The First Step Is An Accurate Diagnosis.

Newton & Bedminister, NJ | 908-760-4272

Why Choose Us?

Dr. James Dwyer & Dr. Paul Vessa

Have a combined 75+ years of successful experience in treating back and neck pain.

Are truly active listeners who take the time to understand their patients needs.

Thoroughly evaluate MRI’s, X-Ray’s and CT Scans and fully explain all possible options to patients.

Use the most advanced techniques, starting with conservative treatments through surgery if needed.

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908-760-4272

Newton, NJ

280 Newton Sparta Rd, Newton, NJ 07860

Bedminister, NJ

1 Robertson Dr #11, Bedminster, NJ 07921

Treated Conditions

Almost 80% of us will deal with back or neck pain at some point in our lives.  In many cases, this pain is the result of overexertion or strain and tends to subside with rest and activity modification.  However, when this pain does not subside after a few days or weeks, it is known as “chronic pain” and often means that there is an underlying spinal issue. For instance, if pain has begun to radiate into the extremities this is a sign of spinal nerve compression and should be addressed immediately.

The severity of these issues can vary but it is always important to see a Spine Specialist at the onset of this pain so that it can be identified and treated before it progresses.

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians.

Disc Herniations are a condition in which one or more of the discs that lies between two spinal vertebrae has become damaged. When explaining this to patients, it is usually helpful to think of discs like tires. The nucleus is the inner portion of the tire, and the annulus is the outer portion (tread). Typically, when a disc herniation occurs, the disc essentially pushes out (nucleus) causing the annulus (tread portion) to put pressure on nerves and causing pain that can present like a sciatic type of pain into the buttocks, thigh, leg, or ankle depending on the level being compressed.

 

It can occur suddenly if the patient has suffered an injury, or gradually over time as part of the degenerative process. A bulging or damaged disc can often put immense pressure on the nerve roots of the spine causing pain or numbness in the neck, lower back upper or lower extremities or the hips.

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians.

Degenerative Disc Disease is not a specific condition but rather a term used to describe the degenerative process the spinal discs may undergo as a result of injury or the aging process. Degenerative Disc Disease occurs when the intervertebral disc loses the fluid within the disc that allows for flexibility of the disc. It is possible for Degenerative Disc Disease to impact any part of the spine but it would be most commonly found in the neck or lower back area.

 

Degenerative Disc Disease Symptoms can include:

  • Pain in neck, thighs or lower back area
  • Feeling the need to switch positions constantly
  • Pain coming “in and out” for different lengths of time
  • Pain while: bending down, sitting down and/or twisting body
  • Anxious to lie down to subside the pain
  • A tingling sensation in all extremities

Factors that can attribute to Degenerative Disc Disease:

  • Overuse
  • Major or minor injury
  • Aging
  • Osteoarthritis
  • Obesity
  • Heavy Smoking

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians.

Sciatica, often referred to as a “pinched nerve”, typically refers to symptoms of leg pain, stiffness and numbness, originating in the lower back. Usually the root of the problem is a ruptured or degenerative disc in the lumbar spine. This disc causes pressure on the sciatic nerve which results in leg pain. It should be known that Sciatica is not an acceptable diagnosis for a patient, it is just a tell-tale sign of a different condition, such as a herniated disc or Degenerative Disc Disease.

Sciatica Symptoms can include:

  • Persistent pain in the leg
  • Pain radiating through the lumbar spine, buttocks, hips and legs
  • Jarring pain while seated
  • Difficulty standing and/or walking
  • Numbness thigh area

If you suffer from Sciatica, you may have one or more of these conditions:

  • Degenerative Disc Disease- The gradual breakdown of a disc over time, making it unable to absorb shock
  • A Lumbar Disc Herniation- Damage to a disc along the lower back, forcing the jelly- like fluid out of the disc
  • Lumbar Spinal Stenosis- The narrowing of space between vertebra in the spine, which compresses the sciatic nerve
  • Spondylolisthesis- A disorder where one vertebra protrudes forward in front of another

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians.

Spinal Stenosis is characterized by the narrowing of the spinal canal and the subsequent pain caused by the canal exerting pressure on the nerve roots of the spine. There are two types of Spinal Stenosis that can occur: Cervical Stenosis takes place in the neck area. Cervical Stenosis is the more serious diagnosis, because of the possible consequences of the compression of the spinal cord. This compression can cause the space between the vertebras to shrink and has the potential to result in weakness of the body and over time cause paralysis. Lumbar Stenosis takes place in the lower back area. Lumbar Stenosis is the more common diagnosis and occurs when the spinal nerves in the lower back are compressed and unable to send clear signals to the lower extremities. This can result in pain and numbness in the leg area, otherwise known as Sciatica. It is important to note that Lumbar Stenosis does not always result in pain or any symptoms but can eventually lead to serious issues.

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians.

Spinal Stenosis symptoms would include:

  • Possible inability to walk without pain
  • Sitting down often to combat pain
  • Tingling feeling in lower extremities
  • Deterioration in motor skills
  • Trouble lifting arms in the air
  • Pains coming “in and out”

Causes:

  • Aging– As the body gets older problems may arise along the spinal cord to cause stenosis. Most commonly, discs will flatten over time, causing the space between vertebras to narrow.
  • Spondylolisthesis– One vertebra slipping past another could result in the space between being narrowed.
  • Hereditary– One could have had a compressed spinal cord from birth, but symptoms may not arise until later in life.
  • Injury– An unfortunate accident may result in spinal fracture or a bone spur. Any sort of fracture to the spine has potential to cause damage to a disc and the space between.Foraminal Stenosis is another form of spinal stenosis and includes many of the same symptoms, however the mechanisms of this condition are a bit different. The foramen are the openings along the spine where nerve roots exit. When this area becomes narrowed, it causes pressure on these nerve roots causing the symptoms seen above. This form of stenosis is more common in the lumbar area.
Spondylitis is a condition in which the joints in the spine become inflamed. In some cases, this will lead to two or more vertebra in the spine to begin to fuse together. The process of the bone growth is called Ankylosis and can occur anywhere along the spinal cord, but is most common in the lower back and pelvic area. This bone growth causes pressure on the nerve roots of the spine and can result in pain and numbness in the extremities. There are many different forms of Spondylitis, but the symptoms are very similar.

 

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians.

 

Spondylolisthesis describes a spinal defect that causes a vertebra to protrude forward or backward from the disc above or below. When this occurs the vertebrae exerts pressure on the spinal cord or spinal nerve root causing pain and discomfort. It is most common in the lumbar spine. This condition often results from repetitive concussive vertical force on the spine and is common among athletes, specifically gymnasts.
Spondylolistheis symptoms would include:
  • Lower back pain
  • Tight and sore hamstrings
  • Back spasms
  • Walking with a gait or waddle
  • Pain or numbness in foot Causes:
  • Repetitive force or injury to the spine
  • Sudden trauma or impact
  • Degenerative Disc Disease
  • Spinal Fracture
  • Genetic Predisposition

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians. 

Kyphosis refers to an abnormal rounding, or “hump”, of the upper back. Kyphosis is most often noticeable during adolescence and can progress over time causing pain, neurologic deficits and respiratory conditions. Kyphosis can also occur as a result of spinal fractures or osteoarthritis of the spine.

 

Kyphosis symptoms would include:

  • Visible rounding of the back
  • Pain or numbness
  • Muscle fatigue or stiffness in the back
  • Loss of bowel or bladder control
  • Chest pain or shortness of breath

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians. 

Scoliosis is classified as an unnatural curvature of the spine. With scoliosis, the spine can round off to one side and curve back towards the middle of the back near the lower back (often resembling a “s” shape. Scoliosis is often discovered once a child hits their “growth spurt” during their adolescent years. Scoliosis may or may not require surgery and is typically surgically corrected if the curvature continues to progress or if the condition causes persistent pain, neurologic deficits or respiratory conditions. Those with scoliosis should be monitored by a physician to determine if the condition is progressing. An adult patient with a curve in the spine that is under 40 degrees should be able to avoid surgery.

Physical Signs of Scoliosis May Include:

• Visible curvature of the spine
•Shoulders at different height
•Head leaning toward one side
•One shoulder blade protruding further than the other
•Ribs higher than normal

Forms of Scoliosis

• Idiopathic: This is the most common form of scoliosis and is usually sudden onset, most often during adolescence. The likelihood of the curvature of the spine is more common with idiopathic scoliosis.

• Congenital: This form of scoliosis is caused by the abnormal formation of vertebrae during the embryonic stage of development. There does not seem to be any genetic link and the cause is unknown. Despite the abnormal formation of the vertebrae in the womb, the condition may not appear until adolescence.

A spinal fracture is considered one of the worse injuries one can suffer and is often referred to as a “broken back”. The most common incidence of spinal fractures result from accidents or sudden traumatic injuries. Elderly patients are also more likely to experience this condition as a result of osteoarthritis of the spine.

Symptoms may include:

•Unable to move without pain
•Inability to move the upper or lower extremities
•Weakness and/or tingling sensation
•Numbness
•Loss of consciousness

The different types of Spinal Fracture:

•Compression- This fracture occurs when the front of the vertebra breaks but the back stays stable. The vertebra should remain stable and in position.

•Burst- When both the front and back of the vertebra break as a result of a heavy force. This type of spinal fracture can lead to long-term damage and possible loss of motion.

•Flexion- When a vertebra is pulled away from the spinal cord. Most commonly occur in car accidents or severe falls.

•Transverse- Can occur from lateral movements and bending. Vertebra should remain stable.

While most spinal fractures are the result of severe accidents such as car accidents, severe falls or sports injuries, it is important to note that some fractures can occur genetically or form over time.

If you or someone you know is experiencing severe pain or the inability to move following an accident, it is important to dial 911 and alert EMS right away.

Spinal discs are comprised of a tough fibrous outer layer (annulus fibrosis) and a water and protein mixture (nucleus pulposus). When the fibrous outer layer undergoes a significant trauma or deteriorates due to overuse, small tears can occur causing the fluid to leak out of the disc. This is referred to as an annular tear or a disc tear. These tears can occur in both the cervical and lumbar spine.

 

Typically, there are three distinct types of annular tears:

  • Radial Tear – Caused by the aging process and may lead to herniation of the disc.
  • Concentric Tear – Often caused by sudden trauma or injury to the spine.
  • Peripheral Tear – Often caused by injury and may cause the disc to break down over time.

Cervical Disc Tear symptoms would include:

  • Neck pain
  • Weakness in the upper arm or shoulder area
  • Numbness and/tingling sensation in fingers/wrist
  • Having trouble gripping with hand
  • Difficulty rotating neck
  • The type of pain varies from dull to sharp

Lumbar Disc Tear symptoms would include:

  • Lower back pain
  • Sciatica (pain that radiates through the leg)
  • Numbness or pain in the foot
  • Numbness or pain in ankle
  • Unable to stretch or extend toes
  • Unable to push off with foot
Facet Joint Disease is a term used to describe a variety of conditions that effect the joints of the spine that provide flexibility and stability, known as facet joints. Many of these associated conditions stem from arthritis of the facet joints. The conditions can effect both the cervical and lumbar spine. However, 55% of facet related conditions occur in the cervical spine.
Facet Syndrome: This condition occurs when the facet joints of the spine become inflamed and begin to exert pressure on the nerve roots of the spine. This pressure causes both localized and radiating pain.
Facet Cysts: Also known as Synovial Cysts, this condition arises when the fluid filled sacs of the spine create pressure on the spinal nerves. This is most likely the result of poor circulation around the spinal nerves which causes an inability for the blood around the nerves to properly drain. This lack of drainage causes irritation and inflammation of the nerve.
Facet Arthritis: Similar to most arthritic conditions, the cartilage of the facet joints becomes thickened and hardened which can lead to swelling and tenderness. This condition is often worse in the morning and persists throughout the day.
Facet Hypertrophy: This condition most often arises as a result of an injury or as part of the body’s natural response to joint degeneration. Over time, in attempt for the body to heal the degeneration, new cartilage will form causing the joint to become enlarged.

Common Procedures Performed

A lumbar Microscopic Discectomy is a Minimally Invasive procedure performed to remove the herniated portion of a spinal disc or bone spurs. This procedure utilizes small cameras, proper illumination and small tubes through which specially designed surgical instruments are placed. Using fluoroscopic guidance, the instruments are precisely positioned between the disc space where the herniation has occurred. Once the instruments have been positioned, the offending portions of the spinal disc are removed and pressure on the spinal nerve is relieved.

This procedure requires an incision of about 3-4 cm and is performed on an outpatient basis. Our Minimally Invasive Approach avoids unnecessary muscle dissection and damage to the surrounding areas and utilizes fluoroscopic guidance to ensure accuracy. With this Minimally Invasive Approach, patients are able to return to their active routines much faster than with traditional spine surgery. At Spine Surgery Associates, all of our procedures are performed by a team of two Board Certified Orthopedic Spine Surgeons to maximize relief and minimize your recovery time.

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians. 

Anterior Cervical Discectomy and Fusion (ACDF) is a Minimally Invasive procedure that is performed to relieve pressure on a nerve in the cervical spine caused by a variety of Degenerative Disc Diseases. This procedure involves the removal of herniated spinal discs and/or bone spurs and uses an implant to fuse two of the spinal vertebrae together to increase stability in the spine.

During a Spinal Fusion surgery, magnification and proper illumination and specially designed surgical instruments are used to remove the herniated disc and/or bone spurs. Once removed, an implant is placed in the space formerly occupied by the disc. This implant is filled with the patients own bone material in an effort to help the bones fuse more naturally. Pedicle screws may be used to ensure stability of the newly fused segments.

This procedure requires an incision of about 3-4 cm and is performed on an outpatient basis. Our Minimally Invasive Approach avoids unnecessary muscle dissection and damage to the surrounding areas and utilizes fluoroscopic guidance to ensure accuracy. With this Minimally Invasive Approach, patients are able to return to their active routines much faster than with traditional spine surgery. At Spine Surgery Associates, all of our procedures are performed by a team of two Board Certified Orthopedic Spine Surgeons to maximize relief and minimize your recovery time.

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians. 

Interspinous Distraction, more commonly known as X-Stop, is a Minimally Invasive procedure used to relieve symptoms of lumbar spinal stenosis. This procedure uses a flexible X shaped implant to reduce the pain from spinal stenosis.

 

The implant is placed between one or more of the bony protrusions of the spine, known as “spinous processes”, and allows patients to maintain range of motion but not hyperextend the spine. This hyperextension is often what causes the pain and sciatica related to lumbar spinal stenosis. This implant does not require the attachment of plates or screws and can remain safely in place indefinitely.

This procedure requires an incision of about 3-4 cm and is performed on an outpatient basis. Our Minimally Invasive Approach avoids unnecessary muscle dissection and damage to the surrounding areas and utilizes fluoroscopic guidance to ensure accuracy. With this Minimally Invasive Approach, patients are able to return to their active routines much faster than with traditional spine surgery. At Spine Surgery Associates, all of our procedures are performed by a team of two Board Certified Orthopedic Spine Surgeons to maximize relief and minimize your recovery time.

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians. 

Artificial Disc Replacement may be an alternative to spinal fusion surgery for many patients. This procedure uses a flexible implant that allows for motion preservation in the spine. Artificial Disc Replacement is used to treat a variety of conditions related to Degenerative Disc Disease.

 

During ADR surgery, small cameras and proper illumination and specially designed surgical instruments are used to remove the herniated disc and/or bone spurs. Once removed, an flexible implant is placed in the space formerly occupied by the disc. This implant allows the spine to remain mobile and function the same as a healthy spine. The implant is comprised of two plates that are attached to the vertebrae above and below the removed disc. Once the plates are attached, a small rounded implant is inserted to function as the spinal disc.

This procedure requires an incision of about 3-4 cm and is performed on an outpatient basis. Our Minimally Invasive Approach avoids unnecessary muscle dissection and damage to the surrounding areas and utilizes fluoroscopic guidance to ensure accuracy. With this Minimally Invasive Approach, patients are able to return to their active routines much faster than with traditional spine surgery. At Spine Surgery Associates, all of our procedures are performed by a team of two Board Certified Orthopedic Spine Surgeons to maximize relief and minimize your recovery time.

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians. 

Lumbar Spinal Fusion is a Minimally Invasive procedure that is performed to relieve pressure on spinal nerve roots caused by a variety of Degenerative Disc Diseases. This procedure involves the removal of herniated spinal discs and/or bone spurs and uses an implant to fuse two of the spinal vertebrae together to increase stability in the spine.

 

During a Spinal Fusion surgery, magnification and proper illumination and specially designed surgical instruments are used to remove the herniated disc and/or bone spurs. Once removed, an implant is placed in the space formerly occupied by the disc. This implant is filled with the patients own bone material in an effort to help the bones fuse more naturally. Pedicle screws may be used to ensure stability of the newly fused segments.

Depending upon the anatomy and area of injury, several different approached are available. All of these procedures requires only an incision of about 3-4 cm and are performed on an outpatient basis. Our Minimally Invasive Approach avoids unnecessary muscle dissection and damage to the surrounding areas and utilizes fluoroscopic guidance to ensure accuracy. With this Minimally Invasive Approach, patients are able to return to their active routines much faster than with traditional spine surgery. At Spine Surgery Associates, all of our procedures are performed by a team of two Board Certified Orthopedic Spine Surgeons to maximize relief and minimize your recovery time.

ALIF (Anterior Lumbar Inter-body Fusion): The incision for an ALIF procedure is made typically through the lower abdomen or side. This procedure is usually assisted by a vascular surgeon who provides exposure to the vertebral bodies in concert with the spinal surgeon.

TLIF (Transforaminal Lumbar Inter-body Fusion): The incision for a TLIF procedure is made through the back of the spine using a muscle sparing approach. This approach allows for the procedure to be performed while maintaining the integrity and viability of the surrounding muscle and tissue.

XLIF (Xtreme Lumbar Inter-body Fusion): The incisions for a XLIF procedure are made through two small incisions on the patients side at the level of the affected spinal disc(s). This approach allows for the procedure to be performed while maintaining the integrity and viability of the surrounding muscle and tissue.

Call Us at 908-741-4187 to learn more and speak with one of our expert physicians. 

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