Posts Tagged ‘disc herniation’

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 >>

Takeaways from Dr. Boden’s Spine Surgery Chat

Thanks to everyone who joined us Tuesday, August 25, for our live online chat on “When Should You Consider Spine Surgery?” hosted by Scott Boden, MD, director of the Emory Orthopaedics & Spine Center.

If you have been told you need spine surgery, it is important to make sure you have the proper information before electing to have spine surgery. The good news is that less than 10% of patients who experience back or neck problems are actually candidates for surgery.

See all of Dr. Boden’s answers by checking out the chat transcript! Below are a few highlights from the chat:

Question: I have disc degeneration at all lumbar levels, can surgery be performed, if not, what else can be done to relieve pain?

boden-scott

 

Dr. Boden: When there is disc degeneration at all levels and the primary symptom is back pain (and not radiating leg pain), we would typically not suggest surgery. You would have to come in to see a spine specialist to fully address your pain and specific situation, though.

 

Question: If less than 10% of patients who experience back or neck problems are candidates for surgery, why is that?

boden-scott

 

Dr. Boden: The majority of back or neck problems will resolve with time or non-operative treatments such as physical therapy or medications. Only a very small percentage will require or benefit from surgery.

 

Question: Could you walk us through a general sequence of determining whether or not a patient should consider surgery following a disc herniation, PT and epidural steroid injections? Having a hard time sorting out the difference between patience to allow healing and delaying and inevitable surgery now 2 years post injury.

boden-scott

 

Dr. Boden: In general, a disc herniation might need surgery if the primary symptom is radiating leg pain rather than just low back pain.

 

 

The majority of disc herniations – over 90% – resolve on their own within three months. During that time steroid injections, physical therapy and medications can be tried to help relieve pain while the body heals the disc.

If the leg pain persists longer than 3 months than the ideal surgical window is between 3 and 6 months after the leg pain started. You can still get acceptable results after 2 years, but the likelihood of success is slightly smaller.

Watch as Dr. Boden shares more insight into when it’s time to consider back surgery in this Fox5 Atlanta news feature. (Note: this news segment contains advertisements and external links which are not endorsed, administered or controlled by Emory Healthcare.)

At the Emory Orthopaedics & Spine Center, our team of highly-trained spine specialists work together to diagnose and treat cervical spine and lumbar spine conditions ranging from herniated discs to more complex problems such as spinal tumors and scoliosis.

To make an appointment with an Emory spine specialist, call 404-778-3350 or complete our online appointment request form >>