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

24Mar

5 of The Worst Injuries to Pro Athletes

Professional athletes train hard to stay in peak physical condition because it helps prevent injuries. Unfortunately, they can still happen no matter how much you train. The following are five of the worst injuries that professional athletes can experience:

  1. Vertebrae Fracture - Vertebrae fractures occur most often in football due to tackling. It's a potentially career-ending injury that can also cause paralysis depending on the severity.
  2. ACL Tear - The ACL (Anterior Cruciate Ligament) is responsible for 90% of the leg's stability, which means that tearing it basically leaves you immobile. The injury occurs more often in football players as a result of quick changes in direction while on the run. It generally takes eight to 12 months to recover.
  3. UCL Tear - The UCL (Ulnar Collateral Ligament) is a part of the body more prone to injury for baseball pitchers. At one point, experiencing a UCL tear signified the end of your career. Now, players can receive surgery, but won't return to the field for at least 12 to 18 months.
  4. Severe Concussion - Concussions in general are considered much more serious than they once were. Severe concussions can cause a loss of vision, memory problems, motor function problems plus long-term effects, such as CTE. Severe concussions have been known to force players into early retirement.
  5. Broken Leg - Broken legs happen in almost all sports, from soccer to basketball. Wherever the leg breaks, it usually takes at least a year to recover.

These are five of the worst injuries that pro athletes can experience. Although they can be career-ending, many athletes do return following an intensive recovery period.

Posted in Expert Blog

10Mar

Join Michael S. Chang, MD, for an Educational Seminar and earn CME credit

Are you a healthcare provider interested in the evaluation and treatment of the growing spine? Join Michael S. Chang, MD, a pediatric and adult complex spine surgeon, for an educational seminar and earn CME credit.

Posted in Expert Blog, Michael Chang MD

07Feb

Spinal Cord Injuries Should Not Be Ignored

The spinal cord is one of the most important organs. Without it, there would be no information from the brain to other parts of the body and vice-versa. In fact, the spinal cord and our brain make up the central nervous system. So it stands to reason that you shouldn't ignore a spinal cord injury or myelopathy.

What happens after a spinal cord injury?

A spinal injury can lead to the loss of physical sensation, which can affect mobility. Loss of feeling or sensation and movement below the injury can be complete or incomplete.

Some causes of spinal cord injuries:

Traumatic injury to back, face, neck, head or chest

Forceful twisting of the middle part of the body

Falling

Spinal cord diseases such as polio

Symptoms of Spinal Injuries or Complications

Tingling feelings

Paralysis

Loss of consciousness or shock

Unusual placement or positioning of the head

Spine Injury Emergencies

Never move anyone you suspect of suffering a spinal injury. Keep the person still and calm until help arrives. You should leave the person’s head and neck in the position where you found them, because unnecessary movement may cause more complications and may dislocate a vertebrae.

Posted in Expert Blog

24Jan

The 2017 Industrial Fee Schedule

The state of Arizona's Industrial Fee Schedule is released around midyear with the schedule covering October through the end of September the following year. The current fee schedules are available through September 2017.

Code Breakdowns

All medical services are given individual codes. This makes it easier for those in the billing department to type in short codes for longer procedures. Most branches within the medical community have individual codes and guidelines. Sections that fall under the physician's fee schedule include:

  • Pharmaceutical
  • Anesthesia
  • Surgery
  • Radiology
  • Pathology and Laboratory
  • Medicine
  • Physical medicine
  • Special services
  • Evaluation and Management
  • Category III

Interested in Individual Codes?

When patients receive bills, they are almost always itemized. It is very important for patients to look over this information carefully to verify they received the services and are not being charged incorrectly. If your bill is difficult to understand, you can look up individual codes from a billing sheet in order to see where it appears in the billing schedule.

When working within the medical industry or making payments on current medical expenses, it is important to understand the industrial fee schedule. The schedule is based on the fiscal year and not the standard January through December calendar. This is why the effective fee dates run October through September. Additional dates for October, 2017 through September, 2018, will be released in the upcoming months.

Posted in Expert Blog

13Jan

Are you living with back pain?

Join Michael Chang, MD for a free seminar to get the facts and understand your options.

Tuesday, January 24th
5:30 – 7:00 pm
Scottsdale Shea Medical Center
9003 E. Shea Blvd., Brady Conference Center, Scottadale

Posted in Expert Blog, Michael Chang MD

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