The Spine Center offers a comprehensive, integrated plan of care for each patient, taking into account his or her unique needs and health situation. We rely on a multidisciplinary team approach, ensuring that each patient receives the level of care that is consistent with his or her diagnosis.
A comprehensive physical therapy program is a crucial component to any pre-operative, post-operative, and interventional approach to pain associated with the spine. In our outpatient Physical Therapy Spine Center, we offer a multi-dimensional approach to reduce pain, restore function, and improve quality of life. Our physical therapists are certified in many approaches to treatment, including Feldenkrais, McKenzie, Pilates, Yoga, and other various manual therapy techniques. Many of our therapists are also certified by the American Physical Therapy Association as advanced specialist within this scope of practice. Beyond exercise and hands-on treatment, our Spine Center emphasizes the cognitive aspect of educating our patients in order to empower them to care for themselves with the goal of optimizing surgical and non-surgical treatment.
- Minimally invasive spinal surgery
- Computer navigation for spine surgery
- Artificial disc implantation
- Spinal instrumentation for complex spinal problems
- Motion preservation without spinal fusion
- Interspinous spacer technology for spinal decompression
- Vertebral augmentation using vertebroplasty/kyphoplasty
- Treatment of sports injuries of the spine
Spinal Tumor Program (Spinal Oncology)
As new, more powerful, and targeted treatments become available, more and more people are living with cancer. Our goal is to provide patients with the full range of cancer management strategies, so that they can continue to live as normally and actively as possible. In cases where cancer cannot be cured, palliative treatments (or symptom relief) can improve a patient's quality of life by increasing or restoring mobility, relieving pain, numbness and other symptoms, and allowing the return to normal daily activities.
Our multidisciplinary spine cancer team is dedicated to exploring all options with patients and their family members, providing the most advanced treatments possible based on each patient's unique needs and desires. Find out more about our Spinal Tumor Program.
Physiatry, also known as physical medicine and rehabilitation, includes services related to the treatment of patients with musculoskeletal disorders, pain syndromes, and sports injuries. At the Spine Center, physiatrists work closely with patients whose spine problems do not require surgery and direct the treatment of patients who have had surgery. The physiatry team educates patients about their treatment options, helps them identify the causes of their pain, and directs interventional pain procedures and other approaches to manage pain, including spinal injections and other minimally invasive procedures. The team emphasizes a continued dialogue between surgeons and non-surgical healthcare providers to help patients achieve the best outcome possible.
Physical therapists at the Spine Center (led by Tracy Maltz, DPT, OCS, Cert MDT) communicate closely with Spine Center physicians to treat patients with neck and back pain throughout their entire course of care. A comprehensive physical therapy program is a crucial component to any pre-operative, post-operative, and interventional approach to pain associated with the spine. In our outpatient Physical Therapy Spine Center, we offer a multi-dimensional approach to reduce pain, restore function, and improve quality of life. Our physical therapists are certified in many approaches to treatment, including Feldenkrais, McKenzie, Pilates, Yoga, and other various manual therapy techniques. Many of our therapists are also certified by the American Physical Therapy Association as advanced specialist within this scope of practice. Beyond exercise and hands-on treatment, our Spine Center emphasizes the cognitive aspect of educating our patients in order to empower them to care for themselves with the goal of optimizing surgical and non-surgical treatment.
Patients may complain of both chronic and acute back pain. The Spine Center team includes specially trained physicians from the Department of Anesthesiology who evaluate and manage complex spine-related pain stemming from disorders such as spinal stenosis, herniated discs, and failed back surgeries. We offer nonsurgical and/or minimally invasive interventional treatments to relieve pain, such as:
- Spinal injections, including selective and translaminar epidural steroid injections and diagnostic facet injections
- Sympathetic neurolysis (temporary and permanent), a way to destroy nerve cells causing pain which is used for complex regional pain syndromes following spinal surgeries; examples include chemical neurolysis, radiofrequency neurolysis, and cryoneurolysis
- Comprehensive pain management for cancer patients who suffer from compressed vertebral fractures and bone metastasis
- Minimally invasive procedures such as nucleoplasty for herniated discs
- Neuroaugmentation techniques, such as spinal cord stimulators and peripheral nerve stimulators
- Implantable drug delivery systems, such as the intrathecal morphine pump (a way of delivering morphine directly into the spine)
Find out more about our Back and Neck Pain Program.
Members of the Spine Center team work closely with physicians and other staff of the Department of Neurology and Neuroscience to diagnose and manage disorders of the spine. Weill Cornell neurologists have a distinguished history of providing comprehensive care to children and adults suffering from neurologic disorders, and are sought both locally and nationally for their expertise and experience.
We recognize that the most important step in your care is an accurate diagnosis of the cause of your pain. In addition to traditional imaging methods such as x-rays, CT scanning, and MRI scanning, the Spine Center conducts specialized diagnostic procedures to visualize spinal problems, such as provocative and dynamic discography to examine intervertebral discs. We also utilize the institution's superb diagnostic facilities, which include a dedicated clinical neurophysiology laboratory that conducts routine and investigational diagnostic testing.
Center for Complementary and Integrative Medicine
Many patients with pain in the neck or back have other issues contributing to their discomfort, some of which may be helped through means other than those offered by conventional medicine. With the objective of preventing and treating chronic disease and promoting health and healing, the Weill Cornell Center for Complementary and Integrative Medicine focuses on the use of mind-body approaches to healing and disease prevention. Patients at the Spine Center have the services of this program at their disposal.
Intraoperative Neurophysiological Monitoring (IONM)
The American Academy of Neurology has recognized electrophysiological monitoring of the nervous system and peripheral system (IONM) as an effective and essential element for preventing complications and identifying neural structures during complex surgical procedures. IONM has been proven to reduce the incidence of surgically induced neurological deficits by over 50% and greatly improves surgical outcomes.
The Brain and Spine Center at New York Hospital/Weill Cornell Medical College works in close collaboration with the Laboratory of Clinical Neurophysiology, directed by Dr. Douglas Labar, which provides state-of-the art Elite Cascade system, a leading-edge IOM system by Cadwell. IONM studies are performed by board-certified technologists (CNIM) and interpreted by board-certified neurologists.
Intraoperative neurophysiological monitoring (IONM): Multimodality neurophysiological monitoring is extremely valuable in the prevention of neurological injury during spine procedures. A thorough familiarity with the spectrum of modalities available for neuromonitoring including SSEPs, TcMEPs, EMG, tEMG, and Pedicle Screw Stimulation provides a highly sensitive and specific diagnostic array for preventing neurological deficits tailored to a particular spinal level.
- SSEP: Somatosensory Evoked Potentials monitor the integrity of the sensory pathways in the dorsal columns of the spinal cord.
- TcMEP: Transcranial Motor-Evoked Potentials monitor the motor pathways in the lateral and anterior corticospinal tracts of the spinal cord.
- EMG (electromyography): Spontaneous EMG is used to detect incipient nerve damage in spine surgery (spinal nerve roots).
- Trigger EMG: Using an electrical stimulus delivered through a hand-held probe used by the surgeon, trigger EMG is also used to identify and test nervous structures.
Pedicle Screw Stimulation: evoked EMG obtained by stimulating a screw placed in part of a vertebra called the pedicle. Since a nerve root lies immediately beneath each pedicle, a response obtained at too low a stimulus intensity level indicates a breach in the pedicle. Used to avoid nerve root damage caused by such a breach.
Because spinal disorders are often associated with other disruptions in the body, Spine Center staff collaborate with other specialists at Weill Cornell Medical College to help each patient most effectively. We consult with:
- the Division of Endocrinology, which manages hormonal diseases and disorders
- Dr. Robert Allan, Ph.D., a clinical psychologist with practice specialties in cardiac psychology, stress, and anger management. For information, call the Spine Center at 1-888-WC-BACKS (1-888-922-2257).
- members of the Department of Medicine
- pain management specialists in the Department of Anesthesiology