Good Morning Spine

Archive for the ‘Uncategorized’ Category

I’m excited to see that patients are using the Internet more frequently prior to a doctor visit. They are much better informed and can research topics or know their physician’s credential. In my practice, we specialize in minimally invasive surgery of the neck and back. I have engaged in research for years and all patients should look for validation of various procedures being recommended before making a decision regarding surgery.

I am seeing more patients wanting to undergo less invasive procedures for treatment if their neck or back pain. Nerve blocks work very well but only for short period of time in many patients. All patients should know all their options and certainly surgical solutions have become much less invasive. Spinal stenosis or disc disease are two major success areas for these newer procedures.

There is a new procedure to hold open a collapsed disc space that can be performed through a very small incision that I now offer to patients. The goal is to get patients with degenerative disc disease back to work quickly with less down time. Removing disc with underlying arthitic disease will make the problem worse and I see a tremendous number of failures.

I am amazed how many patients do not realize the extensive care necessary after spinal surgery.I typically see patients within five days then two weeks then three weeks if everthing is going perfect. You need to be near your surgron for comprehensive care. If distance is a problem , each patients has my home and cell number. I want to know immediately if patients are have increasing pain or symtoms of wound infections. Do not underestimate how important knowing that u can reach your surgeon!

I like to really stress nutrition and weight prior to spinal surgery. Many patients are in poor general health which increases potential for complications.Surgery is an assault on your immune system and basic wellness is essential. Technology can not make up for this!

Each time I see a patient, I try to understand how they must feel after trying so many different treatments from various doctors or therapists. The most important thing is a proper diagnosis! This may require several things including MRI or a visit with my partner Dr Geisse to perform very specific nerve testing. So much of good outcomes requires a thorough review of these tests. I even have a new Dr that specializes in gait to look at patient’s shoes and how they rotate their pelvis when walking. The goal is less surgery and more using a team approach to decrease pain and increase function for the vast majority of patients with neck and back pain.

I think how much trust a patient needs to have to move forward with spinal surgery on the neck and back region given all the bad press regarding spinal surgery. A lot of this is actually good as patients should be cautious on making any decision. There are real risk and surgery gives less then perfect results. However, there is a window after which results are less certain if chronic weakness and pain are treated with narcotics and excessive nerve blocks. Know your options and research on the Internet as well. Education is a fundamental goal in my practice with all patients.

I read a lot about laser for spine surgery. This tool is very easy to use but has very little role for treatment of spinal disorders. There are reasons most advanced trained surgeons do not use it. We would if it help with outcomes. Most of these “lasercenters” do not have peer-reviewed content or doctors that have felllowships in spine. Procedures are performed outside a hospital where Bthere is much monitoring of complications and efficacy. If u are thinking of this option do a complete Internet search of a center including complaints to board of medicine,lawsuits,and community chat centers. Be careful!

I strongly believe spine surgeons should discuss all serious potental complications with surgical patients.I feel that patients should be a little nervous if they are properly prepared for surgery. The results are good but not perfect In most situations. Managing each patients expectations is extemely important. I also find the other extreme, where patients with very correctible problems , are told surgery on their neck or back will not work. In fact, surgery has come along way over past five years with newer technology and more more highly trained spine specialists. Too much narcotics are being prescibed that have no proper role for treatment of stenosis or herniated disc disease.

I read a lot of articles about repeat spinal surgical procedures and want my patients to understand some basic reality.In most cases, the underlying process is a form of aging with degeneration of structures such as disc or facet joints. This ongoing process cannot be changed with surgery. Rather we try to lessen the symtoms of pain or weakness so a patient can be more functional. The undelying process may then pass on to other levels with time requring either non-surgical or possibly more surgery in the future. This process is seen quite often in heart surgery as well. Coronary arteries at other level also nay get blockage over time needing second and even third surgeries. I clearly relay this process to all my patients. Fortunately, new techniques for spine surgery make recovery very rapid from just a few years ago.