Michael J. Goebel, MD

TREATMENT PHILOSOPHY:

While most patients with spinal conditions can effectively be treated without surgery, for those that fail to improve, surgical intervention may be an option for their condition. However, the surgeon must choose the right procedure for the right condition on the right patient in order to have an optimal outcome.

So what is the right procedure or the right condition? To begin with, an evaluation of a neck or back condition entails a complete history and physical exam, as well as a review of any imaging studies. It is important to correlate a patient’s symptoms with their objective findings and imaging abnormalities in order to arrive at an accurate diagnosis. Often times, there are findings on an imaging study that do not correlate with a patient’s symptoms, and therefore are considered “incidental”. These incidental findings likely do not require any specific treatment. Delineating the exact etiology of a patient’s symptoms is the most important initial step in the treatment process. Once that diagnosis is made, various treatment options can then be entertained. These options are based upon literature supported studies, indicating statistical benefit for a specific treatment. From this, we derive the right procedure for the right condition.

Who, then, is the right patient? Many patients with neck and/or back conditions can be treated non-operatively. Suggested modalities may include such things as activity modification, medications, physical therapy, epidural steroid injections, etc. Persistent pain and neurologic symptoms that remain despite conservative treatment, and substantially interfere with one’s lifestyle, may be amenable to surgical intervention. Those individuals who fail to improve with non-operative treatment, and who demonstrate symptoms and signs consistent with abnormal findings present on imaging studies, then become the right patient.

EDUCATION AND EXPERTISE:

Dr. Goebel attended the University of Notre Dame for his undergraduate studies, graduating with highest honors. He earned his medical degree with honors from the University of Iowa. He completed his orthopedic surgery residency at the University of Florida and then completed an additional year of subspecialty training at the Maryland Spinal Reconstructive Surgery Fellowship Program.

Dr. Goebel is board certified by the American Board of Orthopedic Surgery as well as the North Carolina Medical Board. He is a member of several professional societies, including the North American Spine Society, the North Carolina Spine Society, the American Association of Orthopedic Surgeons, and the North Carolina Orthopedic Society.

As a board certified orthopedic surgeon who has additional subspecialty training in the area of spine- neck and back, Dr. Goebel addresses a variety of orthopedic conditions and injuries including:

*bulging/protruding/herniated/ruptured discs (worn shock absorber impinging on adjacent nerves)
*spinal stenosis (narrowing/crowding/pinching of the space for the nerves)
*cervical or lumbar radiculopathy/sciatica (radiating nerve pain down arms and/or legs)
*spondylolisthesis (spinal instability or slipped vertebrae)
*scoliosis (abnormal curvature of the spine)
*spinal fractures (broken vertebrae)
*degenerative discs (wear of the disc/shock absorber between vertebrae)
*spondylosis (arthritis of spine)

Dr. Goebel specializes in many types of surgical procedures for the neck and back including:

*discectomies (removal of fragment of disc)
*laminectomies (removal of bone spur or thickened ligament)
*fusions (stabilizing unstable vertebrae, from the front and/or back)
*disc replacements
*vertebroplasties/kyphoplasties (bone cement augmentation of fractured vertebrae)
*nerve decompressions

COMMUNITY CONNECTIONS:

In addition to his busy clinical practice, Dr. Goebel is committed to teaching. Residents from the MAHEC program have rotated through his practice for many years, learning the specifics of spinal conditions and appropriate treatment options. He has given several talks to the community on common neck and back conditions. In addition, he has guest lectured to regional sports medicine and nursing conferences in the area of spine.