Back and Neck Care

If you suffer from back or neck pain, you know firsthand how it can keep you from enjoying life to the fullest. Spinal injury or degeneration may even prevent you from doing daily activities at work or at home and limit your independence.

SpineONE is northeast Indiana’s leading spine treatment center dedicated to improving your health and quality of life. Our board-certified and fellowship-trained physicians specialize in the diagnosis and treatment of all types of spinal disorders, including scoliosis, degenerative diseases of the spine, disc herniation, tumors, occupational injuries and more. SpineONE offers a comprehensive treatment program that ranges from conservative pain management to advanced surgical procedures such as eXtreme Lateral Interbody Fusion (XLIF).

If you have pain in your back or neck – or tingling and numbness in your arms or legs – call SpineONE today. We’re here to help relieve your pain and restore your mobility.

Common Spine Conditions

At SpineONE, our team of board-certified physicians, physical therapists, patient educators and anesthesiologists are experienced in all types of spinal problems. Here is a brief list of the many conditions we routinely diagnose and treat:

  • Cervical & lumbar disc herniation
  • Sciatica
  • Degenerative disc disease
  • Spinal Stenosis
  • Arthritis
  • Tumors
  • Scoliosis (curvature of the spine)
  • Kyphosis (roundback)
  • Spinal trauma (fractures and dislocations)

Back pain strikes four out of five people at some time in their lives. While most instances are not serious, pain from a spinal disorder or injury can be so severe that it interferes with work and daily activities.

A healthy spine supports the body, allows you to move freely and protects the spinal cord and its bundle of nerves. It is comprised of a series of interconnecting vertebrae, joints, discs and supporting soft tissue. Between each vertebrae, the disc, or soft cushioning tissue, acts as a shock absorber when you bend or move.

Over time the natural aging process can cause discs to wear out and lose their shock- absorbing ability. Discs can tear, bulge or rupture, which can lead to significant pain and stiffness. Arthritis may also develop and sometimes lead to bone spurs. These can cause nerve irritation and pain in the extremities.

Diagnosis

To diagnose your back pain, your SpineONE physician may utilize a variety of state-of-the-art diagnostic techniques and procedures, including:

  • X-rays – Pictures of your bones to help in finding the cause of pain
  • CT scans – Detailed X-rays showing bones and soft tissues, including nerves and discs
  • MRIs (magnetic resonance imaging) — Detailed images of the spine’s soft tissues (nerves and discs)
  • EMGs/NCS (electromyograms/nerve conduction studies) — Electrical impulses that help detect muscle and nerve damage
  • Nerve blocks — Spinal injections that ease pain and help find its source
  • Other tests such as discograms, bone scans or myelograms

Many people suffer from neck pain at some point in their lives. The most common cause is muscle strain or tension resulting from daily activities. At home, some examples include sleeping in an uncomfortable position or sitting with poor posture while reading or watching television. At work, a computer monitor that is placed too high or too low may cause neck pain. Or, during exercise, a sudden twist or turn of the neck may cause pain.

Trauma, such as an accident or a fall, can cause a severe neck injury such as a fractured vertebra, whiplash, blood vessel injury and paralysis. Other serious causes of neck pain include:

  • Herniated disc
  • Arthritis
  • Fibromyalgia
  • Meningitis

Diagnosis

To diagnose your back pain, your SpineONE physician may utilize a variety of state-of-the-art diagnostic techniques and procedures, including:

  • X-rays – Pictures of your bones to help in finding the cause of pain
  • CT scans – Detailed X-rays showing bones and soft tissues, including nerves and discs
  • MRIs (magnetic resonance imaging) — Detailed images of the spine’s soft tissues (nerves and discs)
  • EMGs/NCS (electromyograms/nerve conduction studies) — Electrical impulses that help detect muscle and nerve damage
  • Nerve blocks — Spinal injections that ease pain and help find its source
  • Other tests such as discograms, bone scans or myelograms

Scoliosis may develop as a single primary curve resembling the letter C, or as two curves that form an S shape. Scoliosis is often categorized as structural and nonstructural. In structural scoliosis, the spine not only curves from side to side, but the vertebrae also rotate, twisting the spine.

Scoliosis can be difficult to detect. It is usually painless and often the curvature is too subtle to be noticed. Parents should watch for the following which may be indicators of scoliosis:

  • Uneven shoulders
  • Prominent shoulder blade(s)
  • Uneven waist
  • Elevated hip
  • Leaning to one side

Causes

In 80% of patients, the cause of scoliosis is unknown. These cases are called idiopathic and most have a genetic basis and usually develop in middle or late childhood. It is seen in girls more often than boys. Although scoliosis can be found in children with spina bifida, muscular dystrophy and other conditions, it is usually found in otherwise healthy children.

Scoliosis can also develop in adults. This is usually a progression of an untreated childhood condition, however other factors such as posture and difference in leg length can also play a role in nonstructural (side-to-side curvature that does not twist) scoliosis.

Treatment

Scoliosis is not preventable, but early detection and treatment may limit future problems. Many curves will remain small and only require monitoring for sign of progression. If the curve progresses, an orthopaedic brace may be used to prevent further curvature. Corrective surgery may be needed if the curve cannot be controlled by the brace, or in patients whose curve is severe.

Treatment

Most low back pain is not serious and can be treated safely and effectively by non-surgical methods. Depending on your condition, you may be referred to the SpineONE Center for Pain Management, which specializes in non-surgical treatments and rehabilitation.

Some conditions do not respond to non-surgical treatment. Surgical procedures may be indicated to relieve irritation or compression of the spinal nerves. The surgeon may remove part of the bony vertebrae (laminectomy/laminotomy), part of the damaged disc (discectomy) or both. For patients with instability, a fusion may be performed.

PainONE

Ortho NorthEast’s commitment to the full range of care led to the establishment of PainONE. PainONE specializes in non-surgical treatments of musculoskeletal disorders through a comprehensive and multidisciplinary approach. Therapies may involve prescription drugs, spine injections, assistive devices, stress management and physical therapy. PainONE physical therapy programs emphasize stretching, strengthening and reconditioning exercises, as well as education about low back pain.

PainONE Medical Team

Injury, wear and tear and the normal aging process can all result in low back pain, keeping you from doing your work, participating in physical activities and enjoying life to the fullest. If low back pain does not respond to conservative methods of treatment, your physician may recommend surgery. A number of procedures can be performed alone or in combination depending on your specific condition.

Laminectomy/Laminotomy

Spinal surgery usually involves either a laminotomy or laminectomy. First, the surgeon will make an incision in the midline of the back. Next, a “window” is made in the lamina, the portion of the vertebrae that forms the roof of the spinal canal. Bone is removed to relieve pressure on the nerve and to allow the surgeon access to the spinal canal.

A laminotomy removes a portion of the lamina and is performed when the surgeon needs access to a small part of the spinal canal.

A laminectomy removes the entire lamina and is performed to create more room for the nerves and allows the surgeon greater access to the spinal canal. The bone removed does not grow back.

Discectomy

With access to the nerve and disc areas gained through the laminotomy or laminectomy, further corrections can be made. The surgeon uses small instruments to remove the damaged disc material that is pressing on a nerve root.

Fusion

For patients with instability, a spinal fusion may be recommended. A spinal fusion involves placing bone grafts between vertebrae. Frequently only two lumbar vertebrae are fused. However, multiple vertebrae may be included. Bone grafts may be taken from the pelvic bone and placed in a hollow, porous implant that is placed between two vertebrae or the bone is placed along side the vertebrae on the transverse processes. As the body heals, the bone graft and the vertebrae grow into one unit or become fused. This stabilizes the vertebrae reducing pain caused by too much movement between vertebrae.

Before Surgery

Before performing surgery, your physician will study your back by means of X-ray or other tests such as magnetic resonance imaging (MRI), myelography or a CT scan. Testing will help the physician determine what procedure will be best for you. Your doctor will discuss whether your procedure will be performed on an outpatient basis or if a hospital stay will be required; fully explain the procedure; and explain the risks and benefits of surgery.

To prepare yourself for surgery, you may be asked to do a number of things. You may be asked to lose weight if you are overweight. If you smoke, it is important for you to stop several weeks prior to surgery. If you are taking aspirin or certain anti-inflammatory medications, inform your surgeon; you may need to stop taking these two weeks before surgery.

What to Expect After Surgery

You will be monitored as you recover from your procedure and you will be given medication to relieve pain. As you prepare to go home, you will be given instructions about physical therapy and a prescription for pain medication. You will also be instructed about follow up visits to your physician.

Your active role in your recovery will continue once you are home by following your rehabilitation plan. Call your doctor if you have any of the following:

  • new pain, weakness or numbness that begins after you return home
  • fever, headache or extreme fatigue
  • bladder or bowel problems

Recuperation will depend on the type of procedure performed and varies with each patient. Ask your doctor when it is safe to resume regular activities, including house work, returning to work, and athletic activities.

XLIF TURNS BACK SURGERY ON ITS SIDE.

Ortho NorthEast is first in our region to offer the advanced eXtreme Lateral Interbody Fusion (XLIF) back procedure. Because it approaches the spine from the side, XLIF involves less disruption of muscles and soft tissue. This means less pain and less recovery time for ONE patients. In fact, most people who have the XLIF procedure are walking within a few days and back to their daily activities in 4-6 weeks – as opposed to 6 months or more with traditional back surgeries.

The XLIF surgical procedure was developed by NuVasive, Inc. in San Diego, CA.
Dr. John Williams is the first surgeon in northeast Indiana to perform XLIF and has had outstanding results in dozens of patients. We encourage you to read about the experiences in the testimonials below and view a complete description of the procedure. If you suffer from chronic back pain, call ONE at (260) 408-2345 and schedule a consultation. Find out if XLIF is right for you.

Description of the Procedure

View a video describing the XLIF procedure.

Picture2

Resources

NuVasive, Inc., the developers of the XLIF procedure, have created a web community for people who suffer from chronic back or leg pain and are interested in more XLIF information. Visit their external website, The Better Way Back to access additional resources from this company.

James Horton: “A Better Overall Experience”

As if teaching eighth grade English isn’t challenging enough, 48-year-old James Horton has been living with degenerative disc disease for many years now. He had already had three open back fusion surgeries when the pain began to worsen last year in a different vertebra. As he explained, “It hurt to stand up. It hurt to sit down. And it hurt to lie down. I couldn’t get comfortable to sleep, and bending was out of the question.”

A disc in the middle of his back had deteriorated to the point where pain medications were no longer effective, so he and his surgeon, Dr. John I. Williams at Ortho NorthEast, began to explore his options. “Dr. Williams studied my x-rays and determined that I was a good candidate for minimally invasive eXtreme Lateral Interbody Fusion, or XLIF,” said Horton. Developed by NuVasive, Inc. in San Diego, XLIF employs a surgical approach from the side of the body – reducing the disruption to soft tissue in the back that occurs during traditional back surgery.

Horton underwent the minimally invasive XLIF procedure at Parkview Orthopaedic Hospital in Fort Wayne at the end of April 2009. “I had surgery on a Monday and was released from the hospital that Wednesday. The nurses had me up and around the day after surgery to begin the rehab process.” Having had open back surgery, Horton was able to compare his experience with the XLIF minimally invasive procedure. “I know I healed up faster this time, and my wife even noticed a big difference,” he said. “In fact, I felt well enough to go back to teaching much sooner than I expected.”

Horton says he judges how well he’s doing by how it feels to wash dishes. “I’m 6’5″ so I have to bend over to reach the sink. Since the XLIF surgery, I’ve been able to stand there comfortably for the entire 10-15 minutes it takes.” Horton also reports that he no longer needs to take pain medication for his back. He wears a brace for support and has begun his rehabilitation therapy program at ONE.

James Horton is grateful to his doctors at ONE for making new procedures available close to home in northeast Indiana. “Procedures like minimally invasive XLIF offer new possibilities for people with back conditions like mine,” he said. “I would tell anyone who is a candidate that XLIF was a good overall experience.”

Ethel Weaver: “I Feel 20 Years Younger”

For Ethel Weaver, the pain in her leg was finally too much to bear. It had become so severe that she had to pick green beans from her garden on her hands and knees. Running the vacuum cleaner or doing the dishes was out of the question.

“I had so much pain in my left leg, and my doctor couldn’t figure out what was wrong” said Mrs. Weaver, a 77-year-old native of Syracuse, Indiana. “By the end of each day, I couldn’t stand up anymore. Eventually, I went for an MRI and was referred to Dr. John Williams at Ortho NorthEast. He said the pain in my leg was actually caused by degenerative disc disease in my back.”

Mrs. Weaver and Dr. Williams discussed her condition and treatment options. “He recommended a new procedure that had been very successful and would allow me to heal quicker,” she said. In fact, Dr. Williams is the first orthopaedic surgeon in Northeast Indiana to offer the minimally invasive eXtreme Lateral Interbody Fusion, or XLIF procedure. Developed by NuVasive, Inc. San Diego, XLIF employs a surgical approach from the side of the body – reducing the disruption to soft tissue in the back that occurs during traditional back surgery. It didn’t take Mrs. Weaver long to make her decision. “I was ready,” she said. “I was just tired of having so much pain.”

Dr. Williams performed Mrs. Weaver’s XLIF surgery on December 15, 2008. “I was in the hospital four days, and then I spent two and a half weeks in a rehabilitation facility until I was strong enough to go home,” she explained. “There, I underwent physical therapy – I was in very good hands.”

Looking back, Mrs. Weaver says her recovery seemed to go by very quickly. “When I went back to see Dr. Williams after one month, he was happy to see that I was walking on my own without a walker. By then, I only used it to make sure I didn’t lose my balance around the house.”

Six months later, Mrs. Weaver reports, she was back to her favorite activities. What a difference!” she said. “Last summer, I couldn’t bend over, and this summer, I was back to picking green beans just like old times.”

Mrs. Weaver’s advice to others in her situation? “Don’t suffer as long as I did.” She concludes, “Thanks to Dr. Williams and XLIF, I’m not only pain free – I feel 20 years younger!”

Patient Education Resources

At SpineONE, our goal is to help you understand your condition and know what to expect throughout your treatment and rehabilitation process. Use the information in this SpineONE section, as well as the external links on this page to learn more – and as always, never hesitate to ask questions at your next visit to ONE.

AAOS Spine & Neck Articles

AAOS Osteoporosis Articles