Spine Pain

Emory Spine Center Patient: “Dr. Ananthakrishnan is a miracle worker.”

By Renee Godley, patient at Emory Orthopaedic, Sports & Spine Center

Emory Orthopedics PatientIn 1969, I had scoliosis surgery. During this surgery, my spine was fused and a Harington Rod was attached to the muscles in my spine. After the surgery, I was bedridden for six months and in a body casts for a total of nine months. I recovered well and learned how to live with my limitations.

In 1990, I started to suffer from lower back pain. I visited Emory Orthopaedic, Sports & Spine Center, in Atlanta, Georgia and I was informed that I needed to have additional surgery. The wear and tear on my lower three discs had progressed to the point that I would need to have them replaced and fused within 10 years. I said no immediately because I knew the process, I had a three year old daughter at home and I would again, be bedridden for three months and in a body cast that extended down to my right knee. I was unwilling to go through the process a second time. Fear lead me to that decision.

From 2007 until 2012 I saw a pain management orthopedist, which helped me to numb the pain. Then I was advised to see Emory Orthopaedic, Sports & Spine physician, Dheera Ananthakrishnan, MD. Fear once again took hold of me. I had done research and quickly realized I was suffering from Flat Back Syndrome. I read information about the surgeries (two, for a total of at least 12 hours), and started to panic. I finally reached the point where the pain was too much and I just couldn’t take it anymore. I did not want to have surgery and I did not know what to do.

My life had become very restrictive. I could no longer go out to eat or even sit on the living room couch for an extended period of time, rather I had to lie down to lessen the pressure on my spine. I loved attending Georgia football games and could no longer attend any games, the car ride, walk to the stadium and sitting in the stands were beyond my capabilities. I just could not go anymore. My husband wanted to go to the movies, and you guessed it, I could not; I couldn’t do anything.

After much fear, unbearable pain and many days and nights spent crying, my life would soon change. I was referred to Emory Spine Center to see Dr. Ananthakrishnan (Doctor A). Doctor A examined me and ran numerous tests and the diagnosis was, as predicted, Flat Back Syndrome. Although I did not want to have the surgeries, I had no choice. I was scheduled for surgery in December of 2012. For thirty days I was taken off my medications (anti-inflammatories) and realized just how disabled I had become. I was immobile, I couldn’t walk, much less do anything.

On, December 7, 2012, I had surgery at Emory University Orthopedics & Spine Hospital with Dr. Ananthakrishnan that included three replacement discs. A second surgery was held on December 11, 2012 where two rods and 16 one inch titanium screws were placed in my back.

Thanks to Dr. Ananthakrishnan, for the first time in 30 years, I had no pain in my back! This is the best feeling that I’ve felt since I met my husband and got married. Dr. A is a miracle worker. In the two years since my surgery I have begun to walk for exercise, averaging approximately five miles of exercise per day. I went from not walking at all to averaging over 70,000 steps per week.

Everyone I see can’t believe how good I look. I stand straight. I am no longer hunched over. When someone tells me they are experiencing back pain, the first thing I ask them is, “Have you gone to Emory yet?” I would not have the quality of life I have today without Dr. Ananthakrishnan.

A note from Dr. Dheera Ananthakrishnan

I vividly remember the first day that I met Mrs. Godley. She was still so traumatized from her scoliosis surgery all those years ago! I was very worried that she would have difficulty coping with such a large revision surgery. Was I ever wrong! She sailed through two really large surgeries, and has been a textbook patient, inspiring others to follow in her footsteps.

One of the great joys of performing surgery is to see how life-altering it can be for patients who have lived with disability and pain for a long time. Mrs. Godley embodies this for me. It has been my great pleasure to know her and care for her. Now the only tears that are shed during our visits are tears of joy.

About Dr. Ananthakrishnan

Dheera Ananthakrishnan, MDDheera Ananthakrishnan, MD, trained with one of the pioneers of scoliosis surgery, Dr. David Bradford, at the University of California at San Francisco. After completion of her fellowship, Dr. Ananthakrishnan practiced orthopedic and spine surgery for over three years at the University of Washington in Seattle. In 2007, she left Seattle to work with Medecins Sans Frontieres/Doctors Without Borders in Port Harcourt, Nigeria. She then worked as a volunteer consultant at the World Health Organization in Geneva, Switzerland, before starting her position at Emory University. She maintains an interest in developing-world orthopedics through her non-profit, Orthopaedic Link, and is currently involved in projects in the Philippines, Nepal, and Bulgaria.

Dr. Ananthakrishnan’s practice focuses on adult scoliosis and degenerative conditions. She also treats adolescent spinal disorders as well as tumors and cervical conditions. She has been at the Emory Orthopaedic and Spine Center since 2007.

Successful Grand Opening for Emory Orthopaedics, Sports & Spine at Dunwoody

Emory Orthopaedics, Sports & Spine at Dunwoody

Photo from grand opening event at Emory Orthopaedics, Sports & Spine’s new Dunwoody location. A big thanks to Dunwoody Mayor, Mike Davis, Blessed Trinity High School, Emory at Dunwoody Family Practice, Jerry’s Famous Catering, St. Pius X Catholic High School, William J. Mulcahy, Synergy Sports Wellness Institute and all the wonderful people that shared the day with us. We are grateful.

On January 28, 2015, Emory Orthopaedics, Sports & Spine successfully hosted a grand opening event to officially open its doors to their new Dunwoody location.

The opening reception was an opportunity for local businesses and members of the Dunwoody community to tour the facility and meet with Emory physicians, including the newest physician, Lee Kneer, MD, assistant professor in the Departments of Orthopaedics and Rehabilitation Medicine. Dr. Kneer specializes in non-surgical treatments, ultrasound, rehabilitation and sport medicine.

In an effort to meet the increasing demands for orthopaedic care, Emory Orthopaedics continues to expand its services for the convenience of patient access across Metro Atlanta. The Dunwoody clinic offers a full range of treatments for orthopaedic conditions and injuries including sports medicine, hand and upper extremities, foot and ankle, joint replacement, shoulder, knee and hip, spinal care, and concussions. It also offers X-ray, physical therapy and an ambulatory surgery center.

“The needs of our patients always come first,” says Scott Boden, MD, director of the Emory Orthopaedics and Spine Center. “We are excited to offer top-notch physicians and convenient locations for high-level, specialized care that address the unique needs of our orthopaedic and spine patients.”

Emory Orthopaedics & Spine has locations in Atlanta, Duluth, Johns Creek, Tucker and now Dunwoody. All Orthopaedics, Sports & Spine physicians bring extensive training and experience.

Emory Orthopaedics, Sports & Spine at Dunwoody is located at 4555 North Shallowford Road, Atlanta, GA 30338.

For more information on all Emory Orthopaedics, Sports & Spine clinic, please call 404-778-3350. Appointments for surgical second opinions or acute sports injuries are available within 48 hours at 404-778-3350.

Do You Think You Have a Ruptured Disc? Check Out These Signs and Symptoms of a Herniated or Ruptured Disc

Herniated DiscA 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 resulting 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). There are many causes of a herniated or ruptured disc including:

  • Degeneration due to aging
  • Wear and tear
  • Injury to the vertebrae
  • Sudden strain or sprain in lower back
  • Sports injuries or accidents

Symptoms of a herniated or ruptured Disc

Symptoms of a ruptured disc will vary from person to person but the most common symptoms of a herniated or ruptured disc include:

  • Severe pain in the back around the ruptured area
  • Muscle weakness, numbness, shooting pain or tingling in the legs
  • Muscle spasms
  • Pain in shoulders, arms, chest, ribs or thighs (depending on where the rupture has taken place)

Treatment for a herniated or ruptured Disc

Most often herniated discs can be treated without surgical intervention. We typically recommend starting a patient on anti-inflammatory medications, ice and heat to reduce the severity of the pain. In some cases a steroid injection may be helpful, and in others physical therapy with back exercises can be added to the treatment plan. If all other options are exhausted and radiating arm/leg pain persists after 6 – 12 weeks of treatment, surgery may be recommended.

If a herniated or ruptured disc is identified quickly, treatments are more likely to be successful. Any one with a ruptured disc should modify their activity level to avoid lifting heavy objects as well as avoid bending or any activities which worsens the radiation of arm/leg pain. Sports activities should also be reduced while healing.

Some surgery options for herniated or ruptured discs are:

At Emory, our nationally renowned spine specialists work together to diagnose and treat cervical spine and lumbar conditions. Emory physiatrists (non-operative physicians) and surgeons use innovative approaches to spine care and have extensive experience that allows us to boast high success rates. Emory is one of the largest University – based Spine Centers in the United States. Our physicians typically exhaust non-surgical options first, but if surgery is recommended, most surgeries for herniated or ruptured discs are performed at Emory University Orthopaedics & Spine Hospital in Tucker. Emory University Orthopaedics & Spine Hospital is a dedicated orthopedic and spine hospital and it leverages the pioneering vision, latest research and medical advances to provide high quality patient and family centered care.

About Scott Boden, MD

Scott Boden, MDScott D. Boden, MD, is Professor of Orthopedic Surgery and Director of the Emory Orthopaedics & Spine Center. Dr. Boden started practicing at Emory in 1992. During his fellowship at Case Western Reserve Hospital in Cleveland, Dr. Boden trained with one of the founding fathers of modern spine surgery, Dr. Henry Bohlman. A primary original researcher on bone growth factor development and spine fusion technology, Dr. Boden is also an internationally renowned lecturer and teacher and the driving force behind the Emory University Orthopedics & Spine Hospital (EUOSH).

Dr. Boden’s Clinical Interests:
Dr. Boden’s areas of clinical interest include surgical and nonsurgical management of adult degenerative spinal disorders including herniated discs, spinal stenosis, and spondylolisthesis in the cervical and lumbar spine. He was recently named in another Becker’s list of Top 50 Spine Surgeons in the U.S. and is a skilled surgeon with techniques of microdiscectomy, laminectomy, spinal fusion, and laminoplasty.

The Road to Emory: Education
• Medical School: University of Pennsylvania School of Medicine, Philadelphia, PA 1986
• Internship: George Washington University Medical Center, Washington, D.C. 1987
• Residency: George Washington University Medical Center, Washington, D.C. 1991
• Fellowship: Case Western Reserve University Hospital, Cleveland, OH 1992

Personal
Dr. Boden is the proud father of triplets who graduated first and tied for second in their high school class. He is also a baseball aficionado and coaches high school and travel softball teams.

Related Links

Spinal Stenosis: Treatment Options

spinal stenosisSpinal stenosis is a condition that occurs when the small spinal canal, which contains the nerve roots and spinal cord, becomes compressed (or narrowed). This narrowing occurs most often in the lower back or neck, and can put pressure on the spinal cord and nerves, causing a “pinching” of the spinal cord and/or nerve roots. The pinching can lead to a variety of symptoms, including pain, weakness and numbness. Symptoms often start slowly and get worse over time, and typically a person with this condition complains of severe pain in the legs, calves or lower back when standing or walking. Other symptoms include abnormal bowel/and or bladder function and loss of sexual function. Depending on where the narrowing takes place, you may feel these symptoms in the lower back and legs, neck, shoulder or arms. Usually, it is relieved by sitting down, leaning over or sitting forward.

In most cases, the narrowing is caused by osteoarthritis of the spinal column and discs between the vertebrae. It may also be caused by a thickening of the ligaments in the back, as well as by a bulging of the discs that separate the vertebrae. If you suffer from any or all of the above you should schedule an appointment with an orthopaedic spine specialist to determine if you have spinal stenosis.

How is Spinal Stenosis Treated?

The preferred treatment for cases of persistent back pain from spinal stenosis is a combination of physical therapy, prescribed exercise, and medications for chronic pain. Only if you have persistent pain, or if your pain does not respond to these efforts, will your physician consider surgery to relieve the pressure on the affected nerves or on your spinal cord. Here is what you can do:

  • Exercise: Regular exercise can help you build and maintain strength in the muscles of your arms and upper legs. This will help to improve your balance, ability to walk, bend and move about, as well as control pain. A physical therapist will identify and show you what exercises are right for you.
  • Medications: The most common treatment for chronic pain in spinal stenosis is non-steroidal anti-inflammatory drugs (NSAIDs). These include: ibuprofen (Advil, Motrin), acetaminophen (Tylenol) and Naproxen (Aleve). Your physician may also prescribe other medications to help with pain and/or muscle spasm.
  • Cortisone injections: Injections directly into the area around the spinal cord (known as epidural injections) may provide a great deal of temporary, sometimes permanent, relief. These medications include: Cortisone (Celestone, Kenalog) and methylprednisolone acetate (Depo-Medrol, Medrol).
  • Surgery: In some cases you may need surgery to relieve spinal stenosis, particularly if a disc fragment is lodged in your spinal canal and is pressing on a nerve, which can cause significant loss of function. Some patients with severe or worsening symptoms (but who are otherwise healthy) may be candidates for what is known as a decompression laminectomy. This surgery removes the bone spurs and buildup of bone in the spinal canal, freeing space for the nerves and the spinal cord. This may be done in conjunction with a spinal fusion to connect two or more vertebrae and better support for the spine. It should be noted that while surgery may bring some relief, it will not cure spinal stenosis and symptoms may recur.

Living With Spinal Stenosis:

Spinal stenosis can be a real challenge day to day, but certain steps can be taken to ease some of the symptoms. Some treatment options include:

  • Get moving. If you’re capable, regular exercise is very important and you should do it often – at least three times a week for about 30 minutes. Start slowly and as you begin to feel stronger, add walking or swimming to your plan.
  • Modify activity. Don’t do anything that can trigger or worsen pain and disability such as lifting heavy objects or walking long distances.
  • Hot or cold packs. Some symptoms of cervical spinal stenosis may be relieved by applying heat or ice to your neck.
  • Canes or walkers. In addition to providing stability, these assistive devices can help relieve pain by allowing you to bend forward while walking.

About Dheera Ananthakrishnan, MD

Dheera Ananthakrishnan, MDDr. Ananthakrishnan trained with one of the pioneers of scoliosis surgery, Dr. David Bradford, at the University of California at San Francisco. After completion of her fellowship, she practiced orthopedic and spine surgery for over three years at the University of Washington in Seattle. In 2007, she left Seattle to work with Medecins Sans Frontieres/Doctors without Borders in Port Harcourt, Nigeria. She then worked as a volunteer consultant at the World Health Organization in Geneva, Switzerland, before starting her position at Emory University, where her focus is on adult and adolescent scoliosis.

In 2009, Dr. Ananthakrishnan co-founded Orthopaedic Link, a non-profit dedicated to improving orthopaedic care in the developing world by mobilization of unused implants from the United States. She is also a candidate member of the Scoliosis Research Society. Although Dr. Ananthakrishnan routinely performs complex spinal reconstruction surgery, an injury in 2012 caused her to reevaluate her own approach to musculoskeletal health. Her practice philosophy now focuses on strengthening, stretching and general conditioning as an adjunct to surgical care of her patients.

Related Resources:

Spinal Stenosis: Diagnosis and Symptoms

Spinal StenosisAs the baby boomer population ages, approximately 2.4 million Americans will experience lumbar spinal stenosis by 2021, according to the American Academy of Orthopaedic Surgeons.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases describes spinal stenosis as the narrowing of the spaces in the spine. This results in pressure being applied on the spinal cord and nerve roots. This narrowing condition can happen in three parts of the spine:

  1. The canal in the center of the spinal column, which holds the spinal cord and nerve roots
  2. The canals at the base of nerves that branch out of the spinal cord
  3. The openings between the vertebrae, which the nerves leave through to spread to the rest of the body

Sometimes this narrowing of the space inside the spinal canal produces no symptoms. However, if this places pressure on the spinal cord, cauda equina (a bundle of spinal nerves and nerve roots at the base of the spinal column), or nerve roots, there could be a slow onset and progression of symptoms. The neck or back may or may not hurt. Most often, people suffering from spinal stenosis experience weakness, cramping, numbness or pain in their arms or legs. If the pressure is mainly on a nerve root, they could experience a shooting pain down their leg, also known as sciatica.

If the spinal stenosis is severe, people may have issues with their bowel and bladder function, or even disorders of the foot. Cauda equina syndrome is an extremely rare, but serious form of spinal stenosis, and can cause loss of control of the bowel, bladder, sexual function, and/or loss of feeling, weakness or pain in the legs. This is a serious condition that requires immediate medical attention.

Because of the range of severity and symptoms, it is important to get a proper diagnosis from your doctor. They can use several methods to diagnose spinal stenosis and to rule out other conditions:

  • Questions about your medical history: you may have to explain details about any injuries, conditions or general health problems that could be causing these symptoms.
  • Physical examination: Your doctor will examine you to determine your range of movement, to see if you have pain or other symptoms when you bend backwards, and if you have normal neurologic function (sensation, muscle strength, and reflexes) in your arms and legs.
  • X-Ray: An x-ray of your back may be taken to find signs of an injury, tumor, or other problem. It will show the structure of the vertebrae and if there is any calcification.
  • MRI (Magnetic Resonance Imaging): An MRI can produce cross-sectional 3D images of your back, and can detect damage or disease of the soft tissues in your spine, and can show enlargement, degeneration or tumors.
  • CAT (Computerized Axial Tomography) Scan: This method can also show cross-sectional and/or 3D images, but can also display the shape and size of the spinal canal, what is in it, and the structures around it.
  • Myelogram: This is a liquid dye that x-rays can’t go through. It is injected into the spinal column and circulates around the spinal cord and nerves, which show up as white on the x-ray film. It can show the doctor if there is any pressure on the spinal cord or nerves from herniated disks, tumors or bone spurs.
  • Bone Scan: Your doctor may inject radioactive material that can attach to bone, especially where the bone is breaking down or being formed. This helps detect fractures, infections, tumors and arthritis (though it’s hard to tell between them). So a bone scan might be done along with other tests.

If you feel any of the symptoms outlined above, contact your doctor for a diagnosis. Though there is no complete cure for this ailment, with the guidance of your physician, steps can be taken to reduce pain and discomfort, and improve flexibility.

About Dr. Howard Levy

Howard Levy, MDDr. Levy is an Assistant Professor in the departments of Orthopaedics and Physical Medicine & Rehabilitation at Emory University School of Medicine. Dr. Levy specializes in non-operative spine care and focuses on helping patients achieve their best functional level. Dr. Levy started practicing at Emory in 1993.

Related Resources

Orthopedics at Emory

8 Types of Low Back Pain that Mean You Should Visit Your Doctor

What is the Sciatic Nerve? What is Sciatica? 

When Does Back Pain Call for an Epidural Steroid Injection? 

Could I Be Suffering from a Herniated Disc?

Herniated DiscLower back pain has been found to be the number one cause of disability around the world, according to the 2010 Global Burden of Disease study. Though many conditions can cause back pain, a herniated disc is a common cause.

Discs are the soft, rubber-like pads that fit between the bones (vertebrae) of the spinal column and cushion it. The discs allow the back to flex and bend and absorb shock.

Herniated discs, which can also be called slipped or ruptured discs, are caused when all or part of the disc is forced through a weakened part of it, which places pressure on the nearby nerve and/or spinal cord, causing numbness, and most commonly, pain. Herniated discs can occur both in the lumbar spine (lumbar herniated disc) and the cervical spine (cervical herniated disc).

This can happen when the disc moves out of place (herniates) or breaks open (ruptures) due to injury or strain. It is most commonly found to happen in the lower back, but can also affect the neck’s discs, or, even more rarely, the discs in the upper-to-middle back.

Herniated Disc Risk Factors

If you’re not sure if a herniated disc is causing your pain, the American Academy of Orthopedic Surgeons point out a few factors that can put you more at risk:

  • Usually, herniated discs are caused by the natural aging of your spine. When we’re young, our discs have a high water content, making them spongy. When we age, they begin to dry out, becoming weaker and narrowing the spaces between our vertebrae. This is called disc degeneration.
  • Men between 30-50 are more likely to have a herniated disc
  • Jobs or tasks that require you to repeatedly lift heavy objects can put you at risk, especially if you are lifting with your back and not your legs, or if you are twisting while you lift.
  • Being overweight can add stress on the discs of your lower back
  • If you are frequently in the car, staying seated for long periods of time along with the vibrations of the car, can put pressure on your spine and discs
  • Staying sedentary can cause herniated discs
  • Smoking can reduce the amount of oxygen reaching your discs to cause more rapid degeneration

Herniated Disc Symptoms

For most people suffering from a herniated disc, lower back pain is the first symptom. The pain may come and go, but can eventually lead to leg pain, numbness or weakness. These sensations can reach all the way below the knee, to the ankle and foot.

Additionally, the symptoms can be all or one of the following:

  • Back pain
  • 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 could be a more serious problem known as cauda equina syndrome, which is caused by compression of the spinal nerve roots. This requires immediate medical attention.

If you feel like you may be suffering from a herniated disc, see your orthopedist for a physical examination or MRI scan, so they can make sure that it’s the cause of your back pain. Due to a wide range of non-surgical and surgical treatments available, most patients are free from their symptoms in 3-4 months!

About Dheera Ananthakrishnan, MD:
Dr. Dheera AnanthakrishnanDr. Ananthakrishnan trained with one of the pioneers of scoliosis surgery, Dr. David Bradford, at the University of California at San Francisco. After completion of her fellowship, Dr. Ananthakrishnan practiced orthopedic and spine surgery for over three years at the University of Washington in Seattle. In 2007, she left Seattle to work with Medecins Sans Frontieres/Doctors Without Borders in Port Harcourt, Nigeria. She then worked as a volunteer consultant at the World Health Organization in Geneva, Switzerland, before starting her position at Emory University. She maintains an interest in developing-world orthopedics and is currently involved in projects in the Philippines and Malawi.

Dr. Ananthakrishnan’s practice focuses on adult degenerative conditions, including scoliosis. She also treats adolescent spinal disorders as well as tumors and cervical conditions. Dr. Ananthakrishnan started practicing at Emory in 2007.

Related Resources:

90% of Back Problems Can Be Resolved Without Surgery

The thought of having to have spine surgery is terrifying to most people. The good news is that only about 10% of patients who have back or neck problems are candidates for surgery. At Emory Orthopaedics, Sports & Spine, we have non operative as well as operative physicians who specialize in the diagnosis and treatment of acute back and neck pain injuries. The non-operative physicians, physiatrists, only recommend surgery in the cases where it is absolutely necessary. There are many non-surgical spine treatment options that may fix back problems before opting for surgery. These non-surgical back treatments include anti –inflammatory medication, ice, heat, gentle massage, physical therapy, orthotics, and injections.

Patients should only consider surgery if all of the conservative treatment options have been exhausted. In this short video below, Emory’s non-operative sports medicine and spine physician, Dr. Oluseun A. Olufade describes Emory’s approach to caring for active individuals with back or neck pain. It is important to note that if your physician immediately suggests you have back surgery before giving you other options for your care, it may be a good idea to get a second opinion.

Related Resources:

About Dr. Olufade
Oluseun Olufade, M.D.Dr. Olufade is board certified in Sports Medicine, Physical Medicine & Rehabilitation and Interventional Pain Medicine. He completed fellowship training in both Interventional Pain Medicine and Sports Medicine. During his fellowship training, he was a team physician for Philadelphia Union, a major league soccer (MLS) team, Widener University Football team and Interboro High School Football team. Dr Olufade is also the team physician for Emory University and Blessed Trinity High School.

Dr. Olufade employs a comprehensive approach in the treatment of sports medicine injuries and spinal disorders by integrating physical therapy, orthotic prescription and minimally invasive procedures. He specializes also in treatment of sports related concussions, tendinopathies and platelet rich plasma (PRP) injections. He performs procedures such as fluoroscopic-guided spine injections and ultrasound guided peripheral joint injections. Dr. Olufade individualizes his plan with a focus on functional restoration. Dr. Olufade sees patients at our clinic at Emory Johns Creek Hospital.

Dr Olufade has held many leadership roles including Chief Resident, Vice-President of Resident Physician Council of AAPM&R, President of his medical school class and Editor of the PM&R Newsletter. He has authored multiple book chapters and presented at national conferences.

About Emory Ortho, Sports and Spine in Johns Creek and Duluth
Emory Orthopaedics, Sports & Spine has recently opened two new clinics, one in Johns Creek and one in Duluth. Emory physicians, Kyle Hammond, MD, and Oluseun A. Olufade, MD see patients in Johns Creek. Mathew Pombo, MD and T. Scott Maughon, MD see patients in Duluth. Our new clinic locations care for a full range of orthopedic conditions including: sports medicine, hand/wrist/elbow, foot/ankle, joint replacement, shoulder, knee/hip, concussions, and spine. To schedule an appointment call 404-778-3350.

Atlanta Opera Violinist Back on Her Feet Thanks to Emory Orthopedists!

Fia Mancini Durrett, Atlanta Opera Orchestra Violinist and Emory patient, recently played her violin for Emory Sports Medicine physician Sam Labib, MD and his clinic staff. Fia made a deal with Dr. Labib that if he could help rid her of foot and back pain, she would play her violin for him in clinic.

Dr. Labib held up his end of the deal, so on her last visit to the Emory Orthopaedics & Spine Center, Fia brought her violin along.

Patient Video Story: Back to Life after Spinal Tumor Surgery

Spine Tumor Patient Story VideoDoug House is an Emory Spine Center patient who had a large spinal tumor. Doug was in pain for over 10 years and had several problems performing basic daily activities including walking, sleeping, and controlling his bladder. He thought he would live the rest of his life unable to perform basic life functions. Doug was referred to our team at the Emory Spine Center and now is back to his old self and able to enjoy life again.

Watch Doug’s incredible story in the video below and learn more from Emory physicians Dr. Gerald (Rusty) Rodts and Dr. Daniel Refai on what makes spinal tumor treatment at Emory different.

Are You One of the 7 Million in the U.S. Affected by Scoliosis?

Scoliosis, or a curvature of the spine, is a condition that affects almost 7 million people in the U.S. While it does occur in adults, it is most commonly seen in children, especially girls, during periods of growth. Although the deformity is complex and 3-dimensional, often times the spine in a person with scoliosis looks like an “S” or a “C” instead of a straight line.

Scoliosis

Adolescent scoliosis is the most common spinal deformity affecting pre-teens and teenagers, however it does not always result in significant pain or discomfort. Scoliosis may also occur in younger children and is often referred to as early onset scoliosis (EOS) in children less than five years old. EOS may significantly worsen as the children grow and cause severe spinal deformity and problems with the lungs or other internal organs.

Signs & Symptoms of Scoliosis

  • Uneven musculature on one side of the spine
  • Uneven hips, shoulders, or legs
  • Difference in the chest or breast area
  • Slowed nerve action (in some cases)

Causes of Scoliosis

About 65% of scoliosis cases are from unknown causes. Congenital scoliosis (caused by abnormally shaped vertebrae) accounts for about 15% and the rest is speculated to be caused by neuromuscular disease. Some researchers think genetics may play a role in who develops scoliosis, but it is not completely understood at this point.

Scoliosis Treatment Options
At Emory, we typically use non-operative treatments to minimize the worsening of scoliosis before we consider surgical treatments. Surgery is typically reserved for more severe cases of scoliosis. The vast majority of adolescent scoliosis can be managed with non operative measures including careful observation or spinal braces. Our surgeons have access to many local orthotics groups allowing for accurate and effective bracing for scoliosis.

Emory’s Experience in the Treatment of Scoliosis
Emory Healthcare orthopaedic surgeons have tremendous experience in caring for children of all ages with scoliosis. Our physicians are also unique in that they provide care to patients with scoliosis of all ages. When combined with our adult spine center, Emory is the only center in Georgia capable of treating patients from infancy into adulthood.

Emory pediatric orthopaedists Dr. Robert Bruce, Jr. and Dr. Nicholas Fletcher have extensive experience with growing rod and Vertical Expandable Prosthetic Titanium Rib (VEPTR) for the management of severe scoliosis in young patients. These techniques allow for continued growth of the spine in younger children to allow normal development and function. Emory is also one of the few centers in this region offering Mehta casting which is a non-surgical treatment in which the doctor manipulates the spine and then places the child’s torso in a plaster cast. This is especially useful for young children with early onset scoliosis and has been found to actually correct the curvature in certain patients.

Scoliosis Research On the Horizon
Our physicians have been involved in research evaluating opportunities to maximize scoliosis care in children of all ages and assess the long term outcomes of scoliosis surgery. Our research has been presented locally, nationally, and internationally in places as far away as Japan. Dr. Fletcher’s research has focused on clinical outcomes following scoliosis surgery including one of the longest term follow up studies on modern surgical treatment ever published.

Drs. Bruce and Fletcher are currently heading a study highlighting our post operative care following scoliosis surgery which has resulted in discharge 50% faster than the national average without any difference in complications allowing for early return to school for children and work for their parents. Another study is examining discrepancies in access to healthcare and the impact this may have on scoliosis severity.


Dr. Robert Bruce, Orthopedic SurgeonAbout Dr. Robert Bruce, Jr.
Dr. Bruce has been a fixture in the Atlanta community for 17 years having started practicing at Emory in 1995. His interests in spinal conditions include caring for all forms of pediatric spinal problems with an emphasis on idiopathic scoliosis and scoliosis in patients with cerebral palsy and other neuromuscular disease.

He is the director of the Children’s Healthcare of Atlanta (CHOA) cerebral palsy program and has a tremendous experience caring for all types of orthopaedic conditions in children with cerebral palsy from the spine to the hips to the feet. Dr. Bruce is also specialty trained in Ilizarov and the treatment of leg length differences and angular deformities. Outside of his clinical duties, Dr. Bruce serves on the CHOA medical board, is the past medical director of Egleston campus, and is currently the head of the orthopaedic team at Egleston hospital.

Dr. Nicholas FletcherAbout Dr. Nick Fletcher
Dr. Fletcher has been practicing at Emory since 2010 and cares for all forms of pediatric spinal problems including adolescent scoliosis, neuromuscular scoliosis, congenital scoliosis, early onset scoliosis, kyphosis, and spondylolisthesis.

He also has spoken locally, nationally, and internationally on his research in scoliosis. His work on adolescent scoliosis has been presented as far away as Japan and he has published multiple studies on early onset and adolescent scoliosis. His current research on comparing spinal casting and growing rod surgery was recently nominated as a top 10 podium presentation at the Pediatric Orthopaedic Society of North America meeting. He also received the 2010 T. Boone Pickens Award for Spinal research for his research in Adolescent Idiopathic Scoliosis.

Dr. Fletcher also specializes in pediatric and young adult hip conditions including hip dysplasia, femoroacetabular impingement (FAI), perthes disease, avascular necrosis, and slipped capital femoral epiphysis. He is one of only a handful of surgeons in the southeast with expertise in the Ganz or periacetabular osteotomy (PAO) for hip dysplasia and the modified Dunn osteotomy for slipped capital femoral epiphysis. He takes care of children of all ages with hip conditions in addition to young adults with hip dysplasia and impingement.
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