St. Josephs/Candler Neuro Insert Spinal Disorders and Treatments and Sidebar Dr.

. Suh FINAL Word Count: 377 (451 with side bar)

SURGERY NOT ALWAYS NECESSARY FOR SPINAL DISORDERS There are many options available to those with spinal disorders. Increasingly, treatments are becoming less invasive. St. Josephs/Candler provides the full continuum of spine care, including some of the most advanced procedures available. Daniel Suh, MD, PhD, Neurosurgeon on staff at St. Josephs/Candler, describes some of the most common spinal disorders, and how theyre treated. Disc Herniation and stenosis treatment begin conservatively We often see patients who present with symptoms secondary to a lumbar or cervical disc herniation a condition in which a disc ruptures or pushes outside its normal position. If the disc pinches a nerve root or compresses the spinal cord, patients can experience pain, weakness, numbness or even bowel and bladder problems. Most often, treatment for a herniated disc is non-surgical, including rest and activity modification, ice and heat, medications, often accompanied by physical therapy, or injections. Surgery is recommended only after all other options have been exhausted. Dr. Suh also treats patients with spinal stenosis, a condition associated with narrowing of the spinal canal. Spinal stenosis can be caused by any number of factors, such as degenerative changes in the spine due to arthritis or aging, tumors, trauma, or congential disorders. In stenosis, patients develop symptoms because of pressure on the spinal cord or spinal nerves. Conservative treatment is preferred for patients with stenosis, but sometimes surgery is necessary to relieve significant spinal cord or nerve root compression. Minimally invasive procedures to strengthen or stabilize the spine Spinal insufficiency compression fractures, usually secondary to osteoporosis, are treated with medications, physical therapy and bracing. The primary focus of treatment is to address the underlying condition that makes a patient vulnerable to developing an osteoporetic compression fracture. In the past, surgery was rarely performed. More recently, newer studies have shown that patients with acute insufficiency compression fractures recover more quickly with improved pain control using a variety of new, minimally invasive procedures called vertebroplasty and kyphoplasty. (For additional information see Advances in Spine Technology.)

Mechanical Instability Mechanical instability of the spine can result from a several causes, including degenerative disease, trauma, or cancer. If the degree of instability is excessive the structural integrity of the spine can be compromised. This decreased stability can produced pain during normal activities, a condition known as mechanical low back pain. The pain is typically confined to the lower back, hips, and thighs. Conservative measures are designed to re-establish stability by strengthening supportive structures such as the muscles of the lower back and abdominal wall. Conservative treatment also includes a variety of injection treatments. If a significant degree of instability exists or conservative measures fail, the structural integrity of the spine may be restored through a spinal stabilization surgery. These procedures, known as a fusion and fixation, are intended to eliminate the movement across the unstable portion of the spine and reduce the production of pain. Fixation provides immediate spinal stability through the implantation of metallic devices. Long-term stability is achieved through the growth of a bony bridge between the unstable bones, known as a fusion. Many of these spinal stabilization procedures can now be performed using minimally invasive techniques. Dr. Suh says the vast majority of patients with spinal related problems improve with anti-inflammatory medications, physical therapy and lifestyle alterations. But for those who fail to improve, or for those with significant spinal cord or nerve impingement, surgical intervention may be necessary to prevent longstanding or permanent impairment. The new minimally invasive techniques allow us to perform surgeries that in the past have required a large incision, extensive disruption of the soft tissue and a longer recovery. We now have the technology that helps our patients recover much more quickly, and return to their normal activities.

SIDEBAR WITH GRAPHIC Anatomy of the Spine (Word Count: 74) The spine is divided into several sections. The cervical vertebrae make up the neck. The thoracic vertebrae comprise the chest section and have ribs attached. The lumbar vertebrae are below the last thoracic bone and extend to the top of the sacrum. The sacral vertebrae are inside the pelvis, and the coccyx (tailbone) is the bottom-most vertebral section. In between the vertebrae are soft discs that

cushion the vertebrae and keep them in place.

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