SI Joint Dysfunction:

SI Joint Dysfunction:

Sacro-iliac (SI) Joint dysfunction is often misdiagnosed in people suffering from chronic low backpain. As with other joints in the body, the SI Joint can become damaged, suffer from wear and tear, or the ligaments supporting the joint may be stretched or injured. This may result in altered function of the SI Joint (referred to as SI joint dysfunction) which may cause pain in the buttocks, lower back or spine, pelvis and groin, and even the legs.
Pain in the lower back and buttocks may be caused by the SIJoint, hip, spine, or a combination of these structures. It is important that your doctor thoroughly evaluate ALL potential pain sources during a lower back pain exam in order to give you the proper diagnosis of your symptoms and prescribe the right path of treatment.
For most of the last century, doctors were taught that the SIJoint did not move and therefore could not be a source of low backpain. Today, we know that's not true. Finding a doctor who is well trained in SIJoint diagnosis and treatment gives you a strong opportunity to understand the true source of your pain and step toward the correct treatment for you.
Our surgeons at Neurosurgery of Central Florida are constantly striving to provide the most advanced care for our patients, exploring technologies that reduce discomfort and improve quality of life. We are proud to offer minimally invasive procedures to patients with SIJoint dysfunction as an option for their chronic lower backpain.
Neurosurgery of Central Florida offers these minimally invasive surgical options for patients where conservative treatment methods are no longer helpful. Learn more about this innovative solution that provides patients lasting relief from chronic lower backpain related to the SIJoint.
If you think your SIJoint may be contributing to your chronic lower backpain, Contact us to schedule an evaluation appointment today!

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What is a herniated disc and what are the treatment options?

What is a herniated disc and what are the treatment options?

When it comes to a herniated disc, how much do you know about it? Do you know the many treatment options that are available? Here at Neurosurgery of Central Florida, we have all the answers you are searching for. Located in the heart of Central Florida, get all the information you need today!

What Is A Herniated Disc?
A herniated disc is a fragment of the disc nucleus that is pushed out of the annulus, into the spinal canal through a tear or rupture in the annulus. Discs that become herniated usually are in an early stage of degeneration. The spinal canal has limited space, which is inadequate for the spinal nerve and the displaced herniated disc fragment. Due to this displacement, the disc presses on spinal nerves, often producing pain, which may be severe.

What Is The Treatment
Conservative treatment, mainly modifying activities to avoid movement that causes pain and taking pain medication, relieves symptoms in most people within a few days or weeks.
● Medications
● Over-the-counter pain medications. If your pain is mild to moderate, your doctor might recommend over-the-counter pain medication.
● Cortisone injections. If your pain doesn't improve with oral medications, your doctor might recommend a corticosteroid that can be injected into the area around the spinal nerves. Spinal imaging can help guide the needle.
● Muscle relaxers. You might be prescribed these if you have muscle spasms. Sedation and dizziness are common side effects.
● Opioids. Because of the side effects of opioids and the potential for addiction, many doctors hesitate to prescribe them for disk herniation. If other medication doesn't relieve your pain, your doctor might consider short-term use of opioids, such as codeine or an oxycodone-acetaminophen combination (Percocet, Roxicet). Sedation, nausea, confusion and constipation are possible side effects from these drugs.
● Therapy
● Your doctor might suggest physical therapy to help with your pain. Physical therapists can show you positions and exercises designed to minimize the pain of a herniated disk.
● Surgery
● Few people with herniated disks eventually need surgery. Your doctor might suggest surgery if conservative treatments fail to improve your symptoms after six weeks, especially if you continue to have:
● Poorly controlled pain
● Numbness or weakness
● Difficulty standing or walking
● Loss of bladder or bowel control
● In nearly all cases, surgeons can remove just the protruding portion of the disk. Rarely, the entire disk must be removed. In these cases, the vertebrae may need to be fused with a bone graft.

Contact Our Team Today
Dr. Ramirez is a member of the American Association of Neurological Surgeons, the Congress of Neurological Surgeons. When it comes to all things you need to know about neck and back pain, he is the one to trust. Call Neurosurgery of Central Florida today for more information.

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Back Pain “Red Flag” Symptoms To Seek A Neurosurgeon

Back Pain “Red Flag” Symptoms To Seek A Neurosurgeon

Lower back pain is an extremely common disorder that has a profound impact on millions of individuals every single year. In fact, back pain is the number one most common cause of lost workdays in the United States and also is one of the most common reasons for patients to visit their primary care physicians. Studies project that 50 to 80% of the adult population will suffer from a memorable episode of lower back pain every year.

The majority of back pain cases are the result of sprain, strain, muscle spasm, and/or intervertebral disc degeneration. These types of pain can be difficult to bear when they act up, but the good news is that they typically get better on their own with simple non-invasive treatments like medication, physical therapy, heat or cold packs etc. But there are some cases where severe back pain may be a sign that you need surgery, which is what the neurosurgeons at Neurosurgery of Central Florida handle. The back pain in these cases may be caused by:
• Spinal stenosis, or a narrowing of the spinal canal
• Spondylosis, stiffening from wear-and-tear on the spine
• Developmental disorders
• Tumors
• Trauma

There are many parts of the spine that can contribute to lower back pain, and these are just some of the most common causes for severe cases.

While the majority of cases of lower back pain will not necessitate surgery, you should still be aware of certain red flags that signal a need to go to a neurosurgeon for diagnosis and treatment. Here are some symptoms to keep in mind that may mean a visit to the doctor:
• Back pain that is accompanied by bowel or bladder incontinence and/or numbness in the areas that would “sit on a saddle” (sometimes called saddle anesthesia), which may indicate a medical emergency called “equina syndrome”
• Back pain that comes with weakness, numbness, or pins-and-needles in the legs may indicate a compression of the spinal cord
• Back pain that seems to radiate down your buttock, leg, or foot for more than a few weeks time may be due to radiculopathy
• Back pain accompanied by fever may indicate an abscess
• Back pain that worsens during the night
• Back pain that comes with unexplained weight loss
• Back pain that doesn’t stop for several weeks or months
• Back pain after a serious fall, motor vehicle injury, or other trauma needs to be medically evaluated immediately

The causes of back pain vary widely, so if you experience any of the red flags listed above, then consider making an appointment.


In a lot of cases, lower back pain is able to be treated safely and effectively with non-operative measures such as physical therapy and pain medications. Surgery typically only is required for cases of severe pain, symptoms that are unresponsive to nonoperative therapy and conservative care, and serious conditions that may place risk on the spinal cord or surrounding nerves. Surgical treatments can vary widely and depend on the ultimate cause of the back pain.

To make an appointment, call Neurosurgery of Central Florida today.

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Carpal Tunnel Syndrome: Symptoms, Causes, and More

Carpal Tunnel Syndrome: Symptoms, Causes, and More

Carpal Tunnel Syndrome (CTS) is a common problem that affects millions of people in America. Carpal Tunnel Syndrome is a hand function problem that is caused by compression of the median nerve at the wrist. It occurs most often when the median nerve in the wrist becomes inflamed after being aggravated by repetitive movements, such as typing on a computer keyboard, talking on the phone (holding phone to the ear), texting, or playing the piano. It also impacts professional artists (sculptors, violinists, pianists) or any job requiring long-term repetitive motion of the wrist (jackhammer use, certain types of factory work). The “carpal tunnel” consists of the bones, tendons, and ligaments that surround the median nerve. Due to the fact that the median nerve applies sensation to the thumb, index, middle finger, and part of the ring finger (digits one through four), and also provides motion to the muscles of the thumb and hand, CTS sufferers notice numbness, pain, and weakness in these areas.

Common symptoms of CTS include:

● Hand and wrist pain

● A burning sensation in between the middle and index fingers

● Thumb and finger numbness

● An electric-like shock through the wrist and hand

Such symptoms often worsen when the wrist is bent forward. The numbness or pain may be worse at night, and may actually keep patients awake. Throughout the day, it may occur more often when participating in activities that use the wrist, such as talking on the phone and driving.

Common Causes of CTS

Some diseases or conditions that may raise your chances of developing CTS include broken or dislocation of wrist bones, pregnancy, diabetes, thyroid problems, menopause and/or obesity. Repetitive and forceful grasping with the hands or repetitive bending of the wrist may also contribute to the problem. Basically, any repetitive motions that cause significant swelling, thickening, or irritation of the membranes around the tendons in the carpal tunnel may result in the pressure on the median nerve, which disrupts transmission of sensations from the hand up to the arm and to the central nervous system.


If you notice persistent symptoms, it’s important to seek medical attention, as you don’t want to wait for the pain to become intolerable. Before a doctor is able to recommend a

course of treatment, they will first perform a thorough evaluation of the condition, which includes inquiring about your medical history, a physical examination, and a diagnostic test. The doctor will document any symptoms and inquire about the extent to which these symptoms impact your daily life. The physical examination will include assessments of sensation, strength, and reflexes. If nonsurgical treatment like medication, bracing, or physical therapy are unable to provide sufficient relief, then the doctor may perform further diagnostic studies to figure out if surgery is an effective option. Such diagnostic studies may encompass:

● X-ray in order to examine the bones of the wrist to figure out if any abnormalities are contributing to CTS

● EMG/NCS (Electromyogram and Nerve Conduction Study)- these tests illustrate how the nerves and muscles are working together and measure the electrical impulse along nerve roots, peripheral nerves, and muscle tissues.

If you are seeking treatment for Carpal Tunnel Syndrome, call Neurosurgery of Central Florida to make an appointment today.

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Why Is The Brain So Important?

Why Is The Brain So Important?

The human brain serves as the command center for the human nervous system. It receives signals from the sensory organs of the body and then outputs information to the muscles. The human brain has the same basic structure as other types of mammal brains, but is larger relative to body size than the brains of any other mammals. It is one of the most important parts of the human body because it tells the rest of the body what to do and how to respond in many conscious and unconscious ways.

Human Brain Anatomy

The largest portion of the human brain is the cerebrum, which is divided into two hemispheres. The brainstem lies underneath, behind which sits the cerebellum. The outermost layer of the cerebrum is the cerebral cortex, which is made up of four lobes: the frontal, parietal, temporal, and occipital. Like all vertebrate brains, the human brain develops from three sections which are called the forebrain, midbrain, and hindbrain. Each of these sections of the brain contain fluid-filled cavities called “ventricles.” The forebrain develops into the cerebrum and underlying structures, the midbrain becomes part of the brainstem, and the hindbrain leads into regions of the brainstem and cerebellum. The cerebral cortex is enlarged greatly in human brains and is thought of as the seat of complex thought. Visual processing occurs in the occipital lobe, close to the back of the skull. The temporal lobe processes sound and language, and includes the hippocampus and amygdala, which respectively play roles in memory and emotion. The parietal lobe integrates input from different senses and is key for spatial orientation and navigation.

The brainstem connects to the spinal cord and is made up of the medulla oblongata, pons, and midbrain. The brainstem primarily relays information between the brain and the body, supplies some of the cranial nerves to the face and head, and performs critical functions in controlling the heart, breathing, and consciousness. The thalamus and hypothalamus lie between the cerebrum and brainstem. The thalamus relays sensory and motor signals to the cortex and is involved in regulating consciousness, sleep, and alertness. The hypothalamus connects the nervous system to the endocrine system, where hormones are produced, through the pituitary gland. The cerebellum lies beneath the cerebrum and provides other important functions in motor control, playing a key role in coordination and balance and may also have certain cognitive functions.

Human Brains Are Unique

Intelligence isn’t directly correlated with the size of the brain. For example, a sperm whale’s brain is more than five times heavier than the human brain. The ratio between the size of the brain and the body size is a more accurate measure of how intelligent an animal may be. However, among human beings, brain size is not a clear indicator of how smart somebody is. Certain geniuses in their field sport smaller-than-average brains, while others larger than average. While humans have a high brain-weight-to-body-weight ratio, so do other animals. Human intelligence (as far as current research shows) largely rests in the neurons and folds, as we have more neurons per unit volume than other animals.

Human brains are a highly intricate organ. If you are seeking a neurosurgeon, call Neurosurgery of Central Florida for a consultation today.

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Migraines: Symptoms, Causes, and When to Call a Doctor

Migraines: Symptoms, Causes, and When to Call a Doctor

A migraine is a neurological condition that can manifest in many different symptoms. Frequently characterized by intense, debilitating headaches, migraine symptoms may encompass nausea, vomiting, difficulty speaking, tingling or numbness, and sensitivity to light and sound. Migraines typically run in families and can affect people of all ages. Migraine headaches are generally diagnosed based on reported symptoms, a patient’s clinical history, and through ruling out other causes of the symptoms. There are two main categories of migraine headaches: those without aura (also known as common migraines), and those with aura (also known as classic migraines).

Migraines may start in childhood, or they may not begin until early adulthood. Family history is one of the biggest risk factors for having the condition, and women are also more likely than men to have this condition.

Symptoms Of Migraines

Migraine symptoms may manifest a day or two before the headache itself does. This is known as the prodrome stage. During this stage, symptoms can include:
Food cravings
Frequent yawning
Fatigue or low energy
Neck stiffness

In migraines with aura, the aura typically happens after the prodrome stage occurs. In an aura, problems with vision, sensation, movement, and speech may occur. Some problems that may occur include feeling a prickling or tingling sensation in your face, arms, or legs, seeing shapes, light flashes, or bright spots, difficulty speaking clearly, and temporarily losing your vision. The attack phase commonly follows, which is the most severe of the phases and when the actual migraine pain happens. In certain people, the attack phase can overlap or occur during an aura. Attack phase symptoms can last anywhere from hours to days. Symptoms of a migraine can vary from person to person, and can include increased sensitivity to light and sound, dizziness or feeling faint, nausea,pulsing and throbbing head pain, pain on one side of your head, either on the left side, right side, front, or back, or in your temples, and vomiting.

Many headache disorders like migraines can be a real source of pain, but they may not necessarily mean you have a serious medical issue. However, if you have new symptoms or more severe symptoms than normal, then you should consult with your physician. If you have any of the following symptoms, we recommend going to a doctor right away:
Trouble with speech, confusion, seizures, inappropriate behavior, or personality changes
Weakness, dizziness, sudden loss of balance or falling,tingling or numbness, or inability to move your body
Blurry vision, double vision, or blind spots
Fever, a stiff neck, shortness of breath, or rash
Severe nausea and vomiting
Headache pain that wakes you up at night
Headaches that happen after a head injury or accident
A new kind of headache that occurs for the first time after age 50
Headaches that are triggered by coughing, sexual activity, bending, or other intense physical activity
A recent change in your headache symptoms or pattern of attacks

If you are seeking help from a neurosurgeon, contact Neurosurgery of Central Florida today for an appointment.

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Ulnar Nerve Entrapment, What Is It?

Ulnar Nerve Entrapment, What Is It?

Ulnar Nerves go across the brachial plexus' nervous system, moves across the back downwardly, and goes into the arm. They are known for transmitting electrical pulses through the muscles situated in the arms and the forearms. The fourth and fifth finger sensation is also a result of the ulnar nerve. The sensations at the backside of the forearms and some aspects of the palm are also included. Every bit of numbness you experience in your arms and forearms is due to the ulnar nerve entrapment. Do you reside around Central Florida with Ulnar nerve entrapment? Here at Neurosurgery of Central Florida, we will help you to learn more about it. You can trust us because we are the best in Central Florida!

Possible Symptoms and Diagnosis of Ulnar Nerve Entrapment

It is vital to note the symptoms because most people have no idea about it, which eventually leads to a more severe case that might be challenging to treat. It is why you need to take note of the following symptoms:

Weakness of the joints in the elbow region
Shivering due to Cold
Fourth, fifth finger, and palm sensation
Fragility and weakness of the hand

Once your doctor carries out a careful study using detailed information and analysis, he might suggest a further test to be carried out like NCS (Nerve Conduction Study) and EMG (Electromyography). These tests will help to monitor functioning levels of the nerves and muscles. The EMG analysis analyzes the functioning rate, which includes muscle response and nerve stimulation capacity. The NCS estimates the speed and quantity of electric pulse conduction in a nerve. The following may also be considered:

MR Neurology: The use of MR is to create an improved image of the nerves using unique programming and frequency. Most patients see this procedure as no different from the standard MRI procedure.
Ultrasound Procedure
MRI Procedure

What Leads to Ulnar Nerve Entrapment

When ulnar nerves entrapment occurs at the elbow, the nerves are too far stretched, and the elbows are bent entirely for an extended period. Another way that can lead to ulnar nerve entrapment is when you lean your elbows on a hard surface for a period. This can exert too much pressure on your nerves, causing them to have ulnar nerve entrapment. The same goes for the wrist; when there is a lot of pressure exerted on the nerves, probably from consistent use of a tool, it can lead to entrapment at the wrist.

Treatment / Surgical Procedures for Ulnar Nerve Entrapment

Treatment all depends on how severe the person's condition gets. Once the state of the patient is extreme, a doctor might recommend the following:
Incorporation of splints to the elbow to help with immobility
Prescription of painkillers such as ibuprofen, aspirin, and others to help numb the pain and reduce the chances of inflammation
Unique therapy is recommended to help strengthen the tendons and ligaments in the elbow and arm
When methods such as physical therapy and other treatment procedures prove abortive, nerve release surgery might seem the likely solution. The two types of ulnar release surgery that will likely be carried out are the surgery of the wrist and that of the elbow.

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Suppose you experience Ulnar Nerves entrapment, and you reside around Central Florida., Neurosurgery of Central Florida offer the best neurosurgery service. To learn more about us, click here.

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Neck Pain and When It's Time to Get Help

Neck Pain and When It's Time to Get Help

We all get a headache from time to time, but persistent neck pain should not be brushed aside. Pain that begins in your neck but radiates through the back and arms may indicate an underlying spinal disorder or neurological disease. For neck pain requiring surgery, consult the physicians at Neurosurgery of Central Florida. With our extensive experience in spinal fusion and surgery, we can help you treat not just your neck pain but the root of the problem.

Why Neck Pain Is No Small Inconvenience
Your neck sits atop your spinal column, or cervical spine, which comprises seven vertebral bones. These vertebrae are stacked on top of each other, with an intervening disc that acts as a cushion and shock-absorber. The bones in your spinal column are located near the bundle of nerve fibers called your spinal cord, which originates from your brain and communicates neural commands to your arms and legs. With its proximity to the brain and spinal cord, your neck acts as a crucial indicator of muscle, nerve, and joint health. Pain in your neck could signify muscle tension, arthritis, disc degeneration, or even cancer or meningitis. Don’t ignore persistent, severe neck pain; seek swift diagnosis and thorough treatment before the problem worsens.

Causes of Neck Pain
In diagnosing the cause of your neck pain, there are several possible culprits. Your pain could be the result of an injury or whiplash from a recent car accident. Something as simple as poor posture can worsen neck pain and lead to muscle tension. A degenerative disease such as arthritis might be eroding the discs in your spinal column, or a bone spur could be putting uncomfortable pressure on various spots along your spinal cavity. Each of these causes can and should be treated before your pain worsens, and your spine suffers more damage.

Treating Your Neck Pain
There are many treatment options for neck pain, and not all of them are as invasive as surgery. Depending on the nature of your symptoms and the cause of your pain, you may be able to simply wear a brace or other stabilizing device to align your spine and allow the body to heal. You may be prescribed a pain reliever such as an oral steroid or cortisone shot to soothe the pain for a predetermined time. If the pain persists, you may need more aggressive treatment. Spinal fusion can correct the problem of a degenerated disc by fusing two vertebrae. Your spine may require the support of a plate or other surgically-embedded device to curb chronic pain. If you have severely injured your neck in a sporting or automobile accident and are experiencing numbness or tingling in your arms or legs, seek medical help right away.

Contact Us
You don’t have to put up with the pain in your neck, and you shouldn’t let more insidious symptoms such as numbness go unchecked. Consult a physician at Neurosurgery of Central Florida; we can address your neck pain by treating its source. Call us today at 407-624-5028.

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Carpal Tunnel What is it and how is it caused?

Carpal Tunnel What is it and how is it caused?

Carpal tunnel syndrome is something to take very, very seriously. Nothing is worth compromising your health over, so make sure to listen to your body and take breaks often. In some cases, it may not have anything to do with your working environment or daily activities. Carpal tunnel syndrome has other causes, and these are just as important to investigate as a symptom caused by repetitive motion. Neurosurgery of Central Florida is here to discuss carpal tunnel and how imperative it is that you see your doctor if you suspect you have carpal tunnel syndrome.

Pain in the hand is the basic indicator for carpal tunnel syndrome. Specifically, symptoms present as numbness or tingling, and this sensation may only be present in the index finger and thumb. The feeling is similar to static shock, and you do not need to be using a computer to aggravate it; the pain is often there when your hands and wrists are at complete rest. You may also feel it in your arm along with weakness and an inability to hold or grab onto things as effectively. It may help to shake your hands and arms to rid yourself of the feeling, but this is only a temporary solution. Lifestyle changes or a doctor's visit are required to prevent the problem from getting worse.

What's Going On Inside My Wrist and Arm?
Carpal tunnel syndrome is caused by the median nerve in your wrist being squeezed. Know the feeling of your leg or arm falling asleep? That occurs because you are squeezing the nerves in those limbs. Like a hose being stepped on to prevent water from flowing, those nerves cannot transmit the signals which provide sensation and movement to that part of the body. Of course, all you have to do to restore the signal is to take the pressure off. Easy enough when you're leaning on a limb – but how do you alleviate pressure in the wrist?

Prevention and Treatment
Carpal tunnel is sometimes caused by heredity or injury, and long-lasting symptoms should definitely be checked by a doctor. The best thing you can do in the meantime is to take certain precautions to avoid exacerbating the problem with certain stressors.

Keep a soft grip
Don't squeeze a pen or type too hard
Practice good posture
Take frequent breaks
Do hand and arm stretches every so often
Keep your arm bent at a 90-degree angle when using a computer
Type on a keyboard directly in front of you, not off to the side
Avoid repetitive motions

You don't need to make drastic changes to recover from carpal tunnel syndrome; you just need to undergo treatment for a short period and listen to your body going forward. Your doctor may provide a wrist splint so that your wrist can stay in a straightened, relaxed position long enough for the pressure to be relieved. In extreme cases where there is swelling, surgery may be recommended. Whatever the case, do not take carpal tunnel syndrome lightly. Ignoring the pain can lead to permanent nerve damage. With due diligence and care, however, you'll be fine.

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To learn more about carpal tunnel, contact the professionals at Neurosurgery of Central Florida today!

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