Spine Talk

Dr. Rey Bosita, Orthopedic Spine Surgeon at Texas Back Institute talks about herniated discs, and the symptoms that you need to watch for.

What is a herniated disc?

Between each bony vertebral body is a disc that acts as a shock absorber and a hinge. As we age, the disc becomes dehydrated, making it less supportive and more prone to injury. Even a healthy, well-hydrated disc can be injured. The disc is composed of the annulus, which is a tough tissue that makes up the outside of the disc. The nucleus pulposus is the jelly-like substance contained in the center of the disc. A herniated disc occurs when the nucleus breaks through the outer tissue. A herniated disc is very common and may or may not cause symptoms. Stretching or tearing of the annulus may result in back or neck pain. The discs are immediately in front of the spinal cord and exiting nerves, so when the herniated disc or protrusion compresses the spinal cord or nerves, leg or arm pain and numbness or weakness may occur.

Find more here: https://texasback.com/conditions/herniated-disc/

Dr. Ted Belanger talks about Spinal Instability in this short, but informative podcast. Spinal Instability is described as excessive motion of vertebral bodies in relation to one another is considered spinal instability. Some motion is, of course, normal. Motion can be described as instability when the motion is significantly greater than that at adjacent levels. Spinal instability can be the result of an injury, degenerative process, tumor, previous surgery or congenital condition. Symptoms of spinal instability may include neck or back pain, nerve pain and muscle spasms.

Find More here: https://texasback.com/conditions/spinal-instability/

Dr. Thomas Kosztowski Talks About The Common Causes Of Neck Pain by Texas Back Institute

View the full story here: https://texasback.com/are-you-taking-too-much-ibuprofen-for-your-constant-pain-the-answer-is-most-likely-yes/

Whether it is chronic or acute, pain affects the quality of life of millions of Americans every day. Pain varies in severity, based on its cause and other factors. It is felt when special nerves that detect tissue damage send signals to transmit information about the damage along the spinal cord to the brain. Literally, billions of dollars are spent each year by consumers who are trying to "interrupt" this signal with non-prescription, over-the-counter (OTC) medications.

The Consumer Healthcare Products Association estimates that more than 2.9 billion retail trips are made each year for OTC medications and the average U.S. household spends about $338 per year on these non-prescriptive drugs. Among the most popular of these OTC medications are those that are used to treat pain These includes Ibuprofen, such as Advil® and Motrin ® and acetaminophens, such as Tylenol®

View the full story here: https://texasback.com/are-you-taking-too-much-ibuprofen-for-your-constant-pain-the-answer-is-most-likely-yes/

Dr. Scott Kutz (https://texasback.com/find-a-physician/name/scott-kutz/) , a neurosurgeon at Texas Back Institute (https://texasback.com/treatments/surgical-treatments/fusion/tdr/spinal-cord-stimulation-scs/), treats hundreds of patients each year for back pain and has some first-hand experience with spine stimulation.

“The original spine stimulators were developed in the 1960s,” he said. “However, the technology could not be used in a wide-spread fashion until the 1980s. This was because the pacemaker technology, which, like the spine stimulator, could be implanted and maintain electrical stimulation for a long period of time, improved at this time

“Between the 1980s and 2010, the technology was relatively static. There was a certain recognized range of stimulation frequency that could be delivered to the dorsal column of the spinal cord. If the stimulation was delivered within those parameters, the patient would typically get a reduction of pain, particularly pain to the hips, buttocks, shoulders, some parts of the back, arms and fingers.

“Unfortunately, some patients did not get good pain reduction from this type of stimulation. This could be due to the fact that they might have more pain centered in the neck, at the back of the head or in the lumbar spine area. In some cases, the patients would experience paresthesia with this stimulation, meaning they could feel this stimulation and for many that sensation was disagreeable. It was annoying to some patients, and this made it ineffective in coverage of the pain.

“We now have high-frequency stimulation that cannot to be perceived by humans. Thus, when this stimulation is delivered, it still has effects on the nervous system and still interrupts pain delivery from those distal nerves up to the brain, but it is not perceived by the patient. This means the stimulation can cover deeper pathways within the spinal cord leading to better coverage of pain in the neck itself, the thoracic area (where the ribs attach to the spine) and the lumbar (lower back) area of the spine.”

Using Stimulation Instead of Opioids

The fact that this new version of spine stimulator is being used instead of opioids for treatment of back pain is good news for the medical community, which is concerned about their abuse. From a medical standpoint, how does spine stimulation mimic the effect of opioids for the treatment pain?

“Actually, spine stimulation and opioids work differently on pain,” Dr. Kutz said. “Opioids don’t eliminate pain but rather they increase the tolerance of the mind to having pain. Most patients who are taking opioids say things like, ‘I can still tell that I hurt, but I just don’t care.’

“With spinal cord stimulation, there is an actual disruption of that pain signal coming up to the brain.”

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New Research: An Imaging Biomarker Could Change Treatment of Degenerative Disc Disease

There is promising news for millions of patients who suffer from lower back pain and disability caused by degenerative disc disease. Researchers in Hong Kong recently published their findings in the medical journal Spine. They found a novel imaging biomarker that seems to correlate to degenerative disc disease and lower back pain.

While the researchers noted that much more investigation is necessary before this imaging protocol is used for diagnosing this painful condition, it has the potential of allowing spine surgeons to gain more insights without being forced to use more invasive testing.

As a spine surgeon at Texas Back Institute (https://texasback.com/about-us/), Dr. Jessica Shellock (https://texasback.com/find-a-physician/name/jessica-shellock/) has diagnosed and treated hundreds of cases of degenerative disc disease and her insights about the condition sheds some light on the potential benefits of this research.

What is Degenerative Disc Disease?

Between each bony vertebral body is a disc (https://texasback.com/conditions/herniated-disc/) that acts as a shock absorber and a hinge. With aging, the disc becomes dehydrated, making it less supportive and more prone to injury. Even a healthy, well-hydrated disc can be injured. The disc is composed of the annulus, which is a tough tissue that makes up the outside of the disc and the nucleus pulposus, which is the jelly-like substance in the center of the disc.

What causes these discs to degenerate?

"Degenerative changes within a disc are physiologic," Dr. Shellock said. "This means that as our discs age, certain processes occur, including pathologic changes...

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Dr. Kevin Ju, Orthopedic Spine Surgeon at Texas Back Institute talks about the difference in symptoms and treatment options for patients who suffer from Acute Back Pain and Chronic Back Pain.

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Dr. Kevin Ju, explains what decompression surgery is and who would be a good candidate. So, what is Decompression Surgery?

Any surgery that relieves compression of the spinal cord or spinal nerves is considered to be decompression surgery. If the compression results from a disc herniation, the surgery is a discectomy. If the compression is because of a narrowed spinal canal that is placing pressure on the spinal cord or nerve roots, this surgery is a laminectomy. A laminectomy removes the back wall of the spinal canal to create more space for the spinal cord.

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Facet Joint PainAs a former collegiate golfer and current avid player, Dr. Michael Duffy, a spine surgeon at Texas Back Institute, is an excellent source for information on playing the game at a high level without succumbing to back injuries. As a student of the game and its players, he has excellent insights about the causes for the injuries to these two players and how amateur golfers can avoid them.

“A lot of what’s going on today is due to the fact that golfers are better athletes than they were decades ago,” Dr. Duffy said. “They are swinging harder and creating more torque with the new, so-called ‘X-factor’ swing, and while this makes the ball travel farther, it can also cause serious injuries to the spine and back.

See the full article here: https://texasback.com/is-there-life-after-back-injuries-for-these-two-young-golfers/

Surgeons, such as Dr. Michael Hisey (https://texasback.com/find-a-physician/name/michael-hisey/) of Texas Back Institute, must perform at a high level every time they step into the operating room. In many cases any error – no matter how small – can be catastrophic for the patient. Plus, surgeries can take hours to complete, and it is absolutely critical that the surgeon’s intense concentration remain high throughout the procedure.

As someone who is recognized internationally as one of the best in his profession, Dr. Hisey was asked if it is possible for a surgeon to get into a high-performance zone when he is operating on a patient’s spine.

“I absolutely believe it is possible for a surgeon to get into this state,” he said. “In fact, it happens to me regularly. If a surgery is getting stressful and there are many things happening at once, I will notice that things seem to slow down, distractions in the room seem to go away, I am able to really focus on what I’m doing and the surgical instruments seem to move very intuitively.

“It’s not always easy to start an operation in this state. You have to ‘get there’ through the procedure. In some cases, I will get into a surgery and think ‘wow, this is going to be a tough one.’ There may be lots of noise going on in the room, I’m hearing all of that and having a difficult time getting started. However, once I get started, I will tune out everything but the procedure. Everything fades into the background. It’s not that I’m unaware of everything going on. For example if the anesthesiologist says something to me, I process this information but I am not distracted by it. I simply have tunnel vision where I’m able to focus on what I’m doing.”

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