Indiana Pain Management

Planning continues for Back Talk | Comprehensive Concepts in Spinal Diagnosis and Abnormalities, Indiana Spine Group’s 4^th annual spine symposium. For this year’s conference there will be two educational tracks. One track will provide more general information and one in-depth. These tracks will be held the morning of day one. 

The general track is entitled: Spinal Care Boot Camp | Diagnostics and Treatment. There will be a session on spinal anatomy, entitled Spinal Anatomy 101, presented by minimally invasive spine specialist Kevin Macadaeg, MD.  During this session, Dr. Macadaeg will discuss the functional anatomy of the spine, normal aging process, the spine’s degenerative cascading process and normal and abnormal spinal anatomy.

Another general session which will be presented by minimally invasive spine specialist John Arbuckle, MD, The ABCs of Spinal Diagnostics. In this session, the etiology of spinal pain and common spinal disorders that cause back pain will be reviewed. Additionally, Dr. Arbuckle will discuss the indications and applications of spinal testing, evidence-based guidelines for the diagnosis of lower back and neck pain, and he will highlight the red flags of spinal pain. 

Two other sessions in this track include Understanding Spinal Therapeutics and The Spine Surgery Patient. In the spinal therapeutics session, presented by minimally invasive spine specialist Jonathan Gentile, MD, he will discuss the pharmacological management of acute and chronic back pain, review common noninvasive and minimally invasive spinal therapies and their indications. Spine surgeon Paul Kraemer, MD, will discuss the spine surgery patient and will provide an overview of common spine surgery procedures, their indications and expected outcomes. Additionally, Dr. Kraemer will discuss the applications and limitations of spine surgery, and when referral to a spine surgeon is indicated. 

For a complete Back Talk agenda, link here. 

When an individual continues to have chronic back pain and/or leg pain following back surgery; it is referred to as failed back syndrome. A few treatments for this can include physical therapy or non-steroidal anti-inflammatory medications (NSAID). If medical management is ineffective another treatment option available is a spinal cord stimulator.

A spinal cord stimulator is an implantable device that uses an electrical current to provide a tingling sensation that helps to mask the chronic pain. Dr. Gentile describes it as “a kind of pacemaker for pain.”

In this video, Dr. Gentile describes the procedure for implanting a spinal cord stimulator. Dr. Jonathan Gentile is a minimally invasive spine specialist with Indiana Spine Group.

This procedure is available at Indiana Spine Group. For more information, call 317.228.7000 or toll-free 866.947.7463.

Indiana Spine Group has three minimally invasive spine specialists treating patients with back and neck pain.  The goal of minimally invasive spine specialists is to diagnose the cause of a patient’s neck / back pain – and to treat this cause. Many times medical management and/or minimally invasive spine treatments can effectively eliminate a patient’s neck or back pain.

To learn more about our minimally invasive spine specialists, Kevin Macadaeg, MD, Jonathan Gentile, MD, and John Arbuckle, MD, visit their biographies. Additionally, their videos provide insight into their treatment philosophy and expertise. 

For more information about Indiana Spine Group or to schedule an appointment call:  (317) 228-7000 or toll-free (866) 947-7463.

Another sponsor for Back Talk, Indiana Spine Group's continuing medical education symposium is Stryker Interventional Spine.  Stryker Interventional Spine specializes in minimally invasive spine treatment options for the relief of chronic back pain. Stryker Interventional Spine provides physicians with a wide range of minimally invasive spine surgical tools. This includes spine surgical tools for   radiofrequency, vertebroplasty, disc decompression and discography. 

Vertebroplasty is a minimally invasive spine procedure that is used to treat vertebral compression fractures (VCFs) as a result of osteoporosis, trauma or tumors.  

Discography is a procedure that is used to diagnose the the cause of back pain; and to identify which spinal disc(s) are involved.

Radiofrequency is a type of injection which utilizes an injection which involves heat – and the goal of this interventional pain management procedure is to interrupt pain signals therefore eliminating back pain. 

Disc Decompression is a spine surgical procedure that is performed to alleviate pinched nerves. The two common types of decompression spine surgical procedures are microdiscectomy and laminectomy.  

To learn more about Stryker Interventional Spine, and their minimally invasive spine products visit their web site.  

An article on Spine Universe entitled “Post-Operative Care:  Activity, Incision Care, Rehab and Recovery,” discusses the importance of planning on post-operative care, prior to spine surgery.  This article outlines the expectations immediately following spine surgery, and answers frequently asked questions by the patient and the family; i.e. recovery room, anesthesia and waking up and pain management. 

Part two of this article addresses other key post-operative spine surgical care issues such as physical therapy and rehab, surgical incisions and hospital discharge.

This article was reviewed by Indiana Spine Group spine surgeon, Rick Sasso, MD.  Dr. Sasso thought that this was a good resource for patients that are scheduled for spine surgery and that it is important for patients to be aware of the routine post-operative steps following spine surgery. 

Physicians with Indiana Spine Group presented at the fall conference of the Indiana State Chiropractic Association this past weekend, on November 1 and 2. 

On Saturday Dr. Kevin Macadaeg, a minimally invasive spine specialist, spoke on minimally invasive techniques used to help manage spinal pain.  Additionally, he addressed diagnostic and therapeutic spinal injections.  Spine surgeons - Dr. Thomas Reilly, Dr. Kenneth Renkens and Dr. Rick Sasso also spoke on Saturday.  Dr. Reilly discussed when spine surgery is a potential treatment option.  Dr. Renkens’ talk entitled “Understanding Lumbar Surgery”, focused on the lower back and reviewed spine surgery options and indications for the lumbar spine.  Additionally, he discussed the different types of lumbar fusions and their applications.  Dr. Rick Sasso focused on cervical surgery, and his talk was entitled “The ABC’s of Cervical Surgery”.  In this talk, he discussed common cervical surgical procedures; including spinal fusion and cervical artificial disc replacement. 

On Sunday, minimally invasive spine specialists Dr. Jonathan Gentile and Dr. John Arbuckle reviewed case studies of minimally invasive diagnostic and therapeutic techniques.  Spine surgeons Dr. Thomas Reilly and Dr. Paul Kraemer also reviewed case studies of surgery patients.

For more information about this conference, click here. 

Physicians with Indiana Spine Group attended the 23^rd annual meeting of the North American Spine Society(NASS) in Toronto, Canada.  At this international meeting, all aspects of caring for the patient with spine problems were discussed.  This includes medical management, minimally invasive spine treatments and spine surgery. 

Additionally, Dr. Rick Sasso a spine surgeon with Indiana Spine Group gave numerous presentations.  A few of his presentations included:  A Comparison of the Dynamic Compliance Characteristics of Prosthetic Cervical Disc Materials and Total Disc Replacement for Treating Lumbar Discogenic Back Pain: A Prospective, Randomized, Multicenter Study of Flexicore® vs. 360 Spinal Fusion.  Additionally, he chaired a technique workshop on Interbody Fusion Technologies. 

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. 

A minimally invasive spine specialist is a physician that specializes in the treatment of patients with spine disorders.  The focus of their patient care is to diagnose the cause of the spine problem, and then to treat the specific cause of the problem which will usually alleviate the symptoms; i.e. back pain.

A physician who is a minimally invasive spine specialist is usually board-certified in anesthesia as well as pain management.  Other terms used for this specialty include pain management, interventional spine specialist or minimally interventional spine specialist.  Regardless of the term used, key is physician’s board certification.

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. 

A small certain percentage of patients that undergo back surgery / spine surgery; may continue to have chronic back pain and/or lower extremity pain following surgery, that is referred to as failed back syndrome.   This is not an actual syndrome or medical diagnosis – but more a description of the symptoms.  The technical term for this is  post-laminectomy syndrome.

When medical management and other therapies are ineffective, one minimally invasive interventional pain management treatment for patients if they are suffering from both back pain and lower extremity pain is to implant a spinal cord stimulator.  A spinal cord stimulator, also called a neurostimulator uses a tiny programmable generator and electrical leads/ electrodes placed underneath the skin.  The electrodes are placed in the spinal canal, adjacent to the spinal cord.  (Photo courtesy of Medtronic, Inc.)

To learn more, read this recent press release.  This press release profiles a patient who had chronic back and lower extremity pain following back surgery.  Now she enjoys ballroom dancing!

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.

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

Back pain is one of the most common reasons individuals see their physician.  It is estimated that at some time 80% of all adults will suffer from back pain.  Approximately 70 to 80% of spine problems can be conservatively managed with medications, with or without physical therapy.  Symptoms typically resolve within a few weeks. 

If the back pain does not go away with simple conservative measures, then people would see a spine specialist.  At this point, a specific cause of the pain may be necessary.

To diagnose the cause, in addition to a detailed patient history and examination; other diagnostic imaging tests may be required.  Here is a link, which provides an overview of some of the diagnostic imaging considered.  
 

Many times, an injection into a specific structure of the spine, including a nerve, disc or joint, is necessary for precision diagnosis.  

Once the painful source is determined, a specific treatment plan is tailored to the patient.  This may require a minimally invasive therapy which may be done in conjunction with physical therapy or oral medications.  Only 5% of patients with spinal problems will require surgery.

Minimally invasive procedures typically include an injection of medications directed at the focal area of pain generation, radiofrequency neurotomy or intradiscal therapy.  

To learn more about minimally invasive spine procedures and Indiana Spine Group visit our web site or call 317.228.7000.

Stacia Matthews, health reporter with RTV6, just completed (January 2008) - a marathon in Phoenix.  Stacia has raised over $65,000 for the Leukemia and Lymphoma Society. 

Stacia has reported on many new spinal procedures and treatments, interviewing physicians with Indiana Spine Group.  She has interviewed us for stories about cervical disc replacement, as well as other spine surgery, spine wellness and interventional pain management topics.  You can see her health report on the RTV6's evening news at 5:00 pm.

Congratulations Stacia!

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.