South Bend patients seeking advanced spine surgery often travel 90 minutes to Fort Wayne for fellowship-trained expertise in minimally invasive, robotic, and motion-preserving techniques from Mayo Clinic, Johns Hopkins, and Brown University.
Opening August 2026 • Approximate drive time: 90 minutes via I-80/90 and I-69
South Bend is home to excellent healthcare facilities including the University of Notre Dame and major hospital systems. However, patients throughout northern Indiana often travel when seeking specialized spine surgery expertise for complex conditions requiring advanced surgical techniques.
Fellowship training represents the highest level of spine surgery subspecialization. After completing 5 years of orthopedic surgery or neurosurgery residency, fellowship-trained spine surgeons dedicate an additional 1-2 years to focused training exclusively in complex spine surgery at premier institutions. Dr. Greenberg completed this advanced training at Mayo Clinic, Johns Hopkins Hospital, and Brown University—three programs consistently ranked among America's best for spine care.
This specialized training provides expertise in techniques beyond standard spine surgery capabilities: endoscopic spine surgery through incisions smaller than a dime, cervical disc replacement for motion preservation, robotic-assisted spinal fusion with computer guidance, and complex revision surgery when initial procedures haven't achieved desired outcomes.
For patients facing significant spine surgery decisions—whether for debilitating sciatica limiting work and daily activities, progressive spinal stenosis preventing comfortable walking, cervical myelopathy threatening spinal cord function, or complex spinal deformity—the 90-minute drive to Fort Wayne becomes insignificant when pursuing the best possible surgical outcome and access to cutting-edge techniques.
Subspecialty fellowship training provides access to the most advanced minimally invasive and motion-preserving spine surgery techniques available today.
Computer-guided robotic navigation systems provide real-time 3D imaging and submillimeter accuracy during spinal fusion procedures. This technology excels in complex deformity correction, revision cases with altered anatomy, and challenging screw trajectories where precision is paramount.
Important perspective: The robot is an advanced tool enhancing precision, but surgical judgment, planning, and technical skill remain the surgeon's domain. Fellowship training in both traditional and robotic techniques ensures optimal approach selection for each case.
True endoscopic spine surgery uses specialized instruments through 7-8mm incisions—literally smaller than a dime. High-definition cameras and advanced optics allow treatment of select herniated discs and stenosis cases with preserved muscle and soft tissue, often enabling same-day discharge and rapid recovery.
Candidacy matters: Not every disc herniation or stenosis case is appropriate for endoscopic techniques. Body habitus, specific pathology location, imaging characteristics, and surgeon expertise all influence whether endoscopic, traditional minimally invasive, or open approaches provide optimal results.
Cervical disc replacement offers an alternative to fusion for appropriate candidates, maintaining neck motion and potentially reducing long-term adjacent segment disease risk. The artificial disc replaces damaged cervical disc material while preserving the normal biomechanics of neck movement.
Patient selection criteria: Ideal candidates are typically under 60 years old, have single or two-level cervical disc disease without significant facet arthritis or instability, and prioritize motion preservation for active lifestyles. Some conditions still require fusion for optimal structural outcomes.
Surgical treatment when conservative care hasn't provided adequate relief and symptoms significantly impact quality of life, work ability, or daily function.
When disc material herniates and compresses the sciatic nerve, sharp radiating leg pain often results. Most cases improve with conservative treatment including physical therapy, anti-inflammatory medications, and sometimes epidural steroid injections over 6-12 weeks.
Surgery becomes appropriate when: severe pain persists despite appropriate conservative care, progressive weakness develops, or quality of life is significantly impaired. Microdiscectomy or endoscopic discectomy provides 85-90% success rates for appropriate candidates.
Key symptoms: Sharp leg pain worse than back pain, numbness/tingling in specific leg/foot distributions, potential weakness in ankle or foot
Age-related narrowing of the spinal canal causes neurogenic claudication—a distinctive pattern where legs become heavy, numb, or weak after walking short distances. Symptoms typically improve dramatically when sitting or leaning forward (the "shopping cart sign").
When stenosis severely limits walking ability despite conservative treatment, decompressive laminectomy often provides remarkable improvement in walking tolerance and quality of life. The procedure removes bone and ligament compressing the nerves, creating more space within the spinal canal.
Functional test: Can you comfortably walk through a large grocery store, or do your legs give out after one aisle?
Compression of cervical nerve roots from disc herniations or bone spurs causes radiating arm pain, numbness, and sometimes weakness. The specific symptoms pattern indicates which nerve root is affected—C6 radiculopathy affects the thumb and index finger differently than C7 which affects the middle finger and triceps.
Most cervical radiculopathy improves with conservative treatment. When symptoms persist or worsen, surgical options include anterior cervical discectomy and fusion (ACDF), cervical disc replacement for motion preservation, or posterior cervical foraminotomy depending on the specific pathology and patient factors.
Warning sign requiring urgent evaluation: Progressive hand weakness or frequently dropping objects
Myelopathy represents spinal cord compression—a more serious condition than radiculopathy (nerve root compression). Classic symptoms include difficulty with fine motor coordination (buttoning shirts, handwriting), balance problems, leg stiffness, gait changes, and sometimes bowel/bladder urgency.
Unlike radiculopathy which often responds to conservative treatment, progressive myelopathy typically requires surgical decompression as non-operative care cannot relieve spinal cord compression. Earlier intervention generally provides better neurological outcomes. The decision involves balancing risks of surgery versus risks of progressive cord compression.
Diagnostic clue: Positive Hoffman's sign, hyperreflexia, balance instability, or difficulty with tandem walking
Forward slippage of one vertebra over another can occur from degenerative changes, stress fractures (spondylolysis), or congenital factors. Symptoms range from isolated back pain to combined back and leg symptoms when nerve compression occurs.
Low-grade slippage (Grade 1-2) often responds to conservative treatment including core strengthening and activity modification. Higher-grade slippage, progressive slip on flexion-extension X-rays, or persistent symptoms despite appropriate non-operative care may require spinal fusion to stabilize the spine and decompress affected nerves.
Imaging correlation: Standing X-rays and flexion-extension views assess slip grade and dynamic instability
Osteoporotic or traumatic vertebral fractures cause acute back pain that often improves with conservative treatment including bracing, pain management, and bone health optimization over 6-8 weeks.
When pain remains severe and functionally limiting after 4-6 weeks of appropriate conservative care, kyphoplasty—a minimally invasive vertebral augmentation procedure—can provide rapid pain relief. The procedure stabilizes the fractured vertebra by injecting bone cement under fluoroscopic guidance, typically performed as an outpatient or with overnight observation.
Risk factors: Osteoporosis, chronic corticosteroid use, postmenopausal women, or high-energy trauma
Dr. Marc Greenberg completed spine surgery fellowship training at three institutions consistently ranked among America's best hospitals—a unique training pathway providing comprehensive exposure to diverse surgical philosophies, complex case volumes, and cutting-edge innovations.
Consistently ranked #1 nationally for orthopedics. Training emphasis on evidence-based practice, surgical excellence, and comprehensive patient care.
World-renowned for spine surgery innovation, research, and complex reconstruction. Legacy of surgical pioneers who developed techniques now used worldwide.
Fellowship focused on complex spine surgery and minimally invasive techniques with emphasis on motion-preserving procedures and advanced technologies.
Spine surgery fellowship represents 1-2 additional years of focused subspecialization beyond the 5-year orthopedic surgery residency. This advanced training develops expertise in techniques and approaches that general orthopedic training may not emphasize.
Why This Matters for South Bend Patients: Fellowship-trained spine surgeons offer the highest level of subspecialty expertise in spine surgery. While general orthopedic surgeons and neurosurgeons provide excellent care for many conditions, fellowship training specifically focuses on advanced spine techniques, complex pathology, and the latest surgical innovations. When facing significant spine surgery, patients benefit from this additional specialized training and expertise.
South Bend patients often travel to Fort Wayne for access to fellowship-trained spine surgery expertise with specialized training from Mayo Clinic, Johns Hopkins, and Brown University. This advanced subspecialty training provides skills in cutting-edge techniques including endoscopic spine surgery, robotic-assisted procedures, cervical disc replacement, and complex revision surgery. While South Bend has excellent general orthopedic and neurosurgery capabilities, fellowship-trained spine specialists offer focused expertise in advanced minimally invasive and motion-preserving techniques that patients actively seek when conservative treatments have failed.
The drive from South Bend to Fort Wayne is approximately 90 minutes via the Indiana Toll Road (I-80/90) to I-69 South. Many patients find this distance reasonable when seeking specialized spine surgery expertise, especially considering most procedures require only a single trip for the initial consultation and another for surgery if appropriate.
Follow-up appointments can often be scheduled to minimize additional travel. The investment in driving time becomes worthwhile when pursuing the best possible surgical outcome for debilitating spine conditions that significantly impact quality of life.
Fellowship training at institutions like Mayo Clinic, Johns Hopkins, and Brown University provides expertise in:
These techniques require specialized training beyond general orthopedic or neurosurgery residency and may not be widely available at all surgical centers. Learn more about all available procedures.
Candidacy for minimally invasive techniques depends on your specific diagnosis, imaging findings, body habitus, overall health, and treatment goals. Conditions like herniated discs causing sciatica, spinal stenosis limiting walking ability, and select cases of instability may be treated with minimally invasive approaches.
However, not every patient is appropriate for every technique. A comprehensive consultation including imaging review, physical examination, and discussion of your symptoms and functional limitations determines which surgical approach—whether endoscopic, traditional minimally invasive, or open surgery—offers the best balance of effectiveness and recovery for your individual situation. Read more about surgical decision-making.
Initial consultations typically last 45-60 minutes and include:
Many patients benefit from bringing a written list of questions, all imaging on disc if done elsewhere, and a family member to help process information. The goal is shared decision-making where you fully understand your condition and all treatment options before making any decisions about surgery. Learn more about what to expect throughout your surgical journey.
Ultra-minimally invasive procedures with exceptional visualization through incisions smaller than a dime.
Motion-preserving artificial disc technology as an alternative to traditional cervical fusion.
Computer-guided precision fusion with real-time 3D navigation and submillimeter accuracy.
Gold standard minimally invasive treatment for herniated discs with 85-90% success rates.
Decompression surgery for spinal stenosis to improve walking tolerance and quality of life.
Anterior cervical discectomy and fusion for neck and arm pain relief with high success rates.
Minimally invasive vertebral augmentation providing rapid relief for compression fractures.
Complex revision procedures requiring advanced expertise when initial surgery hasn't achieved goals.
Join the waitlist to be among the first South Bend patients to access fellowship-trained expertise in minimally invasive and motion-preserving spine surgery.
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Content medically reviewed by Dr. Marc Greenberg, MD
Board-Certified Orthopedic Spine Surgeon | Fellowship-Trained at Mayo Clinic, Johns Hopkins, Brown University
Last updated: February 24, 2026