MSH-North-Spine

Trust us to provide the care you need.

From acute pain (like a herniated disc in back) to chronic spine conditions (like stenosis), our orthopedic surgeons--nationally ranked by U.S. News & World Report--and our world-renowned neurosurgeons at MedStar Health deliver unparalleled treatment expertise and the highest quality of patient care. We are committed to providing the care you need in a safe setting. Delaying treatment may pose additional risks to your health. If you’re suffering from neck or back pain, we encourage you to contact us today. Our board-certified spine specialists can evaluate your pain at 13 convenient locations spanning Central Maryland:

Enjoy more pain-free days with expert spine care.

Back pain is a leading cause of chronic pain, missed work, and disability in the U.S. If neck or back pain interferes with your daily life, do your spine a favor—visit a specialist to help relieve your symptoms.

Our expert specialists - both orthopaedic surgeons and neurosurgeons - work as a team to ensure the best outcome for you.Learn more by listening to our podcast.

How a Spine Specialist Can Help
MedStar Health experts diagnose and treat the full range of spine conditions. We offer minimally invasive and standard treatments for adults and teens with common and rare diseases that affect the spine, such as:

Adolescent Scoliosis

Back pain

Bulging discs/Herniated discs

Degenerative disc disease

Myelopathy

Scoliosis

Sciatica

Spinal Stenosis

Spondylolisthesis

Spinal tumors

Spinal fractures

Synovial Cyst

Osteoarthritis

Rheumatoid arthritis

Spinal Tumors

At MedStar Health, our spine specialists are experts in treating primary spine tumors—noncancerous tumors that first develop on your spine or spinal cord. These benign tumors are formed by an abnormal growth or mass of cells and are uncommon, accounting for just 0.5% of all newly diagnosed tumors.

Spinal tumors can occur anywhere in and along your spinal column, which includes your vertebrae, spinal cord, and surrounding tissues. Many are undetectable while others may present as a lump or lesion on the neck or back.

Some spinal tumors cause no symptoms because they’re so small they do not press on or irritate nearby tissues. However, as a tumor grows, it can cause certain symptoms by compressing the spinal cord, nerve roots, and nearby blood vessels. Depending on the tumor’s size and location, it may cause back or neck pain, weakness, numbness, and may affect bladder or bowel control.

Because there are several types of primary spinal tumors, they can be complex to treat. The treatment plan for spine tumors is determined on a case-by-case basis by a team of spine specialists that includes fellowship-trained specialists in neurosurgery, neurology, radiology, neuro-oncologists and others.

For symptomatic tumors, surgery is often recommended. Our neurosurgeons are skilled in minimally invasive and traditional techniques as well as in using leading-edge robotic and image-guided technologies.

Primary spinal tumors we treat include:

Aneurysmal bone cyst, a blood-filled lesion in the bone that tends to expand or grow. While it is referred to as a cyst, it is surrounded by a thin wall of bone. It is most commonly found around the spine, pelvis, or knee.

Hemangiomas, the most common primary tumor of the spine. These lesions are of vascular origin and usually involve a proliferation of normal capillary and venous structures. They are usually seen in the mid-back (thoracic) and lower back (lumbar).

Meningioma, which begins in the thin membranes that cover the spinal cord. It usually appears in the upper portion of the back and is most common in women.

Nerve sheath tumors such as schwannomas and neurofibromas, which form on peripheral nerve roots exiting the spine.

Neurofibroma, a tumor that arises in the protective covering of the spinal cord and nerves. It often occurs in people with neurofibromatosis, a condition that causes nerve tumors throughout the central nervous system and skin.

Osteoma, a small, bonelike tumor that can grow on the spine (among other areas) that is common in children and younger adults.

Osteoblastoma, a bonelike tumor similar to an osteoma that is typically larger and more aggressive.

Osteochondroma, an overgrowth of cartilage and bone that develops during childhood or adolescence. It is an abnormal growth that forms on the surface of a bone near the growth plate.

Schwannoma, composed of Schwann cells, which produce the material that insulates nerves. It is usually located on the outside of the spinal cord.

For more information or to make an appointment click here or call one of our specialists, at 667-328-2134.

Additional Resources Below:

Facebook Live: Spinal Tumors

Doc Talk:

S3:E5 Transforming the treatment of brain and spine tumors

Though rare, there are more than 100 different types of brain and spine tumors, making them complex to diagnose and treat. Because of this, a multi-disciplinary approach to treatment that brings together specialists that include neurosurgeons, radiation oncologists, medical oncologists, neuro-oncologists, and other experts is essential for the best outcomes. During this podcast, Dr. Teresa Wojtasiewicz, a neurosurgeon; medical oncologist Dr. Mahsa Mohebtash; and radiation oncologist Kelly Orwat; all with the Neuro-Oncology program at MedStar Health discuss the different types of brain and spine tumors as well as advances in treatment.

For interviews with any of these specialists, or for more information about this podcast, contact Regional Media Relations Director, debra.schindler@medstar.net.

Scoliosis

The term scoliosis is associated with spinal deformity where the spine is curved unnaturally toward the right and/or left side of the body, often in the shape of an “S” or a “C.” While generally a natural phenomenon in the aging process related to degeneration of the spine, genetics can play a role. In addition to surgeries on adults, our scoliosis specialists also perform pediatric and adolescent surgeries.

Sciatica

Sciatica refers to pain, weakness, numbness, or tingling in the leg. It is caused by injury to or pressure on the sciatic nerve. Sciatica is a symptom of a medical problem and is not a medical condition by itself. It's usually caused when a herniated disk or bone spur in the spine presses on the nerve in the lower back.

Pain originates in the spine and radiates down the back of the leg. Sciatica typically affects only one side of the body.

Spinal Stenosis

Spinal stenosis can cause pressure on your spinal cord or the nerves that go from your spinal cord to your muscles when the space between your vertebrae is too small. Stenosis, which means "narrowing," can happen in any part of your spine but is most common in the lower back. It is often caused by "wear and tear" and your symptoms may get worse over time.

Bulging discs/Herniated discs

Resting between the vertebrae of your spine are discs—strong, pliable cushions that act as shock absorbers and facilitate spinal movement. Disc herniation implies the circumstance where the outer wall of the disc ruptures and extrudes outside of its normal position, compressing the spinal cord or nerve roots.

A herniated, or bulging disc can be caused by:

Degeneration or aging of the spine

Unhealthy lifestyle choices (obesity, smoking, excessive alcohol consumption)

Trauma

Genetic predisposition

Symptoms of a herniated disc can include:

Neck or lower back pain

Numbness or pain in a limb

Muscle weakness and / or spasms

Degenerative Disc Disease

Degenerative disc disease

Degenerative disc disease results from a long-term wear of the intervertebral disc, the cushion between the bony structures of the spine. The disc itself loses its shock-absorbing properties and diminishes in height and integrity. Repeated friction between the structures can create bone spur formation and narrowing causing pain in the neck or back, sometimes radiating through the limbs.

Myelopathy

Myelopathy results from spinal cord compression, which is commonly caused by degenerative changes or a herniated disc in the cervical (neck) or thoracic spine (mid-back). Myelopathy can occur at any age, but most often occurs in older patients and can cause the following symptoms:

Weakness or heaviness in the arms or legs

Pain in the neck or mid-back with radiation to the limbs

Difficulty performing fine motor skills such as writing or grasping small objects

Spasticity or stiffness in upper or lower extremities

Numbness or tingling in the upper or lower extremities

Difficulty walking or feeling unsteady

Loss of bowel or bladder function in very severe cases

Back Pain

There are many causes of back problems. Common injuries, including disc herniations that compress nerves in the neck or lumbar spine, can happen as part of the normal aging process. More serious problems, including tumors, a collapse of the spinal column, and infections, can also occur. Trauma from accidents or falls can cause fractures and nerve compression, which may require surgical attention.
Treatment Options
Most patients find back pain relief without surgery. Our experts will discuss all your treatment options— we will personalize your care plan based on your lifestyle, needs, and goals. For maximum pain management, we may recommend a combination of conservative treatments, such as:

Bulging disc treatment

Lower back pain treatment

Injections and nerve blocks

Physical therapy

Radiofrequency ablation for nerve pain

MedStar Health spine surgeons are experts in minimally invasive and traditional techniques. If you need neck or back surgery, we will help you understand what to expect before, during, and after your procedure. Using leading-edge robotic and image-guided technologies, we offer the full range of spine surgeries, including:

Neck, or cervical spine surgery

Cervical disc replacement. Click here to learn more

Discectomy

Intradiscal electrothermal therapy

Kyphoplasty

Laminectomy

Vertebroplasty

Spinal fusion

Spinal deformity surgery

Physical Therapy

What is physical therapy?

Physical therapy (“PT”) is a non-invasive medical treatment that aims to improve movement and reduce pain in patients with a variety of illnesses, injuries, or conditions. As your therapist works with you to improve your body’s strength, flexibility, and endurance, you will notice a reduction in pain, stiffness, and discomfort. Physical therapy can be an effective treatment option for patients with back injuries and conditions and should be considered before surgery or other invasive procedures are performed.

At MedStar Health, our specialty-trained spine physical therapists are experts in treating a variety of back and spine injuries and conditions. Our approach to care is comprehensive, collaborative, and based on the latest research and technology.

What should I expect?

On your first visit, one of our specialty-trained spine physical therapists will perform a thorough evaluation. This includes a series of assessments and screenings to determine areas of pain, discomfort, muscle weakness, and dysfunction. Based on your results, your therapist will construct an individualized treatment plan that may include manual therapy, manipulation, exercise, and/or modalities, such as electrical stimulation and dry needling. The frequency and duration of treatment will be determined based on your medical necessity. Our administrative team does an excellent job in assisting you with insurance coverage.

How is physical therapy going to help me?

Physical therapy is proven effective at reducing pain and improving mobility in patients with back and spine injuries and conditions. Our spine therapists are expertly trained and experienced in treatment methods and techniques unique to spine care and will develop a treatment plan that is customized to you and your needs. Physical therapy is proven to improve quality of life and reduce the need for surgical intervention, medications, and/or injections for many patients. Our team of therapists also aims to reduce the likelihood of future injury through patient education and instruction in a sustainable home exercise program upon completion of care.

Depending on your injury or condition, most patients with musculoskeletal pain should see an improvement in pain and function in the first few weeks. Some conditions may require longer treatment periods due to healing or other factors.

Do I need a referral from my doctor?

Many insurance plans no longer require a referral from a physician to start physical therapy. If you have an “open access” plan, you do not need a referral and can begin therapy right away. Our administrative team can help determine if you need a referral and guide you on how to obtain one.

Do I have to try physical therapy before I can be considered for back surgery?

Your insurance company or surgeon may require that you try physical therapy before having back surgery. Most musculoskeletal complaints can be greatly improved with a short course of physical therapy. There are many non-invasive treatment methods available that may be recommended by your physician before surgery is considered.
Innovative Technology, More Precise Surgery
High-tech surgical robots and image-guided systems don’t replace surgical expertise, but it does help us give you the most precise outcomes. Using the latest technology, our spine surgeons get a better view of your spine, nerves, and musculature—allowing us to maneuver instruments with more accuracy than ever before.

Robotic-assisted spine surgery generally requires smaller incisions. In our expert surgeons’ hands, we can avoid disturbing healthy tissues around the spine as we correct what’s causing your symptoms. The results?

Shorter hospital stay

Faster recovery

Lower risk of complications
Facebook Live: Robotic Joint and Spine Surgery

Our center was among the first in the U.S. to implement the Excelsius3D™ spinal surgery system, which features real-time 3D video technology for surgical pre-mapping. Our specialists also use the precise Airo and ExcelsiusGPS systems for delicate maneuvers, such as robotic navigation and implant placement. Together, these innovations deliver unparalleled precision during back pain surgery.

Get answers to more frequently asked questions by clicking here

Are you at risk for spine problems?

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Just seven minutes could put your mind at ease. Take our short quiz to assess your neck back or back pain.

Take Our Spine Risk Assessment

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Hear from our patients.

Matt Sandford is back in the gym after complex spine surgery
When a spine doctor becomes a spine patient

US News Best Hospitals - Orthopedics - 2023-24

Meet our spine experts.

MedStar Health is home to one of Maryland’s largest fellowship-trained spine teams. We are on the leading-edge of research, educating future spine doctors in the latest data-driven techniques. Our spine experts work closely with specialists throughout MedStar Health—so every patient gets an exceptionally personalized, team-based treatment plan.

Paul Asdourian, MD

Zeena Dorai, MD

Victor Du, MD

Mark Iguchi, MD

Syed Karim, MD

Mesfin A. Lemma, MD

Paul McAfee, MD, MBA

Bradley Moatz, MD

Zan Naseer, MD

Charles Schnee, MD

Jugal Shah, MD

Teresa Wojtasiewicz, MD

Spine experts

Paul Asdourian, MD

Paul Asdourian, MD

Dr. Asdourian, Regional Director, Spine Program at MedStar Union Memorial Hospital, is a spine surgeon trained in reconstructive spinal surgery. His expertise is in the treatment of adult spinal deformity, spondylolisthesis, and degenerative disc disease. For more than 27 years, Dr. Asdourian has utilized state-of-the-art techniques in the diagnosis and treatment of failed cervical and lumbar decompressions and fusions. Dr. Asdourian was a key investigator in cervical artificial disc replacements. He is a member of the Alpha Omega Alpha Medical Honors Society.

Zeena Dorai, MD

Zeena Dorai, MD

Dr. Dorai is the Chief of Neurosurgery, MedStar Good Samaritan and MedStar Union Memorial Hospitals; Director, Neurosciences, MedStar Health, Central Maryland Region; and an Associate Professor, MedStar Georgetown University Hospital. She is board certified in neurological surgery and completed a board-certified fellowship in brain and spinal tumors. Her special clinical interests include degenerative spine disease, brain tumors, cranial trauma, hydrocephalus, and radiosurgery.

Dr. Dorai has authored articles and chapters in spine reconstruction, brain tumors and cerebrovascular surgery. She has given numerous local and national presentations and served as faculty for surgical courses at national neurosurgical meetings. Dr. Dorai is a member of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.

Dr. Dorai was named a 2018 “Top Doc” by Baltimore Magazine for Neurosurgery and also recognized in 2015, 2016, and 2017.

Victor Du, MD

Victor Du, MD

Victor Du, MD, practices at The Center of Neurosurgery at MedStar Franklin Square Medical Center. Dr. Du specializes in the diagnosis and treatment of diseases of the brain and spine, with a particular focus on spinal surgery emphasizing evidence-based biomechanical principles and patient selection. He deploys diverse techniques such as minimally invasive surgery and complex spinal instrumentation in order to optimize treatments for the entire breadth of spinal disorders, including arthritic degeneration, deformity, trauma, and cancer. In addition he treats cranial pathologies including benign and malignant brain tumors, Chiari malformation,craniocervical instability, and hematomas.

Dr. Du earned his medical degree at Albany Medical College, and completed his residency in neurological surgery at the Northwell Health system in Long Island, NY. Dr. Du also completed a complex spine surgery fellowship at the Northwell Health system, where he developed special interests in the treatment of spinal deformity, spinal oncology, and tethered cord syndrome.

He has published on topics in cranial and spinal surgery, contributing articles and abstracts to a number of professional journals and conferences.

Mark Iguchi, MD

Mark Iguchi, MD

Mark Iguchi, MD, is a board-certified neurosurgeon with nearly 20 years of clinical neurosurgical experience here in the Baltimore area. At MedStar Health, he offers a full range of consultative and surgical services for general neurosurgery. Dr. Iguchi enjoys general neurosurgery and specializes in spine surgery, performing both traditional open spinal surgery along with minimally invasive and microsurgical operative approaches. Dr. Iguchi specializes treatment for spinal disorders associated with herniated discs, degenerative disc disease, prior surgeries, instability, spinal cord compression, spinal stenosis and nerve compression. He sees patients in Pikesville, Timonium, and at MedStar Franklin Square Medical Center.

Dr. Iguchi earned his medical degree at the Medical College of Wisconsin, after attending college in California and an initial career in Finance. Dr Iguchi trained in Neurological Surgery at the University of Maryland / Shock Trauma Center. Prior to joining MedStar Health, Dr. Iguchi was a neurosurgeon at Greater Baltimore Medical Center and served as a clinical Instructor for the University of Maryland Neurosurgery Department.

Dr. Iguchi was recently voted as a “Top Doctor” by Baltimore Magazine. He is a fellow of the American Association of Neurological Surgeons.

Syed Karim, MD

Syed Mohammed Karim, MD

S. Mohammed Karim, MD is a board-certified orthopaedic surgeon who is dual fellowship trained in spine surgery and orthopaedic oncology—one of only a handful of surgeons nationwide with such training and experience. He specializes in the surgical treatment of patients with bone and soft tissue tumors / cancers. After practicing at Mayo Clinic in Minnesota, Dr. Karim returned to his home state and now sees patients at MedStar Franklin Square Medical Center and MedStar Union Memorial Hospital.

Dr. Karim enjoys helping patients with sarcomas, cutaneous / skin cancers, and metastatic tumors in soft tissues and bones throughout the entire body including the spine, sacrum, pelvis, and extremities. He also performs surgery for spinal cord compression, spinal instability from primary and metastatic tumors, and pathologic or impending fractures from metastatic bone disease. In addition to orthopaedic cancer patients, he surgically treats those with degenerative spine conditions, spinal trauma, spinal cord injuries, and spinal infections. Dr. Karim works closely with medical oncologists, radiation oncologists, pathologists, radiologists, plastic surgeons, and other surgical subspecialists of MedStar Health to provide the best treatment possible to each patient.

In addition to caring for patients, Dr. Karim conducts clinical research to improve the outcomes of patients with musculoskeletal and spinal tumors. His research has been published in peer-reviewed journals and presented at international conferences. Dr. Karim is a member of the American Academy of Orthopaedic Surgeons, AO Spine, and the North American Spine Society, for which he holds leadership roles in Spine Oncology, Robotics and Navigation, and on the Resident and Fellow Education Committee. He has a keen interest in education and enjoys teaching and mentoring medical students, residents, and fellows both in and out of the operating room.

Beyond his medical career, Dr. Karim is a proud member of the Civil Air Patrol of the United States Air Force. He is fluent in English, Urdu, and Hindi.

Mesfin A. Lemma, MD

Mesfin A. Lemma, MD

Dr. Lemma is a board-certified, fellowship-trained orthopaedic surgeon, specializing in the surgical treatment of cervical, thoracic, and lumbar spine disorders. He sees patients in Bel Air, Rosedale / White Marsh, and in Baltimore at MedStar Union Memorial Hospital. He currently serves as division chief of spine surgery as well as director of minimally invasive spine surgery at MedStar Union Memorial Hospital.

Pursuing a career in orthopaedic surgery seemed a natural fit to Dr. Lemma's background as a mechanical engineer. After completing his residency and fellowship training at the Johns Hopkins Hospital, he served as division chief of Johns Hopkins Orthopaedic and Spine Surgery at Good Samaritan Hospital, prior to transitioning to MedStar Orthopaedic Institute in 2014.

Dr. Lemma's areas of intellectual interest and clinical expertise center around minimally invasive spine surgery. Using tubular retractors in lieu of traditional open surgery, state-of-the-art technologies, and computer-assisted navigation allows Dr. Lemma to deliver to his patients the best solutions with the least amount of invasion. A large portion of his practice also focuses on spinal problems in the elderly, rheumatoid arthritis of the spine, spinal deformity, and revision spinal surgery.

Dr. Lemma remains active in resident and surgeon education, and was honored to be the recipient of the Teacher of the Year Award from the Johns Hopkins University Department of Orthopaedic Surgery in 2014. He has also been involved in developing innovative spine surgical techniques and new technologies and relates his experiences to other surgeons, both from the podium as well as in smaller teaching seminars. It has been a privilege for Dr. Lemma to be listed by both U.S. News and World Report's and Castle Connolly in their lists of Top Doctors in the U.S., as well as being named among the Top 100 Spine Surgeons in the U.S. by Becker's Healthcare. In 2021, he was named a Top Doctor by Baltimore magazine.

Paul McAfee, MD, MBA

Paul McAfee, MD, MBA

Paul McAfee, MD, MBA is an experienced fellowship trained, board-certified spine surgeon at MedStar Orthopaedic Institute. He has been in practice for over 35 years and now sees patients in Timonium and at MedStar Union Memorial Hospital. He holds a joint appointment in both orthopaedic surgery and neurosurgery.

Dr. McAfee’s clinical interests are spinal reconstruction, adolescent scoliosis, and correcting spinal deformities and neurologic deficits through minimally invasive spine surgery. He is a proponent of education and believes that better informed patients get better results.

Dr. McAfee has been recognized as one of Baltimore’s Top Doctors and is among U.S. News & World Report’s Top 1% of spine experts worldwide for his expertise and contributions to the field of spine surgery. He is an industry pioneer who holds 16 patents, invented a type of cervical disc replacement, and has performed more than 200 motion-preserving surgeries in 10 countries. He is a prolific researcher with more than 200 publications to his name. In addition, Dr. McAfee board certifies other orthopaedic surgeons through the American Board of Orthopaedic Surgery.

Bradley Moatz, MD

Bradley Moatz, MD

Bradley Moatz, MD, is a board-certified, fellowship trained spine surgeon. He will see patients in Ellicott City / Columbia, Hunt Valley and at MedStar Union Memorial Hospital. Dr. Moatz’s clinical interests include spinal stenosis and degenerative spine conditions. He takes great pride in restoring functional movement to his patients and improving their quality of life.

Dr. Moatz, who completed one of the nation’s top-ranked spine fellowships at Emory University, is an accomplished author who has earned many academic honors. These honors include acceptance into the Alpha Omega Alpha Medical Honor Society, which indicates superior academic performance, leadership, professionalism and a firm sense of ethics, future promise, and a commitment to service during medical school. He was also inducted into the Phi Beta Kappa Honor Society as an undergraduate.

Dr. Moatz’s current research includes studies on multi-level cervical discectomies and fusions and on the biomechanics of a modular nucleus replacement system. He is a member of the North American Spine Society, American Academy of Orthopaedic Surgery and Maryland Orthopaedic Association.

Zan Naseer, MD

Zan Naseer, MD

Zan Naseer, MD is a dual-fellowship trained orthopaedic surgeon who specializes in complex and minimally-invasive adult spine surgery as well as pediatric spine deformity and scoliosis surgery.

Dr. Naseer is a Maryland native and graduated from the University of Maryland, College Park with High Honors and a Bachelor of Science in Neurobiology & Physiology. He subsequently received his Medical Degree from the New York Medical College, where he was elected as President of the Gold Humanism Honor Society, which recognizes physicians who exemplify the most compassionate care. During his medical training, Dr. Naseer was awarded a clinical research fellowship focused on Orthopaedic Adult Reconstruction Surgery at Johns Hopkins Hospital and School of Medicine.

Dr. Naseer graduated from the New York Medical College Orthopedic Surgery Residency Program, where he was elected as Chief Resident in his final year. During this time, he trained at Westchester Medical Center, a Level 1 trauma center, which is consistently ranked as #1 in the nation with the highest case-mix index, an indicator of the complexity of patients treated.

He also had the opportunity during his residency to train with world-renowned experts in orthopaedic surgery at both Mount Sinai Hospital in Manhattan and the Hospital for Special Surgery. He further sub-specialized in Spine Surgery and was selected to complete a combined Orthopaedic and Neurosurgical fellowship focused on both adult and pediatric spine surgery at the prestigious University of Pennsylvania and Shriners Hospitals for Children in Philadelphia. During this time, Dr. Naseer had the opportunity to fulfill his passion of providing international surgical care to patients in developing countries. He has traveled to Puerto Rico and Trinidad and Tobago where he has operated and provided surgical care for children with complex scoliosis.

Experienced in the latest surgical techniques, Dr. Naseer has advanced training in minimally invasive spine surgery techniques including computer-guided navigation surgery, robotic-assisted spinal fusions, motion-sparing spine surgery, total disc replacement, and ultrasonic spine surgery techniques. At MedStar Health, Dr. Naseer offers a full range of consultative, conservative, and surgical interventions for the treatment of cervical, thoracic, and lumbar spine disorders including degenerative disc disease, spinal stenosis, and scoliosis. His care philosophy is centered around providing compassionate and individualized care. He works with each patient to develop a personalized treatment plan, taking the patient’s preferences and needs into account.

In addition to his clinical practice, Dr. Naseer is an accomplished researcher with numerous published book chapters and peer reviewed manuscripts in orthopaedics and spine surgery. He has given several presentations and lectures at the national level. He is also the recipient of several awards including a scholarship awarded in 2023 by the Cervical Spine Research Society. Dr. Naseer enjoys teaching and serves as an educator for the MedStar Union Memorial Orthopedic Surgery Residency Program, where he leads the resident spine education curriculum. He is also an active member of numerous professional organizations, including the North American Spine Society, AO North America, The Orthopaedic Research Society, and The American Academy of Orthopaedic Surgeons.

Charles Schnee, MD

Charles Schnee, MD

Charles Schnee, MD, is a board-certified neurosurgeon with more than 20 years of clinical experience. Part of neurosurgical services team at MedStar Health, he offers a full range of consultative and surgical services, including minimally-invasive and microsurgical operative approaches. Dr. Schnee specializes in cranial and general neurosurgical care, as well as treatment for spinal disorders associated with degenerative disease, prior surgeries, osteoporosis, deformity, trauma, infection, congenital anomalies, and tumors.

Dr. Schnee earned his medical degree at Tufts Medical School, where he was elected to the Alpha Omega Alpha Honor Society. Prior to joining MedStar Health, Dr. Schnee served as Chief of Neurosurgical Oncology and Neurosurgery at Saint Agnes Hospital, as well as Chief Medical Officer at the Maryland Specialty Surgery Center. He also served as Chief of Spinal Surgery in the Department of Neurosurgery at the University of Maryland.

Dr. Schnee serves as president of the Maryland Neurosurgical Society and is a fellow of both the American College of Surgeons and the American Association of Neurological Surgeons.

Jugal Shah, MD

Jugal Shah, MD

Jugal Shah, MD, is a board-eligible neurosurgeon who sees patients at MedStar Franklin Square Medical Center, MedStar Harbor Hospital, and in Ellicott City. He was named a Top Doctor by Baltimore Magazine in 2022.

Dr. Shah specializes in the diagnosis and treatment of disease of the brain and spine, with a particular interest in minimally invasive and robotic spinal surgery. He treats spinal degeneration, instability, spinal cord and nerve compression, trauma, and cancer. In addition, he treats cranial pathologies including pituitary tumors, malignant brain tumors, meningiomas, hematomas, trigeminal neuralgia, hemifacial spasm, and hydrocephalus.

As a strong communicator, Dr. Shah’s philosophy is to provide care in a “360-degree” manner. He works collaboratively with his patients, their primary care providers, and other specialists to develop personalized treatment plans. He emphasizes compassionate and accessible communication to patients and their families.

Dr. Shah earned his medical degree at University of California, San Francisco, graduating with Distinction as a Howard Hughes Medical Institute Research Fellow. He then completed his training in Neurosurgery at NYU Langone Health and served as Chief Resident of the Neurosurgery Service at Bellevue Hospital Center in Manhattan. Currently, Dr. Shah is a member of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.

He has published multiple peer review studies and books chapter on topics of pituitary tumors, stereotactic radiosurgery, and neural stem cells.

Dr. Shah’s extensive research background, scientific knowledge, and technical expertise empower him to provide his patients with the latest advancements in neurosurgical care.

S2:E12: The Neuro Approach to Spine Surgery

Most adults have suffered from back pain at some point in their lives. If you have dealt with an injury, nagging aches, or piercing, shooting pain, you probably wondered if the pain would go away on its own. When is does further treatment, or surgery, become necessary?

MedStar Health neurosurgeon Jugal Shah, MD, demystifies back pain and spine surgery on this episode of DocTalk. Learn more about spinal conditions, how and why nature designed the spine, and which symptoms are most concerning.

Dr. Shah sees patients at MedStar Franklin Square Medical Center, MedStar Harbor Hospital, and in Ellicott City, Maryland. Dr. Shah specializes in brain and spine disease, with a particular interest in minimally invasive and robotic spinal surgery. He treats spinal degeneration, instability, spinal cord and nerve compression, trauma, cancer, and cranial pathologies.

Teresa Wojtasiewicz, MD

Teresa Wojtasiewicz, MD

Teresa Wojtasiewicz, MD, a Board Eligible neurosurgeon at MedStar Franklin Square Medical Center, treats all neurological diseases with a particular interest in Parkinson’s Disease, essential tremor, dystonia, trigeminal neuralgia, epilepsy, and spasticity. She is a general neurosurgeon and is able to provide compassionate, skilled care for any patient facing a neurosurgical illness.

Throughout the years, Dr. Wojtasiewicz has developed an interest in functional neurosurgical procedures. She has extensive experience performing a wide variety of treatments to help her patients, including Deep Brain Stimulation (DBS), Stereotactic EEG placement, and laser ablation.

Dr. Wojtasiewicz is highly skilled in using state-of-the-art technology including improving high precision and accuracy with intraoperative navigation and minimally invasive procedures to help make neurosurgery safer and gentler for her patients. She has written publications on stereotactic and functional neurosurgery and deep brain stimulation.

Dr. Wojtasiewicz is fluent in English and speaks conversational Japanese and Polish.

“Neurological problems impact people in such a profound way. I love being able to give someone back parts of their life that the illness has taken away from them. As a surgeon, I am honored to use my own hands and tools to directly address those neurological problems and help my patient begin a path to recovery.”

—Dr. Teresa Wojtasiewicz

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FAQs

What are the symptoms or warning signs of spine problems?

The warning signs you should look for include severe neck or back pain that doesn’t subside with rest or over-the-counter medications, and severe pain in either the arm or leg that doesn’t go away.
What causes spine problems? What are the symptoms or warning signs to look out for?

There are many causes of spine problems. Common injuries, including disc herniations that compress nerves in the neck or lumbar spine, can happen as part of the normal aging process. More serious problems, including tumors, a collapse of the spinal column, and infections, can also occur. Trauma from accidents or falls can cause fractures and nerve compression, which may require surgical attention.

The warning signs you should look for include severe neck or back pain that doesn’t subside with rest or over-the-counter medications, and severe pain in either the arm or leg that doesn’t go away.
Is there anything I can do to prevent spine problems?

Yes, regular exercise, specifically focusing on core stability and sustaining muscle strength can help protect the spine from injury. Maintaining a healthy weight and avoiding smoking can also be beneficial in reducing the risk of spinal complications.
Am I a candidate for minimally invasive spine surgery?

Depending on the specific problem and circumstance of the spinal injury, you could be a potential candidate for minimally invasive procedures. Our providers work with patients to determine the best course of treatment.
Can surgery be avoided? What are some other treatment options?

Many spine-related injuries improve without surgical intervention. Physical therapy and core-strengthening exercises can be effective in reducing symptoms. Steroid injections can also help with pain management.
How can I tell the difference between a strained muscle and a disc herniation?

These injuries are often treated similarly at first, using anti-inflammatory medications, heat, ice, stretching, and physical therapy, if needed. If you develop numbness, tingling, or weakness that radiates down the arms or legs, the injury could be a nerve issue resulting from a herniated disk.
I have been feeling back pain. When should I see a doctor?

Back pain is common and can be treated with over-the-counter anti-inflammatory medications. If pain persists for longer than two weeks, or if there is pain, numbness, tingling, or a sense of weakness in the arms or legs, it is time to see a doctor. The diagnostic process begins with an MRI to assess the severity of the issue, and then back pain treatment options are discussed.
What does it mean when spine surgery is minimally invasive?

Though often successful, traditional spine surgery can involve extensive muscle manipulation at the injury site. This results in a longer recovery process that impacts your mobility and can increase risks for infection and blood loss.

Minimally invasive spine surgery involves much smaller incisions and techniques that minimize trauma to the supporting tissues of the spine such as muscles. This type of surgery allows you to mobilize quickly after surgery and lowers the risk of complications and infections. Our specialized team ensures that the most advanced techniques are accessible to you.
What is artificial disc replacement?

Artificial disc replacement involves placing plastic or metal discs during surgery to allow for continued motion at the procedure site. The devices are long-lasting and minimize the strain on the areas above and below the injury. If you are a candidate for this treatment, this procedure is often the preferred method.
What is motion preservation?

Maintaining the function of the spine is an important long-term consideration for patients requiring spinal surgery. In some fusion surgery cases, patients may need additional surgery to address changes at adjacent levels in the spine after the procedure. Fortunately, spine surgeons have developed prosthesis devices that help preserve the motion of the cervical and lumbar spine and decrease future adjacent level deterioration. These devices can be an alternative option to maximize mobility for appropriately selected patients.
What is my long-term outlook if I have surgery? Do I need to make any lifestyle changes?

Patients can often return to their usual exercise regimens and activities after follow-up appointments that determine if they are healing appropriately. Following more intensive procedures, such as spinal fusions, tumor surgeries, or operations for trauma or scoliosis, patients may be limited from participating in high-impact exercising or intense sports. In general, most surgical patients are not required to make any lifestyle changes after a full recovery.
What is the best treatment for spinal stenosis?
Treatment generally depends on the severity of pain. Our experienced team of surgeons will work with you and your family to develop the most effective care plan for you.

Our team will recommend any combination of non-surgical and surgical treatment options designed to bring you spinal stenosis pain relief and increase your activity level. Non-surgical treatment options may include:

Pain and anti-inflammatory medications

Physical therapy

Exercise therapy

Steroid injections

If non-surgical treatments are not effective, lumbar spinal stenosis surgery may be an option to provide lower back pain relief.
What is the difference between an orthopedic spine surgeon and a neurosurgeon?

In the treatment of the spine, both orthopedic surgeons and neurosurgeons complete similar work, including decompression of the spinal cord and nerves and placing instrumentation in the spine for disc replacement and fusion procedures. Neurosurgeons also typically perform brain surgery and are trained to remove tumors of the nerves and spinal cord. Both orthopedic and neurosurgeons have fellowship or subspecialty training in spine surgery.
What should I expect in terms of recovery? Does it vary by treatment?

Minimally invasive surgeries allow you to be mobile more quickly than traditional procedures. In many cases, patients are out of bed within a day or two after these types of surgeries. Generally, these patients can resume normal activities in four to six weeks, though physical therapy is sometimes recommended to help rebuild muscle strength.

More complicated procedures, including fusions, require longer recovery times, and it can take patients more than six months to return to sports or other vigorous activities. However, these patients can often begin light exercise, such as walking, soon after the procedure if their provider has cleared them.
What types of surgeries do you perform?
We treat a range of conditions that affect the spine, from the base of the skull to the tailbone. Common procedures include:

Removing disc herniations

Disc replacement procedures

Spinal fusion surgeries

Treating complex conditions, including tumors, infections, and deformities
When is surgery necessary?

Surgery is sometimes necessary if someone experiences severe pain or movement limitations or significant weakness or numbness. In many cases, patients have tried conservative treatments of physical therapy and injections without success. Surgery can be a good option in these circumstances to ease pain, restore function and improve mobility and help the patient resume normal activities.

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