The Myth of Laser Spine Surgery

Many people are under the impression that a laser is the main surgical tool used in the procedure advertised as laser spine surgery. That couldn’t be farther from the truth, according to back painneurosurgeon Dr. Scott Simon of Orthopaedic and Neurosurgery Specialists (ONS).

What’s more, Dr. Simon believes that use of a laser in spine surgery is more of a marketing gimmick than surgical innovation. “The laser is only used to remove the soft tissue over the spine after an incision has been made and the surgeon performs whatever minimally invasive procedure is called for,” Dr. Simon explained. “Using a laser actually creates an unnecessary step to the surgery.” If soft tissue needs to be removed from the spine, electrocautery, in which a heated needle is used, is a more effective technique, he added

Lasers are certainly not new technology. Lasers have been available for use in medicine since 1973. However, they have not been widely adopted as a tool to be used in spinal surgery. “Most neurosurgeons do not use or recommend the use of lasers for spine surgery because there are no clear benefits and there are other well-established and documented studies proving the effectiveness of more modern and established spine surgery techniques,” Dr. Simon said, adding that ONS neurosurgeons do not use or recommend laser spine surgery.

The laser is in fact just a light that burns soft tissues and is unable to remove ligaments, discs, bone or bone spurs. It is actually much less precise than the more modern surgical tools. Bone spurs that press on nerves or the spinal cord, for instance, are easily taken care of through minimally invasive spine surgery. “The outcomes are excellent and patients often go home the same day as their procedure,” Dr. Simon said.

The majority of spine conditions can be effectively treated without surgery, noted Dr. Simon. When surgery is recommended, he advises patients to carefully research the qualifications of the neurosurgeon and surgical facility. “Minimally invasive spine surgery, fusionless spine surgery and outpatient spine surgery are often advertised as the latest advances in spine care, when in fact the specialists at ONS and elsewhere have been performing and improving these procedures for nearly 20 years,” he said.

Schedule a consultation with an ONS spine specialist at our offices in Greenwich or Stamford, CT or in Harrison, NY by calling 203-869-1145 or submit this online form.

 

ONS MDs to Discuss Chronic Pain

Demetris Delos, MD and Christopher Sahler, MD of ONS to discuss effective treatments for Chronic Pain.

Maintaining quality of life while living with chronic pain is no easy feat. Two orthopedic specialists from ONS will discuss effective new treatments to help people with relentless pain return to the WavenyPain Flyer (2)activities they enjoy.  Join Demetris Delos, MD, an orthopedic surgeon who specializes in sports medicine an comprehensive knee and shoulder, and interventional pain management physiatrist, Christopher Sahler, MD for this informative talk on Wednesday, May 11 at The Inn at Waveny, 73 Oenoke Ridge in New Canaan.  Doors open at 4:00 pm for refreshments. Presentation begins at 4:30. RSVP at 203-594-5310 or mntiri@waveny.org.

 

Regenerative Medicine Benefits

Dr. Christopher Sahler
Dr. Christopher Sahler

ONS pain management specialist, Christopher Sahler, MD, will discuss the benefits of regenerative medicine at Greenwich Hospital talk.

Does your own blood hold the key to healing your medical condition? The evolving field of regenerative medicine uses biomedical materials, often from your own body, to regenerate cells and rebuild diseased and damaged tissues. Join Dr. Christopher Sahler to learn about this exciting new medical field that uses therapies from blood, platelets and stem cells to treat pain and cure complex, often chronic conditions of the musculoskeletal system.  Healing Yourself: The Promise of Regenerative Medicine for Chronic Pain and Orthopaedic Care will take place on Thursday, March 10 at Greenwich Hospital’s Noble Auditorium.  6 – 7:30 pm. Free.  To register, call 203-863-4277 or go to greenwichhospital.org.

The Importance of Injury Prevention: Don’t Become a Statistic

Quality of life, activity and productivity are affected by painful orthopedic conditions.

One in two Americans over the age of 18 and nearly three out of four age 65 and older have a musculoskeletal condition costing an estimated $213 billion each year in treatment, cadolori articolari 1re and lost wages, according to a report by the United States Bone and Joint Initiative (USBJI), The Impact of Musculoskeletal Disorders on Americans: Opportunities for Action.

The study finds that the quality of life, activity and productivity of an estimated 126.6 million American adults are affected by painful conditions and disorders affecting the bones, joints and muscles, a number which is comparable to the total percentage of Americans living with chronic lung or heart conditions. Among children, musculoskeletal conditions are surpassed only by respiratory infections as a cause of missed school days.

The report states that arthritis and related conditions top the list of orthopedic ailments (51.8 million adults) followed by back and neck pain (75.7 million combined). With an aging population, the number of people faced with musculoskeletal discomfort can be expected to greatly increase.

Fortunately, advances in diagnostic and treatment technologies, such as those that are available from the sub-specialists at ONS, can provide patients with pain relief and a safe return to mobility. However, the report underscores the importance of injury prevention strategies for individuals of all ages and the need for prompt treatment when injuries occur and orthopedic conditions first appear. With top orthopedists, neurosurgeons, physical therapists and physiatrists, ONS is committed to finding non-surgical options as the first line of treatment. Only 10 percent of ONS patients require surgery.

ONS’s Christopher Sahler, MD, Offers Tips for Combating Chronic Pain

Sahler - icontactExercise can help people with chronic pain return to daily activities with ease and comfort, writes Dr. Christopher Sahler, interventional pain management specialist at ONS in this week’s issue of the Greenwich Sentinel.  Slowing down is wise advice if pain is caused by an injury, he said, but a growing body of research suggests people suffering from chronic pain may feel better if they keep moving.  Not only does inactivity lead to a myriad of problems from weight gain to depression, it can actually exacerbate a person’s perception of pain.  Moderate, adaptive exercise, he explains, helps alleviate unrelenting pain because it releases endorphins, brain chemicals that improve mood and act as natural painkillers. Exercise provides the additional benefits of increasing a person’s agility and range of motion and it can stregnthen muscles to prevent injury.  Read the entire article which includes tips for gradually returning to normal, daily activities with greater ease and comfort.

 

Greenwich Hospital Announces New Chief of Staff, ONS Neurosurgeon Paul Apostolides, MD

Paul Apostolides, MD Neurosurgeon
Paul Apostolides, MD
Neurosurgeon

Dr. Paul Apostolides, Section Head of the division of Neurosurgery at Greenwich Hospital, has been appointed hospital Chief of Staff as of January 1. Dr. Apostolides joined Greenwich Hospital’s medical staff in 1998 and has served on many committees including the credentialing committee, executive committee and peer review committee. For three years prior to his current appointment, he was Assistant Chief of Staff. He has served on the Greenwich Hospital Board since 2012.

A graduate of Stanford University and University of Massachusetts Medical School, Dr. Apostolides completed his residency and fellowship training at the Barrow Neurological Institute. He is board certified by the American Board of Neurological Surgery, and is in practice with Orthopaedic & Neurosurgery Specialists (ONS) in Greenwich. He specializes in minimally invasive as well as complex reconstructive spinal surgeries.

ONS is an advanced multi-specialty orthopedic and neurosurgery practice serving patients throughout Fairfield and Westchester Counties and the New York Metropolitan area. ONS physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. For more information, visit www.onsmd.com, or call (203) 869-1145.

Shoulder Pain? (Part I)

Marc Kowalsky MD
Marc Kowalsky, MD.

ONS welcomes Dr. Kowalsky,  a board-certified orthopedic surgeon with expertise in rehab-focused, as well as operative treatments for upper and lower extremity sports injury, and complex shoulder and elbow conditions including degenerative disease, trauma, and revision surgery. He has also authored original research manuscripts, review articles, textbook chapters focusing on AC joint reconstruction, rotator cuff repair, and shoulder replacement, and now he is adding to the educational articles ONS provides.

Shoulder pain is the second most common musculoskeletal complaint to a primary care physician, behind only back pain. Twenty percent of the population will suffer from shoulder pain during their lifetime.  A variety of conditions can contribute to shoulder pain, ranging from rotator cuff problems to arthritis of the shoulder joint.

The rotator cuff tendon consists of the tendons of the four muscles that originate on the shoulder blade and insert on the humerus adjacent to the ball of the shoulder joint.  These muscles participate in rotation and elevation of the arm.  A bursa, or fluid-filled sac, lies on top of the rotator cuff tendon, and helps to protect or shield the tendon from the adjacent structures of the shoulder as the tendon glides.

Although most people who present to their physician with a rotator cuff problem likely have simple tendonitis, or bursitis, some may in fact have a rotator cuff tear.  At least twenty-five percent of people over the age of sixty may have a tear in the rotator cuff tendon.  Most of these tears are chronic and degenerative in nature, without any traumatic cause.  These patients experience shoulder pain with motion away from the body and overhead, typically along the side of the shoulder and arm.  They may also experience night pain that awakens them from sleep.

Some patients may also notice weakness, depending on the size of the tear.  A rotator cuff tear, once present, is unlikely to heal on its own, and may enlarge over time.  Nevertheless, many patients with a tear can be successfully treated with conservative means, including physical therapy, oral anti-inflammatory medication, and perhaps an injection of corticosteroid.  For those patients who do continue to experience pain due to a rotator cuff tear, operative repair is an option.  This procedure is typically performed arthroscopically, and consists of anchoring of the torn tendon to its attachment site with a series of small screws, or anchors.  Ultimately this procedure is effective in improving a patient’s pain and overall function. (…to be continued)

If this topic interests you keep an eye out for the next installment and attend Dr. Kowalsky’s upcoming seminar on March 12th at Greenwich Hospital. The program is free and open to the public.
Registration Requested. Call (203) 863-4277, or register online at www.greenhosp.org.

ONS Physical Therapist, Alicia Hirscht Discusses How to Help Avoid Neck and Back Pain in the Workplace

ONS Senior Clinical Specialist Alicia Hirsch
ONS Senior Clinical Specialist Alicia Hirsch

Let’s face it, if you don’t have a smartphone or a tablet, LTE or Wi-Fi, if you are not tweeting and networking 24/7….well, with the way we all depend on technology today, you might as well be living in a cave and drawing hieroglyphics!

We’ve come a long way from the years of the caveman, the question is, at what expense have we make this progress? From manufacturing and robotics, trading and purchasing, to filing and storage of records and data, almost everyone in the workplace uses computer technology. While computers and the internet enable workers to be more efficient and productive, our global workforce is quickly becoming more sedentary, and more painful.

Data collected from office workers reveals that 20% suffer from chronic neck pain, and 60-70% report having suffered from neck pain at some point in their career. Neck pain is highly correlated to workers who sit with a forward head for more than 5 hours per day, and is twice as likely to affect women and workers older than 40. Luckily, though, research also shows that workers who exercised regularly, reported good sleep habits and engaged in productive stress management reported a lower incidence of neck pain.

While 8 hours of sleep, regular meditation and a gym membership (that you actually use) might not fit into your busy, computer driven life, do not worry, hope is not lost. There are small steps you can take to keep yourself as pain free in the office as possible… and less irritable.

Step 1: Get up and move! We are not built to sit, we are built to MOVE. Set a timer on your computer that reminds you to change position every 20 minutes. Even if you stand for 1 minute 2 times an hour, your risk of developing neck pain reduces dramatically. While standing, engage is some basic exercises that can be done easily at your desk (see below).

Extensions: Place your hands on your waist and lean your shoulders back. Move slowly, repeat 15 times.
Extensions: Place your hands on your waist and lean your shoulders back. Move slowly, repeat 15 times.
Chin tuck: Pull your chin back towards your spine, keeping your eyes focused straight ahead. Hold for 3 seconds, relax, repeat 15 times.
Chin tuck: Pull your chin back towards your spine, keeping your eyes focused straight ahead. Hold for 3 seconds, relax, repeat 15 times.
Stand with your shoulders back and your chin tucked. Take a large step back with your right foot, allowing your left leg to bend. Sit your hips down into the stretch, hold for 20 seconds, repeat on each leg.
Stand with your shoulders back and your chin tucked. Take a large step back with your right foot, allowing your left leg to bend. Sit your hips down into the stretch, hold for 20 seconds, repeat on each leg.
Chest stretch: Reach up and back with one arm while reaching down and back with the other, open up your chest and squeeze your shoulder blades together. Keep your chin tucked, hold for 15 seconds.
Chest stretch: Reach up and back with one arm while reaching down and back with the other, open up your chest and squeeze your shoulder blades together. Keep your chin tucked, hold for 15 seconds.

Step 2: Make sure your work area is set up properly. Your desktop monitor should be even with your line of sight. Not in a corner away from you, right in front of you. If you work with a lap top or tablet, prop them up on risers so that you do not have to look down. Consider wireless/external keyboards to keep your hands in front of you and your elbows bent at 90 degree angles. Use a lumbar support to keep your spine in a neutral position, and adjust your seat height so that your hips, knees and ankles can rest at 90 degree angles. (See the picture below) Download or view our Workstation Ergonomics flyer to use as a guideline for improving your work space to help improve sitting posture and help to minimize neck and back pain.

NeckPain_Office
Desktop even with your eye sight, lumbar support to keep spine in a neutral position, knees and ankles resting at 90 degree angles.

If you are experiencing neck and back pain it may be time to talk to the experts at the ONS Spine Center. ONS Spine Center physicians specialize in non-operative and operative treatments for neck and back pain. Visit the Back and Neck Pain page on our website to learn more and see our physicians. To learn about our physical therapy services visit ONS Physical Therapy.

Orthopaedic and Neurosurgery Specialists, PC (ONS) physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. The main office is located at 6 Greenwich Office Park on Valley Road, Greenwich, CT. For more information, visit www.onsmd.com or call 203.869.1145.