Outpatient Spine Center

This month, we are featuring spine health. Spine specialists with Washington University Orthopedics are nationally and internationally renowned for treating adult and pediatric patients with a wide range of spinal diseases and conditions of the cervical, thoracic, and lumbar spine.

At the Washington University Orthopedic Outpatient Spine Center in Chesterfield, Missouri, spine surgery is a last resort. Click here to learn more about our Orthopedic Spine Center Clinicians:
http://www.ortho.wustl.edu/content/Patient-Care/3037/SERVICES/Spine/Orthopedic-Spine-Center-for-Back-Pain/Meet-Our-Clinicians.aspx

Washington University Orthopedic Spine Center Clinicians, left to right: Heidi Prather, DO, Director, Orthopedic Spine Center; Jacob Buchowski, MD; Chi-Tsai Tang, MD;
Adam La Bore, MD; Devyani Hunt, MD; Lukas Zebala, MD; John Metzler, MD

K. Daniel Riew on neck pain

Learn more about Dr. Riew and neck and back pain on our website at http://ortho.wustl.edu/

Spine Disorders Complicate Hip Arthroplasty

Patients undergoing total hip arthroplasty (THA) who have coexistent lumbar spine disorders (LSDs) do not report as much improvement in pain and function after arthroplasty compared with patients without lumbar disorders.

(HealthDay News) — These are the findings according to a study published in the May issue of The Spine Journal.
Heidi Prather, D.O., from the Washington University School of Medicine in St. Louis, and colleagues retrospectively examined 3,206 patients who underwent THA from 1996 to 2008. To identify which patients were also evaluated by a spine specialist, the International Classification of Diseases, Ninth Revision billing codes for LSDs were cross-referenced with patients who had undergone a THA. Functional outcomes were measured using the modified Harris Hip Score (mHHS) and University of California Los Angeles (UCLA) hip questionnaire, and physician medical charges were assessed.
The researchers found that a higher number of LSD patients were significantly older (64.5 years) compared with patients treated with THA alone (58.5 years). Compared with the THA + LSD group, patients in the THA alone group had significantly greater improvement in the mHHS, UCLA score, and pain. On average, patients in the THA + LSD group incurred significantly more in charges per episode of care ($2,668) and significantly more days per episode of care, compared to patients with THA alone.
"Patients undergoing THA alone had greater improvement in function and pain relief with fewer medical charges as compared with patients undergoing a THA and treatment for an LSD," the authors write.

Read the original article in MD News here:
MD News - Coexistent Lumbar Disorders Complicate Hip Arthroplasty

Spinal Tumor Recovery

Mary Martinez is back to bowling and golfing and is “doing fantastic,” though she says she’s under doctor’s orders not to lift refrigerators or break up concrete. Just one year ago, the 60-year-old Martinez was treated for lung cancer that had metastasized to her spine, and Jacob Buchowski, MD, MS, had to implant two artificial vertebrae to replace those that had been consumed by cancer.
Martinez, whose nickname at Barnes-Jewish Hospital was “the sledgehammer lady,” first learned that something was wrong when her back made an audible “pop” while she was wielding a sledgehammer to break up an old walk around her swimming pool. Excruciating pain below her shoulder blade radiated down her arm and made her left side ineffective.
Based on the advice of her chiropractor, Martinez underwent an MRI when X-rays were negative and three weeks of chiropractic treatment did nothing to relieve the pain. The scans revealed a lesion on her lung, which Martinez, a long-time smoker, says matter-of-factly didn’t surprise her. It took exploratory surgery to find the cancer’s metastasis to the spine.
Eventually, Martinez was referred to a Siteman Cancer Center oncologist, but the disease was unresponsive to chemotherapy, and surgery on both her lungs and her spine was scheduled for St. Patrick’s Day of ’08.
In a complex, day-long surgery, Buchowski and colleagues removed the entire tumor which originated in the lung and invaded two thoracic vertebrae. The extent of tumor involvement made it necessary to reconstruct the spine with a metal cage, screws, and rods.
Although the need for radiation prior to surgery made wound healing difficult and Buchowski had to schedule plastic surgery by a colleague, the problem was completely resolved. Martinez, a former Illinois special education teacher, says now that she is “not quite the Energizer Bunny,” but is grateful to be active again and lucky that the sledgehammer incident introduced her to Buchowski.
“I did my research on the Internet, and he was the right man for the job. He always made me feel very secure, and always told me the truth, including that my surgery would last about 10 hours. I’m very thankful that Dr. Buchowski could help me.”

Acupuncture as a form of treatment

The most common condition I treat with acupuncture is probably chronic lower back pain that has been unresponsive to other treatments, and the most common diagnosis is spinal stenosis. Acupuncture ends up providing some benefit for about half of these patients. Acupuncture is also useful for numerous other conditions such as neck pain, myofascial (muscle related) pain, stress related conditions, headaches, and knee and hip pain due to arthritis. I am also personally interested in using acupuncture to treat sports-related injuries.

By: Chi- Tsai Tang, MD

Washington University Orthopedics - Spine Center

The Spine Center, conveniently located at our Orthopedic Outpatient Center in Chesterfield, provides comprehensive, specialized care to patients with acute back pain and neck pain. We are committed to seeing patients as soon as possible, and in most cases, appointments are given within 48 hours of your initial phone call.

76 percent of Americans suffer from acute back pain at some time during their lives. The focus of our center is to see patients early in the development of their symptoms and to provide a specific diagnosis and treatment plan. In addition to individualized treatment plans, rehabilitation also includes education regarding body mechanics specific to a patient’s lifestyle.

Orthopedic Spine Center in Chesterfield offers non-operative treatment for back pain

The Washington University Orthopedic Spine Center in Chesterfield was featured on the cover of the May 27th Ladue News.

The Washington University Orthopedic Spine Center, conveniently located at the Outpatient Orthopedic Center in Chesterfield, provides comprehensive, specialized care to patients with acute back pain and neck pain. Appointments are given within 48 hours of your inital phone call (314-514-3500), because we understand that acute back pain cannot wait a week. Non-surgical treatment modalities are offered, including medications, physical therapy, massage therapy, occupational therapy, acupuncture, bracing and injections. At the Orthopedic Spine Center, surgery is a last resort.