Posts Tagged ‘spinal 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 >>

Is Minimally Invasive Spine Surgery Right for You?

Minimally invasive spine surgery can treat back and neck pain with a smaller incision, faster recovery and less pain. When nonsurgical spine treatments don’t relieve your spine and neck pain, spine surgery may be your best option. Thanks to new technology and advanced imaging techniques, minimally invasive spine surgery is now an option for some.

Benefits of Minimally Invasive Spine Surgery

In traditional spine surgery, your surgeon makes a 5- to 7-inch incision and moves muscle to get to your spine. This invasive approach puts you at greater risk for infection, muscle damage, scarring and pain. You can also expect a long recovery.

Minimally invasive spine surgery is a game-changer. Its benefits include:

  • Smaller incision
  • Less injury to muscles around the spine
  • Less bleeding
  • Less pain
  • Shorter hospital stay (an average two to three days)
  • Faster recovery

Am I a Candidate for Minimally Invasive Spine Surgery?

Minimally invasive spine surgery is typically used when doctors can pinpoint the damaged area of the spine, such as with a herniated disc or lumbar stenosis. This procedure may be right for you if you have a condition like this.

How Does Minimally Invasive Spine Surgery Work?

Your surgeon makes a 1-to 2-inch incision (ideally the length of a small paperclip) and inserts a thin device called a tubular retractor. He or she feeds tiny surgical tools through this thin passageway to remove disk or bone.

We offer many minimally invasive spine procedures at Emory, including:

Want to learn more about minimally invasive spine surgery?

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About Dr. Michael

michael-keithBuilding on his training and practice at Duke and Emory, Keith Michael specializes in using both minimally invasive and traditional spine surgery techniques to treat cervical and lumbar spine problems. Each surgical procedure is tailored specifically to address the patient’s pathology and clinical complaints, while trying to minimize morbidity and downtime.

His research interests included clinical outcomes measurement, patient education tools and cost-effectiveness studies.

How Aging Affects Your Cervical Spine – Part I: Pinched Nerve

Pinched NerveThe cervical spine refers to that portion of the spinal column that is within our neck. This section of the spine has two essential roles: providing flexibility so that we can move our head up and down and side to side, and protecting the spinal cord nerves that pass through it. Cervical radiculopathy, or pinched nerve, tends to occur when the nerve roots are irritated or compressed by one of many conditions.

Cause

Cervical radiculopathy can occur in a wide variety of patients, with those younger than 50 tending to suffer as a result of disc herniations. Other than trauma or injury, degenerative conditions as a result of aging are the main cause of neck pain. As disks age, they lose height and the vertebrae move closer together, causing the body to respond by forming more bone—called spurs—around the disk to strengthen it. However, the spurs can also contribute to stiffening of the spine. Bone spurs may also narrow the area of the foramen and pinch the nerve root.

Symptoms

The primary symptoms of cervical radiculopathy include pain radiating from the neck into the shoulder, upper arm, forearm, or hand.  Sometimes the symptoms radiate into all of these areas, whereas in other cases, the symptoms may radiate to only some of these areas.  Other associated symptoms can include tingling and numbness.  In some cases, weakness of various muscle groups in the shoulder, arm, and hand may occur.

Treatments

Non-surgical:

Interventional treatments for cervical radiculopathy are generally attempted first and may include:

  • Physical therapy and/or exercise to help relieve the pressure on the nerve root. Stretching as many dimensions of the neck as possible is essential to maintain flexibility and relieve chronic stiffness.
  • Medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain and analgesics to relieve pain.
  • Use of a cervical collar, cervical pillows, or neck traction may also be recommended to stabilize the neck and improve alignment.
  • Injections of steroid medications around the affected nerve root, commonly known as nerve root or epidural injections, can be considered for pain relief as well.

Surgical Treatment:

If symptoms persist despite nonoperative care, or if there is substantial motor weakness, surgical treatment is recommended and generally has excellent outcomes.  In fact, cervical spine surgery generally has the best outcomes of any spinal operation.  Surgical treatment generally involves relieving the pressure off of the affected nerve root.  Depending on the circumstances, it may be performed either from the front (anterior) or back (posterior) of the neck, although the anterior approach is more common.

Some of the surgical spine procedures used to treat cervical radiculopathy at the Emory Orthopaedics and Spine Center are:

At the Emory Orthopaedic & Spine Center, our internationally-recognized spine surgeons research, pioneer and refine the most effective approaches to treating a variety of spine conditions.

Should you make an appointment with an Emory spine specialist? Take our five minute quiz and find out!

About Dr. Rhee

John Rhee, MDJohn M. Rhee, MD, is a Spinal Surgeon and Associate Professor of Orthopaedic Surgery specializing in cervical spine surgery, lumbar spine surgery, complex spinal deformity surgery (scoliosis and kyphosis) and surgery for spinal tumors. Dr. Rhee is an active researcher and sought-after teacher/lecturer at the national and international level in multiple medical societies. He has served as faculty and been an invited lecturer at numerous meetings and courses on spine surgery. In addition, he has served as Program Chairman at numerous national and international spine surgery meetings. Dr. Rhee has also published extensively in a number of peer reviewed journals and books, and he has received numerous awards and honors. He is actively involved the training of international research scholars and other spinal surgeons and has been the author and editor of major textbooks on spine surgery techniques.

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Spinal Tumor Symptoms & Treatment

Spinal TumorsTumors, whether cancerous (malignant tumors) or noncancerous (benign tumors), can develop and affect bones anywhere in the body, but when a tumor develops in or near your spinal cord or within the bones of your spine, it can be an especially serious condition.

Your spine is an extremely important part of your body as it holds up your head, shoulders and upper body. It also houses and protects your spinal cord and the nerve roots that control your arms, legs, and torso. The spine is made up of 31 small bones, called vertebrae, which are stacked on top of one another and make up the three sections of your spine (cervical spine, thoracic spine, lumbar spine) forming the natural curves of your back.

Your spinal cord runs through the middle part of the vertebra, which is called the spinal canal, and extends from the skull to the lower back. Spinal nerves branch out from the spinal cord through openings in the vertebrae, carrying signals between the brain and muscles.

The most common type of spinal tumor is one that spreads (a metastasis) from cancer arising in another part of the body, such as the breast, lung, kidney, prostate, thyroid, blood cells, or other tissues. Rarely, spinal tumors arise from the nerves of the spinal cord itself. Primary spinal tumors are those that arise from the bones in the spine – these are also relatively rare.

The closeness of a tumor to the spine and nerves that run through and between your vertebrae determines the severity of the condition. Tumors can compress and interfere with nerve function, affecting the messages being sent to and from your brain to the rest of your body. Since the spinal cord is relatively narrow, tumors within it may cause symptoms on both sides of the body. Tumors can also weaken the vertebrae, causing the spine to collapse and potentially cause pain or injure the nerves housed within.

Spinal tumors are different for each unique patient since they originate from different areas or develop from different cell types. Depending on where the tumor is, how advanced it is, how quickly it is growing and whether it is malignant or benign, symptoms and treatment options vary.

Common symptoms of spinal tumors include:

  • Pain
  • Muscle weakness
  • Loss of sensation or numbness (in the legs, arms or trunk)
  • Loss of bladder/ bowel control
  • Difficulty using arms or legs, inability to walk

Treatment for spinal tumors is determined on a case by case basis and may include surgery, radiation therapy, chemotherapy or other medications. If surgery is necessary, the goals are to stabilize the spinal column, relieve nerve pressure caused by the tumor, protect the nerves and spinal cord and remove as much of the tumor as safely possible.

For more information about spinal tumors and spine tumor treatment, visit Emory Orthopaedics & Spine Center. Our world renowned, highly skilled, specialized and experienced team includes orthopedic spine surgeons, neurosurgeons, orthopedic oncologists and radiologists, all working together to diagnose and treat a wide range of spinal tumors.

About Dr. Rhee

John Rhee, MDJohn M. Rhee, MD, is a Spinal Surgeon and Associate Professor of Orthopaedic Surgery specializing in cervical spine surgery, lumbar spine surgery, complex spinal deformity surgery (scoliosis and kyphosis) and surgery for spinal tumors. Dr. Rhee is an active researcher and sought-after teacher/lecturer at the national and international level in multiple medical societies. He has served as faculty and been an invited lecturer at numerous meetings and courses on spine surgery. In addition, he has served as Program Chairman at numerous national and international spine surgery meetings. Dr. Rhee has also published extensively in a number of peer reviewed journals and books, and he has received numerous awards and honors. He is actively involved the training of international research scholars and other spinal surgeons and has been the author and editor of major textbooks on spine surgery techniques.

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Patient Video Story: Back to Life after Spinal Tumor Surgery

Collapsed Disc Spine Patient Races to Recovery

For years, triathlete Denise Novicki suffered from excruciating spinal pain in her lower back. Founder of Tri2Remember, a triathlon club that raises money to fight Alzheimer’s disease, Denise had always led an active lifestyle, but her back pain made it difficult, if not impossible, to enjoy her favorite pastime.

“I was in such immense pain that I was looking for some very trusted resources to manage my pain,” Denise says. She chose the Emory Spine Center at the Emory University Orthopaedics & Spine Hospital for assessment and a solution.

“What we’ve tried to do here at the Emory Spine Center is take the worry and the guessing out of a spine or back problem,” says Dr. Scott Boden (pictured left), director of the Center. “When people come here, we help them figure out what’s wrong and give them lots of different options.”

Before the spine doctors at the Emory Spine Center suggest surgery, they investigate all possible nonsurgical interventions, but they also know that, in some cases, a simple surgery may make the difference between experiencing debilitating pain and living pain free.

To find out the cause of her back pain, Denise met with spine surgeon Dr. John Heller, who discovered that she had a collapsed disc. It was clear to Dr. Heller that surgery would bring Denise relief and allow her to get her life back. “Denise came to us seeking advice on how to improve back pain that had really gotten in the way of her normal lifestyle,” says Dr. Heller. “She was an avid athlete and was having tremendous difficulty maintaining a training regiment, let alone a normal, everyday life.”

Before her spine surgery, Denise signed up for an upcoming Ironman distance race. She wanted to be sure she had a goal in place that would help her stay focused on recovery. She achieved her goal. “Coming into doing the Ironman, I had a different perspective than probably most athletes do, because I came to the table with thankfulness that I am actually able to compete. I did what I set out to do, and I couldn’t have done it without the team at Emory.” To learn more about Denise’s experience with spine surgery at Emory, check out the short video below:

Dr. Boden says, “The thing I love about taking care of patients with spine problems is that we have a real opportunity to help patients get their lives back, and that’s a very special thing.”

Dr. Scott BodenThe spine doctors at the Emory Spine Center are dedicated to excellent spine care. “Some places, people are part-time spine and part-time hips and knees, but what’s unique about our group is that everybody primarily focuses on taking care of patients with spine problems, teaching trainees who are learning about the spine, and doing research to try and explore new and better ways to treat spinal problems,” says Dr. Boden (pictured left). “If you end up coming to Emory University Orthopaedics & Spine Hospital, you’ll leave saying that you’ve never been in a hospital that’s anything like it.”

Have you had spinal surgery at the Emory Spine Center? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

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