FAQs (frequently asked questions) about Neck and Spine Surgery


1. Does Dr. Schiffer perform all types of spinal surgeries?

Yes. Dr. Schiffer performs:

Cervical Endoscopic Discectomy (CED) for cervical herniated/protruded disc problems.

Anterior Cervical Discectomy (ACD) for extensive osteophytes (bone spurs) with or without disc protrusions.

Anterior Cervical Fusion (ACF) for an unstable cervical spine.

Lumbar Endoscopic Discectomy and Thermal Annuloplasty (LED/TA) for lumbar herniated/protruded disc with or without annular tears or degenerative disc disease.

Microdiscectomy (MD) for sequestered free disc fragments and/or bone spurs in the lumbar area.

2. Why do other surgeons want to perform only disc fusions and not endoscopic discectomy?

Until mid 80's, fusion was considered the common solution for herniated discs. Ironically, most surgeons still believe in that theory. Medicine has made such advancement in the past 20 years and endoscopic discectomy is a great example of that progress. Endoscopic discectomy requires considerable training and experience, which most surgeons are yet to explore.

3. Why doesn't Dr. Schiffer use a laser?

Dr. Schiffer performs his endoscopic discectomies by suctioning only the herniated/ protruded part of the disc, leaving the rest of the disc intact. He does not see any special benefits from using laser. Moreover, all lasers create heat, which can cause severe pain and damage the nerve root. For this reason, most cervical laser surgeries are performed under general anesthesia, which is an additional unnecessary risk.


4. When are Lumbar Endoscopic Discectomy (LED) and Microdiscectomy (MD) recommended?

Lumbar Endoscopic Discectomy (LED) is recommended to treat herniated/protruded lumbar discs with or without annular tears and degenerative disc disease. This procedure is performed endoscopically with a small probe, under local anesthesia and there is no incision. Dr. Schiffer often combines the LED procedure with Thermal Annuloplasty procedure. Microdiscectomy is recommended to treat sequestered free fragments and bone spurs in the lumbar region. The surgery is performed using a microscope, under general anesthesia through a small incision.


5. When are Cervical Endoscopic Discectomy (CED) and Anterior Cervical Discectomy (ACD) recommended?

Cervical Endoscopic Discectomy (CED) is recommended to treat herniated/protruded cervical discs. It is performed endoscopically under local anesthesia, using a small probe. CED can also be performed on cervical herniated discs that are extruded or compressing the spinal cord. Anterior Cervical Discectomy (ACD) is recommended to treat extensive osteophytes (bone spurs) with or without disc protrusion. This surgery is performed using a microscope, with a small incision, under general anesthesia. Bone fusion is not necessary.


6. How do you handle multiple disc problems?

Both cervical and lumbar endoscopic discectomies can be performed at multiple disc levels to treat herniated/protruded discs. If a patient has a herniated /protruded disc at one level and also osteophytes (bone spurs) at another disc level, both these problematic discs can be treated by doing a combination surgery of an endoscopic discectomy and an open discectomy at the same time. These combination surgeries can even be performed at more than two disc levels. Dr. Schiffer has performed many combination surgeries at multiple disc levels in both the cervical and lumbar areas. These combination disc surgery at multiple levels have reduced the cost of surgeries tremendously.


7. Is a patient with prior spine surgery a candidate for an endoscopic discectomy?

Patients with prior surgery can still undergo an endoscopic discectomy. However, the only definite contraindication would be a prior fusion at the same disc level.

8. What are the long-term results of Cervical Endoscopic Discectomy (CED)?

In our eight years of experience of the CED (Cervical Endoscopic Discectomy) and 14 years of experience with the LED (Lumbar Endoscopic Discectomy), the long-term results are excellent.

9. When is disc fusion indicated?

Disc Fusion is recommended only when the patient has an unstable cervical or lumbar spine, that can be diagnosed by flexion and extension views of the spine.

10. What is main long-term complication of a disc fusion?

There is significant evidence in the medical literature that a disc fusion changes the weight bearing dynamics of the spine and stresses the discs above and below the fused level. In time, these adjacent discs are more susceptible to herniation and degeneration. Because of these negative aspects, Dr. Schiffer strongly opposes disc fusion unless the patient has an unstable cervical or lumbar spine.

11. Do patients need pre-operative tests?

We do require patients to undergo some pre-operative tests in their local area and these tests need to be done at least 10 days prior to surgery.

12. How long do out-of-state patients need to stay in California?

Patients scheduled for an endoscopic discectomy are requested to stay in California for three days. They will be seen for a consultation and surgery discussion on the first day, surgery will be performed on the second day, and they can return home on the third day after a post-operative visit with the doctor. Patients with open discectomies are requested to stay for at least two days post-operatively.


13. How about post-op care?

Post operative care for endoscopic discectomy is minimal. Physical therapy will be recommended in patients' local area. Dr. Schiffer will stay in touch with patients via telephone and e-mail.

14. Do all insurance companies cover Dr. Schiffer's procedures?

Most insurance companies cover endoscopic discectomies and other procedures. Dr. Schiffer is not a contracted provider for any insurance company. Most PPO and POS plans would allow you to be treated by Dr. Schiffer as an out-of-network or non-contracted provider. Our office staff will be pleased to help you with the process of getting the surgery authorized by your insurance company. Unfortunately, HMO plans usually do not allow patients to be treated by a non-contracted provider.