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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 4:28 pm
Source: Ivanhoe.com Reported May 2, 2002 Heat Treatment Helps Back Pain (Ivanhoe Newswire) -- A follow-up study confirms long-term benefits of heat treatment for patients who suffer from chronic low back pain. Intradiscal electrothermal therapy (IDET) is a procedure used in patients with chronic disc-related back pain who do not respond to conventional treatments. Previous studies have already shown the therapy's short-term befits. In the procedure, doctors insert a miniature catheter with a heating element into the center of the degenerated disc, the source of the patient's pain. Heat then toughens and seals the disc and destroys any abnormal nerve endings. Researchers followed 58 patients who underwent IDET for two years. All patients had been in pain for an average of five years before IDET. None had responded to prior treatment, including medications, physical therapy, exercise, and steroid injection. After six months, the patients' pain scores decreased from an average of 6.6 to 3.7 on a 0-10 scale. Patients also reported improvement in physical functioning including the ability to sit upright, one of the most bothersome symptoms of degenerative discs. Average sitting time increased from 33 to 48 minutes. After two years, patients reported further improvement with pain scores decreasing to 3.4 and average sitting times increasing to 85 minutes. IDET was attributed to overall improvement in quality of life, including emotional and mental well-being. Researchers say IDET is a relatively simple procedure. It is done using local anesthesia and does not require hospitalization. In addition, none of the study patients had any complications from the therapy. Doctors say IDET offers a new alternative to disc fusion surgery and potent narcotic drug therapy used to treat patients with chronic disc-related pain. SOURCE: Spine, 2002;27:966-973 Or this!!
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 4:40 pm
Source: Ivanhoe.com Reported April 17, 2000 Myofascial Release for Pain WEST BLOOMFIELD, Mich. (Ivanhoe Newswire) -- Millions of people suffer from chronic pain. Many have tried multiple ways to get rid of it but with no relief. Now help may be in sight. A therapy called myofascial release is producing results. Here is how it is helping.
Running a vacuum cleaner is something most of us take for granted, but not Sue Bernard. For the past seven years, excruciating back pain stopped her from doing this simple chore. Sue says, "It was a deep, deep pain -- very, very intense. I would take a pain pill and have to sit down." She'd given up hope the pain would ever go away, until she discovered myofascial release and physical therapist Teresa Stayer, P.T. Stayer, from SpectraMed, Inc., in West Bloomfield, Mich., explains, "We're taking pressure off their pain sensitive structures, off the nerves, off the blood vessels, all the way down to the cellular level." She uses pressure to manipulate the body and release the fascia, a connective tissue much like a web that encases your nerves, blood vessels and organs. During trauma, that soft tissue can become rigid.
Sue says, "By the second week, without ever realizing, she would ask me, 'How is your pain?' It would be, 'Pain? Hmm. I don't have pain.'" The technique has been around for years, but Stayer says more doctors need to know about it. "There are so many patients out there in pain, and they don't have to live with it. It is not something that is untreatable. It's just pain that hasn't been treated right," she says. Sue used to think housework was a pain. Now she's happy to be able to do it. Myofascial release is covered by most insurance companies and is used to treat conditions such as joint pain, fibromyalgia and carpal tunnel syndrome. Treatment length varies but is typically about three sessions a week for four weeks. Average cost is $45 a quarter hour. If you would like more information, please contact SpectraMed, Inc. 3160 Haggerty Rd., Suite H West Bloomfield, MI 48323 (248) 669-5757 http://www.spectramedinc.com/ My physical therapist used this on my right arm. It hurt so bad I stopped going to the sessions after the 2nd week.
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 4:48 pm
Source: Ivanhoe.com Reported October 4, 2002 Drug Relieves Back Pain in Some ROCHESTER, Minn. (Ivanhoe Newswire) -- A controversial drug can be used to help patients with chronic lower back pain, according to a new study. Opioids are pain relievers derived from the opium plant. Well-known examples of this class of medications include morphine, oxycodone and fentanyl. The use of opioids is complicated because the drug has been misused in the past and there is a potential for drug dependence. Researchers from Mayo Clinic in Rochester, Minn., reviewed previous studies done on opioids prescribed for chronic lower back pain. They found some patients on the drug experienced substantial pain relief, improved quality of life, and the ability to function on a day-to-day basis. Mike Joyner, M.D., from Mayo Clinic, is quoted as saying, "Opioids can be a 'lifesaver' for patients with severe pain. For people with chronic pain, opioids can be like letting them out of jail." In the retrospective study, researchers address some of the issues raised with prescribing these drugs. First, researchers found a risk of moderate side effects, but not long-term adverse effects. Second, there is a concern that the dosage of this drug needs to be continually increased. Researchers say the studies they reviewed showed opioid dosage remains fairly stable over time and the benefits are maintained. Third, the risk of drug dependence and withdrawal is a major concern for many doctors. However, researchers report a low risk of drug dependence and withdrawal with opioids. Study authors say they are convinced that opioids have a place in pain medicine. However, even the author of the paper says while he is a "believer" in this drug for pain relief, he still is cautious about prescribing it to his patients. SOURCE: Pain Medicine, 2002;3:260-271 I would try this, too. I trust myself.
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 4:56 pm
Source: Ivanhoe.com Reported October 17, 2001 Long-term Relief for Back Pain NEW ORLEANS (Ivanhoe Newswire) -- Researchers say heat may provide long-term relief for one of the nation's biggest complaints, lower back pain. The application of heat to a sore back has been known to provide temporary relief, but now pain specialists at the Cleveland Clinic deliver heat treatment with pinpoint accuracy to relieve pain for a much longer time. A technique called intradiscal electrothermal therapy (IDET) precisely delivers heat into the discs in the back, which cause the pain. Researchers found IDET reduced pain by 75 percent. The procedure only works for internal disc disruption, which represents 40 percent of lower back pain cases. Disc disruption happens when fibers around the discs begin to deteriorate. This usually happens as a patient ages. The tissue layer surrounding the center of the disc deteriorates as well. As degeneration occurs, water leaks from the nucleus, which irritates the spinal nerves. The patient experiences severe discomfort. IDET applies heat internally, directly on the ring around the nucleus of the affected disk. The treatment softens and shrinks tissue, reduces irritation and destroys pain receptors. IDET lasts about 45 minutes. During this time, the patient lies on his stomach as the physician leads a needle into the affected disc using an X-ray as a guide. A wire is then moved through the needle in the ring around the nucleus. Once in place, the wire is heated gradually for about 17 minutes. Only one or two disks are treated per session. Researchers say most patients who have received IDET experience significant pain relief for two to three months and continued to remain pain-free afterwards. The procedure restores quality of patients' social, work, recreational and sex lives, according to researchers. SOURCE: American Society of Anesthesiologists annual meeting in New Orleans, Oct. 13-Oct. 17, 2001 Okay, not sure if I qualify. But sign me up!
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 5:01 pm
Source: Ivanhoe.com Reported July 3, 2002 Back Pain Guidelines MORGANTOWN, W.Va. (Ivanhoe Newswire) -- What applies to athletes may also be good advice for people who live with chronic low back pain. A new study shows an athletic approach to managing low back pain may be beneficial to patients. This article is published in the current issue of Southern Medical Journal. Mathew Lively, D.O., of Morgantown, W. Virg., conducted a thorough review of the current guidelines used to treat low back pain and compared them to the athletic approach. He found research to support one approach in particular, the idea of encouraging exercise and discouraging bed rest. He writes, "Research has indicated that, contrary to traditional beliefs, bed rest is not an effective therapy." Low back pain is the second most common cause for visits to physicians and affects between 70 percent and 85 percent of people during their lifetime. Lively says the goal with athletes is to return them to the game in a safe and timely fashion. He says the goal should be the same for non-athletes. In fact, people who remain active and physically fit have fewer recurrences of pain. Lively writes one of the key points is to set goals and perform exercises to achieve those goals. Also, doctors should be realistic with patients and make them aware they will experience some pain while exercising. Lastly, medication may be necessary during this time. SOURCE: Southern Medical Journal, 2002;95:642-6
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Baby
Member
01-08-2006
| Tuesday, May 02, 2006 - 5:08 pm
Herckle, Thank you so much for taking the time to post these articles! I have just started reading through some of them and I am definitely finding useful information. Can anyone go to that site and make copies of some of the articles? I would like to have some of the info on hand the next time the doc comes out.
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 5:11 pm
Source: Ivanhoe.com Reported January 3, 2005 Better Surgery Heals Back Pain SAN DIEGO (Ivanhoe Broadcast News) -- Experts say as many as 80 percent of us will have a back problem at some time in our lives. Many people will need surgery for it, but few will want to take that step. A surgery that's easy on the patient would be a welcome change, and now, it's possible.
As a respiratory therapist, Thomas Bell does a lot of pulling and bending. He has scoliosis, which made his work and his life a big pain -- mostly in his back. "It had gotten to the point where the pain was becoming unbearable, and I had dealt with it for like 20 years," Thomas says. Instead of standard surgery, which is painful with a long recovery, Thomas chose an easier option offered by neurosurgeon William Taylor, M.D. "The surgery has been made much easier for the patient," Dr. Taylor, of University of California, San Diego, tells Ivanhoe. "Now the incision is one, to two, to three centimeters long, which is just enough to get the retractor into that space."
That retractor makes the tiny incision possible. Surgeons insert a small device and expand it to operate inside the body. The surgery is done from the side so there's no need to cut through the abdomen, aorta and other vital body parts. Dr. Taylor says, "The length of surgery has gotten shorter because we don't have to do the large dissection to remove all the muscles and expose everything." Also, if surgeons come too close to delicate nerves, they are alerted so they can work around them. "Since the pain is much less, narcotic rate has gone way down. They're recovering much faster. They're back to their normal activities quickly and safely," Dr. Taylor says. Thomas' wife, Hollie MacTavish, says she's glad to have her husband back. "He's much more of a relaxed, happier person, because he's not dealing with that constant stress of the pain all the time, so it's been great."
Thomas says, "It's hard to explain. It's like; It's Heaven." He now enjoys life's simple moments -- pain-free. With this new surgery, patients are out of the hospital in one night, rather than the five nights required with standard back surgery. Dr. Taylor says some people may not be good candidates for this, but most will do just fine. He says young and older patients alike can be treated with this technique. If you would like more information, please contact: Jeffree Itrich Public Information Officer University of California, San Diego 200 West Arbor Dr. MC 8230 San Diego, CA 92103 (619) 543-6427 jitrich@uscd.edu
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 5:19 pm
Source: Ivanhoe.com Reported February 10, 2003 Better Back Surgery PORTLAND, Ore. (Ivanhoe Broadcast News) -- Four out of five adults experience lower back pain. More than 150,000 of them have spinal fusion surgery, but that can also cause pain and trouble moving. Now, doctors have a new approach.
Two days after back surgery, Sherrie Devencenzi is up, walking around. "There's just a little pressure on my tailbone and just a pinching when I sit up. Other than that, it feels pretty good," Devencenzi tells Ivanhoe. She is one of the first patients at Oregon Health & Science University in Portland to undergo a new type of back surgery.
Orthopaedic Spine Surgeon Robert A. Hart, M.D., says traditional spine surgery required a large open procedure from the back, where the muscles are stripped away from the spine. During the new procedure, doctors drill smaller holes on either side of the spine, using an X-ray to guide them. Then, they insert screws into the vertebrae and hold them in place using a rod guided by a metal arc. Dr. Hart says, "As we swing that arc down, that rod finds the two screws and interlocks, interconnects between the two screws." Like traditional fusion surgery, the hardware stays inside to stabilize the spine. Because this surgery is done from the outside, there's less pain, less scarring and for most patients, a shorter recovery.
Devencenzi says, "I'm thinking I wished I would have done it much sooner." The procedure is called sextant back surgery because the tool surgeons use looks like a sextant, which is a sailor's navigational tool. It is a bit more expensive than traditional fusion surgery, but the cost is often offset with the shorter hospital stay. If you would like more information, please contact: Oregon Health & Science University (503) 494-1143 newmanj@ohsu.edu
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 5:33 pm
Source: Ivanhoe.com Reported June 10, 2002 Less Painful Back Surgery ATLANTA (Ivanhoe Newswire) -- Up to 85 percent of patients who need spinal fusion surgery need it simply because of the normal aging process and wear and tear on the spine. The procedure is invasive and painful and often requires months of recovery time. Now, doctors have found an alternative that is easier and less painful for patients.
C.J. Thompson tried everything to win her 10-year battle with back pain. "I had a degenerative disc. If I did anything strenuous like work around the house or work in the yard, it would get pretty severe towards, in the evening, and I wouldn't be able to do anything," Thompson tells Ivanhoe. When she thought her pain was interfering with her hopes of having a child, Thompson became one of the half a million people to go through spinal fusion each year. Orthopedic spine surgeon Scott Boden, M.D., tells Ivanhoe, "A spine fusion is when we take two adjacent spinal bones and get them to stick together so they no longer have movement or motion." By fusing the bones, the long-term pain is eliminated, but the procedure itself is painful.
"In order to do a spine fusion, at some point it involves moving bone from one part of the body," says Dr. Boden, of Emory University in Atlanta. That additional surgery can cause infection and chronic pain. Now, Dr. Boden says a genetically engineered protein called BMP can eliminate those risks by eliminating the need for a bone graft. "You could think of it as a bone commander signal in a bottle," he says. Doctors soak a sponge with the protein, put it into the spine, and in a few months, the body turns that sponge into bone.
It worked for Thompson. She says, "I've had my child and I went through pregnancy just fine. I'm able to pick him up and play with him and push him around in the driveway." In fact, Thompson hasn't had any pain since she had the surgery. Now she has time to focus on more important things. Dr. Boden says there is also interest in looking at BMP for helping broken bones heal as well, as its use in dental implants and plastic and reconstructive surgery. If you would like more information, please contact: Todd Hinson Emory Spine Center (404) 778-7000
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 5:34 pm
Going to walk Hercky. In th middle of House! Ack! Be back shortly.
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 5:59 pm
Source: Ivanhoe.com Reported May 19, 2004 Is Back Pain in the Head? (Ivanhoe Newswire) -- It turns out psychological factors may be a strong predictor for back pain in some patients. Researchers from the Stanford University School of Medicine in California studied nearly 100 patients for four years. None of the patients experienced back pain at the start of the study. Researchers examined patients’ spines through the use of disc injections and magnetic resonance imaging (MRI). Patients were also given psychological tests. Results show those who fared poorly on the psychological exam were nearly three-times more likely to report back pain. Patients with a history of disputed workers’ compensation claims were also more likely to develop back pain. Even patients who had fluid injected into their spines reported experiencing less pain than those who scored poorly on the psychological test. The fluid injection procedure -- called discography -- is thought to induce back pain. “It was thought that discography could separate the wheat from the chaff. But the bottom line is that it didn’t predict who would go on to develop back pain,” says Eugene Carragee, M.D., lead author of the study. Researchers say only a quarter of the 300,000 spinal fusion operations that are performed each year are done for obvious reasons, such as removing tumors or deformities. Dr. Carragee concludes, “The structural problems were really overwhelmed by the psychosocial factors. The question is, can we better identify groups that have a greater chance of being helped by surgery?” Researchers from Stanford are now working on a five-year study aimed to examine a higher-risk group of people -- those who already have lower back pain. SOURCE: Spine, 2004;29:1112-1117
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 6:07 pm
Source: Ivanhoe.com Reported October 30, 2002 Unexplained Pain Associated with Brain Function NEW ORLEANS (Ivanhoe Newswire) -- Researchers have found the reason for unexplained lower back pain in some patients may be related to their brains. A new study reveals patients with lower back pain that can't be traced to a specific physical cause may have abnormal pain-processing pathways in their brains. The effect, which has no explanation, is similar to an altered pain perception effect in fibromyalgia patients. The study was conducted at Georgetown University in Washington, D.C. Participants with lower back pain reported that they felt severe pain from a gentle finger squeeze that barely feels unpleasant to people without lower back pain. Researchers found those with lower back pain also had measurable pain signals in their brains at the same time their fingers were being squeezed. People with fibromyalgia felt similar pain from a squeeze of the same intensity. The squeeze's force had to be increased sharply to cause healthy people to feel the same level of pain. Researchers used functional MRI, a very fast form of MRI, to examine the brain activity of 15 people with lower back pain whose body scans showed no mechanical cause, such as a ruptured disk, for their pain. While the scanning occurred, researchers applied a small, piston-controlled device that delivered precise, rapid pulsing pressure to the base of their left thumbnails. They also examined 15 fibromyalgia patients and 15 healthy participants. Results show striking differences though brain activity increased in many of the same areas in both patients and healthy participants. All participants had increased activity in eight areas of their brains, but lower-back pain patients showed no increased activity in two areas that were active in both fibromyalgia patients and healthy participants. Meanwhile, fibromyalgia patients showed increased activation in two other areas that were not active in back pain patients and healthy participants. Researcher Daniel Clauw, M.D., now at the University of Michigan, says, "These results, combined with other work done by our group and others, have convinced us that some pathologic process is making these patients more sensitive. For some reason, still unknown, there's a neurobiological amplification of their pain signals." SOURCE: Annual Meeting of the American College of Rheumatology, New Orleans, Oct. 25-29, 2002
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 6:12 pm
Source: Ivanhoe.com Reported January 18, 2002 Antidepressants and Back Pain (Ivanhoe Newswire) -- Patients with chronic back pain may mildly benefit from taking antidepressants, according to a recent study, but the side effects may outweigh the benefits. Researchers with the U.S. Departments of the Navy and Army reviewed data collected from nine different trials between 1966 and 2000 to evaluate the use of antidepressants in patients with chronic back pain. While the medications seemed to alleviate back pain significantly, they did not improve a patient's ability to return to the functions of daily life any sooner. Up to 50 percent of working adults experience back pain every year, although most patients improve within three months. However, those people with persistent and chronic back pain regularly suffer serious disability, often accounting for huge medical costs. While a variety of therapies may help prolonged back pain -- including acupuncture, narcotics, and electrical nerve stimulation -- conflicting evidence has suggested antidepressants may provide relief as well. Researchers note there are several theories why antidepressants may work, such as altering a patient's perception of pain, treating an underlying case of depression, or improving sleep. While the study did find a small but significant change in pain levels among patients taking antidepressants, the adverse effects of the antidepressant medications may outnumber this minor improvement. Drowsiness, dry mouth, dizziness and constipation were reported by more than 20 percent of the patients surveyed, as compared to only 14 percent of the control group. Further, the patients taking antidepressants did not show any more improvement in performing daily activities. Researchers write, "Larger, better-designed randomized control trials that weigh the benefits and adverse effects of antidepressant therapy are needed before the use of antidepressants can be routinely recommended as therapy for back pain in patients without depression." SOURCE: Archives of Internal Medicine, 2002;162:19-24
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 6:21 pm
Source: Ivanhoe.com Reported November 29, 2004 Chronic Pain Shrinks the Brain (Ivanhoe Newswire) -- A Northwestern University study shows chronic back pain shrinks the brain by as much as 11 percent, which is equivalent to the degeneration of 10 to 20 years of aging. Although chronic pain greatly diminishes quality of life and increases anxiety and depression for 10 percent of Americans, it was previously assumed that the brain reverts backs to its normal state after chronic pain stops. This was the first study to examine brain changes due to chronic pain. Using magnetic resonance imaging (MRI) data and automated analysis techniques, researchers compared the brain images of 26 participants with chronic back pain to those of normal participants. The participants with chronic back pain had unrelenting pain for more than one year. The study shows the reduction in brain density is related to pain duration, pain-related characteristics, and is more severe in the neuropathic type of pain, which is caused by sciatic nerve damage. Researchers hypothesize that some of the decrease in brain density reflects only tissue shrinkage, which could be reversed with proper treatment. They say it may also be attributed to more irreversible processes like neurodegeneration. "Given that, by definition, chronic pain is a state of continuous persistent perception with associated negative affect and stress, one mechanistic explanation for the decreased gray matter [the part of the brain that processes information and memory] is overuse atrophy [degeneration] caused by excitotoxic and inflammatory mechanisms," says A. Vania Apkarian, lead researcher. They continue on to say that as the loss in brain elements progresses, it may dictate the properties of the pain state to the point that it becomes more irreversible and less responsive to therapy. SOURCE: The Journal of Neuroscience, 2004, published Nov. 23, 2004
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 6:25 pm
Source: Ivanhoe.com Reported November 11, 2002 Mental Health Therapies for Chronic Conditions LONDON (Ivanhoe Newswire) -- New research shows certain mental health interventions may help patients with chronic fatigue syndrome, irritable bowel syndrome, and chronic back pain, three common somatic conditions. Researchers from the West Middlesex University Hospital in London tested the effectiveness of cognitive behavior therapy, behavioral therapy, and antidepressants in the three conditions. Results showed cognitive behavior therapy and behavioral therapy were both effective in primary and secondary care chronic back pain patients. Researchers found cognitive behavior therapy yielded mixed results for IBS patients. They say, in the studies that showed effectiveness, positive results may reflect the training and experience of the therapist rather than the efficacy of the intervention. However, antidepressants seemed effective in both primary and secondary care patients. Researchers also found cognitive behavior therapy was effective for CFS in secondary care patients. Cognitive behavior therapy fared the same as counseling in primary care patients. Previous studies show patients with functional somatic symptoms are common in primary care and may not receive effective mental health interventions. SOURCE: British Medical Journal, 2002;325:1082-1085
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 6:29 pm
Baby, you can make copies of the ones here, but you'd have to pay to join Ivanhoe.com to see what is on their site. Just tell me what you want me to look for and I will be glad to post what I find.
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 7:15 pm
Source: Ivanhoe.com Reported July 26, 1999 A Better Back Brace Full-Length Doctor's Interview In this full-length interview, Dr. Pizzutillo tells us about a new type of back brace that lets people with minor scoliosis get rid of the big, clunky brace and use one that can fix the problem. Ivanhoe Broadcast News Interview Transcript with Peter Pizzutillo, M.D., Orthopedic Surgeon, St. Christopher's Hospital for Children in Philadelphia, Penn., Can you describe the traditional scoliosis braces that are in existence right now? Dr. Pizzutillo: The traditional braces that exist now are all spin-offs of a brace that was developed in the 1940s, called the Milwaukee brace. Adolescents had nightmares about this brace because of a chin piece and a headpiece that were very apparent. The modern developments of that brace, called TLSO braces, have the same degree of success as the Milwaukee Brace. The brace is worn from the axillary area down to the groin and under clothing, without any accessory pads or metal bars that stick out. It is made of a variety of materials but is usually hard plastic. It may be a very rigid polypropylene or less rigid, such as an orthoplast. There are many variations of the scoliosis brace, but essentially they're just differences in modularity or material. What are the benefits and drawbacks of the traditional brace? Dr. Pizzutillo: Fortunately, it seems that most of the scoliosis braces have the same results. They've been shown to be effective in halting the progression of curvatures of the spine in kids who are immature in their spine growth. On average, 85 percent of treated patients can be treated successfully, i.e. preventing the curve from getting worse. The drawback is that it is a rigid brace and it interferes with activity. For a patient who is involved in dance or other sports, there is the need be out of the brace to be active. Most kids are in the brace from 16 to 22 hours a day depending on their age. Removing the brace for more time than recommended could compromise your result. How is the Spine Cor brace different from traditional ones? Dr. Pizzutillo: The Spine Cor brace involves a totally different concept in treatment. The more traditional brace is one in which we try to restore the alignment of the trunk and the spine in the hopes of keeping it from deforming further over time. Essentially, we are waiting for the soft tissues of the back to tighten with age. The Spine Cor brace was developed in Montreal on the basis of a neurologic and muscular approach to the treatment of scoliosis. The brace is a series of elasticized straps that are attached to a harness that's worn under clothing and allows full motion. It fosters realignment of the spine but it doesn't rigidly hold it in place. In the Montreal study, children were encouraged to be active. So this can possibly correct it? Dr. Pizzutillo: The traditional scoliosis brace is essentially a holding device and does not provide correction. The Montreal group has been using the Spine Cor brace five years. They have noticed those patients with curvatures of the spine less than thirty degrees have been demonstrating correction in spinal alignment and in the rib cage shape. With advancing scoliosis, ribs actually deform, and may make it difficult to comfortably breathe. The overall Montreal experience in the past five years is that for adolescents with idiopathic scoliosis, the Spine Cor brace works as well as existing scoliosis braces in holding the curvature from getting worse. Ongoing research involves immature individuals with scoliosis curves less than 30 degrees. This thesis involves intervention before true deformation of bone, cartilage and disc occurs. By encouraging realignment, it is believed that some degree of correction of spinal deformity can be achieved. We are one of the research sites involved in early treatment of scoliosis with the Spine Cor brace and have been involved for almost one year. Can someone go from wearing a traditional brace to wearing a new one? Dr. Pizzutillo: It's conceivable, but we don't have very much information about what the effect is of changing types of braces. If someone's been in a traditional brace for a period of weeks, I don't believe there would be any problem in changing to the Spine Cor brace. However, strict protocols are followed for the research population. All of the patients in the study group must be still growing, have scoliosis curves less than 30 degrees, and have no history of prior brace treatment. What are the differences between the two braces? Can this one save money because it grows with the patient? Dr. Pizzutillo: The traditional braces, by virtue of the fact that they're rigid, are made specifically and customized in a sense to fit the child's body. These braces are adapted and changed as the child grows taller and becomes heavier. Some braces last for nine to 12 months before they need to be changed. During an average course of treatment for idiopathic scoliosis in a young adolescent, I would expect to use three braces. The cost of the brace that's offered by the Spine Cor company from Montreal is roughly half of the cost of the three braces that would be required. The brace consists of elastic straps and the cost of replacing the straps is very modest. Is there anything that you want to add? Dr. Pizzutillo: The only observation that we've made thus far with the patients that we've treated is that they have really found this to be a friendly device and are able to be fully functional. Hopefully this will improve the wear compliance of these active young people. If you would like more information, please contact: St. Christopher's Hospital for Children Philadelphia, PA 888-STCHRIS (888) 782-4747
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 7:35 pm
Source: Ivanhoe.com Reported April 24, 2000 Television News Service/Medical Breakthroughs ©Ivanhoe Broadcast News, Inc. July 1996 Zapping Spinal Tumors Spinal tumors aren't common but they're usually deadly. Of those who get them, only 10% survive. That statistic may be changing. Doctors at the University of Maryland Medical Center are experimenting with a combination of old and new treatments that gives new hope to people who had no hope before.
Three years ago, Cindy Gaisior felt an unusual pain in her back. Her fiancee, James, thought it might be a pulled muscle. She guessed a kidney stone. Cindy Gaisior, Combination Therapy Patient: "The pain progressively got worse and it wasn't 'til about June that a physical therapist pressed on it and about sent me across the street." Alan Levine, M.D., Orthopedic Oncologist, University of Maryland Medical Center, Baltimore, MD: "She had a tumor about the size of a grapefruit and the difficult part of her tumor was it was in the back of her spine, it was along the side of her spine, into her chest, and also went inside the spinal canal and compressed her spinal cord very severely." Not long ago, a tumor like that would be a death sentence. The traditional forms of tumor treatment -- aggressive surgery and radiation -- weren't an option, because they probably would damage the spinal cord and other organs.
Today, doctors are experimenting with a combination of surgery, external radiation and an internal radiation called brachytherapy, in which tiny radioactive seeds are placed next to the tumor, confining the radioactivity to a small area. Pradip Amin, MD, Radiation Oncologist, University of Maryland, Medical Center, Baltimore, MD: "The brachytherapy combined with the external radiation is able to deliver the maximum amount of radiation with maximum sparing of the surrounding tissues.
Of 20 patients who have had this combination therapy, 16 are tumor-free. Cindy is one of them. Her two-and-a-half year battle has been difficult. Now she and James are ready to plan the wedding they've had to put on hold. Passing the two-year mark has been a milestone for Cindy since most spinal tumors grow back within that time. When she reaches five years, tumor-free, her doctors say they'll consider her completely cured. If you would like more information, please contact: Ellen Beth Levitt Public Affairs Office University of Maryland Medical Center 22 South Greene St. Baltimore, Maryland 21201 (410) 328-8919
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 8:45 pm
Source: Ivanhoe.com Reported January 3, 2005 Better Surgery Heals Back Pain In-Depth Doctor's Interview William Taylor, M.D., explains a minimally invasive procedure as an alternative to traditional surgery to treat back pain. Ivanhoe Broadcast News Transcript with William Taylor, M.D., Neurosurgeon, University of California, San Diego How many people have back surgery every year? Dr. Taylor: In the United States, back surgery is performed on 200,000 to 300,000 people per year. What’s really gone up in the past year is the amount of fusions people are doing. It used to be a small number of people who would have it. It used to be a discectomy or a laminectomy, which is a smaller operation, and the amount of fusions were relatively low. Over the past year or so, that amount has just increased, so now we’re doing approximately about 100,000 fusions per year just in the United States alone. Why are so many people getting back surgery each year? Dr. Taylor: People want their back pain to get better. For example, the 80-year-old who comes into my office who no longer can play golf says in 2005, he wants to go out and play golf again. People who have degenerations in their back or arthritis are now refusing to live with it. They don’t want the back pain, and they want to get better. And the fusions really take care of back pain. The other operations we talk about are more likely when people talk about herniated discs. As our population ages, degenerations of the spine become more and more, and older people are just so much more active than they used to be. What has been the standard surgery for people who had significant damage to their backs? Dr. Taylor: Let’s say for someone who was looking to have a fusion, he would have had a non-instrumented fusion. For this, he'd have a fusion where doctors would’ve just taken bone from his hip, laid it over the bone in the back, and then they would’ve put him in a brace. He would’ve been in bed for the next six weeks. That has changed over the past 10 or 11 years, where we started putting instrumentation in rather than bone from the hip. We’re starting to use metal, titanium and implants in the spine to increase the rate of fusion, and to get people back into their normal activities much more quickly. With that increase in the instrumentation in fusion, we then need bigger surgeries and more operations, and it becomes more complicated and more expensive for everybody at the same time. Now, what is the next advance? Dr. Taylor: The new advance is minimally invasive surgery for the spine. As some people know, minimally invasive surgery, or endoscopic surgery as it’s commonly called, has been available for many different specialties, but it’s only been available for the spine recently. Fusions are larger operations that doctors normally had to do open. So, the patient would come into the hospital and need a fusion operation or a laminectomy and a fusion and instrumentation, and they were looking at a five- to seven-day stay in the hospital, one to two units of blood transfusion, a day in the ICU, and then six to eight weeks before they were back to their more normal activities. The minimally invasive surgery is the latest advance which is made in other parts of medicine, but is late to the spine. It is just now really starting off. Why do you think it has taken so long to develop a minimally invasive procedure for the spine? Dr. Taylor: The cavity to do endoscopic surgery is what everybody looks for, so you have to create a space. When doctors do endoscopic surgery in the abdomen, they put gas or CO2 into the abdominal space, and would then be able to operate off a TV screen into that space. If someone’s operating arthroscopically in the chest, they would use the lung as the space. They would retract the lung out of the way, which would become your space. With spine surgery, we had a difficult time creating that space because the nerves and the bones are so delicate in that location that you can’t put CO2 or gas in that environment or you’ll cause damage to the nervous system. So we didn’t have the ability to create that space to work in, and the other thing that happened is that the technology really hadn’t caught up with the instrumentation on what people wanted. Our idea now is that we’re using specialized retractors and specialized equipment to create that space that we need to work in to do a minimally invasive procedure. How are you able to work your way around the nerves? Dr. Taylor: It has worked its way around the nerves. There are two parts to the spine. One is the bony anatomy, which we think about as causing problems, and the second one obviously is the nervous system or central nervous system. When you’re operating in that space, the nervous system is completely unforgiving. You can cause significant damage to it very quickly. Most of the symptoms that people have are because of compression or pressure on the nervous system that we want to use, so the instrumentation has to be lending itself to creating that sort of space and not putting any extra pressure on the nervous system, which we’re trying to avoid. What is the standard back surgery like? How difficult is it for the surgeon and for the patient? Dr. Taylor: The standard back surgery would have been an incision of about 15 centimeters and maybe eight to 10 inches long for a single, one-level fusion. It would’ve involved stripping all the muscles away on the spine to get good exposure to the spine, so you would need exposure where you would remove all the muscles along the back. It would be a lot of operative time and compression and a lot of pain for the patient because of all that work that needed to be done. That translated to a lot of time in the operating room, significant blood loss, which then translates into a longer time in the hospital and more complications. An older patient just can’t tolerate that. As we’re operating on older and older people and doing bigger and bigger operations, we’ve run into more complications. What is the pain like with the standard surgery? Dr. Taylor: The pain is quite severe in standard surgery. Most people would be on a morphine drip, so after surgery, they would be on IV narcotics. Ten being the worst pain you can imagine, and one being a nagging ache, they would rate the pain an eight to nine. They talk about the pain being an eight to 10 for a number of weeks. They would be on significant long-term narcotic medications to control that pain, which obviously, then, inhibited their recovery and made things a little more difficult. What is the minimally invasive surgery like? What are the differences between the standard and the minimally invasive procedures? Dr. Taylor: Number one is that the surgery has been made much easier for the patient. Now, the incision is one to three centimeters long, which is just enough to get the retractor into that space. It’s really localized now, specifically with fluoroscopy. We don’t look visually to try to find things, but we locate them on X-rays. Then we can put instrumentation, the retractor, into that space by localizing with X-rays. The length of surgery has gotten shorter because we don’t have to do the large dissection to remove all the muscles and expose everything. The blood loss has been reduced to a tenth, so there is no longer a need for blood transfusions. Also, since the pain is much less, the narcotic rate has gone way down. People are out of the hospital in one to two days in lots of situations, and they’re recovering much faster and back to their normal activities quickly. I operated on a lady today who was 79 and her family doctor had told her, "You’re 79 years old, you can’t have any surgery," which is just not the case anymore. With a minimally invasive surgery, which is shorter, faster, with a small incision, less healing time, and less blood loss, she’s able to have a rather large surgery very successfully. Does the minimally invasive surgery cut down on infections that can result from the large incision? Dr. Taylor: It absolutely does. We don’t quite know what that is, now if someone were to do surgery on just the average person with an inserted metal instrumentation, the infection rate is somewhere between 2 percent to 6 percent, which means every 100 times you do it, you’re going to have four or five people. Infection in the spine is a very big problem because you’d have to take out the metal instrumentation and do another surgery. You’re stuck redoing everything. The infection rate has dropped astronomically in the minimally invasive procedures. Number one is because you don’t have the huge muscle bisection the space is much smaller and more controlled that you’re working in, so the patient is not as sick. They’re not bedridden for as long, they don’t require a catheter for as long, the drains come out sooner, everything moves more quickly, which is what you want to try to avoid for risk of infection. Also, the amount of devitalized tissue is much smaller. When we’re cutting away the muscle and the spine for a long operation, we're devitalizing and destroying those tissues. The amount of tissue that is devitalized is very small in a minimally invasive procedure, so you don’t have the opportunity for infection in those tissues. If the rate of infection is up to six people out of 100 in standard surgery, how would it relate with minimally invasive surgery? Dr. Taylor: There isn't a number yet, because people don’t really know. I can tell you we’re putting together groups of numbers at the moment. I’m at about 200 minimally invasive procedures, and I have not had an infection yet. Now, I’m certainly going to have one, because the average clean infection for any procedure is about 1 percent. Re-do spine operations and instrumentation go up a lot from there. Around the country what people are reporting is that the infection rate is much lower. My feeling is it will probably be around 1 percent, which is about a half to a third of what it would be in an open operation, which is a big deal. People want to get fixed and then want to go home and go back to their normal activities, and if you have a complication, it makes it much more difficult to do that. How has the use of the minimally invasive procedure changed the way you do things? Dr. Taylor: Number one, it’s made me more willing to operate on people with a larger set of morbidities or co-morbidities, like an older patient with more complications and problems. Even 20 to 30 years ago in neurosurgery, people would say, "Well, anyone over the age of 65 can’t have neurosurgery because they’re too old." That just doesn’t hold anymore. People are now having surgery up into their 80s and very easily. So, it allows me to operate on people much more safely. Number two, it’s changed in the sense that instead of feeling every time I see the person I have to take care of every single problem he has, I can do things to make sure someone’s going to get better. Now, I can do an operation and the patient can be in and out of the hospital very quickly and back to normal activities. Lots of times they don’t need that other procedure, which we might’ve done because the X-ray looks bad or something looks abnormal, but we’re not sure. It’s allowed me to tailor the operation. I can have patients in to do one thing, and if it doesn’t work, I can try something else. What do you think the biggest advantage is for patients? Dr. Taylor: Number one, nobody wants a blood transfusion anymore. If you tell them they don’t need a blood transfusion, and they see someone else who says, "Well, you have to donate two units of blood beforehand, or you might need a blood transfusion," that makes a big difference. The other thing that’s really good is that lately people have been rushed out of the hospital. For example, it’s not uncommon to hear about people having "drive-thru" deliveries. Insurance companies want people out of the hospital quickly, so doctors are pushed to get people out of the hospital quickly. Even if it doesn’t get the person out of the hospital any quicker, you’re discharging people when they’re ready. When they leave they are ready to go home and get back to activities. Very rarely are we sending people to rehab for some prolonged recovery. The other thing is that when you’re doing surgery, you’re always going to have some kind of complication, and the rate of those complications is much less for this surgery. The unhappy or unsatisfied person who has a problem from the surgery or something else goes way down. Who’s a good candidate for this? Dr. Taylor: Anyone’s a good candidate. Younger people want it because it’s more cosmetically appealing. They want something which is less destructive and less invasive, and older people want it because they recover quicker. People who are still in their 30s, 40s, and 50s want to get back to work, get back to their activities, and don’t want to be in the hospital for a long time. So, 90 percent of what I do now is minimally invasive. There’s a minimally invasive procedure for everybody, for just about every problem that you can think of with spine surgery. Is there anybody who would not qualify? Dr. Taylor: I think what we’re seeing right now is that re-do operations are always more difficult. I think they’re even more difficult with minimally invasive surgery. They certainly can be done, but the re-do operation, which is open, is hard. I think it’s probably a little bit harder with minimally invasive surgery because your tissue plains are less, and you really require anatomy which you can visualize with minimally invasive surgery. We’re also just starting to think about doing scoliosis in a minimally invasive way. Scoliosis is a big problem with spine patients, and that’s going to be the next step for minimally invasive surgery. Then the thing after that is when those artificial discs are starting to happen. It’s a big operation to put an artificial disc in, so the next step is going to be minimally invasive approaches for the placement of artificial discs. If you would like more information, please contact: Jeffree Itrich Public Information Officer University of California, San Diego 200 West Arbor Dr. MC 8230 San Diego, CA 92103 (619) 543-6427 jitrich@uscd.edu
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 9:05 pm
Source: Ivanhoe.com Reported August 11, 1999 Television News Service/Medical Breakthroughs ©Ivanhoe Broadcast News, Inc. 1997 Spinal Cement It's estimated that eight-million Americans have the brittle bone disease called osteoporosis. Each year, 500-thousand of those people will end up with a spine so weak, it actually collapses. It's called a vertebral fracture - and once it happens, little can be done to reinforce the already fragile spine. For years, bed rest and painkillers were the only treatment. Doctors are experimenting with a new way to glue broken spines back together again.
Genevieve Stinchomb loves to watch her son and grandson practice soccer moves. Sometimes she even participates a little. Not long ago, this kind of activity would have been impossible because Genevieve was in a wheelchair. Osteoporosis had eroded her spine so badly that her vertabrae began to collapse. Surgery to repair her fragile spine would make matters worse, so she was told nothing could be done. Genevieve Stinchcomb, Spinal Fracture Patient: "I was at a point where something had to be done. I was in severe pain. I couldn't lift my left arm out or lift up or anything without pain." Then she found out about something new. Gregg Zoarski, M.D., Neuroradiologist, University of Maryland Medical Center, Baltimore, MD: "The technique that we're using to treat fractures can be performed on an outpatient basis, it's relatively easy to perform, it's a safe procedure and it can get patients up and mobilized much quicker. "
The procedure uses an acrylic epoxy to stabilize the spine without major surgery. When the epoxy is the consistency of toothpaste, doctors inject it into the collapsed vertebra, using x-rays to guide them. Within a few minutes, it becomes rock-hard. It's light, yet strong enough to reinforce the spine, relieving pressure and pain. The procedure is done with a local anesthetic, and patients can be out of the hospital and walking within a day. It's given people like Genevieve a second chance to stand up and take part in life again. Genevieve Stinchcomb: "I've still got my mind. I just didn't have part of my body. Now I can get around. I'm glad I had it done."
The medical cement has been used in the past to treat fractured spines, but the procedure involved major surgery, general anesthesia and a long stay in the hospital. By injecting the cement into the spine, patients can stay awake during the procedure, and since there's much less physical trauma, patients usually can leave the hospital the next day. The injection of cement is a fraction of the cost of major surgery. If you would like more information, please contact: Jill Bloom Public Affairs Office University of Maryland Medical Center 22 South Greene Street Baltimore, Maryland 21201 (410) 328-8919
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Baby
Member
01-08-2006
| Tuesday, May 02, 2006 - 9:05 pm
Thanks Herckle, I may just take you up on that offer. I was just telling Cheryl (CND) the other day I need to learn how to copy and paste. The printer I have isn't compatible with my WebTV, so I need to figure out a way to copy just the articles I am interested in and send them to a friend who can print them out for me. I guess I had better get a move on it and start learning how to do it! Thanks again for all of the time and effort you spent on posting all of these articles for us. There is lots of great info in them!
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 9:08 pm
Source: Ivanhoe.com Reported April 25, 2006 New Artificial Disc May Help Neck Pain (Ivanhoe Newswire) -- A new artificial cervical disc may give hope to the thousands of neck pain sufferers looking for an option not including vertebrae fusion. A herniated cervical disc can cause chronic neck and arm pain. The current treatment for this condition involves surgery to fuse the affected part of the spine, resulting in limited mobility of the neck. While the procedure can relieve pain, it can also lead to herniation of other discs over time. Artificial discs that maintain normal neck motion have been available outside of the United States for several years. Now, FDA-approved multi-center trials have concluded in the United States, and researchers say they expect the artificial discs to become an available alternative to disc fusion surgery in the near future. Researchers compared two groups. One group of 54 patients received the standard treatment of cervical discectomy and fusion. The other group of 66 patients received cervical discectomy followed by implantation of the PRESTIGE ST artificial cervical disc. Researchers say the outcomes for both groups were approximately similar. The group with artificial discs, however, reported greater maintenance of neck motion. SOURCE: Presented at the 74th Annual Meeting of the American Association of Neurological Surgeons in San Francisco, April 24-27, 2006
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Herckleperckle
Member
11-20-2003
| Tuesday, May 02, 2006 - 9:14 pm
Source: Ivanhoe.com Reported January 9, 2006 Help for Neck Pain CHICAGO (Ivanhoe Broadcast News) -- One out of two of us will suffer neck pain at some point in our lives. In some cases, it's the result of a pinched nerve, and surgery is required. And while that surgery is successful, the recovery can be tough. But a new procedure is being studied that could change that. Dennis Kistulinec had a herniated disc in his neck. For almost a year, he lived in pain. "Let alone trying to work a labor job ... just your regular way of life's affected -- trying to carry groceries in, or you can't pick up your kids," he says. Now, just two months after undergoing a new surgical procedure, Kistulinec is not only back to work, he's back lifting weights. "I feel five years younger," he says. "No pain. No stiffness. No soreness." Orthopedic surgeon Frank Phillips, M.D., is performing the procedure as part of a clinical trial to test a new artificial cervical disc. Instead of removing the damaged disc, inserting bone into that space and fusing it to the vertebrae, Dr. Phillips, Rush University Medical Center in Chicago, implants an artificial disc made of the same metal and plastics used in hip and knee replacements. Benefits of the new procedure include greater neck movement and a much shorter recovery time. "Patients, in my experience, have done very well. Typically, the arm pain, the numbness, the weakness, the pinched nerve symptoms, tend to get better quickly or almost immediately after surgery," Dr. Phillips tells Ivanhoe. He also says the new disc will likely reduce the need for more surgeries down the road. Kistulinec hopes that's true for him because he'd rather spend his time in the weight room, not the operating room. Recovery with the standard procedure typically takes up to nine months. Dr. Phillips says it will likely be about three years before this procedure is approved by the FDA. Right now, the only way you can undergo the procedure is at one of 20 medical centers across the country participating in the trial. If you would like more information, please contact: Kim Waterman Rush University Medical Center 1700 W. Van Buren Suite 250 Chicago, IL. 60612 (312) 942-7820 http://www.rush.edu
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Emmy
Member
05-05-2004
| Wednesday, May 03, 2006 - 8:04 pm
Wow - what timing with this thread. I just went with my husband to the Orthopedic surgeon's office today to schedule surgery for him. It sounds exactly like what Wendo had. He's been home from work since summer time. Where's the thread about wives almost killing their husbands?
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Herckleperckle
Member
11-20-2003
| Wednesday, May 03, 2006 - 8:13 pm
Hee hee hee. Love your humor, Emmy. Went thru the same thing with mine AFTER surgery. You may be in for an interesting recovery period. Baby, if you send me your address and tell me which ones to print, I'll be glad to do that for you!
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