Blog | Dr. Guive Sharifi



Cervical Osteoarthritis Vs Cervical Disc

Osteoarthritis occurs when the protective cartilage in a joint begins to break down and no longer facilitates smooth movement between bones, which can eventually result in the joint becoming swollen and painful. When this condition develops in the cervical spine, it is called cervical osteoarthritis.

Sometimes confusion is created when general terms are used interchangeably to refer to cervical osteoarthritis, including cervical spondylosis, degenerative joint disease, or simply neck arthritis. On this site, cervical osteoarthritis is the term that specifically describes the degeneration of the facet joints in the cervical spine.

The Facet Joint and What Can Go Wrong

The facet joints, also called zygapophysial joints, are a key part of the spine’s flexibility. Two small facet joints are located at the back of each vertebral level (one to the right and one to the left), enabling limited forward/backward and twisting motion. In the cervical spine, these joints are called cervical facet joints.

A facet joint is comprised of hard yet smooth cartilage on the upper and lower articulating surfaces to protect the back part of vertebral bones. The joint is encased in a protective capsule, and inside this capsule is synovial fluid which provides the lubrication for smooth movements.

When the cartilage starts to wear away, bone starts rubbing against bone, which can facilitate excessive bone growth, known as bone spurs (osteophytes). Bone rubbing against bone can cause inflammation and pain. Furthermore, fragments of bone and cartilage might break off and start floating within the joint capsule’s synovial fluid, which can lead to more inflammation and discomfort.

Causes of Cervical Osteoarthritis

Cervical osteoarthritis becomes more common as people age, so the natural wear and tear sustained by the facet joints over time is considered to be a major factor in its development. However, the medical community continues to study the issue and other factors also appear to play a role in the development of osteoarthritis, including:

  • Genetics. Some evidence suggests that osteoarthritis can run in families, which would indicate some people are genetically predisposed to having cartilage that breaks down sooner.
  • Injury. If the joint becomes injured, such as a tear in the cartilage and/or protective joint capsule, the joint can become more inflamed and cartilage can wear down sooner. Joint injuries can happen in various ways, such as from a fall or while participating in a sport.
  • Occupation. Certain occupations, such as jobs that involve lots of repetitive motions or heavy lifting like construction, can put more stress on the cervical spine.
  • Weight. People who are overweight tend to develop osteoarthritis sooner, including in the neck. More weight means more stress on the joints, but another possibility could be that people with excess weight might experience more damaging inflammation.1

Cervical Discs

Normally, there are six gel-like cervical discs (one between each of the cervical spine’s vertebrae) that absorb shock and prevent vertebral bones from rubbing against each other while the neck moves. Each disc is comprised of a tough but flexible outer layer of woven cartilage strands, called the annulus fibrosus. Sealed inside the annulus fibrosus is a soft interior filled with a mucoprotein gel called the nucleus pulposus. The nucleus gives the disc its shock absorption property. Cervical degenerative disc disease is a common cause of neck pain and radiating arm pain. It develops when one or more of the cushioning discs in the cervical spine starts to break down due to wear and tear.

In children, the discs are about 85% water. The discs begin to naturally lose hydration during the aging process. Some estimates have the disc’s water content typically falling to 70% by age 70,1 but in some people the disc can lose hydration much more quickly.

As the disc loses hydration, it offers less cushioning and becomes more prone to cracks and tears. The disc is not able to truly repair itself because it does not have a direct blood supply (instead getting nutrients and metabolites via diffusion with adjacent vertebrae through the cartilaginous endplates). As such, a tear in the disc either will not heal or will develop weaker scar tissue that has potential to break again


By |Wednesday, August 16, 2017|Blog|0 Comments

Treatment of persistent depression with brain surgery

What is deep brain stimulation?

  1. DBS is a surgical procedure that involves implanting electrodes in the brain.
  2. It has been shown to be useful in the treatment of persistent depression.
  3. Doctors recommend that you try drugs and therapy before opting for DBS.

Deep brain stimulation (DBS) has been shown to be a viable option for some people who have depression. Doctors originally used it to help manage Parkinson’s disease. In DBS, a doctor implants tiny electrodes in the part of the brain that regulates mood. Some doctors have practiced DBS since the 1980s, but it’s a rare procedure. Although long-term success rates have yet to be established, some doctors recommend DBS as an alternative therapy for patients whose previous depression treatments have been unsuccessful.

A doctor surgically implants tiny electrodes in the nucleus accumbens, which is the region of the brain responsible for:

  • dopamine and serotonin release
  • motivation
  • mood

The procedure requires multiple steps. First, the doctor places the electrodes. Then, a few days later they implant the wires and battery pack. The electrodes are connected via wires to a pacemaker-like device implanted in the chest that delivers pulses of electricity to the brain. The pulses, which are generally delivered constantly appear to block the firing of neurons and return the brain’s metabolism back to a state of equilibrium. The pacemaker can be programmed and controlled from outside the body by a handheld device.

Although doctors aren’t exactly sure why the pulses help the brain reset, the treatment appears to improve mood and give the person an overall sense of calm.

DBS is an option for people with chronic or treatment-resistant depression. Doctors recommend extended courses of psychotherapy and drug therapy before considering DBS because it involves an invasive surgical procedure and success rates vary. Age usually isn’t an issue, but doctors recommend that you be in good enough health to withstand a major surgery.


By |Saturday, August 12, 2017|Blog|0 Comments

Link between blood sugar and brain cancer

Surprising link between blood sugar and brain cancer found

COLUMBUS, Ohio – New research further illuminates the surprising relationship between blood sugar and brain tumors and could begin to shed light on how certain cancers develop.

While many cancers are more common among those with diabetes, cancerous brain tumors called gliomas are less common among those with elevated blood sugar and diabetes, a study from The Ohio State University has found. The discovery builds on previous Ohio State research showing that high blood sugar appears to reduce a person’s risk of a noncancerous brain tumor called meningioma. Both studies were led by Judith Schwartzbaum, an associate professor of epidemiology and a researcher in Ohio State’s Comprehensive Cancer Center. The new glioma study appears in the journal Scientific Reports.

“Diabetes and elevated blood sugar increase the risk of cancer at several sites including the colon, breast and bladder. But in this case, these rare malignant brain tumors are more common among people who have normal levels of blood glucose than those with high blood sugar or diabetes,” Schwartzbaum said. “Our research raises questions that, when answered, will lead to a better understanding of the mechanisms involved in glioma development,” she said. Glioma is one of the most common types of cancerous tumors originating in the brain. It begins in the cells that surround nerve cells and help them function. The disease is typically diagnosed in middle age. At present, there is no treatment that ensures long-term survival, but several potential options are being studied.

The Scientific Reports paper included data from two large long-term studies. One, called AMORIS, included 528,580 Swedes. The second, Me-Can, consisted of 269,365 Austrians and Swedes. In all, 812 participants developed gliomas. Schwartzbaum and her collaborators evaluated blood sugar and diabetes data and its relationship to subsequent development of brain cancer and found that those with elevated blood sugar and diabetes had a lower risk of developing glioma. “This really prompts the question, ‘Why is the association between blood glucose levels and brain cancer the opposite of that for several other cancerous tumors?” she said.

The researchers found that this relationship was strongest within a year of cancer diagnosis. “This may suggest that the tumor itself affects blood glucose levels or that elevated blood sugar or diabetes may paradoxically be associated with a protective factor that reduces brain tumor risk,” Schwartzbaum said. “For example, insulin-like growth factor is associated with glioma recurrence and is found in lower levels in people with diabetes than those who don’t have the disease.”

The brainaccounts for only about 2 percent of body weight, but consumes about 20 percent of the body’s available glucose, Schwartzbaum said. The body of research on restrictive diets and their effect on brain cancer development has shown mixed results and more work is needed to determine if there’s something about the sugar/tumor relationship that can be modified in a way that’s beneficial to brain cancer patients, she said. The research was supported by the National Cancer Institute.


By |Monday, July 31, 2017|Blog|0 Comments

What’s the difference between sciatica and a herniated disc?

Sciatica is pain originating in the sciatic nerve, which runs from the lower back down the back of your legs. Symptoms of sciatica include burning in the leg, pain in the back of the leg when sitting, leg weakness, shooting pain, and more. Most often, this condition is sciatica. But sometimes, it’s a herniated disc from a trauma, such as an auto accident. Disc herniations and sciatica are different things.

The sciatic nerve is a large nerve about the size of your pinky finger. It is formed by 5 nerve roots (typically): L4, L5, S1, S2, S3. These five nerve roots exit the spinal cord and outside the spinal cord come together to form this large nerve which runs down the leg to the foot. Whenever the sciatic nerve is irritated there is some characteristic pain and characteristic areas where the pain is in the leg.

However, when there is nerve pressure closer to the spinal cord caused by a damaged or herniated disc, the symptom pattern and physical examination is different. These two are not always easy to differentiate on the initial visit. They differentiate after a few visits, and sometimes advanced imaging is needed to locate the exact lesion or disc involved. MRI is the method of choice because it allows us to see all the bones, ligaments, nerves, and discs. Both the hard and soft tissue. Very key in getting an accurate diagnosis.

What difference does it make if it’s sciatica or a herniated disc?

First off, sciatica, for the most part, is very curable and with proper treatment, patients return to normal in fairly short order. However, herniated discs are often a permanent condition which can affect every area of your life. Undiagnosed, a herniated disc can become much worse and be debilitating. Once a patient understands the difference between the two, often, a large weight of worry and stress is relieved.


What’s the difference between sciatica and a herniated disc?

By |Sunday, July 30, 2017|Blog, News|0 Comments


A meningioma is a tumor that forms on membranes that cover the brain and spinal cord just inside the skull. Specifically, the tumor forms on the three layers of membranes that are called meninges. These tumors are often slow-growing. As many as 90% are benign (not cancerous). Most meningiomas occur in the brain. But they can also grow on parts of the spinal cord. Often, meningiomas cause no symptoms and require no immediate treatment. But the growth of benign meningiomas can cause serious problems. In some cases, such growth can be fatal.
Meningiomas are the most common type of tumor that originates in the central nervous system. They occur more often in women than in men. Some meningiomas are classified as atypical. These are not considered either benign or malignant (cancerous). But they may become malignant. A small number of meningiomas are cancerous. They tend to grow quickly. They also can spread to other parts of the brain and beyond, often to the lungs.

Causes and Risk Factors of Meningioma

The causes of meningioma are not well understood. However, there are two known risk factors.
•Exposure to radiation
•Neurofibromatosis type 2, a genetic disorder
Previous injury may also be a risk factor, but a recent study failed to confirm this. Meningiomas have been found in places where skull fractures have occurred. They’ve also been found in places where the surrounding membrane has been scarred. Some research suggests a link between meningiomas and the hormone progesterone. Middle-aged women are more than twice as likely as men to develop a meningioma. Most meningiomas occur between the ages of 30 and 70. They are very rare in children.

Meningioma Symptoms

Because most meningiomas grow very slowly, symptoms often develop gradually, if they develop at all. The most common symptoms include:
•Blurred vision
•Weakness in arms or legs
•Speech problems

Diagnosis of Meningiomas

Meningiomas are rarely diagnosed before they begin to cause symptoms. If symptoms indicate the possibility of a tumor, a doctor may order a brain scan: an MRI and/or a CT scan. These will allow the doctor to locate the meningioma and determine its size. A biopsy may sometimes be performed. A surgeon removes part or all of the tumor to determine whether it is benign or malignant.

By |Wednesday, July 26, 2017|Blog|0 Comments