Orthopaedic Surgeon, Dr. Harf skillfully provides many types of spinal treatments:
Artificial disc replacement - lumbar
injection - lumbar
Lower back surgery
Microdiscectomy / microdecompression
Minimally invasive surgery
Total hip replacement surgery
Upper back surgery
Orthopaedic Surgeon Board Certifications
♦ American Board of Orthopaedic Surgeons
♦ Fellow of the American College of Surgeons
♦ American Academy of Orthopaedic Surgeons
♦ American Academy of Neurological and Orthopaedic Surgeons
♦ American Board of Spinal Surgery
Spinal Fusion Technologies
Cervical, thoracic and lumbar fusions can be done in many different ways. The traditional surgery was performed without placing hardware along the spine. Bone was packed into the joints of the spine and the individual was then placed
Anterior fusion technologies have also been availed to
in a brace. Approximately
15 years ago, with the advent of segmental hardware, including pedicle screws and hooks, we are now able to obtain higher rates of fusion to the lumbar spine and, more recently, to the cervical spine with various plates and screws. We now can offer high and predictable rates of fusion to the cervical and lumbar spines.
us for a number of years, including placing bone grafts in the disc spaces as well as cage technologies where a metal cage packed with bone is placed in the interspace where the disc had been. This also offers
a higher rate of fusion especially at multiple-fused levels where one places an anterior cage or bony plugs and then supplements it
with hardware fixation posteriorly.
With newer strategies of spinal fusion, we have
been able to fuse longer segments with a much higher degree of success. Additionally, we have been able to distract the discs
and offer a disc fusion in distraction which keeps lumbar lordosis and offers protection from deterioration of the discs that are above the lumbar fusion. This is also similar in the cervical spine. Fusions can be offered for instability of a disc, disc degeneration, facet disease, i.e., pain in the posterior spine, as well as scoliosis and segmental collapse of discs and vertebral end-plates.
Orthopedic Surgeons in Santa Rosa, Petaluma, and Sonoma
Advanced Spinal Concepts
We are a team of orthopedic surgeons in Santa Rosa, Petaluma, and Sonoma serving Sonoma County and all of Northern California. There are many providers of spine care in the US, and we are the only country that has multiple layers of physicians, both surgeons and non-surgeons, as well as chiropractors, physical therapists, exercise physiologists, and trainers, all the way down to health instructors at various gyms. All would be happy to provide opinions on the expertise related to the spine.
However, there are very few physicians that truly have advanced credentials for the treatment of nonoperative as well as operative intervention for spine care. Chiropractors can do chiropractic, physical therapists can do physical therapy, and anesthesiologists can do acupuncture as well as injections, but only a spinal surgeon can martial all of these modalities to benefit the individual spinal patient.
Just because a surgeon has the ability to do surgery certainly does not mean that all of the patients coming to his office require or should be considered for surgical intervention. The treatment of advanced spine in the 21st century requiries an integration that stems from common sense approaches such as exercise and weight reduction, on to the ability to have a supervised exercise program with a physiasist and physical therapist, as well as chiropractic manipulation. When a person does not respond to the usual modalities, injection therapies and/or surgical intervention may need to be considered. North Bay Orthopaedic Surgeons, on a routine basis, offers all of these modalities.
For the treatment of advanced spinal conditions, which can result from instability, disc degeneration, spinal stenosis, tumors of the spine, and disc herniation, surgical indications may be needed. We have been using state-of-the-art, minimally invasive techniques as they have become available. This office is skilled in offering minimally invasive discectomies and, more recently, disc repair techniques as well as total disc replacements. For individuals who have a gross instability, including scoliosis, fusion surgeries may need to be considered. Fusion surgeries these days are usually offered in minimally invasive technologies and techniques.
Dr. Harf has, for his entire professional life, encountered patients and family members that know of individuals who have had one, two, three, four, and up to six or seven spinal surgeries. This is caused by old-style practices, which were ineffective in treating the underlying conditions.
With modern spine care, we try to offer only one procedure one time, and we have been gratified that this has helped in the majority of cases. We provide superior expertise as orthopedic surgeons in Santa Rosa, Petaluma, and Sonoma.
Total Joint Replacement
Dr. Harf is an orthopaedic surgeon and is an acknowledged, skilled expert in total joint replacements including minimally invasive approaches to the hip and knee.
Total joint replacement surgery has been around for 45 years. Total joint replacements now are done with minimal-incision techniques. For our younger patients we offer metal-on-metal, press-fit total hips which take away plastic wear components as well as engage bone integration to the protheses. These are called press-fit, porous-ingrowth prostheses.
A total joint replacement needs to be tailored to the activities and needs of the individual. The common misconception is that a total joint will only last 15 to 20 years. I now believe that total joint replacements, especially in the hip, may last upward of 40 years.
Total joint replacements are continually evolving. However, joint replacement is still one of the most perfected surgeries that is offered in the orthopedic community.
Total knee surgeries are very similar in that we have had very good results, and patient satisfaction techniques range up to 99%. We have been offering joint replacements that are especially tailored to the patient, not just the size of the patient but to the sex of the patient and the activities that the patient is likely to engage in. In short, total knee and total hip replacements are becoming customized to the patient in the 21st century.
Total joint replacements are now being offered in the shoulder for which we are doing both standard as well as the newer reverse shoulder replacements which are for individuals who have rotator-cuff disease. This has been very helpful in reducing pain in individuals who previously were poor candidates.
Total elbow replacements, total ankle replacements, as well as total wrist replacements have also been done.
This office has additional training in all aspects of total joint replacement, performing more than 100 total joint replacements each year.
Orthopedic Surgeons with offices in Petaluma, Sonoma and Santa Rosa.
Serving Sonoma County and all of Northern California.
Artificial Disc Replacement for Treatment of
Low Back Pain
Disc replacement technologies are a very new threshold for spinal surgery. After extensive review, the FDA has approved the first artificial disc for treatment of low back pain...the first and most clinically tested total disc replacement in the world. A breakthrough in non-fusion technology, it offers an innovative surgical option to physicians for treating some patients with degenerative disc disease and related conditions. Dr. Harf has completed extensive training on the use of the artificial disc.
OUR GOALS ARE TO...
- help you feel comfortable
- reduce further degeneration
- get you back to normal activity
Arthroscopic surgery has arguably, in the last 25 years, been the most frequently performed surgery by orthopaedic surgeons, rising from its infancy in the late 1970s to a standard procedure for knees, shoulders, and more increasingly hips and ankles. These are done on a come-and-go basis with no time spent in the hospital overnight. The treatment regimines have revolutionized sports medicine.
Don't go on living in pain!
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Sonoma, Petaluma, and