Spine Wellness

Indiana Spine Group announces their new expanded physical therapy services. In addition to providing spinal therapy, our physical therapy specialists also provide diagnosis-based educational programs to teach patients the proper way to exercise with their given diagnosis. Additionally, wellness programs and classes will soon be available.

 
Physical therapy services are provided at our Indianapolis and Carmel locations. At our new Carmel location, we feature a state-of-the-art physical therapy gym, with equipment selected specifically for treating spinal conditions. 

Patients are seen with a referral from their physician, or self-referrals with a physicians order. For more information, or to schedule an appointment call (317) 228-7000.

In December, Paul Kraemer, MD, is a featured Guest Guru on wcguru.com. Dr. Kraemer is a spine surgeon with Indiana Spine Group.
 

WCGURU is an online resource for worker’s compensation specialists, providing news, resources and information. As a guest guru, Dr. Kraemer highlights his treatment philosophy as well as providing a Top Ten list about Indiana Spine Group’s treatment philosophy and resources for patients, employers and worker compensation professionals.  

Please join us, as we celebrate the grand opening of Indiana Spine Group's
new Carmel facility. Thiscelebration will include tours, health information,
refreshments and giveaways.

November 19, Saturday | 2 - 5 p.m. | 13225 N. Meridian Street, Carmel, IN 46032

(located east of Meridian at W. Main and Pennsylvania Avenue)

Our new Carmel facility provides comprehensive spine care in one centralized location. This includes:

• Patient diagnostics and treatment,
• Physical Therapy,
• Imaging Center,
• North Meridian Surgery Center,
• Medical Academic Center,
• Cafe, and more.

For more information, call (317) 228-7000 or send an email to info@indianaspinegroup.com.

Congratulations to Rick Sasso, MD, a spine surgeon with Indiana Spine Group, on his recent patent assignment. This patent, filed in 2007 was approved in September 2011. US Patent number 8.016,831 is for” instruments and techniques for guiding instruments to a spinal column.”

This patent is related to spine surgery instrumentation and  techniques for anterior cervical discectomy and spinal fusion, as well as safely and accurately placing cervical artificial discs replacements into the intradiscal space. For more detail about this patent, visit this link.

·         Sixteen patient exam/treatment rooms.

·         Imaging suite that will include MRI and CT scanning.

·         Physical therapy suite, that includes equipment selected specifically for treating spinal conditions. In addition to physical therapy treatment, services will also include therapeutic exercise and other spinal-focused physical therapy programs.

·         Outpatient surgery center with three surgical suites specifically designed for spinal surgery, two minimally invasive procedure rooms, and associated support and recovery areas.

·         Medical Academic Center (MAC) that will include a dedicated, state-of-the-art, bio-skills lab with ten fully-equipped work stations. This lab will provide both a local and national resource to physicians and health care professionals for hands-on medical procedure training. Additionally, the MAC will include a 65-seat auditorium, multi-purpose area for receptions/meetings and conference/board rooms.

·          Multiple patient waiting areas, which will include a library / video room, children’s area, and a café.

·         Administrative support areas that will include corporate administration and staff offices, physician offices, medical records, medical research and more.


Other Indiana Spine Group Office Locations
When this new Carmel facility opens, the Harcourt Road office will be closed.
 
In addition to the Carmel office, patients can be seen at their Indianapolis (8040 Clearvista Pkwy, Suite 400, Indpls 46256) , Kokomo (307 S. Berkley Rd, Kokomo, 46901) and Anderson (2101 Jackson St, #203, Anderson, 46016)locations.

For more information about this new facility, visit this link.

As kids get ready to go back to school, shopping for school supplies is on their "to do" list. Often times, one item on this list is a new back pack. This spine wellness blog will provide a few tips for students as they shop for backpacks.

Here are a few tips:

• Select a backpack that has two wide, padded straps - that go over both shoulders.
• Limit the amount of items placed in the back pack.
• Pick the backpack up by bending at the knees, using both hands.

Fourth of July celebrations usually include picnics and fireworks. According to Trip Advisor, of individuals surveyed, 35% will travel over the weekend - of which 63% will drive. For individuals with back pain, even a short trip can be painful.

This spine wellness blog, will provide a few tips for preventing back pain while driving.

• Before you travel - stretch!
• If you are the driver, when possible try to switch periodically. As a passenger, you can ride in a more relaxed and comfortable position.
• If your car seat does not provide good lumbar support for your lower back, use a pillow or roll a towel to provide lower back support.

Recently I was interviewed by Anne Marie Tiernon, health reporter from WTHR, about a new genetic test – ScoliScore AIS Prognostic Test. This new test predicts curve progression in patients diagnosed with mild adolescent scoliosis (AIS) with 99% accuracy.

This test measures patient’s saliva for specific DNA markers. Research has identified two genetic markers in patients with scoliosis. One DNA marker may predispose a patient to developing severe scoliosis (28 markers – progressive genes), and the other (25 markers – protective genes) may protect the patient from severe spinal curve progression. The ScoliScore analyzes these genetic markers and provides a score. The lower the score – the less risk of the patient’s curve progressing.

This test is indicated for Caucasian males or females who have been diagnosed with mild scoliosis, that are between the ages of 9 – 13. For a fact sheet on this test, visit this link. To see the WTHR news / spinal wellness story, visit this link.

This new test is available at Indiana Spine Group. For information, please call our office at (317) 228-7000.

This blog entry highlights the services of one of the silver sponsors of Back Talk - Indiana Spine Group's fifth annual continuing medical education spine symposium. 

Northwest Radiology Network (NWR) is one of the largest physician owned radiology practices in Indiana and has been providing diagnostic imaging services for more than 40 years.  NWR was formed in 1967, with a goal of providing Indianapolis with the latest, most convenient diagnostic imaging services at an affordable price.  NWR has 49 board certified, sub-specialized radiologists.  Their areas of sub-specialties are body imaging, musculoskeletal imaging, breast imaging, interventional radiology, neurointerventional radiology, neuroradiology, pediatric radiology, positron emission tomography (PET), and nuclear medicine.   The sub-specialization of NWR radiologists differs from other radiology practices that may require their radiologists to interpret radiographs across the board.  NWR's mission is to provide high quality patient care in a cost effective, efficient environment.  The physicians and staff of Northwest Radiology Network are committed to compassionate patient care, accurate results, and timely interpretations.

NWR has three free-standing, multi-modality imaging centers, and interprets images for 16 hospitals and 17 outside imaging facilities throughout the state of Indiana. Free-standing imaging centers include:

• Northwest Radiology at 10603 N. Meridian Street
• Northwest Radiology at 8260 Naab Road
• Meridian North Imaging Center at 12188-A N. Meridian Street 

Staff from Indiana Spine Group attended the 4th Annual annual spine run, sponsored by and benefiting The Spinal Research Foundation. The Spinal Research Foundation is a non-profit organization, who's mission is to improve spinal health care through research and education. Funds raised from the event will go directly to spinal research. 

This foundation was established by spine surgeon Thomas Schuler, M.D., F.A.C.S. in 2002. 
Since its inception, The Spinal Research Foundation has produced significant scientific research resulting in enhanced spinal care.  New technologies, treatments and techniques are the results of the research conducted by The Spinal Research Foundation.

For more information about The Spinal Research Foundation, visit this link.

A recent blogger submitted a few questions about degenerative disc disease, and asked about treatment options for the lumbar spine. 

The blogger asked the following:

What about dynamic stabilization devices as an alternative to lumbar fusion? I have been doing some online research, hoping to get plugged into a 522 study, or otherwise explore whether insurance might cover something like this in my situation. (2 degenerating discs.)

Paul Kraemer, MD, a spine surgeon with Indiana Spine Group responded to these questions.

First, there is no perfect treatment for degenerative discs. The technology of motion stabilization is still very much in its early infancy, and at this point that is probably not the best solution.

There are two categories of implants that exist, disc replacement and motion stabilization, but trials have had problems and neither is currently being implanted.  One motion stabilization implant, sought to minimize motion of the disc to prevent pain and decrease revision surgery, but no definitive proof for either of those claims exists, and they have run into recent trouble with the FDA for their longer term data. Another motion stabilization concept, facet replacement devices are motion preservation devices aimed at facet joints, and at least one recent trial was ended early by the FDA.

Disc replacement in the lumbar spine has been done for over 20 years and works well in appropriately selected patients.  This procedure is FDA approved, but insurance companies frequently refuse to acknowledge convincing data. The results for this surgery seem very reproducible, but it’s only approved for single level disease with healthy facet joints.

All of this skips over the point that back surgery is usually not the first or best answer for back pain, and many people with degenerative discs have little or no pain. It's always recommended to talk to a spine surgeon to see what your specific treatment options are.

In respect to web sites that provide spine specific information – a few very popular sites are Spine Universe and Spine Health.  

Expanded Physical Therapy Services

The physical therapy center at the new Indiana Spine Group facility will be over 2,000 square feet. As you can see in the construction picture, it is a work in progress. This center will focus on physical therapy of patients with spine-related problems, as well as fitness models to improve an individual’s overall spine health. 

This physical therapy center is unique in that it will focus on the spine. According to Adam Ebbert, physical therapy coordinator at Indiana Spine Group, “we are excited about our expanded location in that we will be able to provide more comprehensive physical therapy services in one location.” In addition to physical therapy rehabilitation, therapists will also provide therapeutic exercise support. This program will provide patients with spinal problems, such as arthritis or osteoporosis, specific exercises to help them manage their spinal issues.

Patients are referred to physical therapy services by Indiana Spine Group physicians or their own physician.

For more information, or to schedule an appointment call (317) 228-7000.

In addition to the talks previously highlighted in prior blogs, I also gave a few talks on the cervical spine at the annual American Academy of Orthopaedic Surgeons continuing medical education meeting. One Instructional Course lecture, where I served as faculty, focused on the degenerative cervical spine and was entitled, “The Degenerative Cervical Spine: What You Need to Know”.  This talk focused on the evaluation and treatment options for the degenerative spine and it addressed anterior and posterior spine surgery options, as well as non-operative treatment options.

The other talk was a Podium Presentation of the research results for the five-year study of the Bryan Cervical Artificial Disc. This continuing medical education presentation was entitled, “Cervical Disc Replacement: Five Year Follow-up from the U.S. Prospective Randomized Bryan Trial”.  This link provides an overview of the initial results of this study – which followed spine surgery patients post-operatively for five years. Patients evaluated either underwent spinal fusion or arthroplasty (cervical artificial disc).

Recently I attended and presented at the annual continuing medical education conference of the American Academy of Orthopaedic Surgeons (AAOS). This meeting was held in San Diego in February. One of the things that I did for this meeting was to plan one of the educational symposiums. This symposium was on the current concepts of spine trauma. As a part of this continuing medical education session, I brought together leaders throughout the world on cervical spinal trauma to be a part of the panel.

This two hour symposium covered the initial assessment of spinal trauma, imaging, and clearing of cervical trauma, as well as spine surgical techniques and more. In addition to moderating this session, I also presented on occipitocervical injuries, including odontoid fractures. Concluding the program, were presentations of case studies with a discussion and debate that included audience participation.

For a complete listing of this educational conference, visit this link.

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

This spine wellness blog entry will answer a frequent question asked about “toning” shoes, and if they really work. Most likely you have seen the advertisements or watched the commercials where shoe manufactures announce that their brand of toning shoes can help you lose weight or help you get into shape. According to Adam Ebbert, PT, CEAS, a physical therapist with Indiana Spine Group, the most effective way to get into shape is a dedicated exercise program. 
 

The design of these shoes is such that when individuals initially walk while wearing them, they are using muscles that they normally do not use. Additionally, with a few of the shoes – the sole is designed in such a way which forces the walker to balance themselves. Again, this uses muscles that are normally not used.

 A recent study, conducted by the American Council on Exercise (ACE), concluded that these shoes did not have greater impact than normal shoes when worn during walking. This study evaluated calories burned and muscle usage, while participants wore various toning and normal active shoes.

In this study, there were two groups. The first group consisted of 12 active women aged 19-24. While wearing a variety of shoes, their exercise response was monitored while they walked a series of five-minute intervals on a treadmill. The second group, also consisted of 12 active women aged 21-27 who also wore various shoes while walking on the treadmill. While this group walked their muscle usage was measured.

For more information about this study, visit this link. Additionally, an article on WebMD summarizes this study.

This spine wellness blog entry will answer a recent question by a blog reader.

What is the best food and exercise for a degenerative spine?

Unfortunately, the lumbar disc between the vertebrae that degenerate, don’t have a good blood supply, thus it is difficult to get nutrients to these vertebrae. That is why once the lumbar discs degenerate, they cannot be “regenerated,” by certain foods or supplements.
 
For overall spine health, one of the best things that you can do for your spine is to maintain a healthy weight, and do weight bearing and aerobic  exercises such as walking, biking, and swimming. As well as core strengthening exercises. Additionally, aquatic exercise is a great type of exercise for individuals with spine problems. This link provides a good resource for aquatic exercise.

And remember, proper hydration is essential to a healthy spine. So make sure your water intake is adequate.

(This answer was provided by Alta Skelton, RN, MSN, NP-C, and Adam Ebbert, PT, CEAS.)