Good Morning Spine

Archive for December, 2009

Unless major neurological deficit various non- surgical methods should be offered before surgery. I believe less then 5 percent need surgery. Spinal surgical claims such as laser is no exception and can make future repair work much more difficult.

I find the vast majority of my patients do well with a combination if nerve blocks, physical therapy, and non-narcotic medications. I believe only 5 percent need surgery when patient work with a dedicated team. We also add wellness programs to make prevention of future back and neck pain a long term goal. We try very hard to be holistic in our treatment strategy and be open- minded to things like accupuncture and nutrition.

Now that we have real winter snow upon us it is important to understand body mechanics. Lifting a pound of snow can add tremendous force to your lower back muscles. If you have not done any conditioning this can lead to severe strain the next day! It would be wise to take this time of year to commit yourself to 45 minutes of exercise to start the new year. The stress on an unconditional orvweak heart has the same possibility. EXERCISE!

One of the reason spine surgeons try to use less hardware as this usually allows more motion after surgery. We also know that levels of the spine above or below rods and screws begin to breakdown over a period of time. Until there are completely new ways to stabilize the spine less is more for now. I believe using newer implants such as spacers is one of the less invasive options for fusion. Most patients are suffering from spinal stenosis. My younger patients with disc disease seldom need anything but microdiscectomy.

Dr Geisse has been a great addition to our team working to use less narcotics and combination drug therapy that allows patients to be more functional. The therapy department also adds a great addition to the team effort. Only 5 percent of present patients need surgery. I spent my career trying to lower this percent or at least do less invasive surgery when all else fails. The addition of smaller implants allows for better outcomes and lower complications.I see the results of other spine surgeon also do great work in South Florida.I again ask patients to look at peer-reviewed published claims.

I invite people to attend a lecture on Tuesday at Poppies restaurant in Delray Beach to learn more and meet recent patients that have undergone less invasive surgery. We are proud of this group of new patients that are willing to communicate their experience and share with others.

I saw an 88 year old patient willing to speak at symposium Tuesday at 3pm. He convinces me again that MLIFF less invasive is amazing. He has no pain two weeks after surgery.

I find that Dr Geisse has been a great addition to our team .She offers a comprehensive review of a patient’s medical care pertaining to medication anf their interaction potential with steroids. We have tried adding medication that will lower the use of just narotics which cause many uncomfortable side effects. I am amazed that the percentage of patients needing any surgery is now less then 5 percent.

Injection are very helpful with stretching exercises. I usually do not need to consider surgery unless there is arm pain and increasing symtoms.Many patients need to have a combined team as we do at the Institute working both with neurologist and surgeons.I do try to limit the amount of narcotics as an easy fix that have many unpleasant qualities.