Orthopedic Surgery

Meet your Spine Surgeon: A Conversation with Dr. John Heller 

Spine Surgeon

The spine supports the body’s weight and protects the nerves in the spinal cord that run through it. It helps maintain the body’s muscle control and nerve coordination, and without it, we wouldn’t be able to function. Spine surgery, a subspecialty of orthopedic surgery, includes the treatment and management of a wide variety of conditions affecting the neck and back, including herniated discs and fractures.

For Emory Healthcare spine surgeon John G. Heller, MD, the care and treatment of patients with spine issues is personally rewarding. His practice works to improve the lives of patients while training the next generation of spine surgeons.

Patients, understandably, often have many questions regarding spine conditions and their treatment. Recently, Dr. Heller spoke with Dr. Bruce Feinberg for The Weekly Check-up on WSB Radio about a wide range of issues related to the spine surgery. The following are summarized excerpts.

Question: Tell us about your team.

Dr. Heller: Over the last 28 years I’ve been at Emory, our team of spine specialists has grown a lot and so has our field. Right now, we have a team comprised of 11 orthopedic and neuro-spine specialists who are surgeons. We also have more than a dozen non-operative specialists, whose job it is to keep people from meeting the surgeons. It’s the minority of folks who actually need to or end up seeing a surgeon.

Question: How have you seen your practice grow?

Dr. Heller: We’ve been really fortunate in recent years to have the Emory Orthopaedic & Spine Hospital, in addition to Emory Midtown, to work in. It’s been a game changer for us and our patients. We have an entire hospital with a mission focused on joint replacement and spine. It’s a smoother experience for patients and we’ve seen that in our patient satisfaction rates, which are some of the highest in the country. We’re very proud of what we have built as a team, and in doing that alongside our educational and research activities. We now have points of access across the region to serve patients closer to home.

Question: How do you spend your days?

Dr. Heller: I alternate days either in the office all day or in the operating room all day. If I’m in the office, I see about 15 to 20 patients a day, which means I get to spend a good bit of time with each patient.

What we do really takes some time to get to know the patient, what’s going on and their options, and to go over all the information. On the days I’m operating, it can vary between a few operations that are several hours long each, to one operation that lasts anywhere from 10 to 14 hours.

Question: What is myelopathy?

Dr. Heller: We see and treat many cervical spine conditions, and this is one of our most common. Myelopathy is compression of the spinal cord caused by wear and tear which creates multiple points of pressure. We see this most commonly in those aged 55 and over. Myelopathy commonly presents with little to no pain, wobbly legs, and clumsy hands. There are a variety of different operations that we can do to help people with this condition.

Question: What is spinal stenosis?

Dr. Heller: Spinal stenosis is the narrowing of the spinal canal. As patients get older, their discs wear out and the place for the nerves in the low back and neck get crowded out. This condition can be associated leg pain, arm pain, back or neck pain, and sciatica.

Question: What is disc herniation?

Dr. Heller: Disc herniation commonly occurs in young healthy people who have a piece of a disc break off and compress a nerve. More than half the time, they never need to see a spine surgeon.

Question: What are your thoughts on using opioids to manage pain, given the concerns from patients and the medical industry?

Dr. Heller: Opioid abuse is dangerous, and we take prescribing opioids very seriously. Daily, on average, 142 people in the U.S. die because of prescription opioid accidents. We also know that taking opioids for a long enough period of time can make the pain worse, not better since they change the body’s central nervous system. I tell patients to use common sense, use what you need to when you need to, and don’t use it when you don’t need to.

Listen to the full conversation >>

Dr. Heller practices at Emory University Orthopaedics & Spine Hospital. To learn more about Emory Orthopaedics & Spine surgeons and treatment options available to you, visit www.emoryhealthcare.org/ortho or call 404-778-3350.


About Emory Orthopaedics & Spine Hospital

Emory’s Orthopaedics & Spine Hospital has locations across the Atlanta metro area. Emory’s physicians diagnose and treat conditions ranging from simple herniated disc and lower back and neck pain to more complex problems such as spinal tumor scoliosis and spine fractures. Emory Healthcare has the only hospital in Georgia that is dedicated to spine and joint surgery as well as non-operative spine and joint surgical interventions for physical therapy. For more information, or to schedule an appointment or an opinion, visit www.emoryhealthcare.org/ortho.

About Dr. John Heller

John G. Heller, MD, is an orthopedic surgeon specializing in the research and development of instrumentation in cervical spine surgery, including cervical disc replacement and laminoplasty. His clinical interests include herniated disc sciatica, spinal stenosis, and spinal tumors. An internationally renowned lecturer and teacher, Dr. Heller is the past president of the Cervical Spine Research Society and was one of the first surgeons in the country to perform laminoplasty.

Learn more about Dr. Heller >>

Real Patients. Real Stories – Kathleen Karr’s Total Ankle Replacement

total ankle replacement karrKathleen Karr thought her dancing days were over — until she underwent total ankle replacement surgery. 

Kathleen suffered an ankle injury during a car accident when she was 39 years-old. Unfortunately, the injury worsened over time. She began to lose more and more mobility in her ankle until, finally, she found herself barely able to walk.

Frustrated with her lack of mobility, Kathleen scheduled an appointment with an orthopaedist. After performing an initial exam and reviewing her X-rays, the doctor found that she had end-stage ankle arthritis and recommended an ankle fusion. While the procedure would give her back some mobility, the doctor warned that she would still not even be able to walk uphill or downhill following her surgery.

Kathleen had always been an active, vibrant woman. The thought of living out the rest of her life with such limited mobility just felt wrong to her. She had dreams of roaming the streets of Paris and dancing the night away. For her, barely being able to walk on flat ground was just not going to cut it.

Unsatisfied with what she was told, Kathleen decided to seek a second opinion. That’s when she found Dr. Jason Bariteau of Emory Orthopaedics & Spine Center in Atlanta, Georgia. “Kathleen was severely limited from her ankle injury,” recalls Dr. Bariteau. “She had already tried several conservative treatment options, but still couldn’t do the things she wanted to do.” Kathleen and Dr. Bariteau discussed possible treatment options and weighed the risks and benefits of each. They decided that a total ankle replacement would be the best fit for her.

Total Ankle Replacement Procedure

Traditionally, patients with end-stage ankle arthritis have been treated with an ankle fusion, which can lead to significant limitations after surgery and could cause further arthritis in the foot. Fortunately, total ankle replacement has evolved over the last few years. Not everyone is a candidate for total ankle replacement, but those who are, often find it offers them consistent pain relief and improved mobility.

Kathleen had a great experience with the procedure and is now pain-free and loving life. “I went dancing last night. I’ve always been a very active person, and it feels good to get back to the things I enjoy. Going from not being able to do anything, to getting onstage to dance and sing, feels amazing. I’m back to my crazy old self!”

With her trip to Europe booked, Kathleen feels grateful to Dr. Bariteau. “He’s such a great doctor—so thorough and personable. That’s what gave me the confidence to have the surgery. And that’s why I have my life back! Thank you, Dr. Bariteau!”

Emory Orthopaedics & Spine Center

Emory Orthopaedics & Spine Center offers the full-spectrum of orthopaedic care. If you have a foot or ankle injury, we can help. We want to get you back to living the life you love.

Learn more about total ankle replacement

About Dr. Bariteau

Dr. Bariteau grew up in a small town just outside of Albany, New York. After completing his undergraduate degree in Biology at College of Saint Rose, he then pursued his medical degree at Upstate Medical University in Syracuse, NY where he graduated Magna Cum Laude. Following completion of his medical training, he developed his surgical skills during his orthopedic surgery residency at Brown University. He then subsequently completed two advanced orthopedics fellowships; the first at Brown University in orthopedic trauma and the second at Baylor Medical Center in Dallas Texas under the tutelage internationally known Foot and Ankle Surgeon James W Brodsky MD. He currently resides in Atlanta, GA with his wife and three children. Learn more about Dr. Bariteau.

The 4 Most Common Causes of Shoulder Pain

Causes of shoulder pain Whether you’re throwing a football, unloading the dishwasher or scratching your back, shoulder pain can compromise even the most basic daily activity. Here’s how to identify and treat the biggest instigators of shoulder pain, which include:

  • Arthritis
  • Fracture (broken bone)
  • Instability
  • Tendon inflammation and tears

The shoulder is made up of tendons, muscles and bones. Its main purpose is to position your hand for your everyday tasks and movements. Since the shoulder is such a mobile joint, it’s more prone to instability or impingement in its soft tissues. This can lead to acute (sudden) or chronic pain.

1. Arthritis

Arthritis is a frequent cause of shoulder pain. The most common form of arthritis in the shoulder is osteoarthritis, which is known as “wear and tear” arthritis and may crop up as you age.

Many people respond to arthritis pain by reducing their shoulder movements, but this can backfire and cause tightness or stiffness in the soft tissues of the shoulder joint. It can also lead to significant pain when moving the shoulder.

Osteoarthritis is often caused by chronic movements, inflammation of the joint lining from rheumatoid arthritis, work injuries or sports injuries.

Treatments: Rest, physical therapy and at-home range-of-motion exercises can be helpful in relieving pain. Your doctor may also suggest anti-inflammatory medication, such as ibuprofen, to reduce your symptoms. If conservative treatments don’t help, you may need to have joint replacement surgery.

2. Fracture

A fracture, or broken bone, is another common cause of shoulder pain, swelling and bruising. Shoulder fractures often involve the:

  • Collarbone (clavicle)
  • Shoulder blade (scapula)
  • Upper arm bone (humerus)

Fractures are typically caused by a fall in older patients or a sports or vehicle injury in younger patients.

Treatments: Depending on the severity of the injury, you may need to wear a basic sling for three to eight weeks. For worse injuries, you may need surgery.

3. Instability

Shoulder instability means the head of the arm bone (the humeral head) is displaced from the shoulder socket, often as a result of trauma or serious injury. This can cause a “catching” or slipping feeling the shoulder or even a complete dislocation where the ball of the arm bone comes out of the shoulder socket completely.

This can cause the muscles, tendons and ligaments around the shoulder to tear or loosen, which can lead to repeated dislocations. Repeated dislocations lead to pain, unsteadiness and eventually, arthritis.

Treatments: Your doctor will maneuver the arm bone back into the shoulder socket. After that, you will likely wear a sling for a few weeks as the injury heals. If you experience future shoulder dislocations, you may need surgery to correct the problem.

4. Tendon Inflammation and Tears

Shoulders are prone to overuse injuries from repetitive tasks, such as overhead lifting. This often shows up in the form of tendinitis, an inflammation of the tendons, and bursitis, inflammation of the bursa.

The bursa is a fluid-filled sac between tendons and bones that allows them to glide easily. If the bursa is inflamed, the tendons may scrape against the shoulder bones resulting in weakness or tearing. This is called impingement.

The four rotator cuff tendons are the most susceptible to tendinitis. When the tendons are inflamed, there’s less space for the tendons and muscles to move within the joint.

Treatments: Rest your shoulder and avoid positions or activities (like overhead lifting) that cause pain. If this doesn’t help, your doctor may recommend a cortisone injection to decrease inflammation and pain, as well as physical therapy.

Get Treatment for Shoulder Pain

If you’re experiencing frequent, disruptive pain throughout your day — and caring for your shoulder injury at home hasn’t helped — it may be time to get help from a medical professional.

The orthopedic surgeons at Emory Orthopaedic & Spine Center specialize in treating all types of shoulder conditions and injuries. Don’t live with the pain another day.

Call us today at 404-778-3350 to schedule an appointment.

Back Pain Diaries: Herniated Disc – Signs, Symptoms and Treatment 

Dr. Lisa Foster discusses herniated discs

Dr. Lisa Foster, Emory Clinic

A herniated disc is a common lower back injury, but did you know lower back pain is the number one cause of disability around the world, according to the 2010 Global Burden of Disease study. For this blog, we spoke with our own Emory Clinic physician, Dr. Foster, to better understand those rubber like discs that sit between our spinal bones.

Your spine is made up of 26 vertebrae bones. Between them are soft disks filled with gel-like substance. These discs cushion the vertebrae bones and keep them in place. As we get older, the discs tend to degrade. When this happens, the discs lose their ability to cushion the vertebrae bones and this can lead to pain if the back is stressed.

What is a Herniated Disc?

A herniated disc, also commonly referred to as a ruptured disc or slipped disc, occurs when a cartilage disc in the spine becomes damaged and moves out of place. Sometimes, it can result in a pinched nerve. You can have a herniated or ruptured disc in any area of your spine but most often it affects the lumbar spine (lower back area).

How Does a Herniated Disc Occur?

When a disk is damaged, the soft rubbery center of the disk squeezes out through a weak point in the hard-outer layer. A disc may be damaged by sports injuries or accidents, repeated strain, a sudden strenuous activity or sometimes, it can happen spontaneously without any specific injury.

What Are the Risk Factors?

  • Genetic predisposition
  • Jobs or tasks that require you to repeatedly lift heavy objects, especially if you are lifting with your back and not your legs
  • Being overweight can add stress on the discs of your lower back
  • Smoking can reduce the amount of oxygen/nutrition reaching your discs to cause more rapid degeneration.

What Are the Symptoms?

  • Back, leg and/or foot pain (sciatica)
  • Numbness or tingling in the leg and/or foot
  • Weakness in the leg and/or foot
  • Loss of control over the bladder or bowels (very rare.) This requires immediate medical attention.

How Do I Prevent a Herniated Disc?

  • Build muscle strength in the core and legs. This stabilizes the spine, increases shock absorption and decreases overall muscle fatigue.
  • Alternate activities to help prevent injury. Warm up before exercising, including stretching.
  • Practice correct posture while you are walking, sitting, standing, lying down or working.
  • Don’t lift with your back; use your thigh muscles to do the lifting.

What Are Herniated Disc Treatment Options?

Each patient’s treatment plan will be different and is customized based on the precise location of the pain within the spine, the severity of pain and the patient’s specific symptoms. For the most part, patients usually start with non-surgical treatment options, such as physical therapy, spinal manipulations, massage therapy and more. A process of trial and error is often necessary to find the right combination of treatments. If a course of non-surgical treatments prove ineffective, surgery may be considered as an option.

 

Did You Know?

Emory Healthcare has a dedicated Orthopaedics and Spine Center, with locations throughout metro Atlanta. To make an appointment, please call 404-778-3350.

View Emory Orthopedics & Spine Center 

 


By Dr. Lisa Foster

Dr. Lisa Foster is a board certified, fellowship trained interventional physiatrist, specializing in non-operative spine care. Dr. Foster has published numerous articles and presented at national conferences in the fields of spine and rehabilitation medicine. Most recently, she was a contributing author for a book chapter on the workup and conservative management of lumbar degenerative disk disease in JL Pinherio-Franco’s Advanced Concepts in Lumbar Degenerative Disk Disease.

 

3D Printed Knee Replacements at Emory Johns Creek

Emory Orthopaedics & Spine Center will provide advanced technology using 3D printers to design custom knees for patients in Johns Creek. The technology, made by ConforMIS, allows for knee replacements to have several large benefits. These include patient-specific procedures, quicker recovery, less blood loss, easier range of motion and better long-term wear for patients.

The Knee Replacement Procedure

“After performing a CT scan, we use an automated design that maps the size and shape of the joint in 3D,” says Mathew Pombo, MD, orthopaedic sports medicine surgeon and assistant professor of orthopaedic surgery at Emory School of Medicine. “The software allows us to precisely match implants and instrumentation to the model of the knee.” The design of the knee implant is then printed off using a 3D printer.

Pombo bases his practice on caring for the elite athlete during their careers and afterwards. “The unfortunate reality is that all athletes transition from their prime into the aging athlete category where you can see the impact from a lifetime of sports and activity,” says Pombo. “The patient-specific 3D knee implant is ideal for an aging athlete who suffers from an arthritic knee and is considering surgery.”

As a result of undergoing the 3D knee replacement procedure, patients have a reduced hospital stay. This is because it is an outpatient procedure, which allows for patients to return home the same day as the surgery.

Pombo has performed approximately 500 customized 3D knee replacements.

Emory Healthcare & Atlanta Hawks New Partnership

12938175_10153983279726397_3461086211474604166_nWe have great news for our blog readers! Emory Healthcare & Atlanta Hawks Basketball Club announced a new partnership. We plan to build a first-of-its-kind training and sports medicine center on Executive Park Drive in Brookhaven.

About Emory Healthcare & Atlanta Hawks’ Facility

Emory Healthcare & Atlanta Hawks’ new facility will serve as the team’s official practice site. Also, it will feature advanced technology in sports medicine and athletic care. It will be built within a state-of-the-art training center with amenities. The team expects to break ground this summer on the 90,000-square-foot facility. The Hawks Basketball Operations Department will be housed in the facility upon its completion. Emory will become the official sports medicine provider of the Atlanta Hawks.

“When we became owners, one of our top priorities was to provide the resources necessary to build a world-class training facility—a key element of being a first-class franchise that consistently competes at the highest level. We are thrilled with the partnership that Steve and Bud have forged with Dr. Boden and the Emory team in developing a new facility that will be at the forefront of how professional teams approach integrating sports medical technology in their training centers,” Hawks Principal Owner Tony Ressler said. “It is a privilege to be partnering with a local institution that is a world leader in the medical field and that also shares our vision and passion for excellence.  In addition, we are proud that this facility will go beyond benefitting just our players, but will also be a valuable sports medicine resource available to the entire community.”

The new facility will be the first in the NBA to be co-located with an entire sports medicine center. It allows for immediate treatment and on-site access to state-of-the-art equipment. Emory will leverage a part of the facility to offer preventative and rehabilitative treatment and sports performance training. Emory Sports Medicine Center will also make this new center its permanent home and treat patients inside the new facility.

What The New Facility Will Offer

Offerings at the new Emory Healthcare & Atlanta Hawks’ facility are set to include the following:

  • 3D motion capture
  • force plates to measure joint stress
  • on-site blood and sweat testing
  • analysis for nutritional deficits
  • markers vital for the creation of individualized health and recovery plans

A fully dedicated recovery area including cryotherapy, sensory deprivation tanks and in-ground hydrotherapy will also be on-site. All non-sports orthopaedic specialties will continue to be located two blocks away at The Emory Orthopaedics & Spine Center.

“This strategic partnership will enable two outstanding organizations to create a new vision for sports medicine care and research for athletes at the highest levels of their game and translate this knowledge to our college, high school, and weekend athletes,” said Scott D. Boden, MD, Director of The Emory Orthopaedics & Spine Center and Chief Medical Officer of The Emory University Orthopaedics & Spine Hospital. “The addition of P3, the world renowned leader in peak performance enhancement, will make our facility and the city of Atlanta a destination for the most elite of athletes.”

P3 has been pioneering the use of advanced sports science technologies and front-edge applications in US pro sports. P3 specializes in quantifying athletic performance and developing precisely tailored training programs for elite athletes that boost individual performance and enhance career productivity.

Emory Healthcare is excited about the partnership to create this one-of-a-kind facility with the Atlanta Hawks and providing world-class care, treatment and training to athletes of all levels.

The Importance of a Second Surgical Opinion

spine-second-opinion-squareIf you’re one of the 13 million Americans suffering from back pain, neck pain or sciatica (pain running down your leg), your doctor may recommend surgery to relieve your discomfort.

While surgery can be life-changing for the better, it certainly isn’t a decision to be taken lightly. Surgery comes with its own risks and doesn’t always solve the problem. It may even introduce new ones.

You should get a second opinion before you have surgery. Don’t worry about offending your doctor. Second opinions are common practice. It can give you peace of mind that you’re making the right decision, especially if that decision is to go through with surgery.

Questions to Ask your Doctor

Before you jump into surgery, be sure to ask:

  • What is the likelihood of success?
  • What is the possibility of residual or worsened symptoms?
  • What are the risks of anesthesia?
  • What are the risks of spine surgery?
  • What is the chance of recurrence of my symptoms in the future?
  • What will happen if I don’t have surgery?

Rethinking Surgery

The good news is that most cases of back and neck problems can be resolved without surgery. In fact, spine surgery is only absolutely needed in a small percentage of cases.

If pain is the only symptom, then surgery is almost always elective, and the decision to proceed is based on weighing the risks versus potential benefits.

Surgery is usually the best option for severe weakness due to nerve or spinal cord compression; however every case is unique. Every patient has a different set of symptoms, exam findings, medical comorbidities (other health disorders) and life goals that drive the decision-making process.

Weighing the Options

Fortunately, most of the patients seen at the Emory Spine Center can be treated with less invasive treatments such as physical therapy, spinal injections or tweaking lifestyle choices that affect spine health. Usually surgery should only be considered once the conservative therapies have been exhausted. If you haven’t already, be sure to talk to your doctor about nonsurgical treatment options for your condition.

The decision to have surgery for most people with back or neck problems usually comes down to your lifestyle goals and desired quality of life.

For example, some people don’t mind living with a certain amount of pain and are content to manage it with anti-inflammatory medications. They can function well through day-to-day tasks and are willing to give up some activities, like running, in favor of lower impact exercise like walking. For them, they may feel the investment and risk of surgery isn’t worth it.

Other patients at this same level of discomfort may prefer to have surgery in hopes of less pain and more mobility. For some people, pain may interfere with daily tasks like doing the laundry or even just getting in and out of the bathtub. They may feel the potential benefits of surgery far outweigh the risks.

If your pain and other symptoms keep you from doing the kinds of activities you enjoy, and less invasive treatments haven’t helped you achieve your health and lifestyle goals, surgery might be a reasonable choice.

We Can Help

If you have been told you need surgery and would like a second opinion, then the Emory Spine Center is a great place to start. We will review your current imaging and obtain any necessary X-rays the same day. Once your records are reviewed and a history and physical exam are performed, we will give our own opinion on the best course of action. This will give you peace of mind that you are making the right choices for you and your family.

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About Dr. Gary

gary-matt-webMatthew Gary, MD, attended medical school at the University of Florida where he was inducted into Alpha Omega Alpha for academic excellence.  Following medical school, he completed residency training in neurological surgery at Emory University. During his residency, he gave numerous presentations at local and national neurosurgical society meetings and received research awards at the Congress of Neurological Surgeons and Georgia Neurosurgical Society.  He went on to complete a complex and minimally invasive spine fellowship at the University of Miami/Jackson Memorial Hospital under the tutelage of Drs. Barth Green, Allen Levi and Michael Wang.  He is interested in all facets of spine health and maximizing patients’ quality of life with a focus on minimally invasive spine surgery.

Chondrosarcoma Patient Story: “I can now walk unaided and enjoy time with my family.”

skiiing patient storyI noticed something was “not right” with my right leg when I couldn’t sit crisscross-applesauce-style on the floor during my daughter’s music class. The tendon near my groin area was very tight and sore. Pilates exercises were difficult to complete and my left leg responded better than my right during daily activities. At the time, I thought maybe the pain was a sign of aging and simply that I needed more exercise and stretching. I continued to go about my daily life, living with pain that was sporadic and more of an ache at that point.

In March 2009, I was on a spring break skiing trip with my family when I noticed my leg felt “wobbly” during the downhill runs. I couldn’t control my right leg well and immediately knew something was wrong, so I stopped skiing. The next day, we went horseback riding and as I swung my leg up and around to get on the horse, there was a sharp stabbing pain at the top of my thigh. That was my big “ah-ha” moment. I knew that once I returned home I needed to seek medical attention, especially since the bursts of pain continued on and off throughout the rest of my trip. When I got home, I visited my primary care doctor who ordered X-rays, MRI and bone scan. After reviewing my results, my primary care doctor referred me to Dr. David Monson, an orthopaedic oncology surgeon at the Emory Orthopaedics & Spine Center in Atlanta, GA. Dr. Monson met with me and explained I had Chondrosarcoma of the hip, which is a rare type of cancerous bone tumor.

Getting the news that it was cancer was startling and left me feeling quite shocked, especially after thinking the pain was just something having to do with the typical aging process. I was expecting them to find arthritis, not cancer. What made me most nervous was the type of cancer I had and its location in my hip. During the first visit with Dr. Monson that day, he walked me and my family through the different treatment options and then recommended I take some time to compare options. Like most people would, I went straight to the internet and began researching my cancer and different options. What I found scared me – up until five years ago, most tumors of the pelvis were surgically treated through amputation. This made me extremely anxious. I didn’t want to lose my leg.

During this tough decision-making process, Dr. Monson made me feel comfortable and at peace. He was extremely knowledgeable, very caring and direct. After reviewing my options with Dr. Monson, I felt sure he was the guy to do my surgery, so I made my decision and moved forward. Andre Roy, Dr. Monson’s Nurse Practitioner, was available any time I called and provided answers to my multitude of questions. I felt very cared for and looked after at Emory, and I was impressed with the office staff every time I came in for an appointment.

In the end, we decided that during the surgery to remove my tumor, we would reconstruct my hip using a saddle prosthesis. I was pleased that Dr. Monson knew how to perform this procedure comforted that is one of the few doctors that knows how to place such a prosthetic.

Following my surgery in November of 2009, I went through extensive physical therapy. Today I am walking really well and keeping up with my active teenage daughter. My range of motion is limited so minor adjustments have been made in my daily life to stay safe and comfortable. I’m thankful to be able to do all the things that I can do now, and continue enjoying life!

A note from Dr. David Monson

Bone tumors of the pelvis are uncommon and their surgical management depends on multiple factors, including tumor size, location and whether the tumor is benign (noncancerous) or malignant (cancerous). These factors determine whether a limb-saving surgery is possible or not and if the losses associated with surgery may result in a non-functioning extremity.

Three main factors to consider with pelvis surgery relate to stability of the hip after surgery, and function of the sciatic and femoral nerves. A minimum of two out of three must remain intact for the lower limb to be worth saving. Fortunately for Mrs. Powers, both her sciatic and femoral nerves were able to be preserved and we were able to restore stability of her right hip with a saddle prosthesis.

Options for reconstruction of the hip joint after removal of pelvic bone tumors may include prosthesis such as a saddle, a cadaveric bone transplant (allograft) or sometimes no reconstruction at all. Each has its own set of advantages and disadvantages which makes selecting the right treatment for each individual patient unique based upon the factors above.

At Emory Orthopaedics & Spine Center, our goal is to always offer patients with what we expect to be the most functional, yet durable surgical reconstruction possible without compromising the long term likelihood of cure. These surgeries are often quite complex and can take as long as 6-8 hours or longer. Complications can occur and the recovery time after surgery takes anywhere from six months to a year. We want patients to be fully educated before heading into a surgery this complex.

Mrs. Powers has worked extremely hard with her physiotherapy and has achieved an excellent functional outcome. We are incredibly proud of her and most grateful that there has been no recurrence of her tumor!

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Three Emory Surgeons Named to Becker’s Spine Review’s list of Spine Surgeons to Know – 2016

spine250x250Woot woot – it has been a great 2016 so far for Emory Orthopaedics & Spine Center! Three of our spine surgeons were recently named to Becker’s Spine Review’s list of Spine Surgeons to Know – 2016. Congratulations to John Heller, MD, and Tim Yoon, MD, on receiving this achievement. Combined, these three physicians represent seventy-three years of spine surgery expertise. Impressively, eight other surgeons named to the list completed their residency and/or fellowship at Emory Healthcare.

Read below to learn what Becker’s Spine Review had to say about our nationally recognized spine surgeons:

Scott Boden, MD: Board-certified orthopedic surgeon Dr. Boden serves as the director of Emory Orthopaedics & Spine Center and an orthopedic surgery professor at Emory University. He led the research on bone growth factor development and spine fusion technology. Spine and the Journal of American Academy of Orthopaedic Surgeons, among other journals, have published his work. Dr. Boden received the American Academy of Orthopaedic Surgeons’ Kappa Delta Young Investigator Award, Association of Bone and Joint Surgeons’ Marshall R. Urist Young Investigator Award and five North American Spine Society Outstanding Research Paper Awards, among various other honors. Dr. Boden completed his fellowship at Case Western Reserve Hospital in Cleveland.

John G. Heller, MD: Dr. Heller is a spine surgeon and the Baur Professor of Orthopaedic Surgery at Emory Healthcare. He focuses on the research and development of instrumentation in cervical spine surgery, particularly in cervical disc replacement and laminoplasty. He was a Kashiwagi-Suzuki Traveling Fellow and he earned the Volvo Award for Low Back Pain Research. His additional training includes a fellowship with the University of California Medical Center in San Diego.

Tim S. Yoon, MD: Dr. Yoon is an associate professor of orthopedic surgery at Emory Clinic. He is an active researcher, focusing on gene therapy for disc disease. His work has been published in peer-reviewed journals such as Current Opinion in Orthopaedics and Skeletal Radiology. His clinical interests also include cervical fusion, compression fractures, disc degeneration, discectomy, herniated disc, kyphoplasty, kyphosis and laminoplasty. His additional training includes a spine fellowship in Rush-Presbyterian-St. Luke’s Medical Center in Chicago.

About Emory Orthopaedics & Spine Center

Every day, the highly regarded physicians and surgeons at Emory Orthopaedics & Spine Center work together, across metro Atlanta, to diagnose and treat a variety of orthopaedic, sports medicine and spine conditions.

Our physicians use progressive treatment approaches – many of them pioneered right here at Emory and taught around with world. Surgical procedures and other treatments that are rarely performed at other hospitals are routinely performed at Emory. Learn more by clicking here, or call 404-778-3350.

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Pediatric & Adult Hip Dysplasia

hip-painHip Dysplasia

The thigh bone’s connected to the hip bone – that’s what the song says. But sometimes that connection doesn’t work so well, which is the result of a hip socket that is too shallow – a condition known as hip dysplasia.

The hip is the largest “ball and socket” joint in the body, held together by ligaments, tendons and a joint capsule. The hip socket is designed to hold the femur tightly to prevent it from coming out of the socket while allowing enough motion to permit a wide variety of activities. Hip dysplasia simply means that the hip is in the wrong shape, most commonly, the hip socket is too shallow and not positioned to fully cover the femoral head.

Most people with hip dysplasia are born with the condition. Many patients never have any symptoms of dysplasia as a child. However, if left untreated, many patients with hip dysplasia will progress to arthritis in their 30’s or 40’s, if not before. Hip arthritis can be a debilitating condition.

Treatment

Treatment for hip dysplasia depends on the age of the affected person and the extent of the hip damage. Infants are usually treated with a soft brace that holds the ball portion of the joint firmly in its socket for several months, helping the socket mold to the shape of the ball.

But some forms of the condition can develop later in life. Older children and adults usually require surgery to correct hip dysplasia. In mild cases, the condition can be treated arthroscopically — using tiny cameras and tools inserted through small incisions. However, if the dysplasia is more severe, the position of the hip socket can also be corrected or cuts can be made in the bone around the socket (an osteotomy) to increase its depth.

In many cases, the condition will lead to tear of the labrum and eventual arthritis because of damage to the cartilage in the socket. Total hip replacement is possible to improve pain and function in this situation.

Our providers have extensive experience in treating patients of all ages with hip dysplasia. The majority of patients with hip dysplasia are treated with surgical procedures including the periacetabular osteotomy (PAO) or “Ganz” osteotomy. This procedure, only performed by a small handful of physicians in Georgia, offers the ability to correct hip dysplasia and potentially avoid the need for a hip replacement. This exciting treatment has offered patients with hip dysplasia a hope for returning to normal activities.

Learn more about Emory’s experienced, board-certified hip specialists who provide the best possible treatment for a wide range of conditions affecting the hip. Pediatric orthopaedic patients should click here to learn more about the variety of pediatric orthopedic conditions we treat.

If you are considering a pediatric orthopaedic procedure at Emory, we encourage you to make an appointment by calling 404-778-3350 or completing our online request form by clicking the banner below.

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About Dr. Bradbury

bradburyThomas Bradbury, MD, enjoys hip and knee arthroplasty because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.

His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.