Orthopedic Surgery of the Spine

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.

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.

The St.Vincent Orthopedic Center and St.Vincent Spine Center recently earned the Joint Commission’s Disease-Specific Care Certification for joint replacement and spine surgery, respectively. The Joint Commission is the nation’s premier healthcare accreditation entity.  Read the complete story in the Indianapolis Star. 

Dr. Rick Sasso, co-medical director of the St.Vincent Spine Center spine surgeon with Indiana Spine Group was quoted in this article.

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.

A study presented at the 23^rd annual meeting of the American Academy of Pain Medicine early last year – presented the results of the effectiveness of spinal cord stimulators to treat axial lower back pain in individuals with Failed Back Surgery Syndrome (FBSS). 

In this multi-center study, there were 226 patients from 14 different sites.  In the screening phase of the study – which was the 5- 10-day trials, 76% (176) had an average decrease in back pain of 40%.   Following this phase of the study, 159 patients received permanent spinal cord stimulator implants. 

The study concluded that there was a significant reduction of axial low back pain as a result of the spinal cord stimulator.  Preliminary data indicates that the spinal cord stimulator will effectively reduce low back pain on a long term basis, and that results should be similar to what was observed in the shorter time period.

For patient’s suffering from degenerative disc disease in the lumbar spine – surgical treatment options are either a lumbar spinal fusion or an artifical lumbar disc replacement.  The artifical lumbar disc has recently been approved by the FDA.

Computer-assisted spinal navigation provides an alternative to traditional imaging used during spine surgery.  With traditional imaging during spine/ back surgery – this exposes the patient and medical team to unnecessary radiation.  Additionally, the images are not in real-time. 

With the newer computer-assisted spinal navigation system now used – spine surgeons see images in real time and are able to see multi-level images.  Additionally, this reduces radiation exposure and allows for greater visualization for instrumentation.

With this newer technology, it had not been determined if the patient’s time in surgery was affected.  A study that I conducted with another spine surgeon concluded that computer-assisted spinal navigation did reduce the operating time.  For this research, a detailed review of the patient’s medical record was analyzed.  Patients included in the study had undergone spinal fusion surgery for isthmic spondylolisthesis.  

It is my prediction that computer-assisted spinal navigation will become standard practice for spine surgery.  It not only reduces surgical time, but also reduces the risk of radiation exposure to the patient and medical team and also provides a mechanism for greater accuracy for spinal instrumentation during spine surgery.

Here is a link to an abstract of the study.

Last week, I attended and presented at the annual American Academy of Orthopedic Surgeons meeting in San Francisco.  This annual meeting is the largest continuing medical education program for orthopaedic surgeons in the world. 

At this continuing medical education meeting, I was honored to be a faculty member.  On Thursday, I presented the radiographic data from a Bryan Disc Study (a cervical artificial cervical disc).  On Friday as a moderator, I was joined by four world renowned experts in the field of spinal trauma.  For this instructional course, we discussed thoracic and lumbar spine fractures.  On Saturday, I participated in a special program devoted to spine surgery.  I joined other world renowned experts on a debate about the proper treatment for cervical radiculopathy.  (A general definition for cervical radiculopathy is disease of the spinal nerve roots or spinal nerves in the cervical (neck) spine.  Many times this is caused by degenerative disc disease).

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!

Many of you are familiar with the navigational systems found in cars.  It works great – you drive and this map with a little icon that is supposed to be your car – moves along the map following the exact route that you are driving.  This technology works great in cars – but did you know it also works well in spine surgery?

For the last decade, I have been involved in the design and development of a similar technology for spine surgery.  Technically called, Intraoperative Spinal Navigation, this is a GPS system used during back surgery.  During spine surgery, this navigation system allows the spine surgeon to operate more efficiently, effectively, safely and less invasively (minimally invasive spine surgery). 

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.