Currently, Dr. Kenneth Renkens participating in a clinical research study sponsored by Anulex Technologies. Dr. Renkens is a neurosurgical spine surgeon with Indiana Spine Group.   

The purpose of this study is to evaluate the benefits of performing soft tissue repair during a lumbar discectomy as compared to a disectomy performed without tissue repair. The product that is being used to repair the tissue is the Xcloseä Tissue Repair System.  

A discectomy is a spine surgery performed to relieve back pain caused by a herniated disc – sometimes called a bulging disc.  During a lumbar discectomy, the standard of care is to remove the portion of the disc that is applying the pressure to the nerve.  To perform this procedure, a small incision is made into the outer layer of the disc – this outer layer is called the anulus fibrosus.  As a result of this small incision in the outer layer of the disc, it could re-herniate in the future - resulting in back pain and discomfort. 

Typically, during this spine surgical procedure the soft tissue surrounding the disc, the anulus is not repaired.  As a result, this material can push outside the disc and compress the nerve rood resulting in back pain and discomfort.  With the Xclose device it provides a method to repair the anulus during the lumbar discectomy. 

For more information, here is a link to a summary of this study that Dr. Kenneth Renkens is participating in.


The advancements and preliminary research results for cervical artificial disc replacements as an alternative spine surgical treatment for degenerative disc disease are promising.  When spine surgery is required for degenerative disc disease, the traditional procedure has been a spinal fusion.  This has been considered the “gold standard” of treatment.  I predict that in the future, the “gold standard” of surgical treatment of certain types of cervical radiculopathy caused by a herniated disc will be a cervical artificial disc rather than a spinal fusion. 

A recent article that I co-wrote, provides an overview and summary of the different cervical artificial discs that are currently being used in FDA-trials.  The Prestige Disc was approved last summer (2007).  Also last summer, the BRYAN cervical artificial disc received preliminary FDA-approval and the Prodisc-C was approved earlier this year.


In some of my blog entries, I have discussed surgical procedures for a herniated cervical disc.  These surgical procedures include spinal fusion and artificial cervical disc replacement.  The good news is that very few individuals with a herniated cervical disc require surgery.  It is projected that only about 5-10% of patients with a herniated cervical disc need surgery.

 

Many times medical management is an effective treatment for herniated cervical discs.  To learn more about the non-operative spine treatment options for a herniated cervical disc, click here.  This is an article that I wrote for Spine Universe, which outlines the non-surgical treatments for herniated cervical discs. 


In some of my blog entries, I have discussed surgical procedures for herniated cervical disc.  These surgical procedures include spinal fusion and artificial cervical disc replacement.  The good news is that very few individuals with a herniated cervical disc require surgery.  It is projected that only about 5-10% of patients with herniated cervical disc need surgery.

 

Many times medical management is an effective treatment for herniated cervical discs.  To learn more about the non-spine surgical treatment options for herniated cervical disc, click here.  This is an article that I wrote for Spine Universe, which outlines the non-surgical treatments for herniated cervical discs. 


Another treatment option for herniated disc is a discectomy.  This is where a part or whole of the intervertebral disc is removed.  One spine surgery procedure / technique for a discectomy is called a percutaneous discectomy. 

 

A percutenaeous discectomy is a minimally invasive spine procedure.  During this procedure the patient is awake and is given alocal anesthetic.  Then a tiny puncture wound is made in the skin disc and a specialized probe called a DeKompressor is inserted.  This probe, guided by X-ray, has a sharp end that cuts into the disc; and once inside a suctioning mechanism pulls out the affected disc fragments.  This procedure helps to eliminate pressure inside the disc thereby reducing the back pain caused by this pressure. 

 

 


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.


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.


Prior to talking more about cervical artificial discs – here is an overview of cervical herniated discs sometimes called bulging discs.  The cervical artificial disc is a surgical treatment option.  The cervical artificial spine surgery procedure provides a minimally invasive spine surgery treatment for herniated discs. 

 

Here is the definition - a herniated disc is where the soft center of the spinal disc “bulges” or breaks through the weakened part of the disc. This usually occurs in the lower part (lumbar area) of the spine, but can occur anywhere; i.e. in the cervical (neck) or thoracic (chest) areas of the spine.   This is also called a slipped, prolapsed or ruptured disc. 

 

Here is the link to the article that I co-wrote. This article provides more information about cervical herniated discs.  

People with back problems – may have more than just back pain.  Sometimes, if you suffer from leg pain – this can be related to your spine.  If a person has ongoing leg pain that is persistent and increases as you lift your knee to your chest or bend over – it could be related to your back.  One back problem – that causes a shooting pain down your leg referred to as “sciatica” is lumbar radiculopathy. 

 

Lumbar radiculopathy is most often the result of nerve compression due to a lumbar disc herniation.  The pain is caused by the compression of the roots of the spinal nerves. This damage or herniated disc is often the result of wear and tear – or degeneration (degenerative disc disease).  To learn more about the diagnosis of lumbar radiculopathy and diagnosing back pain – click here.

Indiana Spine Group is a center of excellence for the treatment of spinal disorders and abnormalities.  Located in Indianapolis - with offices in Kokomo and Anderson, we provide comprehensive spine care – including interventional pain management treatments, nonsurgical spine treatments, minimally invasive spine procedures, minimally invasive spine surgery and spine surgery.  Treating both adults and children, some common diagnoses that we treat include degenerative disc disease, spinal stenosis, herniated cervical disc, failed back syndrome, osteoporosis and scoliosis. 

 

Physicians with Indiana Spine Group include:

§          Ken Renkens, MD (neurosurgical spine surgeon)

§           Rick Sasso, MD (spine surgeon)

§           Kevin Macadaeg, MD (minimally invasive spine specialist)

§           Thomas Reilly, MD (spine surgeon)

§          Jonathan Gentile, MD (minimally invasive spine specialist)

§          John Arbuckle, MD (minimally invasive spine specialist