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.

When osteoporosis results in a fractured vertebra, called vertebral compression fractures (VCF), a patient can have persistent pain.  This pain may interfere with normal activities.  Fortunately, there are treatment options.  The goals of treatment are to reduce the back pain, and to stabilize and strengthen the vertebral body reducing the risk for additional fractures.

In the treatment of patients, there are a few minimally invasive spine treatment options available.  Treatment recommendations are made based upon the patient’s specific medical needs.

One treatment option is vertebroplasty.  During this procedure, specially formulated bone cement is injected through a hollow-needle (that is guided by X-ray imaging) directly into the fractured vertebra.  This creates an internal cast that stabilizes the bone. 

Another treatment option is called balloon kyphoplasty.  With this procedure, orthopaedic balloons are used to lift the fractured bone and return it to the correct position.   

Both of these procedures can be done on an outpatient basis.  Patient’s are either awake with conscious sedation or are given a general anesthesia.  The procedures take approximately an hour to 90-minutes. 

In addition to continuing medical education credits being provided for physicians, this spine symposium was recently approved for continuing education credits for nurse practitioners.  The American Academy of Nurse Practitioners has approved this symposium for 10.75 credit hours for nurse practitioners.  Additionally, Logan College of Chiropractics will be sponsoring this program for Indiana Chiropractors for 12 hours.  Click here, to read a summary of continuing medical education and continuing education credits provided for this spine symposium.

To date, there is no known treatment for osteoporosis.  Therefore, the focus of treatment is on minimizing the effects of bone loss and reducing further bone loss.  Nutrition and exercise are important components of  the treatment plan (and prevention plan).

Additionally, there are medications available that are used to either increase bone mass and/or decrease bone loss.  Talk to your physician about what is best for you.  Recommendations will be made based upon your age, overall health, medical conditions, family history, among other factors.

For vertebral compression fractures, resulting from osteoporosis, there are treatments available.  Common minimally invasive spine treatments are vertebroplasty and balloon kyphoplasty.

Computer-assisted spinal navigation provides an alternative to traditional imaging used during spine surgery.  With traditional imaging during spine/ back surgery – this exposes the patient and medical team to unnecessary radiation.  Additionally, the images are not in real-time. 

With the newer computer-assisted spinal navigation system now used – spine surgeons see images in real time and are able to see multi-level images.  Additionally, this reduces radiation exposure and allows for greater visualization for instrumentation.

With this newer technology, it had not been determined if the patient’s time in surgery was affected.  A study that I conducted with another spine surgeon concluded that computer-assisted spinal navigation did reduce the operating time.  For this research, a detailed review of the patient’s medical record was analyzed.  Patients included in the study had undergone spinal fusion surgery for isthmic spondylolisthesis.  

It is my prediction that computer-assisted spinal navigation will become standard practice for spine surgery.  It not only reduces surgical time, but also reduces the risk of radiation exposure to the patient and medical team and also provides a mechanism for greater accuracy for spinal instrumentation during spine surgery.

Here is a link to an abstract of the study.

At the Back Talk continuing medical education conference sponsored by Indiana Spine Group, on Friday there will be three key topic categories.  These include:  spinal diagnostics, medical and minimally invasive spinal therapeutics and spine surgery. 

On Saturday there will be special interest sessions.  These sessions will focus on specific diagnoses and treatment options for patients with neck and back pain.  A few topics include; osteoporosis, spinal manipulation, assessment and management of low-back pain in the primary care setting, spinal injuries of athletes and the weekend warrior, pediatric and adolescent spine problems and spinal arthritis. 

Approximately five years ago (May 2002), I performed the first artificial cervical disc replacement in the U.S.  (Read the press release about this procedure.)  As a physician who is involved in the research and development of minimally invasive spine surgery techniques – I was excited to be involved in this research study.  It is my opinion that the cervical artificial disc will be the new gold standard to the traditional fusion procedure. 

Here is more information about the cervical artificial disc.  When a patient suffers with a herniated cervical disc – also called a ruptured disc or slipped disc – traditionally the standard surgical treatment is a spinal fusion surgery.  With a fusion – the damaged cervical disc is removed and then a bone is grafted into place to stabilize the spinal area affected.  The bone used is synthetic or grafted from a second surgical site.  The patient then undergoes a long recovery period – a cervical collar is worn to immobilize the neck for a period of time, and the patient may have two surgical sites undergoing recovery (depending on the source of the bone graft).  Then following the recovery period – the patient may have some stiffness (decreased) mobility in the neck region. 

Now with a cervical artificial disc, the damaged cervical disc is removed – and the cervical artificial disc is inserted into this area.  The cervical artificial disc is designed to mimic the action of the original disc. Following this procedure, the patient returns to normal activities in a few weeks.  The advantages of this procedure are:  shorter recovery time, no cervical collar, one surgical site which reduces the chance for post-op infections/complication, and a shorter hospital.  Additionally, the patient’s mobility is not decreased – and neck movement is normal and not limited.  Needless to say, patients that are active and want to remain active love this alternative! 

To learn more about his procedure visit our web site or  call Indiana Spine Group at 317.228.7000.

Last week, I attended and presented at the annual American Academy of Orthopedic Surgeons meeting in San Francisco.  This annual meeting is the largest continuing medical education program for orthopaedic surgeons in the world. 

At this continuing medical education meeting, I was honored to be a faculty member.  On Thursday, I presented the radiographic data from a Bryan Disc Study (a cervical artificial cervical disc).  On Friday as a moderator, I was joined by four world renowned experts in the field of spinal trauma.  For this instructional course, we discussed thoracic and lumbar spine fractures.  On Saturday, I participated in a special program devoted to spine surgery.  I joined other world renowned experts on a debate about the proper treatment for cervical radiculopathy.  (A general definition for cervical radiculopathy is disease of the spinal nerve roots or spinal nerves in the cervical (neck) spine.  Many times this is caused by degenerative disc disease).

When conservative management or minimally invasive spine procedures are not effective in treating lumbar radiulopathy (lumbar degenerative disc disease), the patient may require surgery.  A common spine surgery procedure is surgical decompression.  The goal of this surgery is to eliminate the compression of the spinal cord on the nerves to reduce the back pain.

Planning continues on the spine conference Back Talk!  We are excited to announce our keynote speaker for the conference.  Our keynote speaker is Dr. Stephen Olvey – who recently wrote a book entitled, Rapid Response:  My inside story as a motor racing life-saver. 

Currently, Dr. Olvey is the Director of the Neurosurgical Intensive Care Unit at Jackson  Memorial Hospital in Miami and an Associate Professor of Clinical Neurological Surgery for the University of Miami School of Medicine.  Additionally, Dr. officer a medical consultant for the Indianapolis 500 and the chief medical officer for the Grand Prix Master’s Series. 

As keynote speaker at the spine symposium, Dr. Olvey  will talk about “Lessons Learned from Motorsports”  and some of the key objectives he will be addressing are :

Key to planning our spine continuing medical education program is determining the overall objectives.  For this process, we reviewed the comments from last year’s spine symposium, as well as identified key issues important to physicians and other health care providers. 

Overall objectives for this year’s spine symposium are as follows:

•Provide a comprehensive diagnostic assessment of patients who present with back and neck pain including appropriateness for referral to spine specialists.

•Understand the overall principles for evidence-based medicine for the treatment of spinal disorders from an operative and non-operative perspective.

•Understand extrinsic factors affecting spine health; i.e. daily activities, lifestyle habits, sports, aging, and with this information will be able to provide patients’ guidelines to maintain a healthy spine.

•Identify surgical and medical advancements in the diagnosis and treatment of patients with spinal problems and disorders.

•Identify medical and minimally interventional treatment options for patients with spinal disorders, and back or neck pain; as well as have an understanding of the indications and effectiveness of these treatment options.

•Understand the diagnostic and treatment options of patients with specific conditions/issues, including the young athlete, scoliosis, rheumatologic disorders, and the osteoporotic spine patient.

To learn more about the conferece visit our web site or call (317) 228-7000. 

All About Our Spine Symposium - Continuing Medical Education  

Welcome to Indiana Spine Group’s spine education blog.  The purpose of this blog is to provide information about continuing medical education opportunities sponsored by Indiana Spine Group.  In 2007, Indiana Spine Group hosted their first spine symposium for physicians and other health care practitioners.  Over 120 people attended this conference. 

At this conference, we kept hearing about the need for this type of conference – so Indiana Spine Group is going to host a spine symposium in 2008.  Entitled Back Talk – the second spine symposium will be held on August 22 and 23, 2008.  This continuing medical education conference for physicians and other health pracititioners will provide the latest information on interventional pain management - including non-surgical spine treatments, minimally invasive spine procedures and back surgery (cervical and lower back surgery) - helping practitioners treat their patients with back pain and spinal disorders.

To learn more about the conference call 317.228.7000 or click here.   

If you would like to receive a spine conference brochure, send us your contact information.  This can be faxed to 317.228.9029 or emailed to lkriech@indianaspinegroup.com.