Dr. McMains uses modern technology to give you the best possible surgical outcomes

Anterior Lumbar Interbody Fusion (ALIF) is performed through the front of the abdomen, allowing direct access to the damaged disc without disrupting the muscles of the back. Removing the damaged disc and restoring disc height can relieve pressure on nerves, improve spinal alignment, and provide a stable foundation for fusion.

Between each vertebra in the spine lie spongy discs that act as shock absorbers during impact and allow the spine to move and bend smoothly. Artificial disc replacement surgery is a minimally invasive procedure that replaces a damaged disc with an artificial implant. Artificial discs mimic the form and function of your spine’s natural disc. This minimally-invasive procedure can provide relief for disc-related back pain and return your spine to the full range of motion. Dr McMains has been trained on a variety of implant systems and will help determine which one the best individual choice for you.

Minimally invasive artificial disc replacement surgery can be used to treat a wide range of spinal disc-related conditions including:

• Herniated disc
• Pinched nerve
• Disc degeneration
• Spinal Stenosis
• Lower Back Pain
• Radiculopathy
• Failed Surgeries

Cervical disc replacement is a motion-preserving procedure that removes a damaged disc in the neck and replaces it with an artificial disc. Unlike fusion, this procedure is designed to maintain movement between the vertebrae while relieving pressure on the spinal cord or pinched nerves that cause neck pain, arm pain, numbness, or weakness. It may be an excellent option for select patients with cervical disc disease.

Cervical endoscopy is an advanced minimally invasive technique used to treat certain conditions affecting nerves in the neck. Through a very small incision, a tiny camera and specialized instruments allow the surgeon to remove disc material or bone that is compressing nerves while minimizing damage to surrounding muscles and tissues. Many patients experience less pain and a quicker recovery compared with traditional open procedures.

Cervical laminoplasty is a motion-preserving procedure that creates more space for the spinal cord by reconstructing the back of the cervical spine rather than removing it. It is commonly used to treat cervical spinal stenosis and myelopathy, helping relieve pressure on the spinal cord while maintaining neck stability and preserving more natural movement.

McMains Spine treats a variety of spine conditions, including scoliosis, degenerative disc disease, spinal stenosis, and spondylolisthesis. Dr. McMains is an expert in minimally invasive treatments for patients with complex spine conditions. Contact us if you are seeking a second opinion or diagnosis and treatment of degenerative disorders, fractures, scoliosis, tumors, disc disease, spinal stenosis, and spinal instability. We treat patients from around the greater Indianapolis area who have chronic pain stemming from a variety of causes.

Lumbar disc replacement removes a painful, worn-out disc in the lower back and replaces it with an artificial disc to preserve motion. For carefully selected patients with isolated disc-related back pain, this procedure can relieve symptoms while maintaining more natural movement of the spine and reducing stress on adjacent levels compared to traditional fusion.

Lateral Lumbar Interbody Fusion (LLIF) is a minimally invasive fusion procedure that approaches the spine from the patient’s side rather than the back. This technique allows damaged discs to be removed and replaced with an implant while minimizing disruption to muscles and surrounding tissues. Dr. McMains helped develop the Prone TransPsoas (PTP®) technique, an advanced evolution of LLIF that allows the procedure to be performed with the patient lying face down, improving surgical efficiency while maintaining the benefits of a minimally invasive approach.

Lumbar endoscopy is one of the least invasive spine procedures available for treating pinched nerves and herniated discs in the lower back. Using a small camera and specialized instruments inserted through a tiny incision, compressed nerves can be treated with minimal muscle disruption, often resulting in less postoperative pain, smaller incisions, and a faster recovery than traditional surgery.

Lumbar microsurgery uses specialized magnification and minimally invasive techniques to relieve pressure on nerves in the lower back. Whether removing a herniated disc (microdiscectomy) or creating more space for compressed nerves (decompression or laminectomy), these procedures are designed to relieve leg pain, numbness, weakness, and spinal stenosis symptoms while minimizing tissue disruption.

Medial Branch Transection is a minimally invasive, motion-preserving procedure designed to treat chronic low back pain caused by the facet joints—without fusion. The procedure targets the small nerves responsible for transmitting pain from the affected joints while preserving the surrounding muscles and spinal stability. For appropriately selected patients, it can provide lasting relief while maintaining normal spinal motion.

Microdiscectomy is a minimally-invasive treatment that removes damaged disc material that is pressing on nearby nerves or the spinal cord causing weakness and pain in the legs or back. There are many conditions or diagnosis’s than can benefit from a microdiscectomy, including:

• Bulging Disc
• Disc Degeneration
• Failed Back Surgery
• Herniated Disc
• Lower Back Pain
• Pinched Nerve
• Radiculopathy
• Sciatica
• Spinal Stenosis

Microlaminectomy, or as Dr McMains calls it a “microdecompression”, is a spinal decompression surgery that is used to alleviate pinching and narrowing around the nerves. Microlaminectomy is a minimally invasive version of a traditional laminectomy, allowing for less pain and a faster recovery. It is often recommended to ease symptoms caused by the arthritic changes that occur with degenerative disc disease and spondylosis. This minimally-invasive treatment may also be recommended if nerve-based pain is linked to:

• Lumbar spinal stenosis
• Bone spurs or osteophytes
• Bulging discs
• Spondylolisthesis

A minimally invasive Transforaminal Lumbar Interbody Fusion (TLIF) stabilizes the spine by removing a damaged disc and fusing two vertebrae through small incisions. Using muscle-sparing techniques and advanced imaging technology, many patients experience less postoperative pain, shorter hospital stays, and in appropriate cases, can safely return home the same day.

The term “minimally invasive” pertains to surgical techniques that use small incisions and the least amount of impact to the patient as possible. Traditional “open back” spine surgeries pose certain risks due to the methods used to reach the part of the back or neck that requires attention, while minimally invasive spine surgery uses techniques designed to target the affected area of the spine without significant disruption to muscles and other tissues.

Minimally invasive spine surgery techniques involve very small incisions, as well as limited blood loss and tissue damage. Dr McMains has even undergone rigorous training to perform the latest lateral lumbar interbody fusions. This technique involves a fusion of the lower spine without the need for any incisions on the back itself. All of this means recovery from most minimally invasive surgery is relatively fast. With our Rapid Recovery Protocol, most patients are even up, walking, and able to go home within 23 hours of treatment.

Conditions that indicate a need for minimally invasive spine surgery are generally the same as those for traditional open surgery, including:

• Spinal Stenosis
• Sciatica
• Pinched Nerve
• Herniated Disc
• Disc Degeneration
• Bulging Disc

Technology and research are leading to rapid changes within the field of spine surgery. Whereas spinal fusion was the typical surgical solution for all historical spine problems, we now have a variety of techniques and implants that allow us to preserve the normal kinematics and motion of the spine. This theoretically leads to better outcomes and a decreased rate of needing future surgery for adjacent levels. Disc replacement is one example of this as are devices like the Vertiflex or Coflex. Dr McMains is well versed on all of the latest advancements and techniques.

Outpatient spine surgery options are designed to help our patients feel better faster. Dr. McMains has the skills and expertise to provide safe and effective surgical treatments in a manner that reduces your pain, speeds your recovery, and helps you get back to doing the things you love.

In many cases, spine surgery can be performed on an outpatient basis which means you can return to your normal life the very next day. All of our procedures are performed in a minimally invasive manner to reduce the trauma caused by traditional, open surgery. We offer multiple treatment options and once we have completed an initial evaluation we will discuss all of the treatment options available with you in order to determine which is best for your condition.

Posterior cervical fusion stabilizes the neck by joining two or more vertebrae through an incision in the back of the neck. This procedure is commonly recommended for spinal instability, deformity, fractures, or conditions requiring decompression of the spinal cord. By restoring stability, it can help relieve pain and protect the spinal cord and nerves.

Faster Recovery

The days of a long, protracted recovery following spine treatment is over. Minimally-invasive procedures now allow for less strain on the body, damage to the surrounding tissue, and blood loss. However, Dr. McMains and his team have further shortened recovery times with the Rapid Recovery Protocol with simple but vital steps before, during and after your surgery.

Pre-Surgery

• Detailed patient education
• Meeting with Dr. McMains
• Medications to reduce inflammation and nerve irritation from surgery
• Specialized and novel pain blocks if appropriate

During Surgery

• Goal-directed fluid management
• Short incisions and Minimally Invasive Spine techniques
• Minimized blood loss
• Use of the latest microscope and surgical navigation technology

Post-Surgery

• Early post-surgery mobilization with a Therapist
• Early removal of tubes and drains
• Early transition to oral pain medication
• Early allowance of food

Enhanced Recovery After Surgery (ERAS®)

The Rapid Recovery Protocol is built on the ERAS foundation. Enhanced Recovery After Surgery (ERAS®) is a patient centered, evidence-based, pain management strategy employed by providers to reduce the need for opioids, improve patient outcomes, and reduce costs. Extensive research has been done on this subject and Dr. McMains is working to further improve our understanding of it.

Less Dependence on Opioid Pain Management

Patient education and communication, special techniques throughout the procedure, and enhanced post surgery therapies reduce the need for excessive use of opioids during and after surgery. Dr McMains and his team are doing their part to combat the opioid crisis while still making sure the patient is pain controlled and comfortable.

Revision Spine Surgery is a procedure for patients who have continued pain after their initial back surgery. Many patients have already undergone their first back surgery and are suffering from severe pain that has not been relieved by the previous procedure. Revision Spine Surgery can help relieve the pain associated with Failed Back Syndrome (FBS). If you’ve had a previous surgery which was unsuccessful, you may be suffering from Failed Back Syndrome. If your symptoms do not improve after your first surgery, then you may need revision spinal surgery. Revision spinal surgery can provide significant pain relief to those suffering from failed back syndrome symptoms. Dr McMains is specially trained to deal with complex and revision cases and can potentially treat your chronic pain.

Robotic spine surgery combines advanced robotic technology with detailed 3D imaging to assist surgeons in planning and performing complex spine procedures with exceptional precision. The robotic system helps optimize implant placement while supporting minimally invasive techniques that may reduce tissue disruption, improve accuracy, and enhance recovery.

Sacroiliac Fusion (SIF) is a non invasive procedure to treat sacroiliac joint pain. The SI joint is located at the base of the spine, and serves at the connection to the hip and pelvis. This procedure fuses the sacrum and the pelvis together to relieve the pain caused by degenerative arthritis in the joints. Specialized implants are placed across the SIJ in order to help stabilize it while fusion occurs over time. Dr. McMains has a proven track record in accurately selecting if this surgery can help patients suffering from sacroiliac joint pain.

Spinal deformity surgery treats abnormal spinal alignment caused by conditions such as scoliosis, kyphosis, or adult spinal deformity. Using advanced surgical planning and modern techniques, the goal is to restore balance, relieve pain, protect nerves, and improve posture, mobility, and overall quality of life.

Spinal fusion is a surgical procedure that reduces or eliminates pain in the spine by permanently connecting two or more vertebrae in your spine, eliminating painful movement and thereby restoring spine stability.

Spinal fusions are most commonly performed on the lower, or Lumbar, portion of the spine but can be used on any vertebrae level. A spinal fusion limits painful instability at the treatment level while still allowing range of motion across the rest of the spine. It is sometimes required to perform a fusion in a stable segment if a large amount of bone must be removed to decompress the nerves. Most of Dr. McMains’ patients do not notice a functional decrease in their overall range of motion.