Whether you’ve suffered a recent trauma or have an ongoing condition, back pain can take you off your feet for an extended period of time. But a local orthopaedic surgeon provides treatment for a variety of spinal issues to get you back to life – and quickly.

“Spine surgery is typically recommended only when a period of nonsurgical treatment, such as medications and physical therapy, haven’t relieved the painful symptoms caused by the back problem,” Dr. James Manzanares of American Spine & Orthopaedics Institute says. “In addition, surgery is only considered if your doctor can pinpoint the exact source of your pain, such as a herniated disc or spinal stenosis.”

When you’re in need of a spine care professional, Dr. Manzanares has your back.

An Expert in the Field
At American Spine & Orthopaedic Institute, Dr. Manzanares utilizes conventional as well as minimally invasive techniques to correct issues causing pain, loss of function or deformity. The practice incorporates three primary areas of expertise: minimally invasive spinal surgery, advanced spine reconstruction and sports-related injury.

“I work to optimize pain relief for my patients in the least invasive way possible so they can get back to enjoying life,” he says.

For some patients, a minimally invasive procedure may be a better surgical option than a traditional or “open” spinal surgery. Instead of removing muscle attachments from bones, the technique spreads and pushes muscles out of the way, making the recovery process much easier. Treatments for disc replacement, rotator cuff repair, shoulder and knee arthroscopy and trauma-related injuries are common at American Spine & Orthopaedic Institute.

One patient credits Dr. Manzanares with providing a second chance at life, noting that he takes his time with his patients and makes them feel like a priority. “I never felt that there was an appointment before or after me. He and his staff are always prompt, professional and courteous. He and his PA make you feel like a human being and that’s why I have recommended him to many people since my surgery.”

Looking Out for Your Spine
Dedicated to providing only the best care for each and every patient, Dr. Manzanares stays on the forefront of technology. He is committed to studying the latest surgical techniques that will optimize his patients’ outcomes while decreasing the potential for complications and improving their recovery time. Most recently he discovered a way to surgically treat adult degenerative scoliosis with a combination of minimally invasive techniques that aim to correct the spinal curvature while decreasing intraoperative time, blood loss, length of hospital stay and recovery time.

“I have required three spinal surgeries within the past year, and I can say without any reservations that Dr. Manzanares is by far the best surgeon I have ever had,” one patient says. “His bedside manner and professionalism are unparalleled. He exhibits a care and concern for his patients, which I feel is so often lacking today in the medical field. I can honestly say, that not only would I recommend him, but if I were to ever need another orthopedist, he without any question would be the one.”

Excellence in Spinal Care
Dr. Manzanares and the staff at American Spine & Orthopaedic Institute are committed to helping patients – both adults and children – address pain and loss of function due to spinal issues. With two conveniently located Orlando offices, the goal is to maximize results so patients can get back to their lives.

If you’re living with back pain, call Dr. Manzanares today to see what he can do for you.

American Spine & Orthopaedic Institute
3724 Winter Garden Vineland Road, Building 2
Winter Garden, FL 34787

7824 Lake Underhill Road, Suite D
Orlando, FL 23833

877.977.7463
FLSpinalSurgeon.com

Benefits of Minimally Invasive Spine Surgery

On average, patients have a faster recovery and return to normal activity and work faster with this surgical technique. These are some of the other benefits:

-Smaller incision and scar
-Decreased blood loss
-Less post-operative pain, narcotic use and soft tissue damage
-Shorter length of stay in the hospital

Meet the Doctor

James Manzanares, MD, FACOOS, is board certified in orthopedic surgery with a special interest in minimally invasive spine surgery techniques and their applications to adult and pediatric spine problems. He earned his doctorate and completed his orthopedic surgery residency at the Mayo Clinic in Rochester, Minnesota. He has also completed dual fellowships, one in pediatric orthopedics at the Nemours Children’s Clinic and another in advanced spine reconstruction at the Johns Hopkins School of Medicine.

Dr. Manzanares practices at American Spine & Orthopaedic Institute and is affiliated with Florida Hospital East Orlando. He diagnoses and treats a wide range of conditions, including scoliosis, pinched nerves, herniated discs, and back, spine and neck pain. A well-known surgeon across Florida, he was named as a 2016 Top Doctor in Altamonte Springs. This award selects and honors healthcare practitioners who have demonstrated clinical excellence while delivering the highest standards of patient care.

Additionally, Dr. Manzanares is a proud veteran who has been deployed to Iraq, Egypt and Germany. He earned the combat patch of the 1st Infantry Division for performance of duties under hostile fire during Operation Iraqi Freedom. Outside of his practice, he enjoys spending time with his wife and three sons, reading and going to the movies.

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Dr. James Manzanares is a very experienced surgeon, having been in practice for more than two decades. His career in medicine began in 1995, when he graduated from the Mayo Medical School in Rochester, Minnesota. He remained at Mayo to complete a residency, and later completed a fellowship at the Nemours Children’s Hospital in Orlando.

More Information
https://www.prbuzz.com/health-a-fitness/383336-expert-orthopedic-and-spine-surgeon-james-manzanares-md-faoos-abos-certified-to-be-recognized-as-a-2016-top-doctor-in-altamonte-springs-florida.html

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Degenerative rotator cuff tears are very common. Many small degenerative rotator cuff tears will not require surgery. After 40, many people will have a rotator cuff tear and not even know it. You may wish to review our first Expert Series post where we covered the cause of rotator cuff tears.

Remember:

The rotator cuff is the most likely source of pain after 30
Most rotator cuff issues, including tears are due to degeneration or attrition
Most patients with small degenerative rotator cuff tears can be treated without surgery.
Surgery for degenerative rotator cuff tears is generally considered after failure of a non-surgical regimen of physical therapy, possible injections and oral medications.

As accomplished shoulder surgeons, when do we consider surgery for a small degenerative rotator cuff tear?

Our Expert Series continues today with an answer to your question:

Do I Need Rotator Cuff Surgery ?
Derek Ochiai, MD: Website, Twitter

Surgery is an option for degenerative rotator cuff tears that fail to respond adequately to non-surgical treatment, such as physical therapy and cortisone injections. Also, the rotator cuff tear is inhibiting the patient’s quality of life.

Scott Slattery, MD: Website, Twitter

There are many options for the treatment of a small degenerative rotator cuff tear. I give all patients with small degenerative tears the option to treat them non-surgically with anti-inflammatory medications as well as physical therapy to improve flexibility, strength, muscle balance and coordination. This can work quite well. If the patient has good function and minimal pain, surgery is not absolutely required. If the tear is degenerative, chronic and large with associated muscle atrophy, initial non-surgical treatment with oral medications, injections and physical therapy is almost always the best option.

Marty Leland, MD: Website, Twitter, Facebook

When I first see a patient over 40 with shoulder pain, my first treatment is anti-inflammatories, physical therapy, and frequently a subacromial steroid injection. I will then see the patients back 6-8 weeks later. If they are much better, there is no need for any further treatment. If they aren’t much better, I get an MRI to evaluate their rotator cuff. I usually do not order an MRI the first time I see them because, even if they do have a small rotator cuff tear, I would like to see if non-operative treatment would help them. If it does, GREAT! They may have avoided a surgery. I only order MRIs if they aren’t getting better. However, if I have a patient with a long history of shoulder pain and weakness and they are very weak on examination, I sometimes do order an MRI after the first office visit.

Jeffery Berg, MD: Website, Twitter

Degenerative rotator cuff tears are extremely common. Often these tears can be asymptomatic and incidentally diagnosed. So the first component of my “treatment” for these tears is to determine if they are symptomatic or not. If not felt to be symptomatic, I direct my treatment towards the suspected source of the patient’s symptoms and I advise observation of the tear. The observation primarily consists of clinical evaluations (history and exam) yearly if they remain asymptomatic or sooner if symptoms worsen, since these tears can progress and that progression usually is associated with an increase in symptoms. Depending on the office evaluation, I might also suggest serial ultrasounds or MRIs to evaluate for progression.

If these tears are felt to be symptomatic, I typically will start with nonoperative treatment. I find this to be the most reasonable treatment as degenerative tears often respond favorably to “conservative care” and although the symptoms can often respond well to surgery, they often don’t fully heal following the surgery. My nonoperative treatment consists of oral anti-inflammatories to treat the frequently associated bursitis as well as the pain that often brings the patient to the office. I will almost always include physical therapy as there usually is associated shoulder dysfunction and finally I suggest avoiding aggravating activities. Typically, I try this for 4-6 weeks, looking for any improvement. If improvement is seen, I will suggest continued nonoperative treatment until symptoms resolve or stabilize at an unacceptable level. If the latter, I will recommend an arthroscopic repair. If there is some retraction (lateral to mid humeral head) seen on the MRI, and depending on some specific patient characteristics (ie. young health, high activity level, etc.), I may suggest surgery on initial diagnosis, as I am concerned that if there is any further retraction, the tear may become unrepairable.

How we as physicians manage certain injuries may not always seem logical to patients. Many will not understand why we do not MRI every painful joint and many do not understand why we do not need to operate on everything that is “torn”. It is our obligation to educate you.

Our last post … When Should We MRI Your Shoulder will help you understand that we can make a reasonably good diagnosis and establish a treatment plan that should work without expensive, time consuming imaging. In addition, many of our parts wear out. Like your favorite pair of jeans … Not all rotator cuff tears need to be fixed. The American Academy of Orthopedic Surgeons produced a document to assist surgeons in evidence based management of rotator cuff tears. In this document, they find limited evidence to support surgery for degenerative rotator cuff tears without a trial of non-surgical management. That said, some rotator cuff tears might continue to hurt after non-surgical treatments … and you might be offered surgery as an option to improve your pain and thus your quality of life.

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AxiaLIF® means Axial Lumbar Interbody Fusion. It is an alternative to traditional open and minimally invasive low back surgery performed to treat degenerative disc disease (DDD), spinal stenosis, or low grade spondylolisthesis at L5-S1.

In some patients, these disorders may lead to spinal instability and pain. The procedure involves implanting the AxiaLIF device (a short threaded rod) after the center of the disc is removed from between the last lumbar vertebra and the sacrum (L5-S1).

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Disc problems can start from over-use, an accident, or just the wear and tear of daily life. Degenerative changes in the discs may result in damage that can cause pain.
When a disc degenerates it can have tears or cracks that lose water, which cause it to become thinner and provide less padding to absorb movement.
Degenerated discs can also bulge (herniate) and pinch the spinal cord or nerves, which causes loss of feeling, weakness, pain, or tingling down the arms and hands.

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Spinal decompression is a type of surgery to relieve symptoms caused by pressure on the spinal cord and/or the nerves branching off from it. Pressure (compression) on the nerves or spinal cord can be the result of several factors including:

Bulging or herniated discs
Bony growths
Loosened ligaments.

Symptoms of spinal nerve compression in the low back include:

Pain in the low back, as well as in the buttocks and down the leg
Numbness or tingling in the buttocks, leg and foot
Weakness

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• Come with you to doctor appointments.
• Stay with you in the hospital.
• Ask questions of healthcare professionals.
• Review consent forms for treatment.
• Remember healthcare instructions for you.
• Know what to look for and who to call should your condition get worse.
• Speak up for you if you cannot.
• Know your wishes regarding resuscitation and life support.

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