Spinal Conditions Non-Operative Treatment

Non-operative treatment of spinal conditions

Most spinal conditions do not require surgical treatment. This means that the vast majority of spinal problems can be managed with non-operative care (often called "conservative care"). Each patient and each case must be approached in a very individual manner, and any treatment program should only be recommended by a physician after a thorough evaluation. This section, in our web site, will give you some very general information regarding non-operative approaches to pain and functional recovery from a spine related problem.

www.Orthospine.com is the number resource online for questions about Flatback, scoliosis, adult scoliosis, spinal stenosis, revision spine surgery, and non operative care.

Myelography (Myelogram)

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Myelography (Myelogram)

To visualize the contour and diameter of the spinal canal (located inside the spinal canal and containing the spinal cord and nerves) a myelogram may be ordered by your physician. This test involves injecting a chemical substance referred to as 'contrast' or dye into the dural sac (the fine tissue that encases the spinal cord ane nerves) and obtaining either X-Rays or a Cat Scan to outline the dimensions of the canal and contour of the individual nerves.

A myelogram is particularly useful in evaluating spinal cord and nerve root compression (i.e. Spinal stenosis, spinal cord compression?. Myelography may also be particularly useful in evaluating spinal problems in the setting of previous spinal surgery where instrumentation was placed. In such cases MRI and other tests can be difficult to interpret due to the metal which has been placed in the spine.

Orthospine - Medical Tests and Imaging Studies

Medical Tests and Imaging Studies

Directing the appropriate care of a patient suffering from a spine condition requires making a correct diagnosis of the problem at hand. Although this may appear simplistic and self evident, the diagnosis of a spinal disorder can be a challenging undertaking. Identifying the source of pain or dysfunction in the setting of spinal pathology requires assembling information gathered from a patient's description of his/her problem, a good physical examination and proper medical tests. After collecting this information, placing it in context of the known natural progression of the disease/condition at hand, a treatment plan can be designed. It is thus evident that medical tests are crucial in establishing the proper diagnosis in a patient suffering from a spinal condition and in directing effective medical care.

One single medical test cannot offer all the necessary information needed to make a clear diagnosis of a spinal condition. Each test gives specific information that can help define the medical problem present. In most cases a physician will start with the most basic test and proceed to more sophisticated tests until a clear diagnosis has been made. Some of the common tests and imaging studies performed in evaluating spinal conditions include: X-Rays, Myelogram, CT Scan, Bone scan, Arteriogram, discogram, MRI, EMG, Sonogram, and Blood tests.

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Orthospine Academic Presentations

Orthospine.com is an educational resource that includes books, articles, academic presentations and more more. Below is a list of our Academic Presentations.

Academic Presentations

The following presentations are talks given at the indicated meetings, you can see the actual slides by clicking on the title.

1. Idiopathic Scoliosis in the pediatric population. Frank J. Schwab, Jean-Pierre C. Farcy. Pediatric Symposium, Maimonides Medical Center, January, 2001

2. Congenital and Neuromuscular Scoliosis. Jean-Pierre C. Farcy, Frank J. Schwab. Pediatric Symposium, Maimonides Medical Center, January, 2001

3. Pain Predictors in Adult Scoliosis: a quantitative radiographic and clinical analysis. Schwab, F.J.; Gamez, L.; Levine, E.; Farcy, J-P.; Strongwater, A.: Annual Meeting of the Scoliosis Research Society. San Diego. September, 1999.

4. Revision Surgery in Adult Scoliosis; Jean-Pierre C. Farcy, Frank J. Schwab; Contemporary Insights in Spine Surgery, Conference, New York City, NY December, 2000

5. Degenerative Lumbar Spine: Circumferential Treatment: Posterior Route - TLIF; Frank J. Schwab, Jean-Pierre C. Farcy; Contemporary Insights in Spine Surgery, Conference, New York City, NY December, 2000

6. Schwab, F.; Farcy, J-P.; Berven, S.; Bridwell, K.; Ferguson, M.; Glassman, S.; Harrast, J.; Horton, W.: A comprehensive clinical impact classification for Adult Scoliois. Spinal Deformity Study Group meeting San Diego, CA. April, 2005

7. Schwab F, Farcy JP, Bridwell K, Berven S, Glassman S, Harrast J, et al. A clinical impact classification of scoliosis in the adult. A multi-center clinical and radiographic analysis. SRS 2005, October 27-30, Miami, Florida, USA.

8. Virginie Lafage, F. Schwab, F. Rubio and J. P. Farcy. "Impact of sagittal plane spinal deformity on the spino-pelvic relationship and gravity line position in adults." Scoliosis Research Society, Monterey, CA. (2006)

9. Frank Schwab, J.P. Farcy, K. Bridwell, S. Berven, S. Glassman, W. Horton, M. Shainline. " Surgical treatment analysis of 809 thoracolumbar and lumbar major adult deformity cases by a new adult scoliosis classification system". International Society for the study of the Lumbar Spine, Bergen, Norway. (2006)

10. Schwab F: When to operate on Adult Scoliosis patients and when to say No. SRS Course September 13-16, 2006 - Monterey, California

Orthospine.com

Orthospine.com

This is an educational site developed for the understanding of spinal problems and back pain. Get top level, unbiased information from leading experts. Get the inside story about conditions such as a degenerative spine conditions like spinal stenosis, or malalignment issues such as flatback or spondylolisthesis and deformities like scoliosis including idiopathic scoliosis and congenital scoliosis and malformed vertebrae resulting in kyphoscoliosis. See the pros and cons of undergoing spine surgery and other procedures such as spinal fusion. Find out how disc surgery on a herniated disc can change the way you live. Discover what treatment may be available for failed back surgery, what to expect from revision spine surgery, and the role of minimally invasive spine surgery. These top New York City doctors have the authoritative answers to your back pain questions right here. Get your questions answered now. It's time to ask the doctors...

Frank J. Schwab, M.D. and
Jean-Pierre C. Farcy, M.D., F.A.C.S.

Visit our main web site at Orthospine.com

Non Operative Care - Functional Restoration

FUNCTIONAL RESTORATION

As part of non-operative care, your physician may prescribe a program of physical therapy or exercises. The purpose of such treatments is usually to assist you in restoring muscle tone and muscle strength. The muscular supports of the spine are crucial to maintaining good function and stability of the back. With aging, injury or underlying spinal problem it is very common for the back musculature to become weakened, with diminished tone and easy fatigability. In fact, poor muscle condition can be a significant source of disability and pain itself.

Physical Therapy
The principle to most physical therapy approaches in spinal conditions is twofold: pain modality treatment (as described above) and structured guided strengthening programs for restoring good muscle function. There are many different types of exercise programs and particular focus on isometric strengthening appears to be quite beneficial for many patients. Isometric exercises involve activities that stimulate contraction of a muscle (working the muscle) while maintaining the length of that muscle (ie. no significant motion across the span of the muscle). Vigorous movements or extremes of motion are often avoided in physical therapy approaches to spinal care.

Exercise
Most patients that see benefit with a physical therapy program are advised to maintain some form of regular exercise on a long-term basis. Even patients with mild or intermittent back pain and no severe underlying problem can receive benefits with regular exercise. A number of studies have shown that regular aerobic activity reduces the chance of developing repeated back injuries. Clear advantages of one type of sport over another have not been shown and it therefore may be most important to find some activity that is enjoyable and easy to maintain on a regular schedule (ex. swimming, fast walking, running…).

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Non Operative Care - Bracing

BRACING

There are a wide variety of collars, binders, belts, braces and other devices designed to offer relief from neck and back pain. Their effectiveness in most cases has not been clearly proven, and yet many patients do feel some relief from their pain with some of these applied devices. Long-term wear of back braces may however lead to gradual weakening of the supportive muscles due to an effect of unloading and may therefore not be desireable.

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