Good Morning Spine

Archive for the ‘Spinal Medicine’ Category

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Many patients that have fusion are to stabilize the spine after removal of disc or fracture. Most of these patients can return to their pre-injury activity after several months. Elimination of pain is a primary goal and this is usually successful in 80 percent of patients.The pain is still there but much less acute and requring less pain medication.

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Many patients with small disc protrusions can have much relief with a nerve block. I then use physical therapist and chiropractors that perform streching techniques.Only if there is continued sciatica down the leg would surgery become an option. The newer type surgeries are performed on an outpatient basis.Less invasive surgery means faster recovery although outcome may be the same.

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I try to managed the expectations of my patient purposely using 60 to 70 percent improvement to be what should be expected after surgery. Many patients come to me with much too optimistic expectations. I also explain that most conditions represent natural aging and not a terrible condition such as cancer Their results should leave them feeling good about all of the newer spinal less invasive treatments.I strongly believe up to 90 percent do well with therapy,medication,injections, and other nonsurgical methods.There is no reason for spinal patients to not have hope as we live in a time where spinal specialist understand that procedure should be less invasive and offer many proven newer technologies , In fact , I give all my patients my home and cell number so as to force me to make sure that what is offered as a choice is totally understood. Should they have any confusion , I would rather know prior to surgery. I also will have to live with the results good or bad as they have direct access to me.I have tried to force a ckeck and balance approach. If there is a poor outcome , I will certainly be hearing from these patients.

Fortunately, there are now much less invasive procedures where small implants can be used to stabilize the spine after laminectomy and fusion.Fusion today is much different then years ago with the associated severe pain. We now use synthetic graft material or design protein called BMP that lessen the need for large bone graft. In general, patient that have failed non-operative treatment should realize how advanced technologies for spine have developed in recent years.

This condition is a naturally occurring process where the disc space narrows and the spinal nerve become compressed. Fortunately, surgery is only necessary in 5 percent of patients. Most times, a nerve block either epidural or facet block and physical therapy have an excellent outcome. Many patients can return to golf and tennis very quickly . Should surgery be necessary, less invasive one hour procedure are quite effective.There is no reason to give up an active quallity of life.

I recommend stetching exercises such as Palates or yoga. I would be careful with flexion of the neck during yoga but continue to feel it has much to add to spinal wellness. Activities that load the spine are important in preventing osteoporosis or disc rupture.I encourage treadmill, running,and long walks. Although swimming helps with streching , it does not load the spine to make it stronger.

There continues to be many new procedures for treatment of spinal stenosis that gives hope to millions of people. This condition is a natural aging of the spine where the space for the spinal nerves becomes smaller.New surgeries use small implants to hold these spaces open such as x-stop,aspen, and even a certain type of cortical bone. This new type surgery takes less then one hour and allows patient to be active and recover much more rapidly.