Appointments: 440-248-1297                         Fax: 440- 349-7131

Clinical Specialties and Surgical Procedures

Dr. McLain has treated patients from all over the world, who've come to Cleveland with the most complex and challenging spine problems imaginable.  He also cares for the people who live right here in Cleveland and Northeast Ohio for the common but disabling problems that affect most of us on a daily basis.  Dr. McLain is expert in the most state-of-the-art surgical procedures and approaches, using the most minimally invasive spine surgery techniques available. 

Here are some of the spinal problems Dr. McLain treats:

Neck Pain and Cervical Spine Surgery

Neck pain, with nerve compression and hand and arm pain, can be incapacitating!

Many patients who are unable to manage even light activities because of neck pain and pain that runs down their arm, often into their hand and fingers, have disc bulges or bone spurs pressing on the spinal cord or nerve roots.  They describe burning, stabbing pain, often with electrical shocks that can be severe. Fortunately many of these problems can be eliminated with surgical treatment.

Surgical options range from microsurgical nerve decompression, using minimally invasive techniques, to full reconstruction of severely degenerated or previously operated spines.  Fusion is the right choice for many patients, but disc replacement is a new and exciting alternative to traditional fusion.

Lumbar Spinal Surgery

When lumbar disc degeneration or herniation causes severe and persistent pain, or when muscle weakness or spinal instability becomes apparent, there are a number of surgical options to consider.

Disc herniation is reliably treated with microsurgical, minimally invasive techniques, while spinal deformity and instability may require fusion, or more extensive reconstruction.  Lumbar disc replacement can provide excellent functional improvement and pain relief in some patients. 

Sacroiliac Joint Disease

Back pain is sometimes caused by arthritis of the Sacroiliac (SI) joint.  SI pain can be intense and limit activities, but the diagnosis is often overlooked. If SI joint pain comes from inflamed, arthritic, or even fractured joints, surgery may be successful in improving function and bringing relief.

SI joint pain must be carefully diagnosed before surgery. If the Si joint can be proven to be the culprit, surgical fusion can dramatically reduce pain.

SI joint fusion using new, minimally invasive techniques offers many patients a good chance for improvement and return to normal life.

Scoliosis

Scoliosis can occur in children and adolescents (idiopathic scoliosis) or develop over the years as discs degenerate and collapse in an imbalanced posture (degenerative scoliosis). Often, older patients present with a curve they have known about since childhood, which has only recently started to get worse again or become painful.

Picking the right kind of surgery for these situations is absolutely key to getting good results in these complex cases: Often the curve looks bad but the problem is simply a bulging disc or narrowing of the spine at a single level - problems that can be fixed with microsurgery without having to correct the whole spine.  In many cases fusion can be avoided all together!

When deformity requires surgical correction, the procedure has to be done right, by a surgeon with extensive experience in just this type of care.

Spondylolisthesis

When one vertebra begins to slide forward, or to the side, over another one, this results in an unstable condition called spondylolisthesis. About 5% of adult Americans have this disorder, but not all have symptoms. 
Spondylolisthesis can cause physical deformity, severe low back pain, compression of nerves resulting in numbness and pain, or even progressive weakness and nerve injury.  If the slip progresses - becomes larger and more unstable - the pain and weakness can become incapacitating.  Treating this problem early can prevent serious problems later.

Minimally Invasive Spine Surgery

When surgery is needed for nerve decompression, or single level fusion, minimally invasive techniques are available which reduce tissue trauma, blood loss, post-operative pain, and speed recovery.

Microsurgical approaches are possible for many cervical and lumbar conditions, and new implants and techniques are being developed all the time! Dr. McLain remains on the fore-front of the best surgical advances.

MIS Techniques available include:
- Microdiscectomy
- Cervical Foraminotomy
- Percutaneous Lumbar Fusion
- Direct Lateral Interbody Fusion
- Minimally Invasive Anterior Spine Fusion

 Disc Replacement Surgery

Where fusion was once the clear surgical choice for single or two-level cervical disc disease, there is now a proven option that selected patients may consider: Total disc replacement.

TDA or Total Disc Arthroplasty, allows surgeons to remove diseased or damaged disc material and replace it with a motion preserving implant that - rather than promoting fusion - will allow the body to maintain a small, carefully controlled degree of flexibility.  This preserved motion relieves stresses that would otherwise be shifted to spinal segments above and below, potentially increasing the risk of adjacent- level disease down the road. 

Dr. McLain uses both the Prodisc Lumbar and Cervical Implants and the LDR MobiC Cervical implants, has served as a surgeon educator for both, and contributed to the FDA trials for LDR.

Back Pain: Sprains and Strains

Surgery is rarely needed for these painful injuries, but physical therapy and proper pain management can help a lot.  Evaluation by a spine surgeon can help guide the patient and their practitioners in the right direction, and reassure them that nothing has been missed and that the nonsurgical road is the best one to take. 
Physical therapy can be provided in the office or the gym, and is always a part of a successful back care program.  Chiropractic care combines traditional P.T. with manipulative modalities that improve motion and relieve pain.  When persistent spasm or nerve-related pain interferes with recovery, Injection Therapy provided by a Pain Management Specialist can greatly improve function and even provide a more specific diagnosis.

Spinal Stenosis

Aches and pains, fatigue and weakness in the legs and feet are not "signs of old age"!

Spinal stenosis - narrowing of the spinal canal by bone spurs, disc bulges, and shifts in spinal alignment - creeps up on many healthy adults as we age.  Symptoms of stenosis come on slowly, making walking more difficult, sapping energy and strength, and causing pain and numbness through legs or arms, depending on where in the spine the stenosis occurs.

Spinal stenosis can be relieved!  Removal of the bone spurs causing the compression (laminectomy) results in dramatic relief of pain and improvement in exercise and walking capacity. Spinal decompression can often be accomplished with a minimally invasive, out-patient surgical procedure.

Failed-Back Surgery

Back surgery can fail for many reasons:  Years pass and the spinal segments above or below a previously successful operation begin to break down; a well-conceived operation is undone when the bone fails to heal or infection sets in; a good-looking operation is carried out, flawlessly, but for the wrong problem or pain generator; or surgical technique and planning just never accomplished what the patient needed or the doctor intended. And sometimes, things just don't go right!

Fixing these problems is often possible, but the surgery is always more complex than the first time around, and clinical judgment is paramount to avoid taking a bad situation and making it worse. Experience is needed both in planning a revision surgery, and in recognizing when to say "No" to more operations.