Jonathan Gentile, MD

Back Talk | A Comprehensive Review and Practical

Approach to Spinal Diagnosis and Treatment

One challenge to physicians is ongoing back pain following spine surgery. This session will provide attendees a better understanding of failed back syndrome / post-laminectomy syndrome.

During this continuing medical education session during the Back Talk spine symposium, speakers will discuss the contributing factors and causes of failed back syndrome. Additionally, the medical and interventional treatments for failed back syndrome will be reviewed – their indications and expected outcomes. One treatment that will be discussed is spinal cord stimulators. Indications for salvageable spine surgery and the outcome predictors will be reviewed.

Faculty for this continuing medical education session includes minimally invasive spine specialist Jonathan Gentile, MD, and spine surgeon Thomas Reilly, MD, FACS.

Back Talk | A Comprehensive Review and Practical

Approach to Spinal Diagnosis and Treatment

Another series of talks during the spine symposium Back Talk, Indiana Spine Group’s fifth annual continuing medical education symposium will focus on treatment options for spine patients and highlight medical, minimally invasive and spine surgery options. This includes their clinical indicators and expected outcomes.

These sessions include:

• Nonoperative and Noninvasive Therapies, which will be presented by minimally invasive spine specialist Jonathan Gentile, MD.

• Minimally Invasive Therapies, presented by Kevin Macadaeg, MD,  minimally invasive spine specialist.

• Common Surgical Procedures, which will be presented by spine surgeon Thomas Reilly, MD, FACS.

 For a complete spine symposium brochure, visit this link.

Paul Kraemer, MD, a spine surgeon with Indiana Spine Group, is featured in a video produced by Community Hospital. In this video, Dr. Kraemer discusses his philosophy of care and working with Community.

A few highlights of this video include:

• Dr. Kraemer’s working relationship with other physicians within Indiana Spine Group, to provide a comprehensive continuum of care to spine patients. In this section, he discusses the advantages of working in the same office with Jonathan Gentile, MD - a minimally invasive spine specialist.
• With the resources provided by Community Hospital, Dr. Kraemer is able to perform complex spine surgery; i.e. operating rooms, surgical equipment, staff expertise, ICUs, etc.
• There is a continued trend towards more minimally invasive spine surgery. This includes smaller incisions and less muscle movement.

Back Talk | A Comprehensive Review and Practical

Approach to Spinal Diagnosis and Treatment

One series of sessions at Indiana Spine Group’s continuing medical education / continuing education spine symposium will focus on the diagnosis of spinal disorders.  In one series of talks, speakers will highlight key issues and steps critical to spinal diagnosis. Topics will include:

• Spinal Anatomy – differentiating between normal and abnormal spinal anatomy (Speaker: Jonathan Gentile, MD, minimally invasive spine specialist with Indiana Spine Group)

• Diagnostic Pearls – identification of the critical components of the physical exam, and essential elements of the diagnostic work-up (Speaker: John Arbuckle, MD, minimally invasive spine specialist with Indiana Spine Group)

• Common Spinal Disorders – diagnostic indicators for disorders such as herniated discs, degenerative disc disease, spinal stenosis, spondylosis and more (Speaker: Kevin Macadaeg, MD, minimally invasive spine specialist with Indiana Spine Group)

• Disorders of the Bones – a review of conditions such as osteomalacia, Paget’s disease, spinal arthritis and osteoporosis (Rashid Khairi, MD, FACP, FACE, an endocrinologist with Diabetes & Endocrinology Associates) 

• Uncommon and Benign Disorders – a discussion of disorders such as infections and vascular disorders. (Kenneth Renkens, MD, FACS, spine surgeon with Indiana Spine Group)

•  The Role of EMG – the role and indications of EMG in the diagnosis of cervical and lumbar radiculopathy. (Larry Lett, MD, Center for EMG and Neurology)

As a part of our ongoing commitment to provide the best care to our patients, Indiana Spine Group routinely sends patient questionnaires. The purpose of these surveys is to ask our patients what we can do to improve our services, as well as recognizing what was done well. 

A recent survey provided the following comments about Dr. Jonathan Gentile:

• I came “hurting” he understood
• I explained – he listened
• We discussed – he started building a path
• He laid out alternatives and explained until I understood
• He took the time – I did not feel rushed in any way

Congratulations! Jonathan P. Gentile, MD, was elected president of the Indiana Society of Interventional Pain Practitioners. He will serve a two-year term. beginning in 2011.  Dr. Gentile is a minimally invasive spine specialist with Indiana Spine Group. 

A recent reader of Indiana Spine Group's blog, asked a question about spinal cord stimulator's.  The question asked was, "Can a chiropractor adjust your back with a spinal cord stimulator implanted in your back?" 

According to Jonathan Gentile, MD, a minimally invasive spine specialist with Indiana Spine Group, the bottom-line answer is that is is not recommended.  If a patient has a spinal cord stimulator implanted, it is possible that the leads can migrate during the spinal adjustment, therefore it is not advisable.  Lead migration can cause the loss of stimulation to the patient.  If the leads migrate (move), revision or replacement of the leads would be required to "re-capture" stimulation. 

For more information about spinal cord stimulator's, visit this link, which provides an overview of the procedure.   

• Ambulatory surgery center
• Dedicated patient care and visitor areas with a cafe
• Imaging suite with MRI and CT
• Osteoporosis treatment center with DEXA scanning
• Physical therapy suite
• Medical academic center

The Nutritionally Healthy Spine – This continuing medical education session, presented by Lori Petrie, RD, will continue to focus on a healthy spine and the importance of nutrition in achieving and maintaining a healthy spine. This session will provide important nutritional recommendations for a healthy spine.  In addition to diet and lifestyle other factors that will be addressed for a healthy spine will include popular over-the-count medications, and a review of herbal, vitamin and nutritional supplements. Ms. Petrie is an outpatient nutritional counselor with St.Vincent Hospital.

Back Pain | Chronic and Failed – It is estimated that approximately 40% of individuals that undergo back surgery continue to have back pain.  Jonathan Gentile, MD, a minimally invasive spine specialist with Indiana Spine Group will address this ongoing issue.  In this educational session he will address both chronic back pain and failed back syndrome and will discuss the differentiation factors, and the diagnostic perils.  Additionally, Dr. Gentile will discuss the treatment options, indications and patient selection for various treatment options.  One treatment option that will be highlighted will included the spinal cord stimulator, used as an option for failed back syndrome. 

For more information about Back Talk, visit our web site, or call (317) 228-7000.

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.

Learn more about spinal / back pain with this education video. This video features Dr. John Arbuckle as he discusses back pain; including the definition, diagnosis and early treatment.  Dr. Arbuckle is a minimally invasive spine specialist with Indiana Spine Group. 

Generally when a patient’s spinal pain is longer than four to six weeks, and the pain is not relieved with the passage of time, anti-inflammatory medications or even physical therapy – a minimally invasive spine specialist will see the individual to evaluate the cause of this pain. 

Minimally invasive spine specialists with Indiana Spine Group include John Arbuckle, M.D., Jonathan Gentile, M.D., and Kevin Macadaeg, M.D. 

If you were not able to attend Indiana Spine Group’s continuing medical education conference, Back Talk | Comprehensive Concepts in the Diagnosis and Treatment of Spinal Disorders -  educational sessions are now available on-line.

Educational Sessions include:

• The Fundamentals of Spinal Diagnostics | Kevin Macadaeg, MD
• Common Spinal Disorders | Paul Kraemer, MD
• The Uncommon and Difficult | Part One: Benign | Michael Stack, MD, PhD
• The Uncommon and Difficult | Part Two: Urgent | Kenneth Renkens, MD
• The Basics | Spinal Imaging | Thomas Reilly, MD
• Non-Operative Care: An Evidence-Based Overview | Jonathan Gentile, MD, and Jeff Hebert, DC, PhD (c)
• Minimally Invasive Spine Treatments | John Arbuckle, MD
• The Surgical Patient | Part One: Cervical | Rick Sasso, MD
• The Surgical Patient | Part Two: Lumbar | Kenneth Renkens, MD

To view these continuing education sessions, click here.  Additionally, if you would like to receive continuing medical education credits for viewing theses sessions, visit the St.Vincent Distance Education Site and view from there. Registration is free.

 
(A very special thank you to St.Vincent Spine Center for making these videos possible.) 

Another session at Back Talk, the continuing medical education symposium for physicians and health care practitioners will address the failed back. Sometimes called failed back syndrome, failed back surgery or post-laminectomy syndrome – these patients continue to have ongoing back pain following spine surgery. 

This session will be presented by minimally invasive spine specialists Jonathan Gentile, MD, and John Arbuckle, MD, and spine surgeon Paul Kraemer, MD. With Indiana Spine Group, these physicians treat patients at our offices located on the north side of Indianapolis. 

During this continuing medical education session, the tools for physicians and health care practitioners to perform a diagnostic assessment of patients with chronic back pain following spine surgery will be highlighted. This diagnostic assessment will help caregivers to understand the underlying causes of ongoing back pain, and the mechanism of failed back. Additionally, medical and interventional treatments for failed back will be discussed – their indications and expected outcomes.

In July, Jonathan Gentile, MD, spoke during the luncheon at the annual Indiana Academy of Family Practitioners (IAFP) conference. This lunch was sponsored by St.Vincent Health, a strategic partner with IAFP. 

Dr. Gentiles talk entitled Understanding the Failed Back, addressed the following:

•  The assessment of patients following spine surgery who continue to suffer from  ongoing chronic back pain; and identification of failed back.
• The treatment options for failed back; their indications and effectiveness.

Another session at the continuing medical education symposium “Back Talk” will highlight case studies.  With these case studies, conference attendees will review specific patient complaints of neck and back pain, and the recommended diagnostic studies.  Spinal imaging studies will be reviewed and radiological findings will be highlighted.  Additionally, the facilitators of this educational session will review different applicable minimally invasive treatment options based on the clinical and radiological results.  A few minimally invasive treatment options that will be discussed will include radiofrequency, IDET and percutaneous discectomy. 

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.

One treatment for ongoing back pain following spine surgery - sometimes referred to as failed back syndrome, is a spinal cord stimulator. A spinal cord stimulator uses electrical impulses to help relieve chronic back pain. Previous blog entries have highlighted this procedure. 

Dr. Jonathan Gentile, MD, a minimally invasive spine specialist with Indiana Spine Group, implants spinal cord stimulators - when indicated -  in patients suffering from failed back syndrome. To watch him discuss this procedure, click here. 

Many times – conservative, non-operative therapies are an effective treatment for patients with back pain and spinal problems. This presentation at Back Talk, Indiana Spine Groups continuing medical education symposium for primary care physicians and health care practitioners, will highlight some of the conservative treatments including physical therapy, activity modification and medications. Additionally, the indications and expected outcomes of these non-operative treatments will be discussed. 

This talk will be given by Jonathan Gentile, MD, and Jeff Hebert, DC, PhD(c), DACBSP. Dr. Gentile, is a minimally invasive spine specialist with Indiana Spine Group. Dr. Hebert is a chiropractic physician and is an assistant professor at the University of Utah; Department of Neurosurgery.