With the temperatures still skyrocketing, it is hard to believe that fall is around the corner.  But if the calendar is correct, soon it will be time to rake leaves! As you get ready to rake leaves – there are a few simple safety tips to help you avoid back injuries and back pain:

• View raking leaves as exercise – stretch before you rake.
• Avoid twisting and keep your back mainly upright.
• To avoid overreaching and twisting – step side to side – using your legs to move rather than your arms.
• To reduce stress on one side of the body -  switch hands throughout the job, and keep your elbows bent.
• And don’t forget to take breaks as needed.  This includes stretching and briefly bending backward to reduce back pressure.

At a recent continuing medical education program one of the speakers Dr. James Anderson discussed the assessment of low-back pain.  Dr. Anderson is a family practice physician in Greenfield.

During his presentation, Dr. Anderson highlighted a few spine wellness / patient education sites.  These sites provide spine eucation information as well as other health information on other topics.  These sites are  http://orthoinfo.aaos.org, http://www.nlm.nih.gov/medlineplus/, and www.uptodate.com/patients.  A few books that he recommended include:  Kortz, JN, Parkinson, G. Heal Your Aching Back.  McGraw Hill, New York, 2007 and Dumhi, HA.  All You Need to Know About Your Back Pain.  Arthritis Foundation, Atlanta, 2002.

Additionally,this link on Indiana Spine Groups web site provides a listing of other useful spine related web sites.   

In July, I presented at the 15^th annual International Meeting of Advanced Spinal Techniques.  I was honored to present two scientific papers at this medical education program.  One was about the US FDA IDE trial for the Bryan cervical disc replacement.  My second presentation was also about the Bryan cervical artificial disc replacement, and was a detailed motion analysis of the Bryan cervical disc. 

Here are links to the abstracts presented –“Radiographic Results from the BRYAN® Cervical Disc IDE Study,”and “Comparison of BRYAN Cervical Disc Arthroplasty with Anterior Cervical Decompression and Fusion: Clinical and Radiographic Results of a Randomized Controlled Clinical Trial.” 

This continuing medical education session will address caring for the patient with traumatic spine injuries.  These spine injuries can occur from motor vehicle accidents, work-related injuries, falls and even sports.  At this session, Dr. Paul Kraemer will discuss the caring for the patient with acute traumatic spine injuries and will also discuss when spine surgery is an option.  The latest research and updates for the treatment of spinal cord injuries will also be reviewed.

Dr. Paul Kraemer is an orthopaedic spine surgeon, who has recently joined Indiana Spine Group. 

As population continues to age, one common problem affecting older individuals is spinal arthritis.  At this continuing medical education session, Dr. Michael Stack will discuss the symptoms, diagnostic triage and treatment options for spinal arthritis.  Additionally, Dr. Stack will also discuss rheumatologic disorders that affect the spine including rheumatoid arthritis and ankylosing spondylitis.  

Dr. Stack is a rheumatologist with Diagnostic Rheumatology & Research, PC.

During this education session, Dr. Rick Sasso will discuss common spinal deformations which affect younger patients; including scoliosis.  This will include the latest diagnostic information and screening guidelines as well as treatment information.  Additionally, Dr. Sasso will discuss when spine surgery is a treatment option.

One of the breakout sessions will be presented by Alta Skelton, RN, MSN, NP, and Jennifer Turner, PA-C.  Alta is a nurse practitioner with Indiana Spine Group and Jennifer is a physician’s assistant – also with Indiana Spine Group. 

During their continuing medical education presentation, they will discuss the expected outcomes following spine surgery for a lumbar fusion.  Additionally, they will review patient care post-op for the spine surgery and how to identify complications following spine surgery.  Other discussion topics include expectations following discharge and patient recovery.

One of the main reasons people go to their doctor is for back pain!  This session, will provide physicians and health care practitioners the necessary tools to treat their patients with acute low back pain.  The presenter of this session is James Anderson, MD.  Dr. Anderson is a family practice physician with Anderson Family Practice located in Greenfield, Indiana.

At this session, Dr. Anderson will provide an overview of the initial assessment and neurological exam.  He will discuss the differential diagnoses for acute low-back pain, including red flags.  Additionally, initial management and patient education of patients with back pain will be reviewed. 

Another breakout session, at this continuing medical education symposium for physicians and health care practitioners, will address injuries incurred by athletes and the weekend warrior.  With the increased number of sports activities and programs, unfortunately this also includes an increase in back pain and injuries. 

During this session, Kevin Macadaeg, MD, and Nate Blume, DC, will provide the latest information for the prevention and diagnosis of spine-related sports injuries.  Additionally, they will discuss when spine problems should be evaluated by a spine specialist and what the more serious warning signs are; i.e. stress fractures.

This special interest symposium will focus on an alternative minimally invasive spine treatment option – spinal manipulation.  Chiropractic physicians Dr. Jeffrey Hebert and Dr. Tony Origer will co-present at this continuing medical education symposium special session.

This session will review the application and effectiveness of spinal adjustments through spinal manipulation and mobilization as a treatment option for lower back and neck pain.  During this discussion, evidence-based research will be highlighted.  Additionally, a review of the different techniques, their indications and safety issues will be reviewed. 

Another special interest symposium for this continuing medical education program is entitled, “The Osteoporotic Spine”.  Co-presenters for this session are Kevin Macadaeg, MD, and Michael Stack, MD.  Dr. Macadaeg is a minimally invasive spine specialist with Indiana Spine Group, and Dr. Stack is a rheumatologist with Diagnostic Rheumatology & Research, PC.

Osteoporosis has been identified as a major health concern, and the National Institutes of Health predicts that one in two women and one in four men over the age of 50 will suffer from a vertebral compression fracture.  Many times, not diagnosed until there is a fracture – this session will highlight the latest screening and diagnostic guidelines and recommendations.  Additionally, there will be a review of the recommended treatments including anti-osteoporotic medications and vertebral augmentation (vertebroplasty and kyphoplasty). 

For individuals diagnosed with a contained herniated disc or protruding disc, which are suffering from leg or lower back pain - one newer treatment option for pain relief is nucleoplasty. 

Nucleoplasty provides a minimally invasive spine treatment alternative.  With this minimally invasive spine procedure, radio waves which produce energy are used to dissolve (ablate) the unwanted disc tissue, and this relieves the pressure causing the lower back pain or leg pain.

This procedure is performed by a physician who is a minimally invasive spine specialist.  During this spine procedure, which takes less than an hour, the patient is awake and the physician will use a local anesthetic.  Guided by fluoroscopy (internal X-ray), the physician will insert a catheter-like device to the affected spinal disc. This catheter will deliver small amounts of radio wave energy to the damaged disc that will create a molecular reaction that will result in the spongy tissue in the damaged disc to dissolve.  This will reduce the pressure in the damaged disc, and thereby allow the herniation in the disc to retract.  The goal of nuceloplasty, is to reduce the pressure on the affected nerve and therefore eliminate back pain.

On Saturday, the Back Talk continuing medical education program will focus on different diagnoses and treatments and will feature concurrent sessions.  These next series of blog entries will highlight these special interest symposiums.

One special interest symposium entitled, The Healthy Spine, will be presented by Alta Skelton.  Alta is a nurse practitioner with Indiana Spine Group.  

During this session, Alta will be discussing how lifestyle can affect the health of one’s spine.  She will address exercise, posture, obesity, smoking and the role of nutrition and diet; and how these key lifestyle factors affect the spine.  Additionally, Alta will discuss key characteristics that dispose an individual to spine problems. 

There are many statistics out there about the prevalence about back pain.  The most common one is that back pain will affect 80% or 8 out of 10 individuals at some point in their life. 

There are four main types of back pain.  Here is an overview:

Acute Back Pain – This is short-term severe pain which is self-limiting.  This means that the back pain will generally go away within a few weeks.  Additionally, this pain generally causes you to limit the activities causing the pain – thereby reducing the chance for tissue damage.

Chronic Back Pain – This pain is ongoing and is persistent and is usually the symptom of an underlying cause.

Nociceptive Pain – This is localized pain that is caused by tissue damage to the joints, bones or muscles.  This pain has been described as sharp, throbbing or aching.

Neuropathic Pain – This is pain that occurs as a result of nerve damage.  It has been described as tingling, burning, or a squeezing pain.  Additionally, the individual may feel a shooting type of pain.

On Friday the continuing medical education session will also be on spine surgery.  Dr. Rick Sasso, a spine surgeon with Indiana Spine Group, will discuss the indications and surgical options for the cervical patient.

Dr. Sasso’s discussion will:

§          Review traumatic and degenerative cervical pathologies.

§          Review the indications and considerations for cervical disc fusion and artificial cervical disc replacement.

§          Provide a brief overview of the surgical procedures and expected outcomes for cervical disc fusions and artificial cervical discs.

This continuing medical education program will also provide in-depth information on spine surgery – areas focused on will be lumbar surgery and cervical spine surgery. 

This session will be presented by neurosurgical spine surgeon Kenneth Renkens, MD, and will provide an overview of spine surgery procedures for the lower back and indications. 

Topics discussed will include:

 §     Identify and discuss the indications for common lumbar surgical  procedures, including decompression, lumbar spinal fusion and disc replacement.

Indiana Spine Group is participating in a multinational, multi-site investigational study for chronic low-back pain (CLBP).  

Investigators with the study include Dr. Kevin Macadaeg (minimally invasive spine specialist) and Dr. Rick Sasso (spine surgeon).  They are assessing the effectiveness of a study drug in reducing pain levels experience by adults who have had chronic low-back pain for more than six months.  Chronic low-back pain, affects 80 percent of the population at some time in their lives. 

On June 4, Indiana Spine Group will host a continuing medical education dinner on treatment options of the osteoporotic spine.  Objectives of this session entitled, “A Current Review of Pharmacologic and Interventional Treatments of the Osteoporotic Spine”, includes: 

• A review of the latest pharmacologic clinical guidelines for the prevention and treatment of osteoporosis. 
• A discussion of treatment algorithms for the osteoporotic spine; including indications and outcomes of vertebral augmentation. 

 

For more information about this program, please call 317.228.7000.