North American Spine Magazine May 2013 issue by North American Spine

North American Spine The Leader in Minimally Invasive Spine Care

NAS Now in Phoenix Also in this issue:

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Baby Tips to Prevent Sciatica Trendy Sciatica Treatment on the Red Carpet? Spine Surgery or Time? Understanding Back Pain Study Says Outpatient Discectomy is Preferred New Bio-engineered Disc May Improve Spinal Surgery Experience Best for Lumbar Spinal Stenosis Surgery Hamstring Health Helpful to Avoid Sciatic Nerve Pain

North American Spine Courtesy Magazine | May 2013

Now In Phoenix

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Phoenix is literally the home of innovation, from Frank Lloyd Wright’s Taliesen West to the Desert Museum. Thanks to Dr. Abram Burgher, Phoenix now has additional visitor attractions: AccuraScope® procedures for neck and back pain. Phoenix’s central location makes it convenient for neck and back pain sufferers in the local area and neighboring states. Patients can fly in, stay at our select partner hotel, undergo the outpatient procedure, and be on their way home before many open back surgery patients could sit up with ease. Double board-certified in interventional pain management and anesthesiology, Dr. Burgher is devoted to helping people overcome pain. After earning honors at the University of Minnesota’s School of Medicine, Dr. Burgher completed his internship, residency, and fellowship in pain management at the world-renowned Mayo Clinic. Today, he stays at the forefront of pain management through his practice and leadership in clinical research.

Dr. Burgher will perform North American Spine’s exclusive AccuraScope Lumbar and Cervical DND procedures at the Freedom Pain Hospital in Scottsdale, AZ - the nation’s first pain hospital.

Baby Tips

to Prevent Sciatica

Expecting a little one? Remember to give some care to yourself, too! A newborn baby, in her hand-held carrier, can weigh 20 pounds to start. So it’s important to make sure your little bundle of joy doesn’t create spine trouble for you later. Before the baby is even born, pregnancy postural changes from the growing baby cause your center of gravity to shift. Hormonal changes cause pelvic and spinal area ligaments to relax. Joints become vulnerable to stress and injuries like herniated discs. Even more, the expanding uterus presses onto nerves often causing pregnancy related sciatica symptoms.

Spine savvy baby tips include: ›› Maintain good posture. ›› Carry your baby on alternating hips to prevent straining one side. ›› Strengthen your abs and legs to regain support for your spine. ›› Keep your baby close and bend your knees when laying her down in the crib. ›› Sit inside the car when easing your baby into his seat. Toddlers can climb in on their own! ›› Get sleep, take vitamins, drink milk and eat plenty of nutritious foods.

Whether you are an expectant mom or a new mom, following these tips will help you enjoy one of the most blessed times in your life. © Can Stock Photo Inc. / wacker

Trendy Sciatica Treatment on the Red Carpet?

One of Tinseltown’s most famous and sizzling hot Spanish actresses has been spotted recently at a movie premiere with an odd configuration of gold needles in her ear. According to sources, including the British Daily Mail, these nifty ear accessories are a form of acupuncture called ‘Auriculotherapy.’ Auriculotherapy (auricle refers to the outer portion of the ear), was developed in the late 1950’s by the French neurologist Paul Nogier. According to the Daily Mail, this doctor came across a patient who claimed to have cured himself of sciatica by applying a form of acupuncture to his own ear. The French doctor then developed a therapy based on this treatment, by mapping out an inverted fetus along the outer ear, and corresponding locations on the map with areas on the body.

Paul Nogier 1908 - 1996

In a 2007 study from the University of Vienna, auricular electro-acupuncture was found to be more effective in chronic lumbar and cervical pain, than the non-electrical variation of the acupuncture therapy. Acupuncture for pain, from conditions like herniated discs, sciatica and other musculoskeletal problems, is considered a form of complementary medicine and should not replace conventional medical treatment and advice from your physician or spine specialist.

Spine Surgery or Time? Understanding Back Pain

Acute, chronic or neuropathic … the nature of back pain is perplexing! Understanding the type of pain you have will help determine whether you have an injury like muscle strain or herniated disc, or a condition like degenerative disc disease or spinal stenosis. Acute pain may be severe but the treatment required may be RICE (rest, ice, compression, elevation) and an analgesic; or the pain may be chronic, involving neurological symptoms that can be tolerable, but if left untreated may develop into permanent nerve damage.

Common types of back pain and sources are: ›› Acute Pain – usually arises from tissue damage as a consequence of direct trauma, such as muscle strain. It may also be a protective natural reflex that causes you to recoil from something painful, such as a hot surface. ›› Chronic Pain – typically lasts for at least 6 months. It is often a result of a treatable condition, like a bulging disc or bone spur. ›› Neuropathic Pain – pain and other sensations, typically from nerve damage. Treatment includes reducing pain signals with painkillers or neurostimulation. Complex pain and the appropriate treatment are as unique as the individual suffering with symptoms. Patience and a positive attitude are key as you undergo treatment and regain your quality of life.

Study Says Outpatient Discectomy is Preferred A recently published study by medical researchers from the University of Iowa found that people who underwent outpatient discectomy procedures had lower complication rates than those who underwent inpatient surgeries. The scientists reviewed data from 4,310 patients who received lumbar discectomies over a 5-year period. They compared complications that occurred within 30 days of the spine surgery procedure. In contrast with the outpatient group, the inpatients endured an approximately 50-percent greater complication rate. These difficulties included repeat procedures, infections and wound healing issues. Other factors that elevated risk for complications across both groups included prior infection, blood transfusion, advanced age and diabetes. The researchers

recommended that these groups receive appropriate counseling about their elevated risk situation for a procedure that might otherwise be considered relatively safe. The complication risk for outpatients was 3.5%.

The subjects in the study, published in the journal Spine, underwent a singlelevel discectomy. North American Spine’s AccuraScope® procedure offers the additional benefit of being able to perform multi-level treatment when necessary, further reducing the need for an additional discectomy procedure to treat a second area. © Can Stock Photo Inc. / wacker

New Bio-engineered Disc May Improve Spinal Surgery

Artificial disc replacement is an alternative to spinal fusion, which has been used traditionally to stabilize the spine where a disc needed to be removed, or was affected by degeneration. The relatively new artificial disc procedure replaces the damaged spinal disc with a flexible, manmade substitute. While artificial disc replacement comes with its own risks, it avoids many of the risks associated with spinal fusion. Researchers from Brigham Young University (BYU), in Utah, developed an artificial disc that replicates the natural biomechanics of the spine. It is a compliant mechanism, which is a jointless and elastic composition that flexes like a pair of tweezers. During most artificial disc replacement procedures, the end pieces of the artificial disc are anchored to the bone above and below the surgical site. Over time, new bone growth will cover these portions of the disc, while the disc’s core remains free to move as needed. Artificial disc replacements are reserved for extreme circumstances, beyond those that can be treated with a minimally invasive spinal procedure like the AccuraScope procedure.

Experience Best for Lumbar Spinal Stenosis Surgery

Have you asked your spine specialist how often he (or she) performs the procedure recommended for your situation? If not, you could be risking a 38% increase in complications from the procedure. A study published in Neurosurgery, the Congress of Neurological Surgeons’ journal, suggests that complications from spinal stenosis surgery are higher with surgeons who perform very few of these procedures. Surprisingly, the number of procedures performed at the surgical facility does not affect the complication rate. So whether the hospital is a large university teaching hospital or a small rural surgical site doesn’t matter. The research study examined medical outcomes from a database of 49,000 lumbar spinal stenosis surgery patients who

underwent the procedure between 2005 and 2008. The complication risk was 38 percent higher for surgeons in the low-volume group than the high volume group. The physicians who work with North American Spine are all highly trained and experienced in minimally invasive spine surgery techniques. But don’t take our word for it. Remember to be open about any questions or concerns you may have.

Hamstring Health

Helpful to Avoid Sciatic Nerve Pain

Not as popular as the “core muscle group,” the hamstrings are important for maintaining proper posture and alignment, which protects the spine from injury and chronic lumbar pain. The hamstring group, located in the back of the thigh, includes three separate muscles: the semimembranosus, semitendonosus and biceps femoris. Together they help flex and extend the knee and extend the leg back from the hip. Tight hamstrings limit the range of motion of the pelvis. Stretching these muscles can help alleviate pain and possibly prevent further injury. Make sure to consult with your physician to determine the specific cause of your pain, and whether it is safe for you to begin stretching. Depending on your level of mobility and pain, choose the most comfortable position, seated or lying down, for your stretching.

In addition to alleviating some pain, you may also find that hamstring stretching will give you better posture. It’s always nice to feel and look better!

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