Kenneth Renkens, MD, FACS

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)

One general session that will be given at Back Talk, Indiana Spine Group’s continuing medical education symposium, is entitled Making the Diagnosis| Differential Factors in Spinal Diagnosis. This presentation will be given by neurosurgical spine surgeon Kenneth Renkens, MD, FACS.

During this presentation, Dr. Kenneth Renkens will discuss the differential diagnoses of lower back and extremity pain. The importance of identifying coexisting conditions affecting spinal pain and treatment will be reviewed. Additionally, Dr. Renkens will discuss spinal infections and inflammations that present as back pain neck pain.  

In early May, physicians with Indiana Spine Group attended and spoke at the annual meeting of the American Association of Neurological Surgeons. This included neurosurgical spine surgeon Kenneth Renkens, M,D., F.A.C.S., and spine surgeon Paul Kraemer, MD. This annual continuing medical education meeting for neurosurgeons was hosted in Philadelphia.  

In July 2009, an article that Dr. Kenneth Renkens co-authored was published in the Journal of the American College of Surgeons. This article was entitled “A Phase 3b, Open-Label, Single-Group Immunogenicity and Safety Study of Topical Recombinant Thrombin in Surgical Hemostatis”.

This study evaluated the affects of a topical hemostat during surgery. (Note:  a topic hemostat is used to control bleeding during spine surgery and other surgical procedures).   For an abstract of this study background and conclusions, link here. 

Dr. Kenneth Renkens is a neurosurgical spine surgeon with Indiana Spine Group. 

Another condition of the lumbar spine is spondylolisthesis. Spondylolisthesis is the result of degenerative changes in the joints of the spine that cause a shifting of alignment. Generally the L4 (lumbar vertebrae) – will slip forward over the L5 (lumbar vertebrae). 

Learn more about spondylolisthesis, the symptoms and treatments with this educational video by Kenneth Renkens, M.D. Dr. Renkens is a spine surgeon with Indiana Spine Group. 

Spinal stenosis is a general term that refers to the narrowing of the spinal canal. Often this is a degenerative condition resulting from aging. More commonly found in the lumbar (lower back) spine, it also occurs in the cervical (neck) spine. 

Learn more about spinal stenosis, the diagnosis and treatment with this education video featuring Dr. Kenneth Renkens.   Dr. Renkens is a neurosurgical spine surgeon with Indiana Spine Group. Orthopaedic spine surgeons with Indiana Spine Group include Rick Sasso, M.D., Thomas Reilly, M.D., and Paul Kraemer, 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.) 

One unique session for “Back Talk”, the continuing medical education symposium sponsored by Indiana Spine Group, will feature a hands-on component. During this session, entitled Hands-On | Surgical Case Studies, attendees will have the opportunity to get a first-hand look at spinal instrumentation, cervical artificial disc implants and other surgical devices used during spine surgery. Spine surgeons Kenneth Renkens, MD, and Thomas Reilly, MD, will lead this discussion. As they review the technology, they will discuss spine surgery case studies including diagnoses, recommended surgical interventions and expected outcomes.

For more information about Back Talk, and a complete continuing medical education conference agenda, click here.

A few weeks ago,  Anne Marie Tiernon - news anchor with WTHR, interviewed me about the recent FDA-approval of the Bryan™ Cervical Disc.  This story aired on June 9, and here is the link to this story. 

As mentioned in previous blogs, I have been involved in the clinical trials for this device, and implanted the first Bryan Cervical Disc in the United States.  This procedure was done at St.Vincent Hospital, and was performed with Kenneth Renkens, MD.  Dr. Renkens is a neurosurgical spine surgeon, also with Indiana Spine Group.  

Additionally, cervical arthroplasty patient Kevin Wacasey was interviewed in this story.  Kevin received the first Cervical Disc in the United States in 2002.  Today, he is doing great!  He enjoys spending time with his teenage son, golfing, fishing and other hobbies. 

In a recent blog entry, Indiana Spine Group announced the FDA approval of the Bryan™ Cervical Disc. This cervical artificial disc, provides spine surgeons an alternative device for implantation when performing cervical arthroplasty.  In 2007, the Prestige Disc received FDA approval. In a recent press release, Dr. Rick Sasso stated that “The Bryan Cervical Disc more closely mimics natural spine disc movement with shock absorbing characteristics than a previously approved device.”

Indiana Spine Group is excited to announce that we are one of the providers of this latest technology. At this time, physicians with Indiana Spine Group are the only ones using the Bryan Cervical Disc in cervical arthroplasty in Indiana. 
 

Dr. Rick Sasso, a spine surgeon with Indiana Spine Group, was a principal investigator in the clinical trials for the Bryan Cervical Disc.  Additionally, Dr. Kenneth Renkens was an investigator in this trial. Dr. Renkens is a neurosurgical spine surgeon with Indiana Spine Group. 

To learn more about the Bryan Cervical Disc, click here.  
 

For more information or to schedule an appointment, call 317.228.7000 or
toll-free 866.947.7463.    

On Monday, Anne Marie Tiernon - news anchor with WTHR, interviewed Dr. Rick Sasso about the recent FDA-approval of the Bryan™ Cervical Disc. This story aired on June 9, and here is the link to this story. 

Dr. Rick Sasso, a principal investigator in the Bryan Cervical Disc clinical trial, implanted the first Bryan Cervical Disc in the United States. This procedure was done at St.Vincent Hospital, and was performed with Kenneth Renkens, MD. Dr. Renkens, also involved with this clinical trial, is a neurosurgical spine surgeon with Indiana Spine Group.

Additionally, cervical arthroplasty patient Kevin Wacasey was interviewed in this story. Kevin received the first Bryan Cervical Disc in the United States in 2002. Today, he is doing great! He enjoys spending time with his teenage son, golfing, fishing and other hobbies. 

Spine surgeons Drs. Rick Sasso and Kenneth Renkens, will be presenting a two part talk on The Surgical Patient at Back Talk. Back Talk is the continuing medical education symposium for primary care physicians and health care practitioners.  These presentations will discuss the cervical spine surgical patient and the lumbar spine surgical patient. The goal of these continuing medical presentations is to help the practitioner understand who the ideal spine surgery candidate is, and the indications and expectations for spine surgery. Additionally, different surgical options will be discussed. 

Dr. Rick Sasso, will discuss the cervical spine surgery patient. In this presentation he will review the cervical pathology and diagnoses for indicative of surgery – both degenerative and traumatic. Additionally, Dr. Sasso will discuss common cervical spine surgical procedures, their indications and expected outcomes.

For the lumbar spine presentation, Dr. Kenneth Renkens will discuss the indications and diagnoses when lumbar surgery is a treatment option. Dr. Renkens will also discuss common lumbar surgical procedures – their specific indications and the effectiveness of these lumbar spine surgery procedures. 

Another talk scheduled for Back Talk, Indiana Spine Group's continuing medical education program is entitled, Spinal Disorders | Uncommon & Difficult. Many times, these patients present with back pain and other symptoms that are similar to many spinal diagnoses, therefore these uncommon problems can be difficult to diagnose.

In one talk, Dr. Michael Stack will discuss benign spinal disorders. This will include a review of rheumatologic and endocrinologic disorders as well as the symptoms, diagnoses and treatment indications. Dr. Stack is a rheumatologist with Diagnostic Rheumatology & Research PC.

Dr. Kenneth Renkens, a neurosurgical spine surgeon with Indiana Spine Group, will discuss the urgent spinal diagnoses. During his discussion, he will identify the red flags of spinal and nonspinal conditions that can present as back pain. This includes infections and vascular disorders. Additionally, he will review the symptoms and diagnostic indications of primary and metastatic spinal cancer. 

A prior blog entry provided an overview of a spine surgical research study that Dr. Kenneth Renkens is participating in for severe spinal stenosis.  This blog entry will highlight another spine surgical treatment for less severe lumbar spinal stenosis. 

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.

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 are actively involved in research.  The goals of the research that they participate in are to develop minimally invasive surgical techniques, and to identify and develop minimally invasive procedures that allow the patients to return to normal activities as quickly as possible.

A few research projects that Indiana Spine Group has participated in include:

Lumbar Disc Implant – Drs. Rick Sasso (a spine surgeon with Indiana Spine Group) and Kenneth Renkens (a neurosurgical spine surgeon with Indiana Spine Group) participated in the FlexiCore lumbar disc study.  Used to treat degenerative disc disease, the lumbar disc implant replaces the damaged disc. This procedure is an alternative to a spinal fusion.

Percutaneous Reference Frame (PRF) – Dr. Rick Sasso developed this devise that improves the capability for spine surgeons to perform minimally invasive spine surgery.  By the use of an infrared camera and the PRF - this allows spine surgeons exact placement of spine surgical instruments – with less of an incision. This technology has been referred to as “global positioning of instrumentation” – and it works similar to the GPS technology used in cars.

Cervical Artificial Disc – Drs. Rick Sasso and Kenneth Renkens also participated in the study for the Bryan Cervical Disc, and performed the first cervical artificial disc implant in North America in 2002.  This cervical artificial disc has received preliminary approval from the FDA last summer. 

Electrothermal Disc Decompression (EDD) and Intradiscal Elctrothermal Therapy (IDET) Studies – Dr. Kevin Macadaeg, a minimally invasive spine specialist with Indiana Spine Group, participated in this study that evaluated the effectiveness of EDD and IDET to treat lower back pain and sciatica.  These treatments use a heat coil, which is inserted via a catheter in the disc of the spine.

This special interest symposium, The Physical Exam, will be lead by Laurie Scott, RN, MSN, NP-C, and Jodi Hetterman, PA-C.  Laurie is a nurse practitioner with Indiana Spine Group, and she works with spine surgeon Thomas Reilly, MD.  Jodi is a physician assistant with Indiana Spine Group and she works with our neurosurgical spine surgeon Kenneth Renkens, MD. 

During this workshop, they will demonstrate using a live-model, the diagnostic steps in conducting a physical exam related to spine pain (back and neck).  In their presentation, they will include key points in evaluating both lumbar and cervical problems.  Additionally, with the lumbar exam – they will specifically discuss the identification of radicular pain from low-back pain, and the evaluation process to rule out hip abnormalities or knee problems. 

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 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