Welcome to the Spinal Diagnostics, Therapeutics and Surgery blog written by Indiana Spine Group.  The main purpose of this blog is to provide an overview and highlight of procedures and treatments for spinal problems and deformities.  For more information, visit our web site or call toll-free (866) 947-7463.

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. 

A recent blog entry highlighted articles about the cervical artificial disc, written by Dr. Rick Sasso  - a spine surgeon with Indiana Spine Group.

In this spine wellness educational video, Dr. Sasso discusses cervical artificial disc; the indications, overview of surgical procedure and the advantages of this procedure. 

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. 

In May 2009, the Bryan Cervical Artificial Disc received FDA approval.  This approval was previously written about in Dr. Sasso’s blog.  The cervical artificial disc provides an alternative spine surgical treatment for cervical degenerative disc disease.

Dr. Rick Sasso, a spine surgeon with Indiana Spine Group, has been a principal investigator in the studies with this spine surgical device – the Bryan Cervical Disc.  A few of abstracts of his published research studies regarding the cervical disc are available on the U.S. National Library of Medicine / National Institutes of Health web site. 

These include:

• Cervical kinematics after spinal fusion and bryan disc arthroplasty 
  
• Motion analysis of bryan cervical disc arthroplasty versus anterior discectomy and spinal fusion: results from a prospective, randomized, multicenter, clinical trial 
  

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. 

For the convenience of our patients’ the offices of Indiana Spine Group will be open during this holiday season.  Our offices will only be closed as follows: 

• Christmas Eve | December 24 at noon
• Christmas Day | December 25
• New Year’s Eve | December 31 at noon
• New Year's Day | January 1

To schedule an appointment for our Indianapolis offices, call (317) 228-7000 or toll-free (866) 947-7463.  For appointments at our Kokomo office, call (765) 236-8700.

Currently there is a scoliosis treatment study underway, entitled Bracing in Adolescent Idiopathic Scoliosis Trial.(BrAIST).  The purpose of this spine study is to compare the effectiveness of bracing as a treatment to prevent further curve progression for adolescent idiopathic scoliosis.  Bracing is the current standard of care.  This study will compare the risk of curve progression in adolescents diagnosed with adolescent idiopathic scoliosis that wear a brace versus those that do not.  This study will determine if there are factors that can predict the usefulness of bracing.  Additionally, this study will evaluate the best dosing and bracing duration schedule, and how bracing affects the quality of life; including functioning and psychosocial issues. 

Earlier this year, Dr. Rick Sasso and I were asked to write a spine continuing education chapter on “Controversies in Cervical Spine Surgery”, specifically about a newer spine surgical technology known as dynamic plating for cervical fusions.  Traditional plates, known as static plates, have a high success rate, but in reviewing the published reports of direct comparisons between the two plates, the dynamic plates have a slightly higher percentage which fuse.  It may be even more beneficial in longer fusions.

I have switched my practice to essentially using only the dynamic plates for cervical spinal fusions.  I have been very happy with the  results.  As with all new technology, it is important to carefully monitor results and compare them against established techniques.  I'm keeping an eye on continuing trials even as I incorporate this technology into my own practice.

(This blog entry was written by Paul Kraemer, MD; a spine surgeon with Indiana Spine Group). 
 

A recent blog entry discussed a spinal cord stimulator as a treatment for failed back syndrome. For additional information – here are a few links: 

• Spinal Cord Stimulators: Risks and Benefits
•  Spinal Cord Stimulators: Who is a Candidate

And here are a few links about spinal cord stimulators from the manufacturers:

• Medtronic
• Boston Scientific

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.

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.

A recent blog entry referenced the International Osteoporosis Foundation (IOF).  The IOF is an international non-profit organization headquartered in Switzerland, whose mission is to increase awareness and understanding of osteoporosis.  Their goals are to:

·                     Increase awareness and understanding of osteoporosis.

·                     Motivate people to take action to prevent, diagnose and treat osteoporosis.

·                     Support national osteoporosis societies in order to maximize their effectiveness.

According to the IOF:

• Osteoporosis affects 75 million people in Europe, USA and Japan.
• In 2000, 9 million individuals suffered an osteoporotic fracture.
• I out of 3 women and 1 out 5 men will suffer an osteoporotic fracture. 
• Of these fractures, approximately 58% will be spinal fractures. 

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. 

The World Health Organization (WHO) introduced a new diagnostic tool in the fight against fractures resulting from osteoporosis.  This new risk assessment tool – call FRAX (fracture risk assessment tool), was created to provide a way to assess the risk for osteoporotic fractures more accurately.   FRAX provides the 10-year probability that an individual may have a major osteoporotic fracture; including hip, clinical spine, forearm, hip or shoulder.  FRAX takes into consideration the results of the FRAX questionnaire and bone mineral density (BMD) at the femoral neck (part of the thigh bone that connects to the hip joint).

Indiana Spine Group would like to recognize World Osteoporosis Day – today October 20.

• It is estimated that 10 million individuals in the US have osteoporosis.
• Eighty percent of those with osteoporosis are female, and twenty percent are male.
• Approximately one in two women will have an osteoporotic related fracture in their lifetime after the age of 50.
• One out of four men will suffer an osteoporotic related fracture in their lifetime after the age of 50.

Here are a few links to resources about osteoporosis:
National Osteoporosis Foundation
International Osteoporosis Foundation
MedLine Plus
American Academy of Orthopaedic Surgeons