mark a. giovanini m.d. neuromicrospine specialist andrews institute
TRANSCRIPT
Mark A. Giovanini M.D.NeuroMicroSpine Specialist
Andrews Institute
www.markgiovanini.comwww.NeuroMicroSpine.comwww.theandrewsinstitute.comwww.smiss.org
What can you do?Home remediesConservative TreatmentPhysician consultEmergent Evaluation
Neurologic DysfunctionBladder Incontinence
Where Can You GoAndrews Comprehensive Spine Center
Physical Medicine and RehabPain ManagementPhysical TherapyDiagnostics MRINeuroMicroSpine SpecialistsOrthoPaedic Spine SpecialistsAthletic Performance Center
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
ConditionsDisc Herniations
LumbarCervicalArthroplasty
Spinal StenosisDegenerative Disc DiseaseSpondylolisthesisScoliosisCompression Fractures
Lumbar Disc HerniationSymptoms
Axial back painSciatica/Pinched
NerveWeakness
Foot Drop
Numbness
Conservative CarePTAnalgesicsMassageChiropractic3 to 6 weeks
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 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
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