8:00 Comment From Linda Linda : ] What advances are ...ftpcontent.worldnow.com/wfsb/spine.pdf · If...

8:00

[Comment From Linda Linda : ]

What advances are available for spinal stenosis?

Thursday June 28, 2012 8:00 Linda

Edit Delete Entry

8:01

Hartford Hospital:

There are several techniques including injections and surgery depending on the

severity of the problem.

Thursday June 28, 2012 8:01 Hartford Hospital

8:01

[Comment From JT JT : ]

I have been diagnosed with DDD and spondilitis. I have been taking medication

since 1989. How often should I be seen by a Doctor since I generally self

medicate?

Thursday June 28, 2012 8:01 JT

8:01

Hartford Hospital:

It is a good idea to be checked yearly for this type of problem, especially if you are

on meds.


8:01

[Comment From Stephanie Stephanie : ]

I slipped a disc when I was 18 and at that time there wasn't a lot of options so I was

in traction for a week and then went to PT. Now I am 49 and there isn't a day that

my back doesn't hurt, I kind of learned how to live with it. How can Imake sure

that I do not hurt my back further

Thursday June 28, 2012 8:01 Stephanie

8:02

Hartford Hospital:

You should keep in as good shape as you can with normal body mass index and

regular exercise for you abdominals. Regular medical followup is advisable.


8:02


The surgery described for fusion looks less invasive than prior surgeries...is this

the case?


8:03

Hartford Hospital:

All spinal surgery is invasive and pain levels can be similar with open as well as

closed cases. The incision is smaller with the less invasive surgery but the

magnitude of surgery is significant.


8:05

[Comment From mary mary : ]

I missed part of the program. Are there advances in scoliosis surgery? The surgery

seems so dramatic.

Thursday June 28, 2012 8:05 mary

8:06

Hartford Hospital:

Scoliosis surgery is still quite invasive and has a significant complication rate. It

should be done only as a last resort.


8:06

[Comment From Lisa C. Lisa C. : ]

Good Evening!

Thursday June 28, 2012 8:06 Lisa C.

8:06

Hartford Hospital:

Thanks.


8:06

[Comment From Ann Ann : ]

How many epidural injections can a spine patient receive in one year?

Thursday June 28, 2012 8:06 Ann

8:06

Hartford Hospital:

The usual recommendation is three


8:06

[Comment From Kris Kris : ]

I like Larry have a grade almost one stage of Spondylolisthesis, I have had 2 really

bad episodes with this condition and this last one has altered my work conditions

in which I have to work from home 2 days a week. I am a bodybuilder and would

like to know other options besides surgery, pills and injections. Any thoughtsa?

Thursday June 28, 2012 8:06 Kris

8:08

Hartford Hospital:

You should be doing specific exercises for transverse abdominal muscle and

general core exercises. Optimal weight is also advisable. If these measures fail

then surgery may be necessary


8:08

[Comment From Patti Patti : ]

10 years ago my husband was told there was "nothing that could be done" . for his

low back pain. in particular- he cannot walk without sitting frequently...he is 82,

any suggestions?

Thursday June 28, 2012 8:08 Patti

8:09

Hartford Hospital:

Sometimes that is true. It depends upon how well localized the problem is. If the

whole spine is degenerated then surgery is not as successful and is more

dangerous. Epidural injections are a reasonable option.


8:09


The last time I had PT, they stretched my back on the "rack". Would you

recommend inversion tables as an alternitive?


8:10

Hartford Hospital:

Many of my patients use them. If traction feels good in PT then an inversion table

is a good option for home use


8:10

[Comment From Judy Judy : ]

Great show. I've had back issues for a very long time. I do have other issues; i;e;

vascular, diabetes, age etc. I've been told of many things; spondylitis etc. My back

hurts consantly, my legs feel weak. What do I treat first and how?

Thursday June 28, 2012 8:10 Judy

8:11

Hartford Hospital:

You should treat all of the problems. Keep blood sugar down, maintain as ideal

body mass index as possible and get appropriate evaluation from a spinal

specialist.


8:11

[Comment From John Picard John Picard : ]

I have had back pain for over 1/2 my life. I am 54. The past 20+ years I have had

severe back pain. I walk most days not fully straight. Most days pain goes half way

down my legs. I was told it was L4, L3, &L5.. I have had PT. Pain injections and

the gammit.

Thursday June 28, 2012 8:11 John Picard

8:12

Hartford Hospital:

It depends on what the MRI shows and your general health. You should try to

maintain ideal body weight, do abdominal exercises and quit smoking if you do

smoke.


8:12

[Comment From Cheryl Overton Cheryl Overton : ]

Hi I am suffering from cervical pain with left arm pain

Thursday June 28, 2012 8:12 Cheryl Overton

8:13

Hartford Hospital:

You need clinical evaluation by a spine specialist who may order an MRI. You

may need PT or home traction or possibly surgery


8:13

[Comment From Dave Dave : ]

What is your experience with devices e.g. X-Stop for stenosis

Thursday June 28, 2012 8:13 Dave

8:14

Hartford Hospital:

I have not had good experience. I have removed some and done decompressions.


8:14

[Comment From Christine Christine : ]

Spinal Stenosis - how many cortizone injections are acceptable to the body and are

there any other kind besides cortizone?

Thursday June 28, 2012 8:14 Christine

8:14

Hartford Hospital:

Cortisone is really the only option at present and you can have three per year.


8:14

[Comment From Guest Guest : ]

If one has multiple degenerated discs and a single herniated disc, does it make

sense to do multiple fusions or just the herniated disc and wait and see with the

remaining discs?

Thursday June 28, 2012 8:14 Guest

8:15

Hartford Hospital:

Treat the herniation if there is a lot of leg pain only. The degeneration causes back

pain. It depends on your symptoms


8:15

[Comment From Carmen Carmen : ]

I have constant lower back pain and neck pain

Thursday June 28, 2012 8:15 Carmen

8:15

Hartford Hospital:

You need formal evaluation


8:15

[Comment From Guest Guest : ]

I have recently had some lower back pain for the last 4 days, it's only when I bend

in certain positions or when I cough. I am only 31yrs old and have been on

numerous deployements overseas wearing and carrying alot of gear which could

have started this issue, but I wanted to know what the best recovery position would

be for me to get my back on track again.

Thursday June 28, 2012 8:15 Guest

8:17

Hartford Hospital:

The best initial treatment is appropriate restriction of bending and lifting as well as

working on core strengthening exercises. You might need to work with a physical

therapist.


8:17


I too have degenative disc 1985 L3/L4 partially removed, now L4/L5, I was told to

consider rod approx one half long, wouldn't this imbolize me to an extent? My left

leg between thigh and calf is pretty knumb. It this the same type of surgery


8:18

Hartford Hospital:

One and two level fusions may not result in much loss of range of motion. It

depends on how disabled you are now.


8:18

[Comment From Joseph Joseph : ]

I have two level severe cervical stenosis (c4-6). What are my option?

Thursday June 28, 2012 8:18 Joseph

8:19

Hartford Hospital:

If the stenosis is severe enough to cause spinal cord compression you should

consider evaluation for anterior discectomy and fusion


8:19

[Comment From mh mh : ]

my spine was fused at L3-L4 5 years ago and now they're saying that I have

herniated discs above the fusion. I'm worried that having another fusion will lead

to further herniated discs above the level of the fusion. I am only 52.

Thursday June 28, 2012 8:19 mh

8:19

Hartford Hospital:

That is a good consideration based upon the length of the fusion and your age. It

should be done only if necessary


8:20

[Comment From Lisa C. Lisa C. : ]

I have neck and back pain from both a car accident and Behcet's Disease that was

diagnosed in 2000. I take morphine on a daily basis but still am in terrible pain. I

have also had 3 spinal epidurals. What else can you recommend?

Thursday June 28, 2012 8:20 Lisa C.

8:21

Hartford Hospital:

Your situation is complicated and requires a pain management specialist Surgery is

not usual a good option but an opinion from a surgery might be an option just to

make sure there is nothing that can be fixed


8:22

[Comment From Lorri Lorri : ]

I have a soon to be 83 year mother whose back/groin pain has severely decreased

her quality of life. She has been given the run around with one doctor telling her

she needs spine surgery but won't be able to bend at the waist to another who said

her back is fine. She has had MRI's, physcial therapy, etc. Her posture is poor now

and can't go out for long periods of time.

Thursday June 28, 2012 8:22 Lorri

8:23

Hartford Hospital:

Has she been evaluated bya spine specialist. Pain may be from spinal stenosis or

possibly aslso hip arthritis. This requires thorough evaluation


8:23

[Comment From DM DM : ]

Is the O Arm available at other hospitals in CT?

Thursday June 28, 2012 8:23 DM

8:24

Hartford Hospital:

The O arm is also now available at Greenwich. Yale migh be getting one now also


8:24

[Comment From joy joy : ]

i just watched your show. I have spinal stenosis and spondolothesis. I have been

getting all kinds of diagnoses, everything from lime disease to fibromyalgia. My

pain is mainly in my legs. I don't seem to have numbness in my legs. just pain. I

don't want surgery if I don't have to but my pain is getting worse. I can't stand for

any more than five minutes and walking is almost out of the question. Helf!

Thursday June 28, 2012 8:24 joy

8:26

Hartford Hospital:

Your symptoms suggest spinal stenosis. There are nerve medications like

Neurontin and also epidural injections. PT for core strengthening is helpful.

Maintaining ideal body weight is essential


8:26

[Comment From Betty Ann Betty Ann : ]

Good job. Spinal surgery sure has changed in the last 40 years!

Thursday June 28, 2012 8:26 Betty Ann

8:26

Hartford Hospital:

Thank you


8:26

[Comment From Helen Siegel 69 Helen Siegel 69 : ]

I have had 6 operations on my spine 2 cervical and 4 lower lumbar including 2

fusions 3 @ HH and 3 @ uconn Dr. Colias was my neuro @HH and Dr Raycroff

my Ortho. Success was great Now my second fusion is not healing I had Feb 13th

I still have pain down both legs at night in bed I have been to Phy therapy aqua and

land and the land makes the pain worse What can I do?

Thursday June 28, 2012 8:26 Helen Siegel 69

8:27

Hartford Hospital:

Fusions can take a while to heal. Hopefully you are a nonsmoker. Electrical

stimulation might help heal you. You might need revision surgery


8:27

[Comment From Diana Diana : ]

I was told I had a thorasic stress fracture; however the medical notes said it was a

herniated disk. I had ex rays and a scan at Backus. I am confused. I have daily

pain. Thank you.

Thursday June 28, 2012 8:27 Diana

8:29

Hartford Hospital:

I would need more information. Thoracic disc herniations do not usual need

surgery unless there is a neuro deficit. Stress fractures usually heal. Evaluation for

osteoporosis may be appropriate.


8:29


The tv show on channel 3 made all the surgeries sound like they were no big deal.

I am concerned about the loss of mobility in my back and reduction even further

than I already have. What could I expect?


8:30

Hartford Hospital:

There is not necessarily a loss of range of motion. Patients who have this type of

surgery usually have restricted motion and function to begin with. Surgery can be

very easy for patients but not all have an easy recovery


8:31

[Comment From gloria gloria : ]

over 40 yrs ago i partially slipped a disc at L4 L5 can this ever be fixed

neurosurgeon at hartford hospital that i saw in my 20s said nothing can be done for

a partialli slipped disc???

Thursday June 28, 2012 8:31 gloria

8:31

Hartford Hospital:

It sounds like you are getting arthritis from an old ruptured disc. You might need

more agressive conservative Rx or possibly a spinal fusion


8:32


I did not catch the name of the Dr. that did Larry's surgery, what was his name?


8:32

Hartford Hospital:

That was Dr. W. J. Krompinger


8:32

[Comment From Jess Jess : ]

I have Schumann's Disease in my lower back and degenerative disc disease in my

neck. Ive been in pt for 2 years now with little to no relief what would be the best

treatment for me?

Thursday June 28, 2012 8:32 Jess

8:33

Hartford Hospital:

It depends on your age and general physical condition. Some thoracic pain can be

referred from the neck. You require more thorough evaluation


8:33

[Comment From Donalyn Donalyn : ]

I fell ice skating a few years ago and bent and cracked mycoccyx. I'm 62. I now

have to sit on a donut or board, can't sit normally at all (have to shift from side to

side) and get cortisone injections once or twice a year. Is there ANYTHING that

can cure this? Something with positive results? Thank you

Thursday June 28, 2012 8:33 Donalyn

8:34

Hartford Hospital:

Thorough evaluation is required to determine if the pain is from the coccyx or

referred from the lower back. Injections sometimes help. Removal of the coccyx is

sometimes helpful


8:34

[Comment From Sophie Sophie : ]

I had a cervical spine fusion (C4-5-6) in 1965 due to a diving accident. I am now

67 and walking with a walker--no balance and fall easily. Have been told by

doctors that no orthopedic doctor would touch me with this fusion. My question is

for Dr. whitikar. I believe you were one of the team doctors that did my surgery

with dr Cavich at the then Newington Childrens Hospital. Just curious.

Thursday June 28, 2012 8:34 Sophie

8:36

Hartford Hospital:

That is not true. If an adjacent disc has a problem surgery might be necessary. If

you can an old spinal cord injury then results from additional surgery may not be

as good


8:36

[Comment From Mark Mark : ]

I was diagnosed10 years when I was 24 with a herniated disc (L5S1) I used to lift

weights alot which is what likely caused this! Had a few cortisone injections over

the years but they never really helped. Everyday i have pain! Back is always tight!

Chiropractor says my biggest problem is my extremely tight hamstrings which

torque my pelvis(chiro sweats when stretching my hams). Feel better after chiro;

any other options?

Thursday June 28, 2012 8:36 Mark

8:37

Hartford Hospital:

Injections are more for leg pain. You have mechanical back pain and should be

evaluated for possible fusion


8:37

[Comment From Crystal Crystal : ]

I was diagnosed with a herniated and degenrative disc in my L4 and L5 with a

pinched nerve.What would you suggest for OTC for meds for nerve pain?

Thursday June 28, 2012 8:37 Crystal

8:38

Hartford Hospital:

Most OTC meds do not help with nerve pain. You probably need a prescription

med such as neurontin, elavil or lyrica


8:38

[Comment From Sandra Sandra : ]

I have bi-lateral sciatica. I am 68 yrs old. For the past year I have been having

sharp stabbing pains, like shocks shooting down my legs, espcially at night. Very

difficult sleeping. Is this part of the same problem? Should I be concerned?

Thursday June 28, 2012 8:38 Sandra

8:39

Hartford Hospital:

Yes you should be concerned and need evaluation to determine if pain is due to

spinal stenosis or a circulation problem with your legs

http://nerve.what/


8:39

[Comment From Elaine M. Elaine M. : ]

My dad has spinal stenosis and degenerative disc disease. He is 86 years young

and although he has had injections he still battles with pain and weakness in the

legs- Is there anything available for him

Thursday June 28, 2012 8:39 Elaine M.

8:39

Hartford Hospital:

That is the usual treatment. If he is in good enough medical shape surgery is still

an option


8:40

[Comment From Dana Gilbert Dana Gilbert : ]

I was diagnosed with spinal stenosis almost 9 yrs. ago and have had a Medtronic

Intrathecal pain pump for approx. 7 yrs. and have recently had it changed for the

1st time. Shortly before my initial pump surgery my back had begun to curve

slightly. Since then my spine has continued to curve and now I have full blown

Scoliosis. I'm also beginning to have more intense lower back pain even with the

pump. Do any of you have any suggestions for me? I seem to have no future ahead

but intense pain...

Thursday June 28, 2012 8:40 Dana Gilbert

8:41

Hartford Hospital:

You have a complicated situation. You need evaluation regarding whether the

stenosis can be surgically corrected


8:41

[Comment From JET JET : ]

I have cervical spinal stenosis and with traction, I have come a long way.

However, I am slowly losing fine motor control in my index fingers. Can anything

be done about that?

Thursday June 28, 2012 8:41 JET

8:41

Hartford Hospital:

If you are still having these symptoms then you should be evaluated for anterior

cervical decompression and fusion


8:42

[Comment From Bob Bob : ]

I have had lower back pain for a few years. I have seen a few Doctors but have had

little in the way of results. In the past few months, I have been getting shots,

radiofrequency ablation, and have had some minor pain reduction. My pain level is

typically 4 to 6, it does not go into my legs and I can no longer walk much more

than 100 feet. Sleeping gets to be a problem but sometimes I can find a position in

my bed where my pain level is lowered to maybe a "2" which is great for me. I'm

67 and would like to be more active with my grandchildren and be able to do some

chores around the house. Can I see someone in your organization to see what you

can suggest?

Thursday June 28, 2012 8:42 Bob

8:42

Hartford Hospital:

Yes. You may call Martha Rogers at 877-774-6303 for a referral


8:42


I do special exercises and work on core strength, just wondering if this condition

after 7 months of no improvment and only comfort is to work from home 2 days a

week relieves it if that is the way to go?


8:43

Hartford Hospital:

You need thorough evaluation and treatment will depend upon the extent of the

problem -- i.e how many discs are abnormal and to what extent


8:43

[Comment From Jean Jean : ]

My husband is in constant pain and is dead set against surgery. If I have this

correct, L4 and L5 is herniated, he has 2 or 3 semi-fused vertebrae in his neck and

the base of his spine is herniated. Only treatment is chiropractor once a week. Any

suggestions/thoughts, thanks.

Thursday June 28, 2012 8:43 Jean

8:45

Hartford Hospital:

The treatment depends on the location of pain - neck vs arms and back vs legs and

how many discs are involved. The chiropractor is getting him by but not solving

any of the problems. He needs formal evaluation


8:45

[Comment From Ed Ed : ]

Have had lower back pain in the past, where I would be flat out. I take it easy now

to avoide

Thursday June 28, 2012 8:45 Ed

8:45

[Comment From Bob Misiaszek Bob Misiaszek : ]

Are there any treatments for thoracic outlet syndrome that are effective and not

high risk. I believe that I have this, and after talking to my PCP he agrees with my

self diagnosis, but I have not yet followed up with any specialist.

Thursday June 28, 2012 8:45 Bob Misiaszek

8:46

Hartford Hospital:

Followup with a specialist is a good idea to confirm the diagnosis. You may

require specific exercises for this condition


8:46

[Comment From Rich Rich : ]

My wife had a cervical spine fusion about 5 weeks ago. She still has considerable

shoulder, neck and head pain. Is this to be expected ?

Thursday June 28, 2012 8:46 Rich

8:47

Hartford Hospital:

Yes, Fusions take at least 3-6 months to heal and required extensive rehab


8:47

[Comment From Mike Mike : ]

I have been having pain on and off for the last 4 yrs but in the last 4 days, the pain

is alittle more than normal. I'm only 31, and have been on multiple deployements

carrying and wearing alot of gear which probably doesn't help the situation. I

wanted to know what recovery postion I can do to relax my back or any stretch

that might help.

Thursday June 28, 2012 8:47 Mike

8:47

[Comment From Betty Betty : ]

I had my fourth spinal fusion a year ago. I still hurt and now my hip has been

boyhering me. I have been I physical therapy since December but I am not sure it

helps. What should I do now? I need to work 2 years for retirement and it is getting

difficult to teach.

Thursday June 28, 2012 8:47 Betty

8:48

Hartford Hospital:

You require evaluation as to whether pain is from an additional level in your back

or possibly from the hip


8:48

[Comment From Susan Susan : ]

I have spinal stenosis, scoliosis, spondolsis. Had a laminectomy which wasn't to

successful about 5 years ago. Have had PT and a couple injections. I exercise

faithfully but the pain down my leg beginning on the side of my hip slows me

down. I am 73. Any suggestions.

Thursday June 28, 2012 8:48 Susan

8:49

Hartford Hospital:

You may have instabilty or recurrent spinal stenosis and need further evaluation at

least with xrays, flexion extension views and likely MRI


8:49

[Comment From tom tom : ]

At L-4-L-5 there is an annular tear with minimal bulge which does not cause spinal

stenosis. peripheral margins of the disc and some facet arthropathy cause mild

bilateral foraminal narrowiing but without discrete root compromise on either side.

English please. Would surgery help this? From MRI

Thursday June 28, 2012 8:49 tom

8:50

Hartford Hospital:

This amount to arthritis that can possibly cause nerve irritation. Surgery might help

but I would consider epidural injection first


8:50

[Comment From Eileen Eileen : ]

I have degenerative disc disease in my neck. I've just been diagnosed. What can be

done for it. The doctors put me on pain meds. I don't want to take.

Thursday June 28, 2012 8:50 Eileen

8:51

Hartford Hospital:

I would do specific PT for strenghening and stabilization and also seek evaluation

regarding how many discs are involved and whether you might need surgery


8:51

[Comment From Marcia Sharr Marcia Sharr : ]

I had lower back disc fusion 25 years ago by Dr. Collias of HH. I have constant

pain now for the last 6 months. My PCP sent me to UConn PT for 8 weeks with

excellent results. I now do my exercises every day, but wake up with pain level 5.

What do you advise?

Thursday June 28, 2012 8:51 Marcia Sharr

8:53

Hartford Hospital:

You need evaluation to determine whether an adjacent level disc is a problem that

might require surgery or if you have generalized arthritis for which the exercises

you are doing might be the best option


8:53

[Comment From Jane Jane : ]

I was diagnosed with tendinitis of the hip. Had PT which made it worse and now

the pain is in my buttocks and going down my legs. Could it be something else.

Thursday June 28, 2012 8:53 Jane

8:54

Hartford Hospital:

You might not have hip tendinitis and should be evaluated for disc herniation or

stenosis


8:54

[Comment From Diana Diana : ]

I had an MRI which showed what they called a compresion fracture at T-4. The

medical notes called it a herniated disc . i am in pain unless I am asleep. marcaine

injections help very little teporarily. Any advice?

Thursday June 28, 2012 8:54 Diana

8:54

Hartford Hospital:

A bone scan might help determine whether you indeed have a fracture


8:54

[Comment From cathy cathy : ]

At L-5-S1 there is no evidence of spinal stenosis. there is some degerative facet

arthropathy which causes mild left foraminal stenosis which is unchanged and a

milder degree of right foraminal narrowing which is also unchanged. English

please....surgery helpful?

Thursday June 28, 2012 8:54 cathy

8:55

Hartford Hospital:

It means you have arthritis that could cause nerve root compression and leg pain.

Surgery might help but is a last resort. Epidural injections might help


8:55

[Comment From Louise Louise : ]

I am almost 80 years old, and haave been very active. Now with my back pain,

radiating down right leg to ankle and foot. MRI done shows lumbar stenosis,

pinched nerve and scoliosis. Epidural injections X4 did not help. Now having PT.

Also SOB and MD evaluating this. I can't walk without pain, and only relief is

lying flat in bed. Any suggestions?

Thursday June 28, 2012 8:55 Louise

8:56

Hartford Hospital:

You might need decompression for your stenosis but you should be check for

circulation problems


8:56

[Comment From gloria gloria : ]

thanks

Thursday June 28, 2012 8:56 gloria

8:56

Hartford Hospital:

You are welcome


8:57

[Comment From Tina Tina : ]

I have spinal stenosis - is there any kind of home care I can practice - like what

sort of exercises, etc.

Thursday June 28, 2012 8:57 Tina

8:58

Hartford Hospital:

Exercise to strenghen your abdominal muscles is the best remedy --this includes

core and Pilates exercises


8:58

[Comment From Chris Chris : ]

I'm a 40 year old male scheduled for L4-L5 TLIF Fusion at HH on 7/11. Why does

fusion have such a negative stigma? What can I expect post surgery during what I

would consider many phases of recovery? Do all docs performing surgery at HH

have the option to use the o-arm? Can I have an active lifestyle after full recovery

such as golf and recreational kayaking? what are the limitations after fusion

surgery once completely healed? why is fusion still the preferred method vs. newer

method such as Total Disc Replacement? See you in a couple weeks at HH!! Great

show tonight!!

Thursday June 28, 2012 8:58 Chris

9:00

Hartford Hospital:

Thanks. Fusion sometimes gets bad press because not all patients get better,

especially those with mulitple level disc problems. fusion also requires extensive

rehab and works bestif you are in good physical shape. The O arm is available to

all HH surgeons. You can usual golf and kayak after fusion of a single disc


9:01

Hartford Hospital:

This concludes the chat. If we didn't get to your question, or if you have any

concerns call the Hartford Hospital Spine Center at 1-877-774-6303. Have a good

night!

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