists at Palmdale Regional treat patients by using the latest advanced technology.
Minimally Invasive Lumbar Spine Surgery
Featured Speaker:
Quang D, Ma, DO
Quang D. Ma, DO is a neurosurgeon and a member of the medical staff at Palmdale Regional Medical Center. He received his medical degree from Western University College of Osteopathic Medicine of the Pacific and has been in practice between 6-10 years. He is one of 6 doctors at Antelope Valley Hospital who specialize in Neurological Surgery.

Melanie Cole (Host): Whether you've injured your back-playing football, or your spine is pressing on a nerve, the spine program at Palmdale Regional can help people who need minimally invasive, same day outpatient surgery, as well as those who may need more complex procedures that require inpatient rehabilitation. My guest today is Dr. Quang Ma, he's a neurosurgeon and a member of the medical staff at Palmdale Regional Medical Center. Welcome to the show, Dr. Ma.  So, let's talk about some conditions for the lumbar spine where a person might need to see a neurosurgeon to start some first line of defense, what are some of the most common causes of low back pain?

Dr. Quang Ma (Guest): Hi Melanie. Thanks for having me. Well, first the good news is most patients with back pain generally will not need surgery. So, what comes to mind in terms of needing to see a surgeon sooner than later are what we considered red flags, and these red flags are persistent pain that has failed non-surgical management or over-the-counter medications or pain medication or if they develop other symptoms, such as numbness, tingling and bowel and bladder difficulty or weakness. Those signs or red flags should prompt them to see their primary care physician or go to the emergency room or to see a neurosurgeon earlier than later.

Melanie: And, Dr. Ma, what are some of the first lines of defense  that you would try with someone if they have low back pain? Do they ice or heat? Do they brace? Do they try NSAIDS or an epidural injection? What would you tell them that you would try first?

Dr. Ma: Right. So, the burden of back pain on patients and on physicians is pretty overwhelming, majority of Americans will have some type of back pain regardless of age actually. And, like I said before, most of them will not require surgery, but the good news is these generally get better with time, with some rest, ice, heat, cold, some anti-inflammatory medication. And I would say, there's no harm to trying any of these really, and if the symptoms persist or the pain persists then the patient should really be seen by their primary care physician and an MRI should be ordered, to make sure that there is not a surgical condition, period.

Melanie: So, if there is, and there are certainly many reasons that you would consider surgery, speak about some of the minimally invasive procedures that you perform at Palmdale, and what listeners can expect from those.

Dr. Ma: Right. So, the major appeal of having a minimally invasive lumbar spine surgery is that it is a smaller incision. The patients generally have shorter hospital stays, even the same day, their re-cooperative time is much shorter, there's less blood loss, there's less operative time, and they can go back to work basically early or go back to their daily activity a little bit sooner than having a standard of open surgery.

Melanie: So, Dr. Ma, when we think about all the different procedures motion preservation, pain management, these are things top of mind for patients, what type of patients do you consider for minimally invasive procedures and who might not be a candidate?

Dr. Ma: That's a great question, and whether you're a candidate for minimally invasive spine surgeon really is how much surgery are you going to need? Is it just a simple micro-discectomy which I really try to do in a minimally invasive approach? Because this is an ideal candidate for minimally invasive surgery. Motion preserving is a bigger question to answer, motion preserving kind of implies that you want to avoid a fusion, and fusions, though they're done frequently, they're not done all the time, and you have to be a candidate for a fusion surgery. We can do fusion surgery minimally invasive too, if the patients are right candidate, if they have the right disease and the right problem.

Melanie: What do you tell people about what they can expect if it's an outpatient surgery? Then, what are they looking at as far as rehabilitation or going home and what kind of activities, they can resume?

Dr. Ma: Right. So, in terms of minimally invasive lumbar spine surgery as an outpatient, the one that I'm generally doing are patients with minimal disease, patients that have some one-to-two levels of narrowing or stenosis is what we call it. Narrowing or patients with a large death or hernia death that would require a smaller surgery or patients with relatively minor medical co-morbidities, and those are the ideal patients that we can do with a minimally invasive approach, that would be going home later that day. And in terms of what they can expect, obviously they'll expect before, even though the incisions rather small, still have major surgery, but they're up, moving around, walking, ambulatory as much as they can tolerate, immediately after surgery.

Melanie: What about recurring symptoms, Dr. Ma, if somebody does have a minimally invasive procedure done, and then they come back to you in a year and say, “You know what I still have the same symptoms," and I know there's such a thing as revision surgery, but what do you tell them about the possibility of some of these kinds of things either recurring or maybe it's the first set above or below or something in those lines.

Dr. Ma: Well that's a huge question to answer in one or two sentences, but in terms of patients not getting better after surgery, if you do the right surgery, and you select the right patients, those patients chattily do better for some period of time, if not hopefully forever, but in terms of the patients who have an initial period of feeling good, and then they come back with similar symptoms then the concern that the surgeon should always ask himself or herself is whether that disease came back, at the same level, which is possible, such as a recurrent disc or the patients are starting to break down, like what you mentioned at the above and below level, which is possible particularly after multi-level or multiple levels of surgery, multiple levels of fusion at the lumbar spine.

Melanie: So, what would you like to tell people about hopefully keeping a strong back, and preventing the need to even see you in the first place, but what do you tell people, as your best advice for really taking care of their lumbar spine?

Dr. Ma: In terms of the general back health, you want to avoid the lifting with your back, you want to use your knees in squatting position, you want to use your legs, avoid prolonged sitting. We know that sitting at work, sitting in cars for long periods of time is not good for your back. You want to sleep in the right position with the right support for your back, pillows as needed to maintain a good lumbar curve or what we call lordosis. And the other thing is weight, if you're carrying a lot of weight in front of your spine, which is indicating abdominal kind of obesity, then those are the things that are going to predispose you to having advanced degeneration of your back, and sometimes that ultimately requires back surgery.

Melanie: And why should they come to Palmdale Regional Medical Center for their care? Tell us about your team.

Dr. Ma: My partner and I, Dr. Parsa approach back surgery and back health, as well as spine surgery, with a complete approach of both non-surgical management, minimalize these approaches, and tackling complex, just spine disorders at Palmdale Regional, and we have a dedicated team both in the hospital, and in the clinic as well as the recovery floor in our joint spine pavilion.

Melanie: Thank you so much, Dr. Ma, for being with us today. You're listening to Palmdale Regional Radio with Palmdale Regional Medical Center. For more information please visit,, that's, Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians, individual results may vary. There are risks associated with any surgical procedure. Speak with your physician about these risks, to find out if minimally invasive surgery is right for you. This is Melanie Cole, thanks so much for listening.