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Dr. Cash weighs in on unnecessary treatments

This week, Dr. Cash participated in an article written by The Daily Rx about the most common needless orthopedic treatments.

American Academy of Orthopedic Surgeons issues list of unnecessary treatments

(dailyRx News) Knowing which medical treatments are needed and which aren't plays an important role in personal wellness and in creating an efficient healthcare system. Now, individuals with arthritis and other difficulties getting around have a shortlist of procedures many of them can do without.

Read the full story here

What is a syrinx?

By Brooke Strickland and Dr. Andrew Cash

Around the spinal cord and brain, a watery substance called cerebrospinal fluid flows regularly to transport nutrients and remove waste. When this fluid abnormally collects and develops inside your spinal cord to form a cyst, it’s called a syrinx. With time, it may grow and damage the spinal cord and cause significant pain, pressure, weakness, stiffness, or numbness. In addition, headaches can also be a symptom.

What are facet synovial cysts?

Synovial cysts are fluid-filled sacs that are benign and develop in the facet joints of the spine. They are somewhat uncommon and usually occur because of degeneration of the spine. If the sacs get large enough, spinal stenosis may develop.  It is most common to see these types of cysts in older patients.

What are the symptoms?

What are pain pumps?

By Brooke Strickland and Dr. Andrew Cash

A pain pump is a way to deliver medication directly to your spinal cord. It is a small metal device that surgically fixed under the skin in your abdominal area and has a catheter that gives regulated doses of medication to your spinal cord. When the device’s reservoir is empty, a doctor or nurse will refill the pump by inserting a needle through the skin. The procedure is also reversible, meaning that the pain pump can be removed at any time if results are not as optimal as expected.

How do I know if I need a pain pump?

What is epidural fibrosis?

By Brooke Strickland and Dr. Andrew Cash

Epidural fibrosis is a condition that develops when scar tissue forms around the nerve root.  It is common to see people develop this condition after back surgery.

What are the symptoms?

What is congenital fusion?

By Brooke Strickland and Dr. Andrew Cash

Congential fusion happens when two or more vertebrae of the spine are fused together permanently, usually while in the womb.  This condition often puts the patient living with this condition at an increased risk for spinal cord injury.

What is Klippel-Feil Syndrome?

By Brooke Strickland and Dr. Andrew Cash

Klippel-Feil Syndrome is a rare disease that is present at birth, but sometimes can be diagnosed later in life when symptoms first become more apparent. The syndrome causes two or more spinal bones in the neck to fuse or join together, which means the person living with the disorder will have a short neck, have limited head or neck movement, or low hairline at the back of the head.

What is spinal cord stimulation?

By Brooke Strickland and Dr. Andrew Cash

For individuals living with chronic back pain, spinal cord stimulation is a procedure that can help. It uses an electrical current that sends pulses to the spinal cord, which react with nerve impulses in the spine that allow you to feel pain. This treatment plan is often used for individuals living with failed back syndrome, nerve pain, or other chronic pain syndromes.

What is post-laminectomy syndrome?

By Brooke Strickland and Dr. Andrew Cash

Even after back surgery is complete, you may have persistent pain. This often depends on type of pain you had before surgery, what type of surgery you had done, and if you have had multiple operations in the same area.

What is revision spine surgery?

By Brooke Strickland and Dr. Andrew Cash

The spine is a very complex part of the body and when it comes to operating on it, it takes great skill and attention to detail. If your doctor has told you that you may need revision spine surgery, it doesn’t necessarily mean that there was a mistake in a previous surgery, or even that it was a complete failure. The spine is a very active part of your body and can deteriorate even after surgery has taken place and a remedy to correct the problem might need to happen. For some people, a second (or maybe even a third) spine surgery may need to happen, depending on the specific problem.

What is failed back syndrome?

By Brooke Strickland and Dr. Andrew Cash

For some people, back surgery is not as a successful as they or their doctors had hoped for. Many times results aren’t what are expected, even with the most experienced surgeon and a perfect surgical operation. This is when failed back syndrome occurs. Failed back syndrome is actually an inaccurate name, as it refers to continued back pain after surgery.

What is thoracic radiculitis?

By Brooke Strickland and Dr. Andrew Cash

Radiculitis causes pain that radiates along the nerve, due to irritation of the root of the nerve that connects to the spine. Radiculitis that happens in the thoracic spine will likely cause pain in the chest area. The area that is inflamed is very painful and can even cause a numb or tingling sensation and many times symptoms can include a tight feeling around the chest. The condition is usually caused by an injury to the nerves in the thorax including strain or sprains. It is more common to see people that are in sports or carry repetitively heavy loads on their backs to have this type of injury. Family history can also play a part in this condition.

What is extreme lateral interbody fusion?

By Brooke Strickland and Dr. Andrew Cash

Extreme lateral interbody fusion (XLIF) is a newer, minimally invasive procedure that allows doctors to get to the spine with little disruption to surrounding connective tissues. It fuses the  front section of the spine with the side. Traditional fusion surgeries are more invasive, have greater risk of blood loss, and usually require longer hospitalization or longer physical therapy sessions. However, XLIF can restore disc height with only a small incision along the lateral part of the back (between the lower ribs and pelvis). People living with scoliosis, spinal stenosis, degenerative disc disease, or spondylolisthesis can all benefit from this procedure.

What are dural tears?

By Brooke Strickland and Dr. Andrew Cash

A dural tear occurs when the sac of tissue that covers the spinal cord and spinal nerves tears during spine surgery. If this tear isn’t recognized it may not heal and can leak spinal tissue which can cause a spinal headache and can increase your risk of infection of the spinal fluid which causes meningitis.

How are dural tears treated?

What is posterior lumbar fusion?

By Brooke Strickland and Dr. Andrew Cash

Posterior lumbar fusion is a common type of surgery used to mend two or more spine bones in the lower back.  When the bones are joined together during surgery using a bone graft, they will eventually heal and form into one solid bone.

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