Frequently Asked Questions
We know that there are many places posting lots of the same information online, which is why we have created an FAQ system. Browse or search our FAQs and you should find the answer to your question.
Q. Are there any side effects after epidural injections?
A. The side effects associated with epidural injection are usually caused by a cortisone injection. These include headaches, water retention with weight gain, foot and hand swelling, upset stomach, elevation of blood sugars, [...]
Q. Can a failed lumbar spine fusion be fixed?
A. Possibly. You need to have current plain x-rays (weight bearing with flexion and extension views), a CT scan (thin slice, high resolution with multiplanar reconstructions), and an MRI scan (with and without contrast) of [...]
Q. Can an MRI change from worse to better for a degenerative disc protrusion by doing nothing?
A. 85 percent of herniated discs resolve, go away, or improve by themselves naturally over time, although disc degeneration does not go away. The MRI is what we use to "see" these conditions.
Q. Can I talk to someone who has had Stem Cell Injections?
A. Upon request we will provide phone numbers of several of our patients who have had a variety of conditions treated with stem cell injections.
Q. Can laser surgery remove boney stenosis?
A. The holmium laser which is used in spine surgery cannot cut bone. The power required to do so will cause a flash fire in the surgical area and can cause serious complications to the surrounding tissue and nerve structures. [...]
Q. Can power plate treatment help a degenerative spine condition?
A. Vibration - the technique used with power plate treatment - is a known stimulus to help bone and soft tissue form and heal faster. However, it is also recognized that vibration can accelerate the degeneration of an [...]
Q. Do I need imaging studies for a correct diagnosis?
A. Imaging studies are helpful to rule out other potential serious problems. Most often, a team approach needs to be employed to optimize the care and recovery of the patient.
Q. Do I need surgery for spinal stenosis?
A. Most cases of spinal stenosis can be managed without surgery, but a recent study showed surgery offered the best short and long term results in alleviating pain and returning patients to an active lifestyle including many [...]
Q. Do I need surgery for spondylolisthesis?
A. Non-surgical treatment of spondylolisthesis is usually effective although surgery may occasionally be required if conservative care fails.
Q. Do I need treatment for a curvature of the spine?
A. Scoliosis deformities are common and generally do not require treatment except in severe cases. There are at least four different types of scoliosis depending on one's age of onset and the underlying cause.
Q. Do I need treatment for Myelopathy?
A. Myelopathy is a serious condition that needs to be treated aggressively or significant and permanent neurological damage can occur.
Q. Do most insurance companies cover disk replacement surgery?
A. Unfortunately, most insurance companies do no cover disk replacement surgery at this point.
Q. Does all degenerative disc disease require treatment?
A. Spinal discs start to break down due to wear and tear over every person's life span, but some may never show signs or symptoms of degenerative disc disease and may never require treatment. However, if you feel pain in your [...]
Q. Does Biscup Spine accept Medicare?
A. Dr. Biscup does not accept Medicare payments and is not a Medicare provider. However, he does see Medicare-age patients and offers his services and care on a fee-for-service basis, provided they sign a contract agreeing to [...]
Q. Does Biscup Spine accept private insurance?
A. Patients with private insurance (non-Medicare) are requested to pay for services up front, then Biscup Spine staff members will help each patient submit insurance claim forms to their carriers for out-of-network benefits [...]
Q. Does facet arthritis lead to disc problems?
A. Typically when degenerative conditions that affect the facet joint are present, the intervertebral disc is usually affected as well. Facet arthritis and disc problems are typically seen together, although there is [...]
Q. How common is surgery for facet arthritis?
A. Surgery for isolated facet disease is common, but does not always produce a consistent and predictable result. Facet and spinal segment fusion surgery can treat facet arthritis and generally produced godo results, [...]
Q. How do I know if I have a herniated disc?
A. The predominant symptom of a herniated disc is usually a "pinched nerve pain" in the upper or lower extremities that can be severe and disabling. Severe back pain may also be present, as well as numbness, weakness, balance [...]
Q. How do I know if I have a pulled muscle?
A. A pulled muscle can be a slight tear of the muscle, an incomplete or partial tear, or a complete rupture. These injuries usually involve a large area of the muscle and can be quite painful.
Q. How do I know if I have a trigger point injury?
A. A localized and well defined bump (usually palpated) is a sign of a trigger point injury. This is generally very painful and very mobile. When massaged, a grinding feeling and sound is often associated with a trigger point [...]
Q. How do I treat a bulging disc?
A. Bulging discs - also known as compressed discs or degenerative discs - occur when the disc collapses. This is part of the normal aging process and generally does not cause pain. However, if pain is present, special testing [...]
Q. How does a physical therapist know what therapy will help you?
A. Physical therapists are given directions by the referring physician but are often asked to evaluate and treat patients as they feel is best. The frequency and duration of treatments are based on the severity of the problem [...]
Q. How does acupuncture work?
A. Acupuncture therapy places small needles in certain anatomical locations in the body. Acupuncture is an ancient oriental medicine technique used to treat a variety of painful conditions. A great deal of skill and [...]
Q. How does an epidural work?
A. Typically, a mixture of numbing medicine, cortisone, and sometimes pain medication such as morphine is injected into the epidural space where the spinal nerves and spinal cord is located. This is to treat the symptoms of [...]
Q. How does massage and massotherapy help?
A. Massage and massotherapy help identify sore or injured muscles or muscle groups. These techniques help break spasms in the muscle by passively stretching the muscle, and help the patient relax.
Q. How does stretching help ease pain?
A. If an injury to a muscle occurs or if the muscle has not been used vigorously for some time, it has the tendency to shorten or cramp into its shortened form. If left in this position, it will become painful and swollen, [...]
Q. How does the X-Stop procedure alleviate pain from spinal stenosis?
A. The technique works by spreading apart the two spinous process bones in the back side of the spine and placing a spacer between them to keep them apart. This allows the collapsed disc space and spinal canal can be [...]
Q. How does traction work?
A. Traction stretches the back muscles to relieve chronic spasm, as well as pulls degenerative intervertebral discs apart to reverse the effects of gravity. Recently, various computerized machines and treatment programs have [...]
Q. How effective is a percutaneous spinal fusion?
A. Percutaneous fusion is effective, but technically demanding and is best performed for single level fusion operations. In addition, the screws and rods are referred to as "high profile," which means they are prominent in [...]
Q. How is black disc disease diagnosed?
A. There is a special view on the MRI called a T2 weighted image where a degenerative disc shows up as a dark or black structure. A normal disc appears as white indicating high water content.
Q. How is facet arthritis diagnosed?
A. A facet block injection can help diagnose and isolate the exact cause of back or neck pain, caused by facet arthritis and other conditions. This involves injecting a local anesthetic and sometime a cortisone preparation [...]
Q. How is spinal stenosis diagnosed?
A. Performing quality imaging studies is important in accurately evaluating the spinal anatomy. An effective combination includes weight bearing x-rays with flexion and extension views of the spine and a view of the bony [...]
Q. How long does it take for stem cell/PRP treatments to work?
A. Stem cells take 3-6 weeks to activate once injected into the problem area of the body. They then continue to heal and regenerate for up to a year and beyond. Healing is a very individual process. It can be affected by [...]
Q. How long should I use conservative treatment methods before exploring more invasive options?
A. Generally, if the pain worsens or does not improve within three months of pursuing conservative treatment methods and the patient's quality of life is affected, other imaging and/or more invasive measures should be pursued.
Q. How many stem cell treatments can a person have?
A. There is no known or documented limit to the number of stem cell or PRP treatments a patient can have.
Q. How many surgeries are performed annually and how many of those fail?
A. It is estimated that approximately 450,000 or more spine operations are performed annually. Recently-developed innovative surgical procedures offer excellent results and allow most patients in all age groups be pain free [...]
Q. How often can I have a cortisone injection?
A. Most pain management physicians will limit this type of treatment to three injections a year due to potential problems and complications associated with too much cortisone use.
Q. How soon can I drive and return to work after spine surgery?
A. Returning to activities such as driving or work depends on the type of spine surgery performed. For most minimally invasive procedures, patients will be driving within a week and can return to sedentary work at that time, [...]
Q. How successful is facet arthritis surgery?
A. Surgery for isolated facet disease is common, but does not produce a consistent and predictable result. This largely depends on the underlying condition being treated. Surgery in the form of facet and spinal segment fusion [...]
Q. I have a morphine pump to treat my degenerative disc disease, is there any surgery you could recommend?
A. In our opinion, a morphine pump is not a good way to treat degenerative disc disease. If the scans are OK, the best surgery is to take out the morphine pump!
Q. If I don’t treat a herniated disc could it lead to more serious conditions?
A. A herniated disc can lead to more serious conditions. If the herniated disc is in the lower back, it can cause pain and numbness in the buttock and down the leg, which is called sciatica, the most common herniated disc [...]
Q. If I have a complication that requires additional treatment, do I have to pay for it?
A. If the problem is related to the original condition and the surgery to correct it was performed by Dr. Biscup, there is no additional charge. This is true if Dr. Biscup has to do one or several procedures to treat the [...]
Q. If I have spondylolisthesis do I need surgery?
A. Non-surgical treatment is usually effective for spondylolisthesis, but surgery may occasionally be required if conservative care fails. Surgical options include a minimally invasive primary repair of the bone defect if the [...]
Q. If I live outside of Fort Lauderdale, FL, how can I come to you for a consultation or surgery?
A. More and more, people are traveling for their health care seeking the best doctors and facilities available in the world. A large percent of the patients at Biscup Spine Institute come from all locations nationally and [...]
Q. If my first surgery failed can I have a second surgery to correct it?
A. After a failed surgery, further treatment options are varied and complicated. Most spine surgeons will not take on these difficult cases because the normal anatomy has been altered, post-operative scar tissue can be [...]
Q. Is it more difficult to treat a sprain/strain in the back?
A. When the muscles and associated structures in our back and neck are injured, the symptoms can vary from a mild discomfort to very severe and crippling pain depending on the nature and degree of the injury. If we injure a [...]
Q. Is minimally invasive surgery available?
A. An alternative minimally invasive micro decompression laminaplasty procedure for the surgical management of Type III degenerative spondylolisthesis can be performed, avoiding the need for more aggressive decompression and [...]
Q. Is spinal instability the same as spondylolisthesis?
A. Spinal instability refers to a vertebrae and spinal motion segment that is moving too much: either front to back, side to side, or up and down. It can occur with a spondylolisthesis and the terms are often used [...]
Q. Should I be seeing a chiropractor for my bulging discs?
A. Bulging discs - or compressed/degenerative discs - can be treated in multiple ways, including chiropractic. However, special testing needs to be done to determine the disc is the actual source of pain. Treatment will [...]
Q. What are considered “core” muscles?
A. The "core muscles" involve the pelvis, back, abdomen, and chest. These are the muscles that support the spine and significantly influence our posture. This is also referred to as “core stabilization.”
Q. What are prescription medications used for when treating back pain?
A. Prescription medications may be required to help manage pain, inflammation, muscle spasms, and nerve damage. The most common prescription medications are anti-inflammatory drugs. Prescription Motrin and Naproxen are still [...]
Q. What are the benefits to aerobic conditioning & personal training?
A. Aerobic conditioning takes the hard work performed in strengthening and improving muscle function and transforms it into enhanced function and endurance. The beneficial effects are improved blood flow, elimination of [...]
Q. What are the most common symptoms of a pinched nerve?
A. Common symptoms of a pinched nerve include extremity pain, numbness, and in severe cases muscle weakness and even partial paralysis. Pinched nerves outside of the spinal canal are commonly referred to as nerve entrapment [...]
Q. What can artificial facet replacement treat?
A. It is not clear what artificial facet replacement will be able to treat, but the presumption is it will be used for advanced facet arthritis or as an adjunct to an artificial disc replacement.
Q. What can I do about cysts in my spine that are pressing on nerves?
A. Sometimes, certain types of cysts can be drained or removed. Special testing needs to be done to determine the type of cyst present. The best surgical results are obtained when treating synovial facet cysts.
Q. What can I do to help keep my back healthy after treating my degenerative disc disease?
A. Exercise and diet are the two most basic things you can do to help keep your back healthy. Eating healthy and keeping your weight at a normal level will help alleviate some of the burden your spine is required to support. [...]
Q. What causes a stiff back?
A. The "stiffness" felt with a stiff back is usually due to bone spurs and arthritis, but spinal stenosis may contribute to the problem.
Q. What causes foraminal stenosis?
A. If an excessive amount of bone spurs form around the facet joint, they can occupy and narrow the foraminal canal that is formed by the facet joint above and below each vertebra.
Q. What causes spinal stenosis?
A. Arthritis of the spine, degenerative disc disease, disc herniation, enlargement of soft tissue structures inside the spinal canal, facet joint cysts, inflammatory and post surgical scar tissue, spine fractures, and certain [...]
Q. What complications can occur with spine surgery?
A. Fortunately, the complication rate for spine surgery is low, between 3 percent and 10 percent according to the spine surgery literature and government statistics. These complications can include excessive blood loss, heart [...]
Q. What condition can a microdecompression laminaplasty treat?
A. Microdecompression laminaplasty is an operation performed to treat symptomatic central spinal stenosis. It is typically performed for patients 55 and older, replacing the need to do a laminectomy.
Q. What condition is treated with a transforaminal micro decompression?
A. Transforaminal microscopic or endoscopic foraminotomy is used to treat a condition called foraminal stenosis. The goal of the surgery is to create a larger bony foraminal canal to take the pressure off of the exiting nerve.
Q. What conditions does stem cell therapy treat?
A. Conditions that we have treated include but are not limited to; Degenerative Disc Disease, Degenerative Facet Arthritis, Piriformis Syndrome, Paraspinal Trigger Points, Spinal Nerve Injury, Degenerative Joint Disease, [...]
Q. What does a selective nerve block treat?
A. A selective nerve root block is performed both as a treatment for a pinched nerve and/or as a diagnostic test to determine if a particular nerve is the source of pain.
Q. What does IDET (intradiscal electrothermic therapy) treat?
A. IDET, or Intradiscal Electrothermic Therapy, is a percutaneous procedure that treats symptomatic degenerative disc disease. It is not recommended or performed for a herniated disc.
Q. What factors will affect the possible success of my fusion surgery?
A. Several factors have been identified that can cause a failed fusion surgery. These include persistent motion at the fusion site, poor health and nutrition, smoking, and various underlying medical conditions such as [...]
Q. What forms of payment do you accept?
A. Biscup Spine accepts cash, checks, most major credit cards, and various other payment options. Our courteous and professional financial staff will be more than happy to review the various options and find the most [...]
Q. What is an Osteopathic Physician and how are they different from M.D.s, or Allopathic Physicians?
A. Osteopathic (D.O.s) and Allopathic Physicians (M.D.s) are similar in that each treats patients in both out-patient and in-hospital settings, prescribes all medications, performs surgery and other complex procedures, and [...]
Q. What is Holistic Medicine and what does it have to do with my back problem?
A. Holistic Medicine simply means looking at the patient as a whole person. Modern medicine breaks the body up into specialized areas with each having its own specialty. Holistic medicine recognizes the importance of [...]
Q. What is the advantage of undergoing a laminaplasty procedure?
A. A laminaplasty procedure can have the same benefits as a laminotomy or laminectomy but works by enlarging the bony spinal canal without removing the lamina.
Q. What is the best treatment for hip bursitis?
A. The best treatment for hip bursitis is a local injection of cortisone.
Q. What is the cost of Stem cell and/or PRP Therapy?
A. The cost depends on the area being treated and the type of cells be used. Our prices range from $1500 – $10,000 and include facility, supplies, personnel and your care for the following year (all office and/or phone consults).
Q. What is the difference between a desiccated disc and a normal functioning disc?
A. Desiccation means "dried up." When we are young, the nucleus of intervertebral disc has high water content and appears as a bright white signal on an MRI scan. As we age, the chemical structure of the nucleus changes and [...]
Q. What is the difference between a laminectomy and a laminotomy?
A. A laminectomy is an aggressive operation where the entire lamina or back side of the spine is removed. It is performed for very severe cases of spinal stenosis, revision spine surgery, fractures, tumors, massive herniated [...]
Q. What is the difference between a MED and a microdecompression laminaplasty?
A. MED is different in that an endoscope (TV camera) is used rather than a microscope. Preference for either procedure depends on the surgeon and their comfort level with visualization.
Q. What is the difference between a percutaneous nucleoplasty coblation and a percutaneous laser discectomy?
A. Percutaneous nucleoplasty coblation is another type of percutaneous discectomy performed using electric radio frequency energy and a liquid medium to create a plasma spray at a temperature much lower than a laser. It is [...]
Q. What is the difference between a pinched nerve and radiculopathy?
A. A radiculopathy is an advanced form of a pinched nerve. When a nerve compression or a pinched nerve causes nerve damage it is considered a radiculopathy. The most common cause for a radiculopathy is a disc herniation in [...]
Q. What is the difference between a ruptured disc and a herniated disc?
A. The term ruptured disc is often used instead of herniated disc as it refers to the action of the soft nucleus pulposis in the center of the disc as it bursts through (ruptures) the outer rings of the disc structure.
Q. What is the difference between a segmental dysfunction and a trigger point injury?
A. A segmental dysfunction, representing a swollen facet joint, is deeper than a trigger point which tends to be more superficial and more mobile. Some practitioners believe that segmental dysfunction is also a manifestation [...]
Q. What is the difference between a shifted spine and spondylolisthesis?
A. Spondylolisthesis and Shifted Spine are the same thing, and the terms can be used interchangeably.
Q. What is the difference between a slipped disc and a herniated disc?
A. Slipped disc and herniated disc are the same conditions, and the terms are commonly used interchangeably. Slipped disc refers to the action or motion of the soft nucleus pulposis in the center of the disc rupturing through [...]
Q. What is the difference between a strain and a sprain?
A. The most common back and neck problems involve injuries to the muscles, muscle fascia, tendons, ligaments, and joint capsules of the spine. These collectively are referred to as sprains (ligaments) and strains (muscles and [...]
Q. What is the difference between an epidural and a caudal-epidural?
A. An epidural and a caudal epidural injection are similar. Both are performed very low in the spine at a location called the sacral hiatus.
Q. What is the difference between an epidural and a transforaminal epidural?
A. The transforaminal epidural injection is similar to the standard epidural, but accesses the epidural space through the foraminal canal, allowing for more accurate placement of the needle.
Q. What is the difference between Endoscopic and Microscopic spine surgery?
A. Endoscopic and microscopic surgery of the spine are visualization approaches used to perform minimally invasive spine surgery. The major difference is that endoscopic surgery is performed using an endoscope (or fiber [...]
Q. What is the difference between ice and heat?
A. Ice should always be used initially to treat pain, swelling, and inflammation. Although heat can be beneficially at times, it tends to increase blood flow causing swelling and increasing pain.
Q. What is the difference between invasive and minimally invasive surgery?
A. Invasive surgery requires a larger incision and is usually paired with some form of spinal stabilization method, while minimally invasive surgery requires a smaller incision with a quicker recovery period.
Q. What is the difference between major spine reconstruction and a spinal fusion procedure?
A. Major spine reconstruction surgery is a further extension of the instrumented spine fusion operation. It usually involves more than one level of the spine and also adds correction of a significant deformity or treatment of [...]
Q. What is the difference between normal exercise and water exercise therapy?
A. Water exercise therapy individuals to exercise muscles and joints in a low or zero gravity environment, meaning the muscles and joints don't have to support you at the same time. It promotes normal range of motion, [...]
Q. What is the difference between sciatica and a pinched nerve?
A. Sciatica refers to the compression of the sciatic nerve specifically. When the sciatic nerve is compressed symptoms may include severe pain, numbness, and even weakness in the lower extremity.
Q. What is the difference between stem cells and PRP?
A. Platelet rich plasma (PRP) is a component of bone marrow and peripheral blood that contains platelets, which are not cells, but fragments that play a role in clotting and healing. Platelets are responsible for healing [...]
Q. What is the standard surgery performed on a problematic herniated disc?
A. The standard operation is a microdiscectomy, performed as an outpatient procedure in most cases. This has a very good success rate, but between 5 percent and 10 percent of disc herniations can recur since there is [...]
Q. What muscles should I develop in my back to help provide more support for my spine?
A. The muscles responsible for providing vital support function are collectively referred to as the "core muscle group." In addition to posture, they perform abdominal support of vital organs, assist in breathing, movement of [...]
Q. What pain medication is prescribed for a herniated disc?
A. OTC medications such as ibuprophen, naproxen, or acetamenophen are generally used first. This may be followed by Rx cortisone pills, muscle relaxants, and/or narcotic pain killers if pain persists. None of these [...]
Q. What the difference between a bulging disc and a herniated disc?
A. Bulging disc is a condition when the space between the intervertebral space starts to collapse and the outer rings of the disc begin to bulge out (think of a soft ice cream sandwich with the ice cream bulging out as it [...]
Q. What type of laser is used during a laser facet ablation?
A. There are many lasers used for medical applications today. The holmium yag laser is used for laser facet ablation. It is preferred because the laser beam is delivered through a very thin fiber optic cable and does not have [...]
Q. What’s the difference between a microdiscectomy and a laminotomy?
A. Microdiscectomy is the same procedure as a laminotomy, but performed using an operating microscope or endoscope through very small incisions. The surgery can be safely performed under local or spinal anesthesia as an [...]
Q. When should a patient have only PRP treatments?
A. PRP can be used alone to treat a variety of inflammatory conditions such as tendonitis, painful trigger points, and nerve inflammation. PRP only injections are also used to further stimulate stem cell activity and [...]
Q. When should I use heat as a treatment?
A. The only time heat should be used is to "warm up" tissue and muscle prior to exercise or physical therapy. This improves blood flow. If heat is used, it should always be followed by ice after the planned activity.
Q. When should I wear a back brace?
A. Today, many surgeons use back or neck braces after a spinal fusion operation. Though rest and immobility is desirable, too much bracing can cause more harm than good. Further, most braces will not completely immobilize the [...]
