Spinal conditions we treat, by category

How this section is organized

Spinal conditions sort into a small number of categories based on what’s actually happening anatomically. Disc and nerve pain (herniations, radiculopathy). Stenosis and narrowing (central canal, foraminal, lateral recess). Joint and facet pain (facet syndrome, SI joint dysfunction). Post-surgical pain. Each category has different treatment options, different recovery trajectories, and different things to verify before agreeing to surgery.

The conditions listed below are the ones Synergy treats. Each links to a detailed condition page explaining symptoms, diagnostic workup, conservative options, and surgical alternatives where relevant. Most conditions can be addressed without fusion — that’s the consistent thread across the practice.

Disc and nerve pain

Most patients arriving at Synergy fall into this category. A disc herniation compresses a nerve root, producing leg or arm pain in a specific distribution. Sciatica is the colloquial term when lumbar roots are involved. Endoscopic discectomy is the procedure that removes the offending fragment through a small portal.

Specific conditions: herniated disc, lumbar herniated disc, sciatica, lumbar radiculopathy, cervical radiculopathy, disc extrusion, disc protrusion.

Stenosis and narrowing

Spinal stenosis is narrowing of the canal or foramen, often producing neurogenic claudication (leg symptoms with walking) or radicular pain. Endoscopic decompression addresses the narrowing without fusion in most cases. The choice of procedure depends on whether the narrowing is central, foraminal, or lateral recess.

Specific conditions: spinal stenosis, central canal stenosis, lateral recess stenosis, foraminal stenosis, spinal claudication, cervical spinal stenosis, cervical myelopathy, spinal synovial cyst.

Joint and facet pain

Axial back or neck pain (without leg/arm radiation) often originates from the facet joints or the sacroiliac joints. The treatment isn’t disc surgery — it’s targeted intervention at the source. Diagnostic blocks identify the source; radiofrequency procedures provide durable relief.

Specific conditions: facet joint syndrome, SI joint dysfunction, spinal arthritis (facet), hip arthritis, shoulder arthritis, knee osteoarthritis.

Post-surgical and complex pain

Persistent or recurrent pain after prior spine surgery has many possible causes. The right treatment depends on identifying which one applies. Revision isn’t always the answer; sometimes targeted intervention at a specific pain source resolves what multiple prior procedures didn’t.

Specific conditions: failed back surgery syndrome, post-laminectomy syndrome, adjacent-segment disease, adult degenerative scoliosis.

Written bySteven Lockhart, Healthcare Marketing Group

Medically reviewed byMarion R. McMillan, MD, Interventional Pain Medicine & Endoscopic Spine Surgery

Spine conditions we treat

Clinical focus is on spine conditions amenable to full-endoscopic surgical treatment or to interventional pain management. Most common diagnoses: lumbar spinal stenosis, lumbar herniated disc, cervical radiculopathy, foraminal stenosis, radiculopathy (cervical and lumbar), chronic back pain, and chronic neck pain. The cluster reflects the practice’s focus on conditions where decompression alone can address pathology without fusion.

Joint conditions for COOLIEF

Beyond spine, the practice treats joint pain conditions amenable to COOLIEF cooled radiofrequency ablation: knee osteoarthritis, hip arthritis, and shoulder arthritis. COOLIEF is appropriate for patients with significant joint pain who aren’t ready for replacement, aren’t replacement candidates, or want a less invasive alternative.

Specialized conditions and revision cases

Also: spinal synovial cysts, adult degenerative scoliosis (with limitations — see condition page for candidacy criteria), facet joint syndrome, SI joint dysfunction, cervical myelopathy. For prior spine surgery patients with persistent symptoms: failed back surgery syndrome and post-laminectomy syndrome, with revision spine surgery and spinal cord stimulation evaluation as potential paths.

Conditions for which the practice refers out

Several conditions are outside the practice’s clinical focus and result in referral: spondylolisthesis with significant instability, severe scoliosis requiring deformity correction, end-stage joint disease appropriate for replacement, and conditions requiring fusion. Candor is structural — see /no-fusion-promise/.

If you’re not sure which condition applies

That’s common among new patients. The free MRI review is the practical path to clarity: submit imaging, get clinical assessment of what it shows. For patients without recent imaging, obtain MRI through your primary care physician first. Process at /how-it-works/; condition reference resources at MedlinePlus.

How conditions relate to procedures — matching pathology to treatment

Spine conditions and spine procedures don’t have a one-to-one relationship. A single condition (say, lumbar spinal stenosis) can be treated by several different procedures depending on the specifics. A single procedure (say, endoscopic decompression) can address several different conditions. Understanding how conditions map to procedures helps patients understand their options.

For lumbar spinal stenosis, the primary surgical option is decompression — removing the compressing tissue (typically bone from facet arthritis, thickened ligamentum flavum, or both). Endoscopic decompression, microscope-assisted decompression, and open laminectomy all accomplish this goal through different technical approaches. Fusion is added only when instability is present. The condition page at /lumbar-spinal-stenosis/ covers the full clinical picture and treatment considerations.

For lumbar herniated disc with radiculopathy, the primary surgical option is discectomy — removing the herniated disc material compressing the nerve root. Endoscopic discectomy, microdiscectomy, and open discectomy accomplish this through different approaches. The condition page at /lumbar-herniated-disc/ covers indications and outcomes.

For cervical radiculopathy, the surgical options include anterior cervical discectomy and fusion (ACDF, which the practice doesn’t perform), posterior cervical foraminotomy (which can be done endoscopically), and cervical disc replacement (a fusion alternative the practice doesn’t perform). For patients with cervical radiculopathy amenable to posterior foraminotomy, endoscopic technique is available; see /cervical-endoscopic-surgery/. For patients whose anatomy or pathology requires ACDF, referral is appropriate.

For joint conditions, the surgical options are joint replacement (which the practice doesn’t perform) or joint-preserving alternatives including COOLIEF cooled radiofrequency ablation. COOLIEF doesn’t repair the joint — it interrupts the nerve signals carrying pain from the joint. For patients whose arthritis has advanced beyond what COOLIEF can address, joint replacement referral is appropriate. The condition-specific mapping is available at knee, hip, and shoulder pages. For diagnostic ambiguity or complex overlapping conditions, the free MRI review provides the clearest path to a specific recommendation.

Further reading and authoritative sources

The pages linked below cover related topics in more detail. For patients who prefer independent, non-practice sources, the external references at the end of the list provide authoritative verification of clinical facts, procedural information, and regulatory context. This practice’s clinical statements are traceable to the peer-reviewed literature and professional-society guidelines listed here.

Related pages on this site:

• Full Conditions Hub — details, indications, and process context relevant to the topic above.
• Treatments Hub — details, indications, and process context relevant to the topic above.
• Free MRI Review — details, indications, and process context relevant to the topic above.
• How It Works — details, indications, and process context relevant to the topic above.
• The Evidence — details, indications, and process context relevant to the topic above.
• Our Philosophy — details, indications, and process context relevant to the topic above.

Independent authoritative sources:

• MedlinePlus — Health Information — authoritative independent source for verification and further reading.
• NASS — North American Spine Society — authoritative independent source for verification and further reading.

For patients whose questions extend beyond the material covered here, the direct path forward is the free MRI review for candidacy-specific questions or a phone call to (864) 886-9888 for process or logistics questions. The practice’s broader clinical philosophy — including the reasoning behind the no-fusion-first orientation and the single-surgeon model — is documented at /our-philosophy/.