For the past decade Dr. Nelson Astur, a board certified spine surgeon has been practicing in Sao Paulo. He received his medical degree from the University of Sao Paulo School of Medicine, completed his orthopaedic residency followed by a Spine Surgery fellowship at Santa Casa de Sao Paulo. He spent years 2011-12 at Campbell Clinic, University of Tennesse, Memphis, as a Pediatric Spine Fellow and became Medical Instructor. Specialized in Minimally Invasive Spine Surgery at Semmes-Murphey Neurologic & Spine Institute in 2012. Continued his pediatric spine education at Boston Children’s Hospital, Harvard Medical School in 2014. He has been published in several issues of Journal of Bone and Joint Surgery, The Spine Journal, Journal of the American Academy of Orthopaedic Surgeons, Journal of Pediatric Orthopaedics and many others highly impact medical journals.
Dr. Astur currently practices at his private clinic at two adequate locations in the city of Sao Paulo, Brazil; works as an Associate Physician of the Spine Group of Santa Casa de Sao Paulo School of Medical Sciences, Department of Orthopaedics and Traumatology; and, develops spine research and education as council member of AOSpine Brazil.
Spinal surgery is a sub-specialty of orthopedic surgery that involves the diagnosis and treatment of a range of conditions related to the back and neck. Dr. Astur always exhausts all conservative non-surgical options and treatments, if appropriate, before he recommends surgery of the spine. Spine surgery, including back or cervical surgery, is appropriate for only a small percentage of individuals with back or neck problems after conservative treatment has failed. In most cases, spinal surgery is performed to relieve relentless pain from pinched nerves or loss of function due to spinal cord compression or mechanical instability of the spine. Spinal deformities such as adolescent scoliosis needs specialized medical follow-up to prevent complications and, when necessary, provide timely surgical treatment.
Minimally invasive spinal surgery does not apply to any one particular type of surgery. The goal is to achieve the same effect as with traditional surgery, but to do so through small incisions. This also involves less trauma to muscles. Surgery is sometimes done through small tubes. There are minimally invasive techniques for several spinal surgeries, including discectomy and fusion. However, this method cannot be applied to all patients. Often, a minimally invasive method of placing screws and rods is combined with a traditional fusion.
Recovery from minimally invasive spinal surgery varies greatly among patients and is dependent on the exact type of spinal surgery as well as the age and health of the individual. Return to work also varies greatly among patients and is related to overall health and the type of work you do.
Endoscopic spine surgery encompasses the use of a specialized minimally invasive instrument, which contains a high definition optic camera and light system and a working portal, which permits the use of other specialized instruments. The camera allows for direct visualization of the neurologic structures. Instruments such as pituitaries, dissecting tools, and radiofrequency allow the endoscopic surgeon to decompress and free spinal nervers.
Disc herniations, foraminal or spinal stenosis are ideally suited for endoscopic techniques. Patients with lumbar, thoracic and cervical disc herniations are candidates for endoscopic spine surgery.
Conditions such as scoliosis, spine fractures, and severe multi-leves spinal stenosis are not ideal candidates for endoscopic spine surgery
Endoscopic spine surgery has several advantages as compared to traditional spinal surgery. The surgery is often performed as an outpatient using local and intravenous sedation anesthesia. The incision is less than 1 cm in length. Patients can return to work usually with 5-14 days post operatively. If the endoscopic surgery does not alleviate the primary symptom, other more invasive procedures can be performed at a later time.
Several spinal problems can be seen at or shortly after birth – or sometimes even before birth using a prenatal ultrasound. Others, such as idiopathic scoliosis, will usually develop as the child grows, most often during the child’s adolescent growth spurt. Congenital scoliosis is present at birth, but may not be apparent until later. Consult your pediatrician or a pediatric spine specialist if your family has a history of spinal problems, or if your child is:
Spinal conditions such as scoliosis (curving of the spine), kyphosis (increasing roundback of the spine), spondylolysis (stress fracture of the spine), and spondylolisthesis (movement of one part of the spine on another part) may affect children during their early or late childhood years. The majority of spinal disorders do not require bracing or surgery although regular checkups are needed to ensure that the condition does not worsen.
Risk factors for developing spinal problems vary from condition to condition. Common risk factors and predispositions for some spinal conditions can include:
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