PATIENT SATISFACTION
If you’re evaluating hospitals based solely on patient satisfaction surveys, you may want to reconsider. A new Johns Hopkins University study (recently highlighted in Kaiser Health News) found little correlation between patient satisfaction scores and quality care.
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Spine surgery is a continually evolving specialty. Some recent changes have been positive, while others can be viewed negatively. For example, an important positive change is the trend toward less invasive surgery, which results in faster recovery times, allowing patients to return to daily activities more quickly.
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It is common to experience back and neck pain after a fall or an accident. Although it can take a few days to manifest, in most cases the pain resolves itself in several weeks. If it does resolve in a short period, it generally indicates a low level of injury.
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Many people have heard the term spinal fusion, but most people probably have no idea what spinal fusion really is or why it might be necessary. Spinal fusion is designed to stop the motion at one or more points in the spine. We call these points motion segments. A motion segment in the spine is a combination of a vertebra, a disc, another vertebra, and two facet joints.
We consider spinal fusion as a surgical option for patients if there is spinal instability (spondylolisthesis), deformity (scoliosis, kyphosis), or spinal fractures. It can also be helpful for patients with a narrowing of the spinal cord (spinal stenosis), and less often for degenerative disc disease (low back pain caused by a disc).
During the surgery, we take bone from the patient or synthetic bone substitutes and place it along the spine, in the disc space, or in the facet joints. Eventually, the bone attaches the vertebrae together, which is what we call spinal fusion. Sometimes we use rods, screws or plates to help the fusion take. The operation can be done from the front, side, or back of the spine depending on the problem and the surgeon’s preference.
After surgery, patients usually spend a few days in the hospital. They wear a brace for 6-12 weeks. Once the fusion is mechanically stable, physical therapy may be recommended. Patients can expect to see a 50% decrease in pain and a 50% increase in function. Some patients will need the rods and screws removed at a later date if they become painful.
Since spinal fusion limits motion at one portion of the spine, other motion segments may break down in the future and require treatment including additional surgery. Patients have a better chance of success if they have a positive attitude, maintain a healthy weight and avoid smoking. It is important for patients to ask their doctor about what they can expect in the short- term and long-term issues before deciding on surgery.
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SELECTING THE RIGHT HOSPITAL
There are many ways to evaluate a hospital. Several organizations, including U.S. News and World Report and Thomson Reuters, rank hospitals, using a variety of criteria. Insurers also recognize facilities that have distinguished themselves by exceeding certain quality and service levels. Feedback from friends and family about their experiences can also be useful.
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If you’re facing back surgery, it’s important to educate yourself about the potential outcomes of your surgery – including infection. A recent study shows that certain conditions – such as obesity and heart disease – may increase the risk of infection after low back surgery.
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When a surgeon recommends an operation, it is generally a good idea to get a second opinion. Not all surgeons are alike. Different surgeons look at spine problems differently and there are multiple ways to get a good result. It helps a patient to get another perspective on the problem, including recommended options and possible outcomes.
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Sometimes a narrowing of the spinal canal can lead to less room for the nerves, which causes them to be pinched. We call this spinal stenosis. Not all pinched nerves are caused by spinal stenosis, but when it occurs in the low back it can cause serious symptoms that could require surgery.
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CHOOSING THE BEST MATTRESS FOR YOUR BACK
Many patients ask me what kind of mattress is best to purchase if you are suffering from back or neck pain or recovering from surgery. While no two people are alike, and everyone's back problems may be different, here is some general information to help you make an informed decision.
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Informed surgical patients have the best chance of a successful surgery. Patients who are well informed about their options and their surgical procedure have the least stress before and after surgery.
With so much information available online, it is difficult for many patients to know what is most relevant for their own surgery.
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Proper training is important to prevent or minimize injuries from winter sports. Skiing and snowboarding require strengthening your leg muscles, improving your flexibility and getting your CORE stronger.
CORE muscles stabilize the spine. They help transition forces from the legs to the torso. In the low back, these are the abdominal muscles, specifically the transverse abdominus muscle and the paraspinal muscles in the back, the multifidi. From a spine perspective, CORE strengthening is the key to protecting the back during sports activities, and preventing flare-ups of existing back problems as well as new injury.
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I've often said that maintaining your health and weight is the most important factor in keeping your body in the best possible condition. Even with back, neck and spine problems, your overall fitness is the best way to ensure a lifetime of pain-free, healthy living. Fad diets that ask you to eliminate something from your diet might make you drop some pounds in the short-term, but your body needs those nutrients to function at its best:
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Clinical trials are an important research tool. They help spine surgeons and other medical professionals learn how new technologies and medicines can benefit our patients. The goal of a clinical trial is to test the safety and efficacy of new drugs and medical devices before they are approved for use by the general public.
You can find a list of actively recruiting clinical trials at Spine-Health. According to clinicaltrials.gov, here is some important information for anyone who is considering participating in a clinical trial. You can also learn more about it at Spine-Health or clinicaltrails.gov
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Wintertime can be stressful enough; don't add the strain of back pain. Follow these simple tips to avoid back injuries and keep the cold months pain free and healthy.
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Magnetic Resonance Imaging, or MRI, is a technology that allows physicians to see musculoskeletal and internal anatomy and diseases much more clearly. MRIs are especially helpful for spine surgeons who need to be very precise about where to operate to achieve the optimal outcome without causing harm to a patient.
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Summer is a time to get outside and enjoy some fun in the sun. But outdoor exercise, yard work and even those much-needed family vacations can be hard on your back. Remembering a few simple tips can help you to avoid injuring your back or neck during this time of increased activity.
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Patients suffering from chronic, debilitating low back pain know that it can prevent them from working and even from participating in normal daily activities. After exhausting every conservative, non-surgical treatment they can find, from chiropractic care and physical therapy, to spinal injections, alternative medicine and psychology, six months later many of these patients are still...
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Medicare patients with spinal disorders present significant challenges to physicians. In many cases, these patients have a variety of medical problems in addition to spinal disease, making them difficult to evaluate and treat, and more likely to develop complications after surgery.
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Depending on your situation and symptoms, chiropractic care can be an option for patients with low back pain and neck pain. The treatment involves manipulation and or mobilization of joints to decrease pain and improve function.
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If you have a lumbar herniated disc in your spine (sometimes called a "slipped" or "ruptured" disc), you've probably gotten several opinions from spine doctors regarding surgical options for your condition. Surgery may help to alleviate your pain and increase your mobility, but it's important to know all the information about the pros and cons...
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The back is designed to be strong and flexible, but like everything else, it has its limits. Lifting something too heavy, overdoing it on the ski slopes, court or ball field, or spending too much time at the computer without the proper ergonomics can lead to short-term or chronic pain. As we age, something as...
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You may have seen newspaper ads from chiropractic clinics promoting a new type of "space age" spinal decompression machine. These mechanical traction devices have become quite popular, especially in the past two years.
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In the past, neurosurgeons typically performed decompression surgery on the spine that involved maneuvering the nerves and spinal cord, while orthopaedic surgeons performed fusion surgery and scoliosis reconstructions.
As the specialty of spinal surgery evolved and became more complex with the introduction of new technologies and devices such as rods, screws and artificial disc, both disciplines...
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It is amazing how many of us live with constant pain. More than 80% of Americans complain about back and neck pain at some point in their lives. It is one of the leading causes of missed time from work is one of the main reasons that people get up "on the wrong side of...
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At a presentation during the 24th annual meeting of the North American Spine Society, a study from the Scoliosis Research Society examining the incidence of infection after 108,419 spine surgeries indicated a superficial and deep wound infection rate of 2%.
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