Dr. Brian R. Subach, MD, FAANS, FACSS, FACS
Neurosurgeon
1635 N George Mason Dr. Suite 150 Arlington VA, 22205Rating
4/5
About
Dr. Brian Subach practices Neurological Surgery and is an expert in treating the spine in Arlington, VA. As a Neurological Surgeon, Dr. Subach prevents, diagnoses, evaluates, and treats disorders of the autonomic, peripheral, and central nervous systems. Neurological Surgeons are trained to treat such disorders as spinal canal stenosis, herniated discs, tumors, fractures, and spinal deformities, among many others.
Education and Training
Kalamazoo College B.A. - Chemistry 1989
University of Michigan School of Medicine MD 1993
Board Certification
American Board of Neurological Surgery
American Board of Spine Surgery
Neurological SurgeryAmerican Board of Neurological SurgeryABNS
Provider Details
Dr. Brian R. Subach, MD, FAANS, FACSS, FACS's Expert Contributions
Is a back brace good for computer work?
Especially after a spinal surgery, the low back needs support. We suggest the NuForm LSO spine. The Ovation Medical Nuform Spinal LSO Fusion technology material-not sewn, so is breathable=reduced patient sweating Multi-direction, moldable for bony prominences Low profile-thinner Easily adjustable by clinician/patient Relief zone over spinous processes 5 year warranty READ MORE
What causes lower back pain?
There are a number of conditions that may be behind your pain. There is not enough time to discuss them all, but we will briefly review some of the more prominent ones. Pelvic Inflammatory Disease Pelvic inflammatory disease is a disease that affects the reproductive organs in women. This condition affects approximately one million women in the United States every single year. There are a number of bacteria that can cause this disease. With time, the bacteria can create infections in the pelvic organs. One of the common symptoms of this disease is persistent pain in the lower back. A Herniated Disc A herniated disc is another common reason for lower back pain. To understand how this condition occurs, you first need to visualize the construction of your spinal column. Your spinal column is constructed with a series of bones, or vertebrae. These bones are stacked one on top of the other. They form sections in your spine. The top seven are your cervical spine. Then, there are 12 in the middle that are your thoracic spine, or the spine that covers the area where your rib cage and chest are located. Finally, you have five on the bottom. These comprise your lumbar spine, or your lower back. In between your vertebrae are cushioning discs. These discs have been designed to serve as shock absorbers. So when you run, walk, lift, or twist, they take some of the shock. Your discs are made up of two parts. You can almost imagine them being like a jelly filled doughnut. On the outside of your disc, there is a hard surface. On the inside, there is a soft, jelly-like inner portion. When the outer portion of the disc is damaged, some of the inner portion is able to protrude out into the outer ring. This is a slipped disc or a herniated disc. This condition can cause some serious pain or discomfort. This is especially true if the herniated material puts pressure on the nerves in your spine. Not only will you experience pain in the location of the slipped disc, but it is also possible for you to experience pain all the way down the path of the nerve. This could include severe pain in the buttocks, down the leg, and in the foot. You know that you might be battling with a slipped disc if you feel muscle weakness, a burning sensation, or pain that gets worse as you sit or stand. The type of pain you experience with a slipped disc is going to vary, but for many, this is the cause of their chronic lower back pain. Sciatica Sciatica is a condition that may be linked to a herniated disc. Your sciatic nerve is the largest nerve in your body. It starts at your spinal cord and goes down to your buttocks and then legs. Your sciatic nerve is one of the most important nerves that you have as it is responsible for your ability to control as well as feel your legs. When this nerve is irritated, it produces sciatica. Sciatica may be a moderate pain, or it could be a severe and excruciating pain in your lower back, buttocks, and legs. Sciatica is a condition that is often caused by a herniated disc, but it can also be caused by issues with the muscles in your buttocks. Other conditions that might cause sciatica include: Spinal Stenosis Piriformis Syndrome Spondylolisthesis Kidney Stones As the name implies, kidney stones are a solid, stone-like material that typically originates in your kidneys. That being said, kidney stones may originate from another part of your urinary tract, including: Kidneys Bladder Urethra Ureters Kidney stones can be unbelievably painful. The material that they are made up of varies, depending on the condition that led to their creation. Spinal Stenosis Your spine is made up of a number of bones called vertebrae that not only give you stability but also make it possible for you to twist and turn. In the center of your vertebra, there is an opening where nerves are able to run from your brain down your spine. These are the nerves that send signals to your entire body. They determine how your limbs function, they determine the sensations you feel, and they determine how well you are able to maintain balance. Spinal stenosis is a condition where your spinal column gets narrow and starts to put pressure on your spinal cord. This is a gradual process, but it can leave you with debilitating pain. We have discussed just a handful of the more common reasons why you may be experiencing chronic lower back pain. Now let’s switch our focus and discuss some of the treatment options that are available. Treating Chronic Pain in the Lower Back At times, it can be difficult to pinpoint the exact reason why a person has chronic lower back pain. This is why most medical professionals are not in a rush to diagnose the source of back pain if the cause is not readily identifiable. If the source of the pain cannot be identified or if the source of the pain cannot be treated, the goal becomes minimizing flare-ups as well as making the pain manageable using conservative treatments. Physical Therapy Exercise is key when treating most back pain. One of the first treatment options that is usually offered is physical therapy. That being said, physical therapy should not be seen as a one-size-fits-all thing. A physical therapist is going to need to tailor the exercises they offer you to your specific symptoms. In-office physical therapy is just part of what’s needed. In order for there to be long-term improvement, you would also need to do your exercise routine at home. Some of the goals of physical therapy for an individual with lower back pain may include: Exercises to improve flexibility Aerobic exercises Core strengthening Improving posture Improving limits of pain tolerance Modifying Your Lifestyle There are a number of foods that lead to inflammation. These include foods that have a lot of refined sugar or trans fats. During your medical consultation, your diet may be examined to see if there are certain foods that are making your condition worse. One of the hardest things for an individual with chronic pain is to make changes to their lifestyle. It may be necessary for a person to accept the fact that their body has changed and that they now have new limitations. If they want to heal and if they want to get the most out of life, they are going to have to listen to what their body is telling them. This includes being conscious of activities that make the pain worse as well as activities that make the pain better. If there is an underlying condition causing the pain, being mindful of what your body is telling you may help you prevent the condition from getting worse. Finding an Emotional Balance Chronic pain can take a toll on you physically, but it is also be emotionally straining. Frustration, depression, and irritability may make your chronic lower back pain worse. There are a number of relaxation strategies and techniques that can be used as part of pain management to help prevent your mind from focusing on the pain. READ MORE
What happens after spinal fusion surgery?
Spinal fusion basics A spinal fusion uses bone graft material to permanently fuse together two adjoining vertebrae in your spine. It may be done to stop abnormal or excessive joint motion between the bones, or it may be done to transform two weak or unstable bones into one larger bone that’s stronger and more supportive. Once it’s set in place, the bone graft material forms a powerful, stable bond between the two vertebrae. Metal rods and screws may be used to keep the graft in place during the healing process so it can form a single, solid unit. Spinal fusion benefits Spinal fusion surgery can effectively address a range of spine-related disorders and conditions associated with chronic back pain, including: Vertebral fractures While many vertebral breaks don’t require surgery, spinal fusion is an ideal solution for any bone fracture that makes your spine less stable, including osteoporotic compression fractures. Spinal instability Degenerative conditions, such as arthritis or spinal stenosis, can cause abnormal motion between vertebrae and make your spine less stable over time. A severely damaged or herniated spinal disc can cause similar vertebral instability. Spinal fusion can address both of these problems. Structural deformities Spinal fusion can be used to correct the sideways curvature of the spine (scoliosis). It can also be used to correct the abnormal rounding of the upper spine (kyphosis). No matter what the underlying objective happens to be, the overriding goal of any spinal fusion surgery is to reduce or eliminate spine-related pain so you can move normally once again. Spinal fusion outcomes Spinal fusion is designed to stiffen a problematic section of spine as a matter of necessity, so it’s only natural that many people worry about how the procedure might change their mobility and overall range of motion. Fusion doesn’t freeze the spine While spinal fusion does restrict mobility within the treated vertebrae in order to put an end to painful joint motion, it doesn’t freeze your entire spine. In fact, this small joint limitation is precisely what helps you overcome the pain that limits your range of motion in the first place. Remember, the 33 vertebrae that make up your spine work together to help you enjoy a wide range of motion. Spinal fusion simply creates a localized immobility that’s offset by increased motion in nearby spinal discs and/or the hip joint. The limiting effects of a spinal fusion are much less pronounced when the surgery involves just one or two vertebrae ― as it does in 80% of cases ― or when it involves a segment of spine that has less motion to begin with, such as the lumbosacral joint. Fusion helps increase mobility Most people are able to resume their normal, active lives — including participating in recreational sports — once they’re fully healed. Many patients actually tell us that spinal fusion has allowed them to become even more active, as they no longer experience pain every time they move. Whenever possible, our team uses minimally invasive endoscopic techniques to perform spinal fusion surgery. Because minimally invasive spinal surgery can be done with very little disruption to surrounding tissues, it comes with fewer risks and makes the healing and recovery process easier, faster, and less painful. READ MORE
What kind of doctor should I see for back pain?
If you are dealing with chronic lower back pain, it is likely that you never imagined your life would end up like this. Pain can be a constant battle. Back pain in particular can be a setback in life. It can make it challenging for you to complete everyday activities or simply enjoy yourself. No doubt, you long for the days of yesteryear when chronic pain did not define who you were or what you were able to do. Finding relief for chronic lower back pain can change you as a person. It can affect you physically, emotionally, and mentally. A major part of treating pain in the lower back is understanding what causes it. From there, it’s important to examine some of the different treatment options that might be available for you. This is exactly what we are going to do when you visit our office. What is Chronic Pain? Before we delve into reasons why you might be experiencing pain in your lower back, we think it’s good to define what chronic pain is. Chronic pain is different from acute pain. Acute pain is the pain that you feel when you cut your finger or pull a muscle. The injury that you’re experiencing is what’s producing the pain. Your body is trying to tell you that something is wrong so that you can take corrective measures. It is very different when a person has chronic pain. When a person experiences chronic pain, the pain can last for months or years, even after the injury that caused the initial pain is gone. The medical community defines chronic pain as pain that lasts for at least three months. As you may know all too well, chronic pain takes a toll on a person’s mental health and day-to-day life. There are a couple of reasons why a person may be experiencing chronic pain. One could be that they have a chronic injury that they have not been able to correct. Once a trained doctor is able to correct the injury, then it’s likely that the pain will subside. However, other individuals have experienced an injury in the lower back and the injury has healed itself, but their nerve signals are still firing after the condition has healed. Some people experience chronic pain with no trigger whatsoever. However, most people who have chronic pain in their lower back have it as the result of an injury. What Conditions Can Cause Lower Back Pain? There are a number of conditions that may be behind your pain. There is not enough time to discuss them all, but we will briefly review some of the more prominent ones. Pelvic Inflammatory Disease Pelvic inflammatory disease is a disease that affects the reproductive organs in women. This condition affects approximately one million women in the United States every single year. There are a number of bacteria that can cause this disease. With time, the bacteria can create infections in the pelvic organs. One of the common symptoms of this disease is persistent pain in the lower back. A Herniated Disc A herniated disc is another common reason for lower back pain. To understand how this condition occurs, you first need to visualize the construction of your spinal column. Your spinal column is constructed with a series of bones, or vertebrae. These bones are stacked one on top of the other. They form sections in your spine. The top seven are your cervical spine. Then, there are 12 in the middle that are your thoracic spine, or the spine that covers the area where your rib cage and chest are located. Finally, you have five on the bottom. These comprise your lumbar spine, or your lower back. In between your vertebrae are cushioning discs. These discs have been designed to serve as shock absorbers. So when you run, walk, lift, or twist, they take some of the shock. Your discs are made up of two parts. You can almost imagine them being like a jelly filled doughnut. On the outside of your disc, there is a hard surface. On the inside, there is a soft, jelly-like inner portion. When the outer portion of the disc is damaged, some of the inner portion is able to protrude out into the outer ring. This is a slipped disc or a herniated disc. This condition can cause some serious pain or discomfort. This is especially true if the herniated material puts pressure on the nerves in your spine. Not only will you experience pain in the location of the slipped disc, but it is also possible for you to experience pain all the way down the path of the nerve. This could include severe pain in the buttocks, down the leg, and in the foot. You know that you might be battling with a slipped disc if you feel muscle weakness, a burning sensation, or pain that gets worse as you sit or stand. The type of pain you experience with a slipped disc is going to vary, but for many, this is the cause of their chronic lower back pain. Sciatica Sciatica is a condition that may be linked to a herniated disc. Your sciatic nerve is the largest nerve in your body. It starts at your spinal cord and goes down to your buttocks and then legs. Your sciatic nerve is one of the most important nerves that you have as it is responsible for your ability to control as well as feel your legs. When this nerve is irritated, it produces sciatica. READ MORE
How should I sleep with back pain?
Try to sleep on your side, whichever one is more comfortable. Some people like a pillow between their bent knees READ MORE
Do orthopedic doctors treat back pain?
Both orthopedic surgeons who specialize in spine and neurosurgeons are able to treat back pain. The key is finding someone you trust. Through word-of-mouth is more reliable than the credentials of the doctor. You should probably start with an anti-inflammatory agent and some physical therapy. If necessary a muscle relaxant or a steroid can help. Avoid anyone who’s conversation centers on surgery at the initial visit should be avoided. Brian R. Subach, MD FACS READ MORE
Expert Publications
Data provided by the National Library of Medicine- Posterior lumbar interbody fusion: indications, techniques, and results.
- Early results using the Atlantis anterior cervical plate system.
- Management of acute odontoid fractures: operative techniques and complication avoidance.
- Defining substantial clinical benefit following lumbar spine arthrodesis.
- The use of a dehydrated amnion/chorion membrane allograft in patients who subsequently undergo reexploration after posterior lumbar instrumentation.
Areas of expertise and specialization
Faculty Titles & Positions
- Former Medical Staff HCA Reston Hospital -
- Active Medical Staff Inova Fairfax Hospital -
- Active Medical Staff Virginia Hospital Center -
- Division Chief in the Division of Spinal Surgery HCA Reston Hospital 2017 - 2018
Awards
- Top Doctors 2018 Castle-Connolly
- Top Doctors 2018 The Washingtonian
- 100 of the Best Spine Surgeons and Spine Specialists in America 2018 Becker’s Orthopedic and Spine Review
- Spine Surgeon Leader to Know 2017 Becker’s Spine Review
- 2011 Washington, DC-Baltimore-Northern Virginia Super Doctors
Treatments
- Neck Pain
- Pinched Nerve
- Herniated Disc
Professional Memberships
- Fellow of the American Association of Neurological Surgeons
- Fellow of the American College of Spine Surgery
- American Board of Spine Surgery
- Fellow of the American College of Surgeons
- American Board of Neurological Surgery
- Diplomate of the National Board of Medical Examiners
- American College of Spine Surgery
- American College of Surgeons
- Virginia State Medical Society
- Medical Society Northern Virginia
- Fairfax County Medical Society
- ANSPAC
- AANS/CNS Joint Section on Disorders of the Spine and Peripheral Nerves
- American Medical Political Action Committee
- American Association of Neurological Surgeons
- Alpha Omega Alpha Honor Medical Society
- American Medical Association
Fellowships
- Complex Spinal Surgery, Emory University Medical School, Atlanta, GA USA 2001
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Nearby Providers
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Robert E. Rosenbaum8901 Wisconsin Ave. Bethesda Maryland 20889![]()
Dr. Sean A Jebraili MD8280 Willow Oaks Corporate Dr Fairfax VA 22031![]()
Michael D. Sirdofsky Other3800 Reservoir Rd NW Washington District of Columbia 20007![]()
Christopher Kalhorn Other3800 Reservoir Rd Nw Washington DC 20007![]()
Dr. Jared Joseph Marks MD6420 ROCKLEDGE DR STE 4920 BETHESDA MD 20817![]()
Dr. Jae Y Lim M.D.8501 Arlington Blvd Fairfax VA 22031
Nearest Hospitals
MEDSTAR GEORGETOWN UNIVERSITY HOSPITALl
3800 RESERVOIR RD WASHINGTON DC 20007SIBLEY MEMORIAL HOSPITALl
5255 LOUGHBORO RD NW WASHINGTON DC 20016HALQUIST MEMORIAL INPATIENT CENTERl
4715 NORTH 15 STREET ARLINGTON VA 22205