Posts Tagged ‘spine specialist’

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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When Does Back Pain Call for an Epidural Steroid Injection?

Back pain epidural steroid injectionAs a physiatrist at the Emory Orthopaedics & Spine Center, I diagnose and treat back pain non-operatively, and one of the questions I’m asked most often by patients is whether they’re candidates for an epidural steroid injection.

If you have spinal pain, whether in your neck or back, your doctor will ask you whether it’s axial pain or radicular pain. Axial pain does not radiate into the arms or legs—it’s localized in one area. Radicular pain does radiate into the arms or legs. Axial pain typically is treated conservatively, with pain medication and exercise, and does not benefit from an epidural injection. However, if you have radicular pain and conservative measures haven’t helped, you may be a candidate for an epidural steroid injection.

In most cases, radicular pain is caused by one of two conditions—a herniated disc or spinal stenosis. Herniation is when a piece of the disc becomes disclocated, or slips, and presses on a nerve. This is more common among middle-aged patients, and 80% of patients with a herniated disc will get better over time without intervention. Disc herniations shrink as the body naturally self-heals. However, an epidural steroid injection can ease the pain and make the healing process more comfortable.

Spinal stenosis usually is caused by the natural wear and tear on the spine that comes with aging. Most patients with stenosis are 65 or older. Stenosis is degenerative and can lead to spinal nerve root compression or bony stenosis, which can cause pain, numbness, and weakness. While spinal stenosis may eventually require surgery, an epidural steroid injection can be a good temporary measure if you’re not quite ready for surgery or are not a candidate.

At Emory, we used different injection techniques depending on the condition. An interlaminar epidural is similar to the epidural a pregnant woman may opt for before giving birth. In this case, the goal is to introduce the steroid around the nerve root to decrease inflammation, which, in turn, eases pain. A transforaminal epidural is a more selective injection in which we target a specific nerve root that may be compressed by a herniated disc or a bone spur. Your doctor will decide which technique will benefit you.

In most cases if you have back or neck pain, your first step should be to try conservative pain-relief measures. However, when pain medication and exercise don’t help, and you’re suffering from radiating pain, an epidural steroid injection may be a good solution. An Emory physiatrist can work with you to diagnose your pain and set you on the right course of treatment.

Have you had an epidural steroid injection for back pain? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below. If you’re interested in learning more, we have some great information on epidural steroid injections for back pain our website.

About Susan Dreyer, MD:

Dr. Dreyer is an Associate Professor in the departments of Orthopaedics and Physical Medicine & Rehabilitation at Emory University School of Medicine.  Dr. Dreyer specializes in non-operative spine care and focuses on helping patients achieve their best functional level. She has taught many national and international courses on spine care and spinal injections for sciatica and other causes of back and neck problems.  She is also active in several professional societies. Dr. Dreyer started practicing at Emory in 1992.

3 Cervical Spine Procedures that Reduce Recovery Times

John G. Heller, MDWhen people think about neck conditions requiring surgery, they usually think about cervical spine injuries. We’ve all seen those tense moments during football or other sports when a player is injured and lies motionless on the field. A dramatic example comes from a Boston Celtics basketball game back in February, when Marquis Daniels bumped into another player and then fell motionless to the floor.

Fortunately, these events are rare. Most cervical spine surgery is needed because of wear and tear that affects your discs over time. In younger adults, this tends to be a herniated disc, which compresses the nerve roots or spinal cord. And, as we age, we all develop bone spurs to varying degrees (the “gray hair of the neck”). These spurs can be a source of nerve root or spinal cord compression, as well.

Cervical spine procedures are typically performed through the front of the neck, or anteriorly. In the United States, the primary surgical technique for the past 50 years has been the anterior cervical discectomy and fusion (ACDF). Since bone spurs form at the margins of the discs as they degenerate, these operations involve a discectomy, or the removal of the entire cervical disc, plus any bone spurs that border the discs.

Over the last two decades, spine surgeons at Emory have been leading the way in performing several innovative cervical spine procedures: laminoforaminotomy, artificial cervical disc, and laminoplasty. These procedures are performed from the back, or posteriorly, and don’t require a spinal fusion, thereby allowing patients to retain range of motion in the neck and also get back to their normal activities more quickly.

How do surgeons at Emory determine if one of these procedures might be right for you?

The first, laminoforaminotomy, is reserved for disc herniations that sit far enough to the side of the spinal canal that they do not compress the spinal cord. This procedure has been performed for many years, but new technology is allowing it to now be done using a minimally invasive microsurgical technique.

The second, for patients who meet the right selection criteria, is an artificial cervical disc, which may be inserted in place of the traditional bone graft with a plate and screws. This artificial disc is a moving part that’s ready for use when the patient wakes from anesthesia. Essentially, this procedure is a “get up and go” operation that avoids most of the limitations we traditionally impose on fusion patients while they heal. The artificial cervical disc is a ground-breaking option that has been very successful in clinical trials, many of which took place at Emory. Like any novel technology, longer term follow-up is needed to fully assess the risks and benefits of artificial cervical discs. But the data thus far are quite promising.

The third procedure, laminoplasty, is most often used in patients who are older and have three or more levels of spinal cord compression that would usually take three or four fusions. During this procedure, which is performed from the back of the neck, the roof of the spinal canal is re-shaped to provide more room for the spinal cord without the need for fusion. A mini-plate device, developed by surgeons at Emory Spine Center, is used during this procedure – allowing patients to move their necks right away after surgery, speeding up rehabilitation.

If you have been told you need cervical spine surgery, I would encourage you to contact the Emory Spine Center for an appointment to learn more about these innovative procedures.

Have you had or are you going to have cervical spine surgery? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

About John G. Heller, MD:
John G. Heller, MD, Baur Professor of Orthopedic Surgery and spine fellowship director, specializes in the research and development of instrumentation in cervical spine surgery, including disc arthroplasty and laminoplasty plates. He is the past-president of the Cervical Spine Research Society. Dr. Heller started practicing at Emory in 1989.

As an Academic Medical Center, Emory Provides Superior Spine Care

Dr. Scott BodenI am often asked questions like “Will YOU actually be doing my surgery?” and “Does a teaching hospital mean someone will be practicing surgery on my back?” These questions made me realize that many patients don’t understand what it means to receive care in an academic medical center, so I thought I would try to explain this in more detail.

Most of the differences in a true academic medical center, especially for a spine center, represent benefits that the patient may not even realize. First, to be a physician at an academic medical center, the surgeon also must be a professor, usually in a School of Medicine. As part of the medical school faculty, these physicians, in addition to taking care of patients, are teaching surgical techniques to the future generation of surgeons and/or performing research that is allowing for new discoveries and advancements in the field. This means that patients are exposed to the latest advances in surgical techniques and technology.

In addition, because of the teaching process, the patient will likely have a second MD assisting (helping retract and hold tissues), rather than just one surgeon and a nurse or surgical assistant. I would liken it to a pilot and co-pilot flying an airplane. Spine surgery is serious business, with little room for error, so you can rest assured that at any reputable academic center (such as Emory), the key portions of the surgery will be performed by your surgeon.

A second benefit comes from the collaborative environment in a multidisciplinary spine center. At the Emory Spine Center, one of the largest in the U.S., there are physical medicine/rehabilitation, occupational medicine, psychology, orthopaedic surgery, and neurological surgery physicians all seeing patients side by side every day. This spectrum of physicians ensures that no matter what a patient’s spine problem may be, he or she is sure to find a true expert among the staff. This environment takes the worry away from the patient about which type of specialist to see.

All of the surgical and nonsurgical physicians working at the Emory Spine Center have been fellowship trained (which means they’ve received extra training to specialize in spine care) and spend the majority of their clinical practice diagnosing and treating only patients with spine problems. This level of sub-specialization is harder to find outside an academic center. In addition, academic medical centers usually have the resources to have the latest and highest quality imaging technology—which is also very helpful in spine care.

A third benefit comes from the fact that some of the toughest cases are referred to academic centers. As a result, these physicians have more experience with the toughest problems and rarest complications, so that in the unlikely event you do experience a complication, they are very comfortable diagnosing and managing it to minimize any long-term impact on your outcome.

Most of these and other advantages of an academic medical center typically go on behind the scenes, which is probably why so few people truly understand the difference.

How have you benefitted from spine treatment in an academic medical center? We welcome your questions and feedback in the comments section below.

About Dr. Boden
Scott D. Boden, MD, Director of the Emory Orthopaedics & Spine Center and Professor of Orthopaedic Surgery, is an internationally renowned surgeon, lecturer, and teacher and the driving force behind the Emory University Orthopedics and Spine Hospital (EUOSH). Dr. Boden started practicing at Emory in 1992.

What’s So Special About a Spine Specialist?

If you have back or neck pain, you may wonder whether you need to see a specialist. Why not just go to your family doctor or a general orthopedist? Any good doctor will tell you that the spine is complex and requires special attention. When it comes to spine care, you should begin with your family doctor, but if the condition isn’t improving in a few weeks, or especially if you also have radiating arm or leg pain, then a specialist is the only way to go.

A specialist is defined as a physician whose practice is limited to a particular branch of medicine or surgery, especially one who is certified by a board of physicians. All physicians have undergone a residency training program after medical school in a general area of medicine. Usually a specialist has undergone a formal fellowship training program, after residency, in a very specific field.

Spine specialists, both surgical and nonsurgical, spend the majority of their time diagnosing and treating spinal disorders. It’s our passion—it’s what we do. We use judgment based on years of experience to determine which procedures will work best in a given situation. We’re up to date on new techniques, and we know how to use available technology. At Emory, our world-class physiatrists (nonsurgical spine physicians) and our spine surgeons are perfecting tried-and-true methods and pioneering new techniques every day.

When you see a nonsurgical spine doctor, or physiatrist, for back pain, that doctor has been trained specifically to diagnose and treat your pain with all options short of surgery. And the right early treatment can lead to a faster, more complete recovery.

If, after diagnosis, you find that you are in the very small subset of patients who do need spine surgery, you want a surgeon who operates on spines every day—a specialist who can determine the best surgery for your unique situation and has the skills, an understanding of the available technology, and the surgical hours logged to do it right.

At the Emory Orthopaedics & Spine Center, we take the specialist concept to new levels. Not only do our patients have the most qualified spine specialists in the country working for them—they have all of them working together as a team, sharing ideas and information about patients. Our patients benefit not just from the collective wisdom of the physician they’re seeing, but also from the experience of many other physicians whom they have not seen. We make sure every patient receives the highest level of technical care and that the highest level of expertise and decision-making go into formulating each treatment plan. Moreover, the Emory University Orthopaedics & Spine Hospital (EUOSH), which opened in 2008, has the highest patient satisfaction ratings of any hospital in the United States (as measured by Press-Ganey, one of the largest independent surveyors of hospitals).

Are you thinking about seeing a spine specialist? Have you already benefited from specialized spine care? We welcome your questions and feedback in the comments section below.

About Scott D. Boden, MD:

Dr. Boden is the Director of the Emory Orthopaedics & Spine Center and Professor of Orthopaedic Surgery, is an internationally renowned surgeon, lecturer, and teacher, and the driving force behind the Emory University Orthopedics and Spine Hospital (EUOSH). Dr. Boden started practicing at Emory in 1992.