Spine Surgeries

Are you having back pain? Are you considering surgery? looking for a second opinion?

Dr. Vaksha is one of our surgeons, and he has clinical fellowship training in Spine, Sports and Arthroscopic surgery, and over 15 years of experience with Spine and Sports Surgery.

Watch him talk about the spine in this video, and then give us a call…

 

We have your back!

Many of us have gone through back pain and realize how disruptive it can be. We have watch friends and relatives struggle with back problems sometimes for years. For those of us who have never had back pain we should be grateful.

Back pain is a result of a number of things going wrong with our body. The muscles controlling the multiple joints of the spine and pelvis become either too weak to control movement of the joints or too tight to allow normal excursions of joints that are designed to move.

This results in the loads going through the spine increasing to the point where ligaments get inflamed, discs herniate, spurs develop and nerves get impinged upon. What can you do about it?

First cut back your activity. Back pain means you are asking your back to do something it can’t. So spend less time upright and weight bearing. Try to cut back to a level where your back doesn’t hurt.

Now that you have found an activity that your back can handle, the next step is to increase the back’s capability so it can handle more. You do this with an appropriate exercise program involving strengthening and endurance.

The strengthening should focus on the muscles of the back and abdomen They should be done in a supine position. The endurance exercises should be done semi or non-weight bearing either on a bicycle or in a pool.

Sitting tends to worsen back problems. Try a towel roll in the small of your back. Get up every 10 minute and stretch your back. Consider a kneeling chair.

Remember. Pain means your back can’t do what you’re asking it to do.

If you try to take pain medication and keep doing what you are doing, then your pain is going to get worse. The remedy for your pain then becomes more prolonged and involved.

Back pain means you can’t do it. Back off.

Start an exercise program. Pain medication doesn’t cure your back, so don’t act like it does.

This is Dr. Vaksha, a spine surgeon here in our office

ANATOMY OF THE SPINE

Spine is a complex structure which is made of multiple bones called vertebrae along with their associated ligaments, capsules, muscles, and nerve structures.  It extends from the base of the skull to the pelvis.  Spine is essentially made up of 33 vertebrae.  The lower four vertebrae are joined together to form the coccyx or the tailbone.

X-ray of the lumbar spine in the lateral view

X-ray of the lumbar spine in the lateral view

The five vertebrae above the tailbone are joined together to form the sacrum.  Rest of the other vertebrae are mobile units.  The spine is divided essentially into 3 parts.  The neck or the cervical spine, the mid back or the thoracic spine, and the lower back or the lumbosacral spine.

The cervical spine is made up of upper seven vertebrae. It allows movement of head. The thoracic spine is made up of twelve vertebrae and hinges the ribs in the front to make the chest.  The lumbosacral spine is made up of five lumbar, five sacral, and four coccyx vertebrae and it helps in distributing the weight of the upper body to the pelvis and the lower limbs.

ANATOMY OF THE SPINE VERTEBRAE

Vertebra is the basic unit of the spine.  Each vertebra is made up of two parts, the front solid portion called the body, which is strong and stable and stacked over each other to provide stability to the spine.  The back portion of the vertebrae is made of a V shaped flat bone called the lamina and is joined to the body by two pedicles.

The lamina forms the arch over the back of the body make a canal through which the spinal cord and nerve roots pass and are protected.  There are vertebral foramina below each pedicle through which the nerve root from the specific level passes out of the spinal canal to supply the structures in their respective areas.

The portion of the junction of the lamina with the pedicle is called pars interarticularis.  This may be involved or fractured in some patients (especially young patients) causing instability of the spine.  There are articular processes above and below from the back of lamina called facets which articulate with the facets above and below on each side to form the facet joints.  The two vertebral bodies articulate with each other also through an intervening intervertebral disk.

INTERVERTEBRAL DISC

Intervertebral Disc is present in between bodies of vertebrae above and below. It helps providing stability as well as mobility to the spine.  It also acts as shock absorber preventing injury to the vertebral body.  A disk is made up of outer fibrous rings called annulus fibrosus and the inner jelly called the nucleus pulposus.

The disk can be damaged due to injury or wear and tear or aging.  This may lead to herniation of the nucleus through the annulus fibrosus causing herniated disk.  This herniated disk may cause compression over the spinal cord or nerve roots, which may lead to radicular pain down the leg or the arm called radiculopathy.  Degeneration of the disk itself may cause back pain.

FUNCTION OF SPINE

The spine functions to keep our body erect and straight as well as protect all the nerves in the form of spinal cord and the nerve roots that come from the brain within the spina canal and are distributed all over the body.

The mobile segments of the spine in the cervical, thoracic and lumbar spine are essentially made of three joints in between each vertebra which allow movement at well as stability.

The spine is wrapped around with muscles especially on the back and on its sides.  The major vessels of the body run along the front of the spine in the thoracic and lumbar spine while the food and wind pipe runs in front of cervical spine with other many complex and vital structures around the spine.

SPINE DISEASES

Due the complexity of itself and its surrounding structures, spine is prone to many type of diseases.  The diseases that usually affect the spine are either of the following types:

  • Congenital or developmental – These types of conditions are usually present at birth or develop in the early developing years of life.  Development of scoliosis either at birth or during adolescence is an example of this type of problem.
  • Traumatic spine injury – These injuries happen either due to motor vehicle accident or falls or other such accidents.  The patients may suffer a fracture or a dislocation or a combination of the two.  Such patients need to be treated accordingly under supervision of a spine surgeon.
  • Neoplastic – It means the patient has neoplastic lesion or tumor involving the spine.  These lesions may be either malignant or benign and usually need a diagnostic workup to rule out or confirm the diagnosis before a treatment can be planned and carried out.
  • Infective – It means that the spine is involved in an infection.  Infection of spine is an uncommon phenomenon but may happen especially in patients who are immunocompromised like patients of HIV or AIDS or patients who are on chemo or radiotherapy or on immunosuppressive medications. It is also common in IV drug users.
  • Metabolic and Inflammatory diseases of the spine – These usually include osteoporosis or osteomalacia which means weakening of the bone structure.  This usually happens due to ageing but may also happen due to medications or diseases. Most common inflammatory disease of Spine is Rheumatoid arthritis which usually involve the cervical spine or the neck.
  • Degenerative – This is the most common cause of diseases of the spine, usually involves the cervical or the lumbar spine.  It essentially involves ageing process but can be accelerated due to injuries or over use of the spine or bad posture for a long time.  Most of the patients usually present with pain in the affected area, either the neck or the lower back in most instances.

PRESENTATION OF THE PATIENT WITH SPINE PROBLEM (SYMPTOMS)

Most common presentation of a patient with spine problem is pain localized to the neck or back. The pain may be in the midline along with in paramedian location. It may be associated with muscle spasms.

The pain is usually aggravated with activity and relieved with rest.  Occasionally, the patient may have radiating pain down the extremity with or without tingling, numbness, weakness of the muscles, involvement of bowel or bladder or gait. Bowel and bladder may be in the form of retention or incontinence.

The patient may also have sexual dysfunction rarely. Rarely in cases of thoracic spine disease there may be radiating pain or tingling and numbness along the chest or abdomen.

RED FLAGS

  • The patients who have back or neck pain with any of these following conditions should seek medical attention as soon as possible.
  • Cancer, neoplasia or malignancy.
  • Unexplained weight loss of more than 10 pounds in the last 6 months.
  • Immunocompromised comorbidities like on chemo or radiotherapy or having disease like HIV or AIDs or being on prolonged corticosteroid therapy.
  • IV drug users.
  • Urinary tract infection.
  • Fever of more than 100 degrees centigrade.
  • Significant trauma from a fall or accident.
  • Bowel or bladder involvement in the form of incontinence or retention.
  • Weakness in the major joint of arm or leg.

SPINE HEALTH

Our spine is S-shaped and curved which curves to the front in the neck and lower back while curving towards the back in the thoracic spine. A healthy spine with a good posture and strong musculature is the key to prevention of spine problems.  There are multiple lifestyle changes that can be done to prevent developing spine problems as well as prevent deterioration of preexisting diseases.

Regular exercises which also include core strengthening exercises which help  strengthen muscles in the front and the back of the spine are helpful in prevention of spine disease. These exercises can be performed at home or in the gym with or without the help of a physical trainer. Yoga is one of the many good exercise routines that can help stretch and strengthen all muscles of back apart from the muscles of the extremities.

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5.0
Based on 107 reviews
Dr. Nakul Karkare is awesome! And patriotic! Thank you, Dr. Karkare for displaying the American Flag in your waiting room, honoring and mourning our military personnel, this Memorial Day, who died while serving in the United States Armed Forces.
Dave
00:52 30 May 23
Excellent and skilled orthopedic practice specializing in joint replacements. Dr Karkare was trained at the Hospital for Special Surgery and has excellent results, as do his associates!! Would gladly refer family members to the practice!!
Eclectic54
00:24 30 May 23
I had such a wonderful experience with Complete Orthopedics in Stony Brook. Not only did Dr. Kuo fix my broken wrist with such kindness and care, but the office staff, including Billing, Reception and the X-Ray Technician, was always so helpful, going out of their way to ensure that each patient felt welcome, answering any questions with a smile, and ensuring any issues with insurance/billing were handled with the utmost professionalism. I highly recommend their practice!
Victoria DeMatteo
19:49 10 May 23
I'm very happy St. Catherine's sent me to this office for treatment after I broke my collar bone! Unfortunately the break was too severe to repair on its own and I had to have it rebuilt a week after the injury. Dr. Vaksha did a great job fixing it. I'm three months out, and I have full use of the arm and shoulder. The whole office staff is very professional, accommodating, and welcoming. I hope to not need orthopedic services again, but Dr. Vaksha will be my number one choice if I or anyone in family suffers such am injury.
Tina Rivera
20:42 08 May 23
No one likes going to the doctor. But these people make it painless. I go for knees, hips and shoulders. At almost 70 Complete Orthopedics keeps my active life style running smoothly. Whether chasing my Grandson and even surfing again, I highly recommend them!!
Thomas Slavin
15:02 02 Mar 23
Dr. Kuo knowledgeable and competent surgeon- very good experience and more importantly great result.
Joseph McCoy
21:23 25 Feb 23
Dr Vaksha was so kind and helpful. He took extra time with us and explained things so thoroughly. Highly recommend. Office very clean.
Susan Bosinius
20:20 19 Feb 23
Dr Vaksha, is a great doctor very professional knows what he talking about. Treat patient with upmost respect. Thank You
Troy Spencer
16:46 19 Jan 23
Dr. Karkare is an amazing doctor, very caring and attentive, the girl at the front desk is very kind and helpful. .elizabeth .thank you so much .
blanca ventura
21:32 26 Oct 22
Been going to this place before my accident and after I had my knee surgery. So happy how I been treated and how well I am getting. Thank you all and specially Dr. VAKSHA for everything and getting back on track.
Ita Opico
19:01 25 Oct 22
Love this place From the minute I called I was treated kindly. When I arrived The Dr saw me right away he was compassionate and ordered the appropriate tests for me. I came back in for my follow up and had the same great experience.
Christine Rostock
21:28 23 May 22
Dr Vaksha and Dr karkare are 2 of the best orthopedic doctors around my wife Susan had a very serious broken ankle in March of 2019 she didn't think she was going to walk again Dr vaksha did an excellent surgery on her ankle he said it was his toughest he ever did he put a lot of hardware in her ankle and told her she would be alright she made remarkable recovery thanks to his surgery as of now she regained 100 percent use of her ankle she would highly recommend him to anyone. My own experience with Dr karkare has been wonderful he takes his time with you listens to what you have to say and prescribes various treatments and is very caring I would highly recommend him to anyone I would give both doctors a 10 plus rating we are very happy with them the best.
Harry Jones
23:31 19 May 22
Complete orthopedics is a wonderful place to go when you hurt or injured a great staff and wonderful doctors very knowledgeable and helpful I would recommend this place to all of my family and friends that is in me of orthopedic care I give them 10 thumbs up
Wayne Pemberton
17:39 18 May 22
The staff is very professional and helpful. Dr. Vaksha is excellent. He takes time to listen and offer suggestions to help you get better. I’m very thankful and happy to be a patient here at Complete Orthopedics.
Phoenix Rising
19:54 16 May 22
Dr.Karkare is the best. He listens to everything and explains everything I recommend him to everyone. I am so happy he is my doctor.
Myrna James
00:48 13 May 22
Dr.Kuo is amazing very attentive,caring,and passionate and staff is awsome too.Thank you for everything Dr.kuo.
Erick Murillo
23:17 12 May 22
I was in a car accident November 1 I was referred to Dr. Vaksha For shoulder surgery . I he was amazing he made me feel very comfortable and explained everything that was going to happen from surgery all the way through my physical therapy highly recommend Dr. Vaksha
Yolanda Ojeda
19:37 09 May 22
My appointment with Dr. Vaksha was amazing. Dr. Vaksha was very thorough and kind. I would refer this office to anyone who needs a great orthopedic doctor.
John Senechal
19:54 05 May 22
Scheduling my appointment was quick and easy. The staff was super friendly and down to earth. I was seen on time. The appropriate test, “x-rays” were taken before the conversation with doctor, something I really liked, test for analysis and conversation was done upfront. Dr. V had a great personality and was no BS, straight forward diagnosis and a play on next steps. I am happy I found them and would refer them to friends and family.
Sam
00:46 03 May 22
I have seen Dr. Kuo two times already and he's awesome along with his staff. Very friendly office and I'm glad to be a patient here.
Camaris A
20:01 28 Apr 22
Amazing team!! Very caring, profesional, and friendly!! Dr. Kevin Kuo, you are the best, very passionate, caring, and helping thank you for getting me better and being so kind to me! Elizabeth you the best thank you for you help always and you big smile and positive actitud❤️🙏🏼
breidy valerio
19:01 22 Apr 22
The staff is truly exceptional, they make you feel comfortable and welcomed. The doctors are amazing,always professional, compassionate and great listeners.
Elizabeth Collado
03:25 09 Apr 22
What a great place! The place is clean and organized.The staff is wonderful. Setting up physical therapy is right there as well.I'm so glad I found this place.
Donna Anne
22:45 05 Apr 22
This was my 1st time breaking something in my 27 years on this planet. I was recommended here by a friend Dr. Vashka helped me from day 1 and still continues to check in on me and my healing ankle. Would highly recommend
tyron davis
16:06 01 Apr 22
Brand new office, same great doctors! Rooms are clean, plenty of parking, physical therapy attached, Dr. Karkare and his staff are awesome. Thank you!
Emily B
02:49 24 Mar 22
Dr.VAksha is the best, I love the way he treats me as his patient, he is caring,understanding and very attentive to my needs
Mirna Caballero
14:53 03 Mar 22
Great staff. Dr. Vaksha is awesome and takes the time to listen to his patients. He is very compassionate. I would highly recommend this office.
Bebe Doyle
01:24 23 Feb 22
After suffering from a severe ankle injury Dr. V was able to help me heal and return back to work completely to a job where I stand for 12 hours a day. The office is very clean and I appreciated the reminders of my appointments via phone call and through text. The patient portal made it easy for me to access all my documents including work notes. The office staff is wonderful and Rebecca was able to schedule me with a busy schedule and awesome at answering all of my questions including referring me to a great physical therapy office. I highly recommend this office to anyone who’s looking for knowledgeable and kind orthopedic office.
Elizabeth Birchwell
21:31 28 Jan 21
The staff here are great, I was seen at the time of my appointment and was well taken care of!
Shaun Berry
18:14 07 Jan 21
They are an excellent practice. The front and back office people are amazing and so helpful. Rebecca is such a kind and understanding person. I had an issue with paperwork and she cleared it right up. Dr. Karkare is very knowledgeable, helpful, and caring.
Matt S.
19:31 18 Nov 20
Rebecca K. - What a true burst of sunshine. Very friendly and definitely an asset to the practice!
Laura Aston
18:17 17 Nov 20
Great experience, the Doctor is nice but the staff is incredible. I worked with Linda, who was profession and assisted me beyond what any person has done at other practices. Complete Ortho should be complimented for having such a person on their staff.I highly recommend this place!!!
Joe Allen
17:26 17 Nov 20
Linda and Becca they are so good ever time I come they are very nice I would tell everyone I no to come to this office..
Barbara Victor
16:45 17 Nov 20
I was rear ended in an auto accident , Dr Vashka was recommended by a friend of mine .I was experiencing Back , neck , and shoulder pain . After a thorough examination and given exercises to do at home , I am feeling much better , and I ended up avoiding surgery . The staff at Complete Ortho is extremely attentive and show great care when making an appointment and are very friendly and i never waited more than 5 minutes for my appointment . So I would strongly recommend Complete Orthopedics for any aches and pains that one might be experiencing.....
Bill Becht
04:44 17 Nov 20
It was the afternoon of Friday Sept. 24. We were in Pt. Jefferson and my wife, Mary Ann, broke her hip. We went to Mather Hospital and it was determined that she would have to have an operation to have it repaired. This would be her third time under the knife in the past year. It just so happened that we were very fortunate enough to have Dr. Karkare, who was on standby, perform the surgery. He put in a rod and two screws in her hip. She spent a few days in the hospital and then went to Gurwin rehabilitee for another few weeks.It has now been almost six weeks and we both worked the election the other day. If it wasn’t for Dr. Karkare’s expertise she never would have been able to work. She is able to walk with a walker and is doing physical therapy three times a week.We can not thank the doctor enough for the compassion and dedication that he puts into his work. It allows Mary Ann do the things that she likes to do, even on a limited basis for a while. I know that with her will, perseverance and the great work that the surgeon performed she will be back on her feet in no time.Sincerely:John V. PlumpEast Northport, NY 11731
Jack Harris
14:36 06 Nov 20
In the year of 2018 I was referred to Dr. Karkare because I was experiencing severe knee joint pain. After exhausting physical therapy and trying to labor through the pain, I had to make a quality of life decision. Total knee replacement was the only viable option. Dr. Karkare made my decision easy as he walked me through the whole process from surgery to recovery.On 12/13/19 ( Friday the 13th) I enter Lenox Hill Hospital in great hands. From the time I entered Dr. Karkare’s office for the first time until now, his staff has been amazing. Andrea the medical coordinator walked me through all the paper work and necessary preparations for the surgery. Courtesy and kind would be an understatement. Dr. Karkare went over and beyond from the wellness checks and phone calls all to assure me that I was important to him. This was the right decision no pain and no limp. Complete Orthopedics should be your choice!
Kenneth Randolph
22:18 25 Sep 20
Dr. Vadshka has a great bedside manner. He really takes his time and explains treatment options.
T Lee
12:33 09 Sep 20
I suffered with pain in both knees for years. My orthopedic doctor kept recommending knee replacement . I fought it for years, as I was just afraid. When I had no choice and could barely walk , it was recommended I see Dr. Karkare. We set up a consultation and my wife and I left his office feeling totally confident and comfortable with moving ahead with the surgery. He explained everything to us, and the office staff set everything up for us and made the process easy. So about one month after our initial meeting I had the first knee done. I was up walking mere hours after the surgery, and on the workout machines the next morning. I went home two days after the surgery, and yes walked my daughter down the aisle at her wedding only one week after the surgery without even a cane! Three months later I had the other knee done and went home the very next day. Dr. Karkare put my fears to rest . I would highly recommend him. His expertise gave me my life back. Thank you Dr. Karkare.SincerelyVito Congro
Ethel Congo
23:58 12 Aug 20
Dr Rhodin really cares for his patients. When I see him he makes sure to review my progress in detail.
Micki Cahill
15:03 08 Feb 20
My mom had a total hip replacement by dr karkare. He is the BEST orthopedic doctor.Her incision is almost invisable.She is going back for her other hip next week. The office staff is the best, love Andrea.You wont find a better doctor.
Ryan Brigandi
21:06 13 Jul 18
There is no better Orthopedic doctor you will find. Broke my ankle three places on a Saturday. Called Dr. Karkare. He had is team ready at the hospital and operated on me within 6 hours after my injury. Now After 3 months of great care by him and his staff, I am walking to normalcy.
Spacecom Tel
04:13 23 Mar 18
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I am Vedant Vaksha, Fellowship trained Spine, Sports and Arthroscopic Surgeon at Complete Orthopedics. I take care of patients with ailments of the neck, back, shoulder, knee, elbow and ankle. I personally approve this content and have written most of it myself.

Please take a look at my profile page and don't hesitate to come in and talk.