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Publications

Virtua's spine service rescues those in pain

Bookmark and Share When back and leg pain kept 38-year-old Ron Lanahan from lifting his infant daughter, he knew something had to change. Caused by stress fractures that occurred during his teenage ice hockey days, the pain had gradually taken its toll. Lanahan was frustrated and depressed as life's simplest tasks grew increasingly difficult. A common complaint
Conservative and minimally invasive treatment
Pain comes in many shapes and sizes
Pain relief is possible

A common complaint
Like Lanahan, eight in 10 Americans will experience life-altering back, neck or leg pain at some point in their lives. Nearly half of these episodes will become recurrent or chronic, causing discomfort over months or even years. And it can happen to anyone at virtually any age. As the frustration of living with chronic pain takes hold, it's easy to believe that there is no solution. Yet, nothing could be further from the truth. The spine service at Virtua Memorial Hospital brings hope to those with back and neck pain by offering a comprehensive continuum of care. This includes evaluation, treatment and rehabilitation from an experienced team of specialists. "You can see a fellowship-trained orthopaedic spine surgeon, neurosurgeon, pain management physician or physiatrist who can offer advanced treatment for any kind of back or neck pain," says Gerald Hayken, MD, chief of orthopaedics at Virtua Memorial. "Services range from treating disc disease and arthritis to traumatic injury. Rounding out the program are certified physical therapists. And, the patient's care plan is coordinated and implemented by nurses who have received special education in the complexity of the spine." "When I heard about Virtua Memorial's service, I was at the end of my rope," says Lanahan. He had already tried oral pain medication, physical therapy, therapeutic injections in the spine and chiropractic therapy to alleviate the pain of spondylolisthesis, an instability of the spine. "The bones in Ron's lower back were unstable due to a stress facture that occurred while he was an adolescent," says Orin Atlas, MD, Virtua orthopaedic surgeon. "Because of this instability in Ron's spine, the bones began to slip out of place and collapse on to one another. After reviewing Ron's options, he and Dr. Atlas decided that the best course of action was spinal fusion surgery and decompression to alleviate his back and leg pain. "We surgically fused his two adjacent vertebrae using a bone graft." Six months past surgery, Lanahan is pain free. "I feel like I can do anything. Most importantly, I can now be the father I want to be for my daughter," says Lanahan. Conservative and minimally invasive treatment
While Lanahan's relief came in the form of a complex surgery, there are a number of conservative and minimally invasive treatments. Years ago, Mary Ware injured her back in a car accident. Her pain had become increasingly intolerable; it kept her awake most nights. "I was in agony and so exhausted," says 67-year-old Ware. That's when Virtua family physician Robert Denniston, MD, referred her to Robert Friedman, MD, a Virtua anesthesiologist who specializes in pain management. Dr. Friedman recommended a series of three epidural steroid injection treatments to reduce nerve inflammation at the base of Ware's spine. Even after the first treatment, the pain was diminished. Ware exclaims: "I can finally sleep through the night. I never thought it would happen." Like Ware, 87-year-old George Rausch took his pain for granted. He had lived with it most of his life because of fractures in his spine and, more recently, osteoporosis and new fractures. Because of Rausch's age and diagnosis, he was a good candidate for a new minimally invasive procedure called kyphoplasty. "Two tiny keyhole-sized incisions are made to access the fractured vertebrae," says Dr. Atlas. "A void, created within the vertebrae, is filled with surgical cement to stabilize and strengthen the bone and relieve pain." As Rausch says: "The doc did a weld job to my spine, and I was back on my feet in less than a week." Pain comes in many shapes and sizes
"We take our patients' pain seriously," says Dr. Friedman. "We use a graduated scale to get the most accurate description. We recognize that pain is experienced subjectively by each patient, and that it can be acute, lasting a few days, or chronic, persisting more than three months." Diagnosing the source of the pain means taking a medical history and performing a complete medical exam including blood, neurological and imaging tests such as a CT scan or MRI. The most common cause of pain is degenerative disc disease due to arthritis, injury, infection, a tumor and the overuse or misuse of the back or spinal column. "We can successfully treat pain in 85% of patients without surgery, using the most conservative treatment first," explains Steven Kirshner, MD, an orthopaedic surgeon and medical director of the spine service at Virtua Memorial. Non-surgical, conservative options include physical therapy, weight control, steroid injections, non-steroidal anti-inflammatory medications, rehabilitation and limited activity. Emerging technologies are also used, including pulsed radio frequency (PRF), a procedure proven highly successful in interrupting pain signals through low-level electronically pulsed currents. Andre Hu, MD, a Virtua physiatrist, adds yet another dimension to pain relief. "As a doctor who specializes in physical therapy and rehabilitative medicine, my goal is to maximize patients' function by restoring their ability to perform daily activities," he explains. Pain relief is possible
Dr. Kirshner sums it up: "Our multidisciplinary spine team is dedicated to overseeing our patients' care from beginning to end with one goal in mind: We want to return them to pain-free living as quickly and as safely as possible." For more information or to make an appointment with a Virtua primary care physician, orthopaedic surgeon, neurosurgeon, pain specialist or physiatrist, call 1-888-Virtua-3.