Our Team Spinal Disorders Treated at the About Us Comprehensive Spine Center MICHAEL C. GERLING, MD The Comprehensive Spine Center is a multi-specialty Assistant Professor, Orthopaedic Surgery We provide a full spectrum of spine care, from group of highly trained physicians and care providers, Director, Spine Service exclusively dedicated to the most modern treatment conservative measures and pain management to Board-Certified in Orthopaedic Surgery options for spinal disorders of the neck and back. EDUCATION: University of California, San Diego minimally invasive procedures and large scale RESIDENCY: Ochsner Clinic, New Orleans reconstruction of spinal deformity. Our patients receive comprehensive care for the FELLOWSHIP: Case Western Reserve University myriad conditions that cause neck or back pain, AREAS OF EXPERTISE: Minimally Invasive Surgery, Disk Degeneration, • Ankylosing Spondylitis including trauma, work-related injuries, spinal Cervical Spine Conditions deformity, radiculopathy, infection, tumors, and • Arthritis degenerative spine diseases such as osteoarthritis, osteoporosis and kyphosis. CARL B. PAULINO, MD • Cauda Equina Syndrome University Orthopaedic Associates Assistant Professor, Orthopaedic Surgery Cervical Radiculopathy As the only academic medical center in Brooklyn, Scoliosis Surgeon, Spine Service • ComprehensiveComprehensive SUNY Downstate Medical Center is on the cutting- Board-Eligible in Orthopaedic Surgery edge of research and technology. Our surgeons EDUCATION: Saint George's University • Compression Fractures RESIDENCY: SUNY Downstate Medical Center are the only ones in the borough employing the FELLOWSHIP: NYU Hospital for Joint Diseases • Degenerative Disc Disease (DDD) latest, minimally invasive surgical techniques. Smaller AREAS OF EXPERTISE: Fractures and Dislocations incisions, less blood loss, and faster recovery time Scoliosis, Spinal Deformity, Back Pain, • result in the best possible outcomes for our patients. Total Disc Replacement Herniated Disc • SPINESPINE We also understand the importance of commun- SANJEEV AGARWAL, MD • Low Back Pain/Instability ication. Consistent interplay among our various Assistant Professor, Physical Medicine & Rehabilitation services ensures continuity of care under one Director, Interventional Pain Management • Myelopathy healthcare umbrella. Board-Certified in Physiatry and Pain Medicine EDUCATION: King George Medical College • Sciatica We are dedicated to eliminating our patients' pain, RESIDENCY: Nassau University Medical Center CenterCenter improving their quality of life, and returning them Scoliosis FELLOWSHIPS: Case Western Reserve University; • to a fully functional lifestyle as quickly as possible. University of Cincinnati AREAS OF EXPERTISE: • Spinal Cord Injury Interventional Pain Management, Back Pain, Fluoroscopic Injections • Spinal Stenosis • Spondylolisthesis Practice Locations • Torticollis According to the American Academy University Hospital of Brooklyn • • Traumatic Disorders of the Spine 470 Clarkson Avenue, Lower Level, Brooklyn, NY 11203 of Orthopaedic Surgeons, 80% of 710 Parkside Avenue, Brooklyn, NY 11226 Americans will suffer a bout of back pain • Whiplash Long Island College Hospital in their lifetime. 97 Amity Street, Brooklyn, NY 11201 Most insurance plans are accepted, including Medicare, No Fault, Workers’ Compensation and Managed Care Plans. • Back pain is the most common cause of Park Slope job-related disability in America, according 33 Prospect Park West, Brooklyn, NY 11215 Call for an Appointment to the National Institutes of Health, and Bay Ridge costs about $50 billion a year in treatments. or Additional Information 9202 Fort Hamilton Parkway, Brooklyn, NY 11209 6900 4th Avenue, Brooklyn, NY 11209 (718) 270-2045 An Affiliate of SUNY Downstate Medical Center • Approximately 1 in every 50 people will Department of Orthopaedic Surgery & Rehabilitation Medicine Canarsie experience a herniated disk at some point 9413 Flatlands Avenue, Suite 102 East, Brooklyn, NY 11236 MAILING ADDRESS in their life. 450 Clarkson Avenue, Box 30, Brooklyn, NY 11203 (718) 270-2045 Rockaway 114-12 Beach Channel Drive, Suite 7, Rockaway Park, NY 11694 www.downstate.edu/orthopaedics Back and Neck Pain— Comprehensive Diagnosis Spine Surgery Advantages of You Don’t Have to Live With it Minimally Invasive Surgery We work closely with board-certified When non-surgical options have been unsuccessful, surgical musculoskeletal radiologists to provide treatment can decompress the nerves, stabilize the spine and Many people live with daily back or neck pain, perhaps Small incisions from a pinched nerve or auto accident.They often a comprehensive diagnosis. help to correct spinal deformities. • Small surgical scars assume—incorrectly—that their only choices are to If pain still persists after conservative Some spinal procedures can be done with minimally • suffer or undergo major surgery. treatments are exhausted, we will invasive techniques, such as microscopic diskectomies • Less blood loss However, at the Comprehensive Spine Center, we have order diagnostic tests, such as x-rays, and cervical decompressions. In other cases, large scale • Less trauma to the body many levels of treatment options available to alleviate CT scans, bone scans, MRI or nerve reconstruction of Less post-operative pain their discomfort. Whether a crushed disc or just chronic, studies. spinal deformity • nagging pain, we can treat all spine problems. may be necessary. • Lower infection rate Degenerative We are the only surgeons in Shorter hospitalization Brooklyn performing state-of-the-art Disorders Related to Aging spondylolisthesis, • minimally invasive spine surgery. spinal instability, Quicker recovery Most patients leave the hospital the The Baby Boomer generation is already experiencing age- • following day with merely a bandaid! related spinal problems such as spondylolisthesis, disc disease, sciatica or radiation sciatica, spinal stenosis, myelopathy and radiculopathy. Most into the arms are Nerve Root Compression… conditions respond to conservative treatment. When sur- common disorders Microscopic Surgical Decompression gery is deemed necessary, minimally invasive procedures Interventional Pain Management that respond very well to surgical generally result in a much quicker, easier and full recovery. "People with sports injuries—led by boomers— A very small percentage of patients actually require surgery. are now the No. 2 group coming into the doctor's intervention. Many people find relief from pain through non-surgical office, behind those complaining of a cold." — U.S. News & World Report For patients who The majority of spinal disorders can be interventional procedures. have had previous treated without surgery. Our specialists in Interventional Pain Management use surgery and still experience difficulty, we are considered fluoroscopic-guided injections for non-surgical treatment the leading experts in Brooklyn. Our team consists of of back and neck pain. In addition to its obvious therapeutic orthopaedists, physiatrists, neurosurgeons, anesthesiologists, benefit, an injection can also play a very important diagnostic physician assistants, nurses and physical therapists. Traditional approaches require A minimally invasive technique large incisions resulting in muscle achieves a similar goal while Early Intervention is Advisable role in the identification of the source of pain for patients damage. That delays recovery minimizing tissue injury and who have had back pain unresponsive to treatment. and can ultimately lead to collateral damage. decreased strength in the back. After a complete medical history and physical examination, Epidural or facet joint injections can be extremely effective we generally begin with conservative treatment, such as in relieving chronic pain, sometimes permanently, and various types of nerve blocks may be used to avoid surgery. Spinal Minimally Invasive... Ms. Miller had spondylolisthesis…tremendous pain, bone anti-inflammatory medications, muscle relaxants, nerve crunching on bone, pressure smashing down on the nerve roots. stabilizers or prescription pain patches. cord stimulation may also be an option in select cases. Maximally Effective “The pain was going on for eight or nine years. I was very Team of Physical Therapy Spine Specialists depressed. I’m a single mother and I always worked. I was Just as open knee surgery was rendered archaic by the Physical therapy is often very effective and may include NEVER out of a job. Now I couldn’t work, I had no income and advent of arthroscopy, spine surgery has recently taken a this was DEVASTATING. I couldn't stand long enough to take a modalities such as heat, cold, massage, ultrasound, electrical similar leap. When surgery is warranted, the procedures of shower. When I was walking I had to stop every three or four stimulation, traction Scoliosis in Adults and Children today barely resemble those of the past. Only 10 years ago, minutes to take a break.” or acupuncture, and if you had back surgery, you could expect to spend up to a a specialized exer- She had been seen by at least four doctors.They sent her for Scoliosis, an abnormal curvature week in the hospital and a year of recovery before returning everything except, apparently, an MRI and an evaluation for cise program. We to normal activities, not to mention a very large scar. have both inpatient of the spine, most often manifests spinal surgery. "People warned me against doing back surgery." and outpatient itself in children