Expert Blog

11Oct

Stem Cell Study Shows Promise for Paralyzed Patients

Stem cell therapy is among the most exciting developments in modern medicine. The science is still in its early stages, so it’s not quite time to make an appointment, but legitimate trials are beginning to show promising results.

Can Stem Cells Cure Paralysis?

Asterias Biotherapeutics conducted one of the largest human trials in 2016, using a sample group of six patients with varying degrees of paralysis. The trial’s results began to roll in in October 2017, a year after 10 million stem cells had been transplanted. Four of the six patients experienced improved mobility significant enough to impact their quality of life. While a study of this size and scope cannot be viewed as conclusive, researchers have high hopes based on these results.

Human Trials in Stem Cell Spine Research

As yet, most trials have had small sample groups or animal subjects. Stem cell research has ambled along at a sluggish pace, and Asterias’ trial patients may have improved for reasons unrelated to the use of embryonic cells. Spontaneous recovery is surprisingly common in patients with some forms of paralysis. 27% of traumatic six-nerve palsy patients recover on their own, and most of those with Bell’s palsy recuperate within six weeks.

Stem cells could restore communication between your body and brain, but with no clear direction in sight, researchers are still arriving at the most effective way to handle transplants. 99% of spinal cord injury patients who are paralyzed a month after a back injury never walk again, so researchers have been focusing on transplanting new cells into the cavity formed by the damaged area in the spinal cord. They also hope that stem cell therapy will reduce inflammation that causes further paralysis.

Nobel laureate Shinya Yamanaka says there are 10 diseases that may respond to embryonic stem cell therapy. Medical breakthroughs takes time, but the science is already beginning to prove its mettle. 

Posted in Expert Blog

11Oct

How Do NFL Players Recover From Spine Injuries?

NCAA football season has arrived with all its fans, thrills, and injuries. Each year, scholastic football endures almost 15 catastrophic cervical spine injuries. That’s a rate of four injuries for every 100,000 players. That said, the situation does come with a little hope. A study by Wolters Kluwer Health found that most NFL players who undergo upper cervical spine surgery for herniated discs recover and move on to enjoy another season -- three seasons, in fact, with performance comparable to athletes who have not sustained these types of injuries.

CDH Surgery and the NFL

The study surveyed 53 players who’d had the life-changing surgery between 1979 and 2017. 15 had upper spine herniation and 25 had lower level injuries. Nine months after the procedure, between 67 and 72% of the players had returned to the game. Of those who’d had spinal fusion, four required further surgery. Of the six who had less invasive ACDF surgery, half needed more treatments. Researchers believe that professional athletes should receive treatments tailored to their desire to return to high-performance athletics.

Cervical Spine Surgeries

Minimally invasive percutaneous cervical disc nucleoplasties are effective in 81% of patients. 95 to 98% of non-players who undergo the procedure enjoy excellent results, which underlines the importance of post-operative care. Football players in the Kluwer study returned to the field only nine months after their procedures, which may not be long enough for the bone to mature and solidify.

It’s recommended that patients get back to exercise once the fusion has set, and a reconditioning program is needed to gradually introduce stretching, strengthening, and aerobic exercise. While some patients can begin training six months after the procedure, every case should be treated as unique. Full recovery usually occurs at between 12 and 18 months.

Posted in Expert Blog

15Sep

Community Outreach

community outreach 2017

Thank you to all those who donated their time, resources, products, and services to help this Albanian Catholic Religious Sister get her spinal deformity surgery done.

Posted in Expert Blog, Dennis Crandall MD

05Sep

What is TLIF?

The first spinal fusion procedures were performed in 1911, using a strip of tibia to fuse the spine and provide extra stability. Medical research has focused heavily on developing more effective and less invasive ways to perform the surgery, but this hasn’t done much to make spinal fusion less contentious. Long-term improvement is hugely ranging depending on the condition the procedure is intended to treat. Spinal stenosis patients do as well with surgery as they do with physiotherapy. Those with degenerative disc disease do a little better with surgery. This is true for fractures and spondylolysis, too, but disc herniations and general lower back pain usually don’t respond well to fusion.

Understanding Spinal Fusion

Today’s fusions can be done using minimally invasive techniques that cause less damage to soft tissue. There are many different approaches, all of which have the same goal: to relieve pressure on the nerves and stop the disc from causing pain. Transforaminal lumbar interbody fusion (TLIF) uses an interbody spacer to restore height and stabilize the anterior spinal columns. Screws, rods, and a bone graft support the column. The procedure has shown remarkable results in trials. Patients’ pain was improved by between 60% and 80% depending on their diagnosis.

No surgery is free of risks, and TLIF has its potential complications. Nerve injury can happen, pain may continue, and the fusion may fail. These complications are rare, but they often happen because the cause of the patient’s pain wasn’t correctly identified. Getting an accurate diagnosis is one of the most important ways to benefit from TLIF. Patients should also exhaust other treatment options before considering the procedure.

Spinal fusion surgery is a relatively drastic approach that can have dramatic, and even life changing, results as long as it’s carefully chosen according to a well diagnosed condition. 

Posted in Expert Blog

05Sep

Is fibromyalgia real or imagined?

Chronic pain that lacks an obvious cause has confounded doctors for as long as medicine has existed as a field. Fibromyalgia (FMS) is thus one step forward in a journey that has lasted centuries. To answer the question of whether FMS is imaginary, you must understand the purpose of diagnostics: to give doctors an efficient way to treat patients.

Difference between Syndromes and Diseases

Diseases with obvious causes such as diabetes and cancer are no more legitimate than those with obscure origins. Suffering patients deserve the right care. FMS has unknown origins, so it’s known as a syndrome rather than a disease. The fact that there are no laboratory tests that can confirm its diagnosis doesn't make the symptoms any less genuine.

FMS was first defined in 1990 as a way to research a pain phenomenon with a specific symptom set, but it has evolved to become a diagnostic label. Its symptoms include:

  • Chronic and widespread pain
  • Insomnia and lack of fourth stage sleep
  • Fatigue
  • Lack of clarity

Patients respond to the same broad therapies. Doctors don’t need to know the cause to treat the symptoms any more than you need to understand how your digestive system works in order to sate your hunger. Many syndromes share this characteristic—doctors can only guess at the cause of migraines and even the reason their treatments work. This does not make migraine sufferers’ need for treatment any less urgent.

Chronic pain patients are almost four times more likely to attempt suicide, so treatment is potentially lifesaving. Doctors are stuck in the initial stages of understanding fibromyalgia’s physiological causes, so as knowledge improves, they may learn that these patients have a few different diseases. The symptoms and their causes are nonetheless authentic: You needn’t see the roots of a tree to know they are there.

Posted in Expert Blog

26Jul

Spinal Surgery Can Improve Quality of Life

Quality of life is something most doctors dream of offering their patients, but sorting through the risks and potential benefits of treatments must be done in partnership. For Jim Scheiter, however, invasive care provided the new life he hoped for. 

He came back from two tours in Iraq so utterly disabled that he couldn’t stand for longer than 15 minutes at a time. He spent years trying medication and physiotherapy to no avail. Then a spine surgeon recommended a lumbar interbody fusion, a surgery usually reserved for disc disease. This therapy has performed well in trials, with 88% of patients gaining quality of life. The operation is able to remove the cause of pain without cutting through muscle.

Within a week, Scheiter was already walking, and today, he’s completely pain-free. 

Is Spine Surgery for You?

Aside from the obvious fact that your individual condition may or may not warrant surgery, there are a number of factors to consider. Every patient has a different degree of tolerance to the risks associated with spine surgery, and every surgery has different rates of success. Surgery is a process rather than a choice you make at a single point in time. In most cases, patients exhaust non-invasive options before considering invasive ones. More importantly, they must find a skilled, board certified surgeon they can trust.

This is no easy decision to make, so make sure you feel comfortable asking your doctor questions about your options.

Quality of Life

Back surgery’s efficacy rates vary enormously from condition to condition, and your idea of what quality of life means is core to your choice because patients’ values vary as much as their personalities. Quality of life can be seen as a subjective idea of happiness, but for pain patients, it frequently means restoring a normal lifestyle. You deserve a full life and your best chance at a pain-free one. At Sonoran Spine, our doctors recommend only strong evidence-based medical treatments. We cannot promise miracles, but we can offer realistic hope.

Posted in Expert Blog

26Jul

When Did the Human Spine Evolve?

If you’ve ever had back pain, you’ve probably cursed your spine as the root of all evil, and you would be partially right. 90% of animals have no spine. The human form has a problematic backbone that is responsible for many chronic pain conditions.

Ancient History of Back Pain

The spine evolved about 500 million years ago. The Cambrian explosion responsible for upright walking began when the ocean’s creatures developed vertebrae. They didn’t have a spine yet, though, only “notochords”, which are made of a material similar to cartilage.

Nobody agrees on which creature is humanity’s earliest ancestor, but recently, researchers discovered the fossil of a young child that might answer that question more precisely. It reveals that the human spine has existed for at least 3.3 million years. Even more exciting, the fossil’s vertebrae were in the process of forming into individual parts, which gives scientists insight into how the backbone evolved. The flexibility that the backbone lost when it evolved from a notocord to a spinal cord was replaced by stronger bone, but came with parts that rubbed together to cause neuropathic and muscular pain. 

The first hominids climbed trees and walked, so they had both apelike and humanoid qualities. They became bipedal about six million years ago, but the curved spine we recognize today only formed 2.5 million years ago. Early human backbones connected to the back of the skull like a chimpanzee’s. They evolved to connect underneath the skull to allow for upright walking.

Chronic Pain Conditions Not Caused by Injury or Illness

If you can't attribute your pain to a single injury or illness, it may be due to repetitive motion or strenuous activities. Walking upright has unfortunate consequences, particularly because the muscles that support your body attach on an inward curve. Now we've added behaviors like playing sports, working at a desk, and texting to complicate matters for the spine. Since you can't wait around for your skeleton to adapt perfectly to your lifestyle, we work with what you have. Come in for a consultation to discuss your diagnosis and which non-invasive and surgical treatment options best address the issue.

Posted in Expert Blog

30Jun

Preparing for Outpatient Spine Surgery

Though we strive to build trusting relationships with our patients and to empower them with knowledge, spine surgery can be scary. Because of this, your preparations need to be practical and emotional.

Household Preparations a Week Before Surgery

Items that you use often should be placed at arm height so that you don’t need to bend down or stretch to reach them. Paper plates are useful to cut down on cleaning up, and a reacher will take care of the rest of your needs.

Stock your freezer with prepared meals and buy slip on shoes so that you don’t have to bend. Prepare canes, walkers, and crutches as needed. A toilet riser will help you to stand up during the weeks after your surgery. You may need pre-surgery evaluation and EKG.  Smoking can increase post-operative infection and can slow your healing, so consider stopping.

Try To Relax

Gather information about your surgery so that your postoperative time goes without a hitch. Consider your personality style when it comes to pain. Information seekers tend to relax more easily into their pain if they have all the data related to their surgery. Information avoiders do better with tools that distract them from their pain. If that’s you, a series marathon is doctor’s orders -- just avoid shows that make you lean off the edge of your seat!

A Day Before Surgery

Some of the most common medications to stop before surgery are warfarin, aspirin, and blood pressure pills. Many of these mustn’t be taken two weeks before your procedure, but our physicians will weigh up the risks of your unique case, so make sure you’re clear on your doctor’s advice.

Remove your jewelry the night before your operation and confirm the time you must arrive for the procedure. Don’t eat or drink from midnight on the night before your procedure, and pack comfortable, loose clothes to wear after the procedure. Arrange a ride home because you’ll be groggy and distracted. 

Always defer to your specific doctor's orders, since they vary based on individual patients and procedures. If you have any questions before your surgery, don't hesitate to call.

Posted in Expert Blog

30Jun

Why Choose an Outpatient Spine Center?

The shift from inpatient to outpatient spine surgery has surged in recent years with the rise in innovative techniques that cost a fraction of what they used to. Anyone who’s spent time in a hospital will know that the flow of nurses, doctors, visiting hours, and meals are enough to exhaust inpatients, so our outpatient clinic provides precisely the rest our doctors prefer.

On average, inpatient care in Arizona costs between $1,965 and $2,581 per day, so the less time spent in the hospital, the more money you can save. Of course, this saving is only beneficial if you’re careful with your rehabilitation. Failed back surgeries have many causes. Muscle spasms caused by inflammation and poor compliance with physical therapy are the most common of these.

Infection Control

Surgical site infections are a significant risk that can be diminished by outpatient care. It’s important to choose a healthcare institution with excellent infection control. Avoiding overnight stays entirely can shrink your infection risk dramatically.

Complications

Inpatient care generally reduces scheduling delays, but it also gives physicians more autonomy when it comes to your care. If your surgery has complex rehabilitative needs, our ambulatory centers have visiting nurses and physical therapists to support follow up care. Complications such as hematomas and reherniation of discs can be monitored better when you're prepared thoroughly by your surgeon.

Pain

Pain is an odd creature, often responding in ways that are completely counter-intuitive. Your emotional state has a significant effect on your pain levels, as does your clinical setting. Outpatients tend to suffer from less pain than inpatients and feel more satisfied than their inpatient counterparts.

Patient Empowerment and Responsibility

Patients who do not support their own care will enjoy few of these outpatient benefits. If you educate and empower yourself, though, you'll see improved outcomes. Be proactive in asking questions and voicing concerns to your spine specialist.

Posted in Expert Blog

30May

Chiropractic Risks and Alternatives

Why don’t we offer chiropractic adjustments?

As spinal specialists, we provide a range of treatment options based on each patient’s needs. We perform surgery on some patients for whom the benefits outweigh the risks. For others, we recommend alternatives to surgery such as physical therapy or massage. However, we don’t recommend chiropractic adjustments, and this is because we prefer strong evidence-based treatments that are as low risk as possible.

Risks of Chiropractic Adjustments

There’s no denying that some patients report excellent results from receiving adjustments from a chiropractor. Alternative treatments may have the advantage of long tradition, developing over centuries and resulting in a good number of positive anecdotes supporting their efficacy. However, as medical experts, we choose not to base our decisions on anecdotal evidence. We are willing to consider treatments that have undergone rigorous clinical trials. This is for your health and safety. Even if someone you know swears by chiropractic, what works for them may turn out harmful to you.

Twisting and cracking the spine typically causes short-term pain, and chiropractors might tell you this is simply a side effect. However, there is limited evidence that chiropractic is safe and effective in the long-term. Meanwhile, patients have suffered from strokes, pinched nerves and other complications due to damage caused by spinal manipulation. Unless a strong body of scientific evidence emerges in support of specific chiropractic methods, we are not willing to put our patients at risk.

Alternatives to Alternative Treatment

We understand the risks of the treatments we do offer, and are able to educate our patients about the benefits and drawbacks of each approach. Some chiropractors do offer treatments we recommend, while others make wild and unsupported claims. When you choose Sonoran Spine, you can have confidence that you’re choosing experts who have filtered out hypotheses from strong conclusions.

Spinal decompression can be performed without violently manipulating the spine. Gentle cervical traction addresses neck pain and other conditions stemming from the upper back. This method decompresses the neck while stretching muscles and joint structures. Of course, we cannot recommend any treatment without a proper examination, but we strive to take a minimally invasive course without overreliance on medication. If you have questions about treatment methods, please feel free to ask.

Posted in Expert Blog

17May

Scoliosis Myths vs Facts

Scoliosis is a common condition in adults and teenagers. Most patients have mild curves that rarely if ever cause pain. For those who do experience pain, most benefit from conservative treatment. More severe curves (over 40-50 degrees, depending on your age) may warrant surgical intervention to improve quality of life. Whatever the severity, it's time to bust some myths concerning spinal curvature.

1. Myth: You Can't Have Children or will Suffer a Difficult Childbirth

Fact: The process of conception is not affected by scoliosis. Further, scoliosis does not cause complications during childbirth. If you receive an epidural, be sure to let your anesthesiologist know about any spinal conditions you have.

2. Myth: Casting can Completely Cure Scoliosis

Fact: Unfortunately, today, the only way to treat scoliosis is through spinal surgery. Casting or bracing might work for very young patients or if the curve is very slight. Braces are effective ways to stop curve progression, however, which can eliminate the need for surgery later in life.  

3. Myth: Sports are Dangerous 

Fact: In fact, patients should try to stay active in order to strengthen their back muscles. Stretching and physical therapy can reduce pain, even though it won't cure the curve or stop its progression. Of course, if you are recovering from treatment, your doctor might tell you to put the exercise on hold until the healing is complete.

4. Myth: You'll Get Detained at Airports

Fact: Metal placed in the spine during surgery might not set off metal detectors. If it does, simply let the security agent know where in your body the metal is located. They will either scan you or use a metal detecting rod to locate the implants. You do not need a doctor's note or ID card.

5. Myth: You Can Prevent Scoliosis

Fact: Scoliosis is defined as an idiopathic condition, which means there is no known cause for the disease as of yet. Heavy bags may certainly cause back pain, but they do not cause spinal curvature. Proper posture, stretching and exercise, while good for you, does not prevent, stop, or slow curve progression.

Posted in Expert Blog

24Apr

Should My Teen Get Surgery for Scoliosis?

Adolescent scoliosis can be alarming to parents because curves progress quickly during growth spurts. Many parents feel guilty that they didn’t notice the curve sooner, and worry that the curve may continue to progress at a rapid rate. However, the ultimate level of curvature depends on how much more growing your child has to do. Once your child reaches their adult size, the curve will most likely stop growing, unless it was greater than 40-50 degrees during adolescence.

Small to medium curves, which we define as 10-25 degrees and 25-40 degrees respectively, generally don’t advance in severity beyond the teen years. We can’t reverse the curves, but we do monitor them and may recommend treatment with a TLSO brace to stop curve progression. These nonsurgical options reduce the risk of the curve growing large enough to warrant surgery.

If someone tells you that physical therapy, chiropractic treatment, exercises or other remedies besides research-supported braces can reverse or stop curve progression, be skeptical. It’s best not to take your chances with therapies that haven’t been clinically proven. Time is an important factor to consider: the sooner a medium-sized curve is properly braced, the less time it has to potentially develop into a large curve.

Surgery has some drawbacks, so we prefer to avoid it if possible. Active teens have to consider how recovery time might affect extracurricular activities. As with any surgery, complications are possible. When we discuss surgery, we help you and your teen weigh the benefits versus the drawbacks and make our recommendation based on the individual patient.

Here are some reasons to consider surgical treatment on large curves:

  • Unlike most small to medium curves, large curves often continue to advance even after your child stops growing.
  • Recovery time for adolescents is typically shorter than that for adults.
  • Adolescents are typically more flexible than adults, making curves easier to correct.
  • Thoracic curves can lead to breathing and cardiac issues.
  • Lumbar curves can lead to painful conditions and premature arthritis.

You can read more about adolescent myscoliosis on our patient education page. Please feel free to reach out to us or the Scoliosis Research Society if you have questions.

Posted in Expert Blog

21Apr

Dr. Datta Presented with Certificate of Appreciation from St. Joseph's Foundation

Dr. Datta was proud to receive a Certificate of Appreciation from a grateful patiented who honored him with a philanthropic Contribution for National Doctor's Day.  

Datta Certificate Appreciation 4 17

Posted in Expert Blog, Jason Datta MD

19Apr

Ranking Arizona

Ranking Arizona is at it again. Please take a moment to vote for Sonoran Spine and Total Body Physical Therapy…let’s make it two years in a row! Voting ends July 31, 2017.

You can find us in the following categories under healthcare:

  • Orthopedic Practice
  • Pain Management
  • Physical Therapy
  • Spine Specialists

http://azbigmedia.com/vote-ranking-arizona

Posted in Expert Blog

10Apr

Why You Should Avoid Cracking Your Neck

You might think there's nothing as satisfying as cracking a stiff joint. The relief isn't long lasting, but for that one instant, the release of the air pocket building up in the joint can feel satisfying. However, there are some joints and areas of the body you should never crack on your own, including the neck. Before you crack yours (or anyone else's), consider these points.

Cracking can Cause Damage

When cracking your neck, you run the risk of damaging your brain stem or spine. When twisting the spine where it connects to the skull, it increases the chances of you tearing vertebral arteries running along this area. These arteries run to the brain and, if enough damage occurs, it can potentially lead to a stroke. Though the risk is small, it is significant enough for you to think twice before cracking your neck.

Cracking Leads to More Cracking

Most people who crack their joints form a habit. We all know someone who cracks their knuckles multiple times throughout the day. If you practice cracking your neck and experience the instant gratification of a pop, you'll become inclined to do it more often, which in turn increases the chance of damage to your spine, arteries and muscles. In the long run, cracking can end up proving more detrimental than good for you.

While cracking your neck may feel great in the moment, the potential consequences are not worth the risk. If your neck is sore and stiff, talk to a specialist for a long-term solution. At Sonoran Spine, we can identify the cause of your neck pain, relieve it and prevent it from returning. 

Posted in Expert Blog

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