Minimally Invasive Spine Procedures

Saturday’s continuing medical education sessions will include three concurrent sessions with nine different topics for conference attendees to choose from.  This blog entry will highlight those sessions available in “Concurrent Sessions Three” that will be on Saturday morning (9/11/10). 

These sessions will include:

The Anatomy of the Exam - This is a clinical workshop that will be co-presented by minimally invasive spine specialist Kevin Macadaeg, MD, and nurse practitioner Alta Skelton, RN, MSN, NP-C.  This workshop will provide an in-depth look at the patient exam and will utilize a live-model to demonstrate the critical components of the physical exam.  What is normal and abnormal during the cervical and lumbar exam will be discussed, as well as a review of the neurological exam.  Additionally, this session will also discuss multiple problems that present as back or should/neck pain and will review clinical algorithms. 

Active and Injured | A Look at Sports Injuries – This session, presented by chiropractic physician Tony Origer, DC, ATC, will highlight common sports injuries related to popular recreational activities of adults, e.g. golf, tennis, weights/fitness training and running.  This continuing medical education session will review the anatomical and physiologic functional changes of the spine that result with aging, and the effects of sports on the spine.  Additionally, the patient assessment of patients that present with spinal pain and injuries from sports-related activities will be discussed, as well as appropriate levels of care and red-flags. 

(Tony Origer, DC, ATC, is a chiropractic physician with Performance Chiropractic and Sports Rehabilitation.)
 

The Workplace | Back Pain and Injuries |  This continuing medical education concurrent session will be presented by Marc Duerden, MD, FAAPM&R, CIME.  Dr. Duerden is a physical medicine and rehabilitation physician with Rehabilitation Associates of Indiana. 

According to the Bureau of Labor Statistics, it is projected that annually more than one million workers injure their back representing one out of five work place injuries.  During this session Dr. Duerden will review common workplace spinal injuries and their contributing factors to back pain.  Additionally, the short- and long-term effects on the worker’s status will be reviewed.  Spinal conditions and physical attributes that predispose an individual to back injuries will be discussed as well as the indications and treatment options for low back pain.  

For more information about Back Talk, or to register click here, or call (317) 228-7000.

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.

Back Talk, Indiana Spine Groups continuing medical education symposium, will provide concurrent sessions in addition to the two educational tracks (general and in-depth) and general sessions. These concurrent educational sessions will provide conference attendees a wide array of topics related to spinal conditions and treatments. A few of the concurrent sessions include:

Myths and Realities | Treatment of Vertebral Compression Fractures – This session, which will be presented by Indiana Spine Group minimally invasive spine specialist Kevin Macadaeg, MD, will highlight the symptoms, diagnosis and treatment indicators for vertebral compression fractures. Vertebral compression fractures have been identified as one of the most common fragility fractures in the U.S. During this educational session, two common treatment procedures for vertebral compression fractures will be discussed – this includes kyphoplasty and vertebroplasty.    

The Wellness Paradigm – Presented by chiropractic physician Nate Blume, DC, this continuing medical education session will apply the concept of functional medicine to spine health. The role of functional medicine in spinal health looks at contributing factors such as genetics and lifestyle. In this session, how to apply a wellness model to patient care and the role of functional medicine to improve the quality of a patient’s back health will be discussed. 

(Nate Blume, DC, is a chiropractic physician with Lakeside Chiropractic.)

Indiana Spine Group is hosting a fund raiser for The Leukemia and Lymphoma Society on September 11, 2010. This fund raiser is in honor of Kevin Macadaeg, MD, a minimally invasive spine specialist with Indiana Spine Group. Dr. Macadaeg was diagnosed with Grade 3A lymphoma in November 2009. All proceeds benefit The Leukemia and Lymphoma Society. 

 You and your guests are invited to attend! 

 Date:              September 11, 2010

Time:               7:00 p.m. – 11:00 p.m.

Place:               The Westin Indianapolis | 50 S. Capitol Avenue

Guests will enjoy live music, dancing and a silent auction. Hors d’ oeuvres will be served, and a cash bar available. 
Click here for more information, and to make your reservation or call (317) 228-7000.

At Indiana Spine Group’s Back Talk continuing medical education symposium, as highlighted in a previous blog entry , there are two educational tracks that will be available for conference attendees on day one.  In addition to the general track discussed in the prior blog, there is a more in-depth track entitled, More Specifics | Spinal Diagnostics and Treatment. 

In this education track there will be a few sessions focusing on the diagnosis of spinal disorders and abnormalities.  One session titled Spinal Imaging | Technology and Diagnosis, will be presented by Stephen Pomeranz, MD. Dr. Pomerance is a radiologist. In this session, Dr. Pomeranz will provide an in-depth look at spinal imaging technologies and highlight the latest developments in spinal imaging technology and their applications in spinal diagnostics.  Additionally, using case studies, he will review radiological finds and diagnostic indicators. 

The second session of this educational track will focus on The Electrodiagnostic Evaluation, and will be presented by physical medicine and rehabilitation specialist Dr. Shashank Dave.  During his presentation, Dr.Dave will discuss the role and application of electromyography in the diagnosis of spinal disorders and diseases.  Additionally, he will review case studies which utilize electromyography and identify specific diagnoses. 

Another session presented for the in-depth track will focus on Diagnostic and Therapeutic Injections of the Spine.  This will be presented by minimally invasive spine specialist John Arbuckle, MD.  During this session Dr. Arbuckle will review and differentiate between the different type of therapeutic injections and will review the treatment efficacy of injections, the clinical protocols, indications and expected outcomes. 

The last session of this continuing education track will highlight spine surgery, and is entitled Surgical Perspectives | Fusion vs Arthroplasty, presented by spine surgeon Rick Sasso, MD.  During this session, Dr. Sasso will provide a detailed analysis of spinal fusion and arthroplasty and he will discuss motion preservation modalities for the treatment of generative disc disease.  He will highlight lumbar and cervical artificial discs as well as review research studies and discuss patient selection, indications and expected outcomes. 

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. 

According to the National Osteoporosis Foundation one in two women and one in four men will sustain an osteoporotic fracture sometime in their lives.  One of the most common fractures as a result of osteoporosis is a spinal fracture. 

In this spine wellness educational video, Dr. Kevin Macadaeg discusses osteoporosis and vertebral compression fractures.  Dr. Macadaeg is a minimally invasive spine specialist with Indiana Spine Group. 

One procedure performed by the minimally invasive spine specialists at Indiana Spine Group is vertebroplasty.  Vertebroplasty is one of the treatment options for vertebral compression fractures. 

During vertebrplasty,a very specialized orthopaedic cement is injected into the vertebral body.  The advantages of vertebroplasty include:  immediate fix of the fractured area of the spine, that area of the bone is stronger as a result of the cement and the patient has pain relief in 1-2 days. 

Often time’s patients that have idiopathic scoliosis may also have a visible rib deformity that may be present following corrective spine surgery.  The traditional spine surgical procedure to correct this has been open thoracoplasty.  A newer, minimally invasive procedure used is video- assisted thoracoplasty.  This procedure is less invasive than the traditional spine surgical procedure.

In October, I was a faculty member at the 8^th Annual Symposium on “Innovative Techniques in Spine Surgery.” This continuing education meeting, hosted in Phoenix, addressed the innovative and emerging technologies of spinal surgery including; arthroplasty, minimally invasive procedures, motion sparring technologies and biologics.  At this meeting I gave a talk on Lumbar Artificial Disc Replacement, and presented the results of the FDA studies for the Cervical Artificial Disc.

This education program was sponsored by the Organization of Spinal Teaching and Research.  The purpose of this group is to facilitate education and discussion among spine care providers and industry and this organization includes leaders in the field of spine surgery and technology that utilize the most advanced and effective technology available for the treatment of spinal disorders.

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. 

Previously, I blogged about the research results of a spine patient study – which evaluated the clinical outcomes of patients who received a Bryan Cervical Disc compared to those that had a standard spinal fusion at 24-months post-operatively. I recently completed a new study, which evaluated these patients 48-months post-operatively. This study will soon be published.

In this study – the functional outcomes of patients at 48-months (4 years) following their spine surgery was evaluated. This study had two groups of patients – one group received a spinal fusion (Anterior Cervical Discectomy and Fusion - ACDF) and the other group received the Bryan cervical artificial disc prosthesis. This spine surgery was for the treatment of radiculopathy and myelopathy, after minimally invasive spine procedures were determined ineffective.

There were 47 patients enrolled in this spine study. Of this group, 21 were enrolled in the Bryan cervical disc arm of the study and their mean age was 40.  In the group that received a spinal fusion (control group), there were 26 participants and their mean age was 43.

This study concluded that patients that received the Bryan Artificial Cervical Disc at 48-months, when compared to the control group:

•     Had less neck and arm pain,
•     Greater mobility,
•     Less adjacent segment degeneration, and
•     Lower secondary operation rate.

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.

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.