A Top Minimally Invasive Expert.

Board Certified Neurosurgeon, Dr. Anthony Virella, is a pioneer in Minimally Invasive Spinal Surgery. Unlike traditional spinal surgeries that require large incisions and recoveries, Dr. Virella specializes in minimally invasive procedures that often require an incision of an inch or less.
Call Today: (805) 409-0229

 

About Dr. Virella:
Dr. Virella is a Board-Certified, Fellowship Trained Neurological Spine Surgeon with advanced training in the management spinal disorders. He is also a graduate of the UCLA Neurosurgery Residency Program and completed his Complex Spine Resident Fellowship at the world-renowned Cleveland Clinic Foundation. Additional work included a second Fellowship in Minimally Invasive Spine Surgery at the UCLA Comprehensive Spine Center.  Dr. Virella is a nationally recognized spine specialist and has authored numerous articles and lectured nationally and internationally in the field of Complex and Minimally Invasive Spine Surgery.
Education:

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Conditions We Treat

Studies show that upwards of 80% of Americans will suffer from back or neck pain at some point in their life.  In most cases, this pain will subside with rest and over the counter medications.  However, when this pain lasts more than a few days or does not respond to over the counter medications, it may be considered chronic.  Chronic pain is the type of pain that limits your ability to carry out your activities of daily living and affects your overall quality of life.  It is at this point that you should contact a specialist to diagnose your specific condition.

What is a Lumbar Herniated Disc?
Lumbar Herniated Disc, also known as slipped disc or ruptured disc, is a condition in which the spinal disc begins to protrude into the spinal canal.  This protrusion of the disc can irritate the surrounding nerve roots of the spine and cause localized or radiating pain.

What are the Symptoms?
Many patients will show visible disc herniations on an MRI but never experience pain or symptoms and others will experience chronic symptoms that include:

  • Lower back pain
  • Muscle spasms
  • Stiffness
  • Sciatica
  • Numbness or tingling the legs

What is a Cervical Herniated Disc?
Cervical Herniated Disc, also known as slipped disc or ruptured disc, is a condition in which the spinal disc begins to protrude into the spinal canal. This protrusion of the disc can irritate the surrounding nerve roots of the spine and cause localized or radiating pain.

What are the Symptoms?
Many patients will show visible disc herniations on an MRI but never experience pain or symptoms and others will experience chronic symptoms that include:

  • Neck pain
  • Shoulder pain
  • Muscle spasms
  • Stiffness
  • Radiculopathy
  • Numbness or tingling the arms and fingers

What is Sciatica?
Despite being commonly used as a term to describe radiating pain in the buttocks and legs, Sciatica is not an actual diagnosis and is instead a symptom of an underlying spinal condition.  The sciatic nerve is the longest continuous nerve in the body and extends from the lumbar spine through the back of each leg.  When a spinal disc, piece of bone or other process irritate this nerve it can cause the radiating pain that is referred to as Sciatica.

The most common conditions that cause Sciatica are:

  • Lumbar Disc Herniation
  • Lumbar Spinal Stenosis
  • Degenerative Disc Disease
  • Spondylolisthesis
  • Spondylosis
  • Spinal Arthritis

What are the Symptoms?
Sciatic pain usually occurs at one side of a person’s body and it is very unlikely that if affects both sides of the body.  The most common symptoms of sciatica are:

  • Burning or radiating pain in the lower back, buttocks, hips or legs
  • Weakness in the legs or feet
  • Numbness in the legs or feet

What is Spinal Stenosis?
Spinal Stenosis is a condition in which the spaces in the spinal cord begin to narrow which consequently increases pressure on the spinal cord and the nerves of the spine.  Almost all cases of Spinal Stenosis occur in the lumbar spine (lower back). Spinal Stenosis can occur in the cervical spine, yet is far less likely. Spinal Stenosis causes the impingement of one or more spinal nerve roots, which is the cause of the pain associated with Spinal Stenosis.

What are the Symptoms?
The symptoms of Spinal Stenosis can include:

  • Lower back pain
  • Muscle spasms
  • Stiffness
  • Sciatica
  • Numbness or tingling the legs

What is Cervical Radiculopathy?

Similar to Sciatica, Cervical Radiculopathy is a term used to describe radiating pain that originates in the cervical spine (neck) and radiates into the extremities, but is not an actual diagnosis.  When a spinal disc, piece of bone or other process irritates a nerve in the cervical spine it can cause the radiating pain that is referred to as Radiculopathy.

What are the Causes?

Cervical Radiculopathy is always caused by an underlying cervical spine condition and the most common conditions that result in Cervical Radiculopathy are:

  • Cervical Disc Herniation
  • Degenerative Disc Disease
  • Spondylolisthesis
  • Spondylosis
  • Scoliosis
  • Spinal Arthritis

What is Spondylolisthesis?
The term Spondylolisthesis is formed by the Greek words “spondylos” and “listhesis”, meaning ‘spine’ and ‘to slide or slip’, respectively. As these words themselves explain, Spondylolisthesis is a condition in which a vertebrae in the spine slides over to the vertebrae below it. It most commonly occurs in the lumbar spine.

What are the Symptoms?
The condition varies from mild to severe. Therefore, the symptoms and signs can be different too.

Some of these symptoms may be:

  • Lower back pain
  • Stiffness
  • Muscle tightness
  • Weakness in legs
  • Numbness or tingling in legs

What is a Compression Fracture?
Spinal Compression Fractures are characterized by several small fractures or “cracks” in the vertebrae of the spine.  Over time, these fractures begin to weaken the vertebrae and result in spinal instability as well as pain.  Spinal Compression Fractures are a progressive condition and are generally the result of osteoporosis or other bone disorders.

Spondylosis is a term that describes a reduction in the space between two spinal discs. This decreased space often leads to the exiting nerve root becoming irritated or impinged. In more severe cases, the shock absorbing inter vertebral discs will completely wear away causing bone on bone contact. This can often lead to spinal fractures and bone spurs.

Symptoms:
Because Spondylosis can occur both in the cervical and lumbar spine the symptoms may vary depending on the location of the condition.

The most common symptoms of Cervical Spondylosis are:

  • Pain in the neck
  • Pain that radiates into the shoulders and arms (Radiculopathy)
  • Numbness and tingling in the arms and hands
  • Pain that radiates throughout the neck, tingling in the shoulders, arms, hands and
  • Decreased range of motion when raising your arms or a sharp pain when you attempt to raise your arms

The most common symptoms of Lumbar Spondylosis are:

  • Low back pain
  • Pain that radiates through the buttocks and legs (Sciatica)
  • Numbness in the legs or feet
  • Decreased strength and mobility in the legs
  • Inability to walk more than a short distance

A pinched nerve in the spine is a term that is loosely used to describe nerve compression caused by a herniated disc, a bulging disc, spinal bone spurs and various other conditions that affect the spine.  This can occur in either the cervical or lumbar region of the spine and the symptoms can vary depending upon the location.  It is important to seek the advice of a spine specialist if symptoms are present because, left untreated, these symptoms can become permanent.

Symptoms of a Pinched Spinal Nerve Include:

  • Pain in the neck
  • Pain in the lower back
  • Pain that radiates into the arms (Cervical Radiculopathy)
  • Pain that radiates into the buttocks and legs (Sciatica)
  • Numbness or tingling in the arms or legs
  • Difficulty standing for long periods
  • Difficulty grasping objects
  • Headaches

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Nervous or Apprehensive about taking the first step?
People all over the world delay their treatments due to long-term anxieties and fears surrounding spine surgery and treatments in general. Our practice has worked with many patients over the years and we understand these valid concerns. If you have these general concerns, please click below to read “A Message from Dr. Virella“.
Read: A Letter To Patients From Dr. Virella

Relieving your pain should not be a cause for anxiety, and we take every step possible to make sure our patients are comfortable, secure and relaxed from their first visit to their last. Remember, there is nothing scary about taking back control of your life and relieving your pain. Our practice is highly organized and provides step-by-step guided help the entire way to keep you relaxed with your focus where it should be- on you.

You’ve already taken the first step by searching for the right doctor and can soon be on a path to a pain-free life. Call our practice today (805-449-0088or request a callback to come and visit with me. We will sit down together and discuss your concerns. Then, I will provide you with a thorough analysis and review of a suggested care path and treatment options.

I pride myself in being extremely attentive to my patients, using extreme caution and putting to work my experience (of nearly two decades) in conservative treatments and minimally invasive procedures that have given thousands of patient their lives back. I have spent my life designing a new approach to spine treatments that reduce any anxieties of my patients by providing them with a comprehensive strategy that makes sense and is proven.

Don’t let your pain get worse by delaying getting the help you need. Neglecting needed treatment will (almost certainly) make your situation worse. We hope you decide to take control of your pain and your life. We welcome and look forward to meeting you and having the opportunity to shares our skills and successes with you. Thank you for taking the time to read and we hope to see you soon.

ANTHONY A. VIRELLA M.D., F.A.C.S

Common Procedures

For many patients considering spinal surgery, the fear of a large incision, hospital stays and a long recovery period was enough to scare them away from surgery.  However, innovative new technology now allows for Spinal Surgery to be performed through an incision as small as an inch in what is known as a Minimally Invasive fashion.  

With this Minimally Invasive approach, small surgical instruments and a tiny camera are slipped between tissue and muscle fibers to access the spine.  Once these instruments have been inserted, the surgeon will use real time imaging, known as fluoroscopy, to navigate the structures of the spine and remove herniated portions of the spinal discs or bone spurs causing nerve irritation. Once the procedure is completed, only small stitches and a bandage is required and most patient are able to return home the same day.

What are Lumbar Spinal Fusion Procedures?

The goal of Minimally Invasive Spinal Fusion Procedure (and open Spinal Fusion) is to remove portions of, or the entire, spinal disc and/or any bone material that may be causing spinal nerve compression to reduce impingement on the targeted nerve roots.

Once the disc(s) have been partially or completely removed, an implant is placed into the space where the spinal disc once was in an effort to restore the normal height of the spinal disc space.  This implant will also contain bone graft that triggers a biological response, which, over time, will knit together with the vertebrae above and below and form one continuous stable vertebrae.  Additional plates, rods or screws may also be used to ensure stability of the spine.

Depending upon the area of the spinal condition and the best option for the patient, Lumbar Spinal Fusions can have several different approaches, including:

  • ALIF (Anterior Lumbar Interbody Fusion)
  • TLIF (Transforaminal Lumbar Interbody Fusion)
  • PLIF (Posterior Lumbar Interbody Fusion)
  • XLIF (Extreme Lateral Interbody Fusion)

Many of these procedures can be performed on an outpatient basis and utilize Minimally Invasive approaches that minimizes disruption to surrounding muscle and tissue.

Cervical instrumentation and fusion is used to treat conditions of the spine which cause spinal instability such as Degenerative Disc Disease or spinal arthritis.

During this procedure, a small incision (usually 1inch) is made toward the front of the cervical spine.  Through this incision, small surgical tools are used to remove the damaged spinal disc(s) as well as any bone spurs that may be causing irritation to the surrounding nerves.  Once the disc space has been cleared, a small implant that is filled with bone graft material is inserted.  This bone graft material will eventually fuse into one complete vertebrae and restore stability to the spine.

To further stabilize the spine, instrumentation such as plates, small rods or screws are attached the the vertebrae above and below.

What is a Microdiscectomy?

A Microdiscectomy is a procedure that requires a small (1-2 inch) incision and is used to treat pain caused as a result of disc herniations by removing only the herniated portions of the spinal disc while leaving the remaining portions of the disc intact.  This procedure is commonly performed for those who are experiencing pain that radiates into the buttocks and legs (Sciatica) but can also be performed for patients with cervical or thoracic radiculopathy.  By removing the herniated portions of disc, and any bone spurs, the spinal nerves that are causing pain and numbness are no longer impinged.

In most cases, a Microdiscectomy can be performed on an outpatient basis due to the reduced trauma to the spine and muscular structures.   In fact, most patients are up and walking shortly after this procedure and physical therapy will begin within a few days of the procedure, if needed.

What is a Cervical Artificial Disc Replacement?

The purpose of the artificial disc used in the surgery is to eliminate nerve root, spinal canal or spinal cord compression and preserve motion of the cervical spine. This procedure requires a small (1 inch) incision and is an alternate to anterior cervical discectomy (and) fusion (ACDF). The CADR procedure involves the surgical replacement of the cervical disc implant that allows mobility of the neck. This procedure is a similar principle to a knee or hip replacement procedure.

This new procedure of CADR is minimally invasive and approved by the Food and Drug Administration (FDA). Cervical Artificial Disc Replacement may be preferred over traditional cervical disc surgery because it allows more movement and reduces stress on the neck.

A Laminectomy is a type of surgery which relieves pressure on the spinal nerves and improves symptoms caused by the narrowing of the spinal canal in the lumbar or cervical spine. This minimally invasive procedure involves the trimming or removal of the lamina, which is the domed piece of bone at the back of the vertebra.
During the procedure the lamina and any bone spurs on the vertebrae are removed so that the trapped spinal nerve(s) can be decompressed.  Once the nerve is decompressed, back or neck pain and radiating pain in the arms or legs will subside. In most instances, patients who undergo a Lumbar Laminectomy are able to return home the same day as their procedure.
The term “laser spine surgery” has become increasingly popular over the years and many patients often ask their doctor if they are candidates for this type of surgery.  The truth is that “laser” spine surgery is term used to make what is already known as Minimally Invasive Spine Surgery sound fancier.  Despite what you may have been told, lasers can not correct the issue within your spine and a surgeon still needs to decompress the spinal nerves or stabilize the spine in order to relieve your pain.  However, modern advancements in Minimally Invasive Spine Surgery now use incisions as small as an inch and many patients are able to return home the same day.  At Virella Spine Surgery, we have been at the forefront of Minimally Invasive Spine Surgery and Dr. Anthony Virella is considered a pioneer in this field.

Relieve Your Pain. Call Today!

805-409-0229