Good Morning Spine

Archive for the ‘Spinal Stenosis’ Category

In its January 8th, 2015 issue, Becker’s Spine Review identified Dr. Eidelson as a “Spine Surgery Leader to Know“.

The article was part of Beckers ongoing feature series that identifies “surgeons to know” across America.

Beckers Spine Review is the leading publication covering the world of Spine Surgery in the United States.

To learn more about Dr. Eidelson

Hello Carmel and Monterey Community! I have expanded my care for spinal stenosis to Northern California. Now working at an office in Monterey County I am able to treat and educate additional people who want to retain an active lifestyle. After 25 years of research I am still convinced that the majority of people do not require surgery and respond nicely to other less invasive options. Options such as diet, limited medications, therapy and targeted injections. Should surgery be your last option, newer techniques allow for rapid recovery, less pain and increased mobility. I look forward to meeting new people across the country. For more information please visit www.ortho-spine.com.

One of my greatest challenges and personal disappointments treating patients for 30 years is when I have failed to communicate the responsibility for the safety of a patient, which I believe is paramount. Manytime , there are choices for surgery that run from minor to major risks to a patient. Caring physicians look at the totality of risk factors prior to offering surgical choices. I have patients that are unaware of the association of smoking, obesity, hypertension, cardiac, pulmonary and a variety of other comorbitities that can lead to tragic consequences. I have seen examples of death and infections as well. In select cases, I try to stage solutions offering less invasive surgery to lower the risk of complications in high risk patients. Unfortunately results may be less then perfect, in higher risk patients, but most cases would allow a choice of additional procedures at a future time. I try to manage patients expectations so they never cross into the abyss and feel that they have no possibility of further recovery. I take complications and the results of surgeries extremely personal since I realize my patients have a choice in surgeons and they have put their trust in me.

Do yourself a favor and aak about your post- operative care. Who is going to make rounds and explain what was done. Surgeon tend to make smalll changes that are in the consent but can be confusing. I make this clear prior to surgery as each case is quite unique. Please also look at new section at top for consultation from outside the Florida area.

I am amazed how many patients are not adequately treated for neck or cervical disease. Many patients have weakness in their deltoids or numbness into their digits not realizing there is severe compression of spinal cord. Because their pain may not be as great compared to sciatica, useless amounts of therapy and neglect occur. Patients should know this pain and weakness relates to a combination disc herniation and secondary bone spurs that compress the spinal cord. A problem can lead to permanent loss off function. New surgical techniques using a microscope can give a great outcome if applied early in the care plan. Most patients are not properly evaluated or diagnosed. Know all your options!

The use of hardware in spinal procedures is very confusing. Patients need to have this explained in a way so they embrace the concept when necessary to stabilize the spine. Many patients with severe stenosis with leg pain have collapse of bone around the exit of the nerve roots and these devices keep the bone away from the the nerve when patients are walking.The goal is a much better quality of life after surgery which usually means less pain when standing or walking. Certainly, not all patients require these device when there is a less severe form of stenosis.

Operated on 95 year old patient with spinal stenosis and he left hospital 2 days. The newer technologies allow faster recovery and lower complications in such an extremely high risk patient. It still is very unfortunate that active senior delay due to fear the possibility of considerable pain relief and increase funtional lifestyle. Again, we tried every other option to no avail before making this difficult decision.Patients need to know all their options.

Age is not an issue rather quality of life for decisions regarding surgery. I operated on 95 year old doctor’s father who actually was up and left hospital second day after laminectomy and fusion three levels. He was still living in his own home and driving to places. I believe there many elderly patients that do not realize withproper planning and cautious surgery they can be helped. These patients do poorly with medication for pain.

I do recommend a less complex procedure if patients have complex co-morbitities such as cardiac requiring blood thinners. However, sometimes this will require taking them back for a second procedures if the results are not adequate rather then having one 4 or 5 hour first surgery. Safety ranks number one in my planning.

One of the most concerning complication of spinal surgery can be an infection. This reported problems can occur in 15 percent of elective surgeries requiring hardware such as rods and screws. I believe that if patients seek early contact with their surgeon the consequences can be minimized. Unfortunately, any delay can serious change the outcome. I give everyone of my patients my home and cell number for this very reason. Early detection can allow prompt initiation of antibiotics that can resolve the superficial wound infection from becoming a complex recovery.When a patient has redness or drainage that occurrs 1 vto 2 weeks after surgery they must become aggressive to let their surgeon know.