Mark A. Giovanini M.D.NeuroMicroSpine Specialist

Andrews Institute

www.markgiovanini.comwww.NeuroMicroSpine.comwww.theandrewsinstitute.comwww.smiss.org

OverviewSpine AnatomyDefinition of TermsSpine evaluationConditionsTreatment options

Spine Components

Terms Axial PainRadiculopathy

PainParasthesiaMotor WeaknessSensory Sciatica

Mechanical Pain

Pinched Nerve

Nerves

Low Back Pain

Causes of Low Back Pain

What can you do?Home remediesConservative TreatmentPhysician consultEmergent Evaluation

Neurologic DysfunctionBladder Incontinence

Home Remedies

Where Can You GoAndrews Comprehensive Spine Center

Physical Medicine and RehabPain ManagementPhysical TherapyDiagnostics MRINeuroMicroSpine SpecialistsOrthoPaedic Spine SpecialistsAthletic Performance Center

See your Physician

Conservative Specialists

Conservative ManagementPhysical TherapyMedications

Anti-inflammatoriesSteroids

Pain managementEpidural InjectionsFacet Blocks

Chiropractic CarePerformance Enhancement

Spine SurgeryWho get’s better?

Patient motivationNerve pain vs. back painDoes everything add up?

Questions to ask yourselfCan I live with this condition?Is it getting worse?Have I given it enough time?

Spine surgery is usually a temporary fix in most cases

SurgeryMinimally InvasiveBenefits

Smaller incisionsBack to the good life earlierLess pain post op and long termLess blood lossLess tissue damage to surrounding support

structuresGoals

Same as traditional surgery through smaller less destructive portals

Artistry in SpineSurgery designed specific to a patients problem

Open vs. MISS

ConditionsDisc Herniations

LumbarCervicalArthroplasty

Spinal StenosisDegenerative Disc DiseaseSpondylolisthesisScoliosisCompression Fractures

Lumbar Disc HerniationSymptoms

Axial back painSciatica/Pinched

NerveWeakness

Foot Drop

Numbness

Conservative CarePTAnalgesicsMassageChiropractic3 to 6 weeks

Lumbar Disc Herniation

Minimally Invasive Discectomy

Cervical Disc HerniationSymptoms

Neck painArm pain or paresthesiasWeakness/Numbness

Aggravating factorsLateral bendingNeck extensionSleeping with head backCompression activities

TreatmentPhysical Therapy

TractionROMDecompression Therapy

Pain ManagementEpidurals

SurgeryNeurologic DeficitIntractable Pain

Cervical DiscSurgery: Anterior Cervical Discectomy and Fusion

Cervical Disc ReplacementIndications

Age 20 -45Single levelSoft Disc herniation

BenefitsPreserves motionNo Recovery time

Spinal StenosisDefinition

Narrowing around the spinal cord and nervesSymptoms

Back painBurning pain in legs or arms made worse with

walkingMay have “Neuropathy”

Warning SignsWeakness, Numbness or Bladder dysfunction

Spinal Stenosis

Minimally Invasive LaminectomyOutpatientMinimal recovery timeMinimal Tissue Damage

Degenerative Disc DiseaseDefinition

Aging discNot a disease

CauseNormal aging with aggravating activities

Symptoms/SignsAxial Pain with motionMay have associated mechanical limb pain

DDDTreatmentConservative

Pain management: Facet blocks, EpiduralsPTChiropracticModification of Activities

Surgical Fusion

Anterior Posterior Side

DDD and SpondylolisthesisSurgery

Compression FracturesKyphoplasty

Video

Conclusion

Andrews Institute Spine TeamCoordinator

Bette HarrimenPatient Liason

Maria HalpinPhysical TherapyPain ManagementNeuropsychologist

Joel FairbanksPhysical Medicine and Rehab

Robert Jensen and Dave LemayNeuroMicroSpine Specialist

Mark GiovaniniOrthospine surgeon

Dave Chandler