Patient Information:

 

Complete Spinal Care
The delicate nature of the spine requires specialized care. By providing complete diagnostic, treatment, and rehabilitation capabilities, as well as preventive interventions, Intermountain Spine and Orthopaedics offers relief from pain and a return to normal activity for adults and children with a wide range of neck and spine problems.

The Latest Techniques and Technology
While the causes of spinal problems have not changed much over the years, the methods for diagnosing and treating the condition are constantly evolving. Following an initial evaluation, which includes a detailed medical history, reviewing previous records and x-rays, and performing a multidisciplinary physical exam, we employ the latest techniques and technology for:

Diagnosis. To make the most accurate diagnosis, we have access to a complete spectrum of resources. These include the most advanced diagnostic equipment, including high-speed magnetic resonance imaging (MRI), computerized tomography (CT scan), bone densitometers, myelography, and discography.

Treatment. Remember, most cases of neck and spine pain can be treated with nonsurgical interventions, but more serious cases may require surgery. To that end, we provide access to a complete range of services:
• Physical and occupational therapy
• Individualized spine rehabilitation programs
• Back school instruction
• Exercise physiology
• Job site evaluation
• Aquatic therapy
• Posture correction
• Nonsurgical interventions
• Epidural steroids
• Trigger point injections
• Nerve root blocks
• Facet joint injections
• Surgical services are individualized to your particular condition with treatments being offered for cervical, thoracic, and lumbar spine conditions.

Recovery. Our staff is fully trained to provide all the resources needed to enhance your rehabilitation and recovery process. Psychological well-being is a vital aspect of the recovery process, and is incorporated into the treatment regimen.

Treatment for a Wide Range of Spine Problems
Intermountain Spine and Orthopaedics specializes in the treatment of neck and spine pain due to injury, deformity, and degenerative conditions, including:
• Painful degenerative disc disease
• Spinal fractures
• Spinal deformity (scoliosis, kyphosis, ankylosing spondylitis)
• Herniated cervical, thoracic, and lumbar discs
• Spondylolisthesis
• Spinal stenosis
• Instability
• Osteoarthritis
• Failed neck and spine surgery
• Bone cancer and related tumors

A Commitment to Care
We at Intermountain Spine and Orthopaedics strongly believe that communication with patients and referring physicians is a critical part of effective patient management. To that end, whether a patient requires a more conservative outpatient treatment or surgical intervention, the goal remains the same: to restore health as rapidly and completely as possible. Bone and soft tissue diseases can be frightening and painful. Intermountain Spine and Orthopaedics spends time with patients and their loved ones to explain all aspects of diagnosis and treatment, answer questions, and alleviate concerns — both during and after regular office hours.

 

Frequently Asked Questions

I am scheduled for surgery, when should I stop taking my aspirin? - You should stop taking aspirin 5 days prior to surgery unless otherwise advised by your physician.

Can I take my regular medications the morning of my surgery? - You can take your regular medication the morning of your surgery. Take them as early in the morning as possible and only with a small amount of water, just enough to get the pills down. Do not use any other liquid besides water to take the medications. Do not take blood thinning medications the morning of your surgery unless otherwise directed by your physician.

When can I remove the dressing from my incision? - The dressing can be removed 1 or 2 days after surgery. At that time it is OK to shower but do not soak your incision or let it get submersed in water. If you have steri-strips and a dissolvable stitch, the steri strips can be removed in 7 to 10 days. If you have staples or a non-dissolvable stitch you will have an appointment to get them removed 10 days after surgery.

How long do I need to wear my brace? - If prescribed a corset brace for you lower back, wear it until it is discontinued at one of your post-op appointments. It is OK to remove the brace when you are in bed or in the shower unless otherwise directed.

How much weight can I lift? - Do not lift more than 5 to 15 pounds after your surgery unless otherwise instructed.

When can I drive? - It is best to avoid driving for the first 2 weeks after surgery, presuming that you were able to drive before surgery. You should not drive if you are taking narcotic pain medications.

What type of exercises should I do? - In general it will be good for you to do some mild stretching and walking for the first 2 weeks after surgery. You were given a prescription for physical therapy at the hospital and you can begin physical therapy 2 weeks after your surgery. Take the prescription to the physical therapist of your choice unless otherwise directed.

Can I sit in a chair? - Yes, however, make sure it does not put too much pressure on your back. Reclined positions are more preferable.

Can I lay on my side or my back? - Yes. Put a pillow between your legs when you are lying on your back.

Can I walk on a treadmill? - Yes. You can walk if you are comfortable.

How long until I can have sex? - You may have sex after your first post-operative appointment as long as you are comfortable, careful, and avoid jarring.

Can I use a walker? - Yes.

Can I climb stairs? - If necessary, however, it is best to avoid stairs for 2 weeks after surgery.

How long until I can go back to work? - You may return to work as soon as you are comfortable, and as long as you follow the post-operative restrictions.

I have an aching, electrical feeling down my leg when I stand and walk. What could it be? - You could have symptoms coming from a condition called spinal stenosis. This is a condition in which there is narrowing of the nerve openings either around the spinal cord or nerve roots - usually as a result of deterioration and aging of the spinal column. The leg pain, weakness and/or numbness are caused by the progressive narrowing that puts pressure on the spinal nerves. Your physician will suggest the best of several treatments for spinal stenosis, which include injections, medications and, sometimes, surgery (laminectomy).

I have pain that shoots from my hip down to my foot. My doctor has diagnosed a low back problem even though I don't have back pain. Is this possible? - Advice from an expert is recommended, but it sounds like you have sciatica. There are many causes of sciatica. Your pain symptoms are from pinched or inflamed nerves that go from the back down the legs - causing pain, burning, and numbness in the leg. This can occur in the absence of any back pain.

I'm pregnant and experiencing back and leg pain. What can be done to help alleviate this discomfort during my pregnancy? - With most women, pregnancy comes with some back pain. The most common cause of back pain in pregnancy is your sacral iliac joint. Your obstetrician should be alerted to your low-back discomfort and may recommend prenatal-safe medication, exercises and support belts. Only in cases of severe neurological impairment is spinal surgery remotely considered.

Is it true that smoking is bad for my back? - In general, smoking is very harmful to your health. Evidence shows that smoking is a risk factor for degenerative disc disease because it diminishes nutrition and hydration to discs. The lack of nutrition and hydration to the disc causes the disc space to collapse - creating a bone-on-bone situation and abnormal wear on the joints.

I think my scoliosis is progressing. What should I do? - Scoliosis is a side-to-side bending of the spine, rarely progressing in adults but most frequently will progress during adolescent growth spurts. If evaluation shows your curve is progressing, surgery could be considered if bracing and other non-operative measures failed.

Why does my arm feel like pins and needles? - Most commonly, this involves a compression of a nerve either at the wrist (carpal tunnel syndrome), elbow (cubital tunnel syndrome) or neck (herniated disc). An evaluation by a physical examination and an MRI of your neck will determine the exact source. Treatment modalities include medications, physical therapy, bracing, injections or surgery.

Generally, what causes back pain? - There can be many different causes of back pain. The most common is degeneration of the spinal joints or discs. Other causes are muscle strain, problems with the sacral iliac joint, referred pain from your kidneys and/or trauma.

I’ve been told I have a bulging disc. Is this normal? - Most bulging discs are the natural result of disc degeneration for people over the age of 30. The nature of the bulge rarely causes symptoms unless it is associated with conditions such as spinal canal narrowing, also known as spinal stenosis. Disc bulges are generally left alone unless they are compressing the nerves, causing leg pain.

I have arthritis in my spine. Is this something I have to learn to live with? - Backaches from arthritis can usually be managed with physical therapy, medication and, in rare cases, a back brace. Generally, surgery is not helpful for back pain caused by arthritis.

What is a laminectomy? - It’s a surgical procedure to remove the lamina – the part of bone in the spine covering the spinal cord and/or nerve roots. The purpose of this procedure is to gain access to the nerves, to treat spinal stenosis or remove a disc herniation.

Can I bend over if I have a fusion? - Yes. Most of the motion, when you bend at your waist, occurs in yours hips. Most likely, you’ll only have 1 or 2 levels of your spine fused. Sacrificing some motion may occur – but the alternative is less back pain, allowing you to have better motion than before. Generally, there is very little change in motion from this operation.

What is lumbar instability? - This is a condition that may contribute to back or leg pain. It refers to abnormal motion of the spine under normal conditions. It may also result in certain spinal deformities and/or nerve compression.

Two weeks ago I had a microdiscectomy. I don’t feel pain, but I still have numbness in my leg. Will the numbness be permanent? - It is typical for pain to dissipate quicker than numbness in the leg. You can expect it to take several weeks, months, or maybe even a year before the numbness will go away completely. After a year, if the numbness is still there it is probably permanent.

My back bothers me during the night. What are some things you suggest that would help my back so that I can sleep? - Try to avoid sleeping on your stomach. If you find yourself in this position often, try placing a pillow under your stomach to maintain support of the lumbar spine. A pillow between the legs can be a good support when lying on your side. A pillow under the knees is often helpful when lying on your back.

Is an MRI the only test used to determine if and what nerves are being compressed? - An MRI scan is definitely the best test, but there are other alternatives. A CT scan with myelography is just as effective as an MRI but is more painful because it involves a spinal injection. An EMG study of the leg (electromyography) can explore whether a muscle group is affected; but this is a non-specific test and does not find a lot of disc herniations.

I am feeling a lot of back pain. I’m about 80 years old and have been diagnosed with severe calcification of the lower spine. Vioxx has not helped to relieve my pain. Is surgery my only answer? How else is calcification treated? - Typcially, calcification is not painful or relieved through spinal surgical techniques unless they compress the nerves - causing sciatica. The pain could be from degenerative spondylolisthesis or osteoarthritis. Water therapy and physical therapy are highly recommended for this condition. Surgery is indicated for a sciatica.

I have a ruptured disc. Could this affect my bladder function as well as sexual performance? - It could directly affect the bladder function and cause either incontinence or an inability to empty the bladder. If you have these symptoms you should contact your physician immediately. If you’re in a lot of pain, it could also indirectly affect sexual function.

I have been diagnosed with spondylolisthesis. Most of the time I feel fine; but once in a while the pain is nearly excruciating. Is surgery something I should consider, or should I try to go with conservative treatments? - Exercising is a better option than surgery. Make sure to stretch your hamstring muscles each day. With spondylolisthesis, the hamstrings tend to get tight – increasing the pressure across the lumbar spine and causing lower back pain. Staying well conditioned doing regular stabilization exercises to keep the back strong are important.

What causes a herniated disc? - Every patient's situation is different, but, in general, disc herniation is a combination of an acute, specific injury to the lining of the disc with leaking of the inner contents of the disc. The herniation is most-likely related to a lifting, bending or twisting injury to the disc.

When is spine surgery usually necessary? - Surgery is recommended for spinal problems only after all appropriate conservative measures have been applied. If symptoms are not controlled effectively with medications, physical therapy and injections, then surgery can be considered, depending on the specific situation.

Can disc herniations in the low back eventually cause paralysis? - Rarely, a large disc herniation can cause loss of bowel or bladder control due to damage to the sacral nerves, or progressive weakness in the legs due to damage to the lumbar nerve roots. Immediate medical attention should be given if you experience either of these conditions.

My child has been diagnosed with scoliosis. What are the chances she will experience severe back pain in adulthood? - There is about an 80% chance that she will experience low back pain at some point in time – which is the same statistic for the general population. Because scoliosis is a structural deformity primarily in the chest area of the spine, it is not typically painful in childhood or adulthood.

What are bone spurs and what is their cause? - Bone spurs occur as the body tries to decrease the pressure by expanding the surface area and are caused by joint degeneration in the aging process. Bone spurs are a marker for degenerative arthritis; so, if there is back pain, the cause could be from the arthritis. Removing bone spurs does not relieve back pain because they are not the cause. The only time spurs need to be removed is if they push on a nerve and cause leg pain.

What is the best sleeping position to protect my back after spine surgery? - In general, bending the knees slightly by placing a pillow under them while lying on your back is comfortable after surgery. Sleeping in a reclining chair or an adjustable bed that allows you to lift your head and knees up is also helpful.

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David Christensen, MD
1411 Falls Avenue East
Suite 1301
Twin Falls, ID 83301