Easy as kyphoplasty: End back pain with a simple procedure

Easy as kyphoplasty: End back pain with a simple procedure

Photo of back painAre you tired of suffering from back pain? For many of us, we accept back pain like we accept the onset of gray hair and wrinkles – an unwanted eventuality for all of us, a consequence of getting older.  But it doesn’t have to be. At AppOrtho, in many cases we can say goodbye to back pain for good, thanks to a simple outpatient procedure known as a kyphoplasty.

 

Are you ready for relief?

 

Back pain is often caused by a break between your vertebrae known as a compression fracture. This fracture frequently occurs in senior adults as a result of wear and tear to the cartilage in the joint, in many cases brought on by osteoporosis. Vertebral Compression Fractures (VCFs) can occur suddenly and without warning, and simple tasks like bending over to pick something up can lead to a break. A silent disease, osteoporosis causes gradual bone loss over the years without symptoms and is the cause of more than 800,000 VCFs annually in women and men.

The good news is that compression fractures can and usually do heal on their own. At AppOrtho, all non-operative treatment options are considered before recommending surgery.  However, a standard treatment for VCFs involves pain medications and bedrest, which unfortunately often leads to opioid dependency.

As an alternative to surgery, a quick and minimally invasive surgical procedure known as kyphoplasty can be performed to stop the pain, repair the bone and restore functionality.  Furthermore, reports show that patients who elect to have kyphoplasty have lower mortality risk, lower readmission rates and three times the pain reduction of other treatment options.

 

How it works

 

Think of the spine as a flexible chain of interconnected bones that work in unison to help hold the body together. When a compression fracture occurs, the area between these bones or vertebrae thins causing painful friction between the bone fragments. To repair this type of fracture, your surgeon may recommend a kyphoplasty procedure; here is what you can expect.

  1. In the operating room, the patient will lie down on their stomach and be given general anesthesia, which puts them to sleep.
  2. A sterilized hollow needle is then guided by x-ray and placed between the injured vertebrae.
  3. Once the needle is in place, a balloon is inserted through the needle and then inflated to create needed space between the bone fragments.
  4. Bone cement is then injected through the needle to fill in and repair that space between the vertebrae.
  5. The needle is then removed and a bandage is applied. No stitches are required for this procedure. The entire process typically takes less than an hour to complete.

Patients usually notice a reduction in pain immediately after the procedure. In most cases, patients can resume their normal routine with an improved quality of life within two days.

 

We’ve got your back

 

With more than 25 years of experience performing spine surgeries, James Califf, MD, an orthopedic surgeon at AppOrtho, is the only orthopedist in the High Country who performs kyphoplasty procedures, along with other complex spine procedures, at Watauga Medical Center.

In addition to intra-operative procedures like kyphoplasty for osteoporosis and trauma, Dr. Califf and his assistant Jeremy Freitas, PA, provide extensive patient follow up care for all patients as needed at AppOrtho. These follow up appointments allow patients to ask lingering questions, get feedback on their progress and address any concerns they or their family members may have.

Although Dr. Califf specializes in the treatment of spinal disorders, he also performs shoulder, hip, hand, joint replacement and arthroscopic surgery.

“At AppOrtho, we are pleased to offer advanced spine surgery right here in the High Country,” said Dr. Califf. “Simply put, our goal is to help our patients feel better and to provide that care close to home.”

To learn more about spine surgery at AppOrtho, call (828) 386-2663 or request an appointment here. No referral is required.

Orthobiologics: Use your body’s own cells to repair knee cartilage

Orthobiologics: Use your body’s own cells to repair knee cartilage

Dr. Parker with Maci product_1200[May 23, 2019]

Are you a put ‘er offer when it comes to knee pain? Like so many of us, you grin and bear it, hoping to avoid or at least prolong the need for an eventual knee replacement. At AppOrtho, we understand that no one likes to think about knee replacement surgery. That’s why we are pleased to present a new and less-invasive treatment option that involves using the patient’s own cells to repair cartilage in the knee.

Yes, you read that correctly, welcome to the world of orthobiologics, now available right here in the High Country.

 

Breaking new ground

The first cartilage restoration procedure, otherwise known as Matrix-induced autologous chondrocyte implantation (MACI), was recently performed by Dr. Benjamin Parker at Watauga Medical Center.

To be clear, cartilage restoration in the knee is not a new concept. Similar procedures have actually been around for several years, but surgeons have been hesitant to recommend them due to the historically invasive and technically demanding nature of the surgery.

Now, thanks to new technology, this FDA approved procedure is simplified, less invasive and easily reproducible. It also provides long-lasting pain relief and improved knee functionality for the patient.1

 

How it works

Cartilage restoration surgery is a three-step process.

  1. The first step is for the surgeon to take a biopsy of healthy cartilage (arthroscopically) from a non weight-bearing area of the patient’s knee. The biopsy is then sent to a FDA-licensed, cell-processing center, where it is stored cryogenically (frozen) for up to five years.
  2. The patient can then wait and see how the knee progresses. If knee pain subsides after the initial debridement, no further action is required. However, if symptoms persist and surgery is recommended, the healthy cartilage cells from the biopsy are then expanded and seeded on a special membrane implant at the cell-processing center. The implant is then delivered back to the hospital for the surgeon to shape and fit into the area where the damaged cartilage was removed from the patient’s knee. No suture is required for this outpatient procedure; rather the implant is applied with surgical glue.
  3. The third step in the treatment process requires that the patient participate in a physician-prescribed rehabilitation program. Recovery time can vary, but patients are generally able to return to full weight-bearing and range of motion within four to six weeks.

 

Is it right for me?

This procedure may be considered for patients with acute cartilage injuries between the ages of 18 and 54. Acute cartilage injuries can occur after a fall or as a result of a traumatic athletic event. Symptoms may include pain, swelling, clicking and locking of the knee.2

In some cases, the MACI procedure may be considered to help prevent the knee from needing a joint replacement in the future. Not every patient is a good candidate for a cartilage restoration surgery. At AppOrtho, each patient is carefully evaluated in order to determine the most appropriate treatment option. All non-surgical treatment options are considered before surgery is recommended.

To make an appointment at AppOrtho, call (828) 386-2663 or request an appointment here. No referral is required.

 


References

  1. Saris D, Price A, Widuchowski W, et al. Matrix-applied characterized autologous cultured chondrocytes versus microfracture: Two-year follow-up of a prospective randomized trial. Am J Sports Med. 2014;42(6):1384-94.
  2. Gomoll AH, et al. Surgical management of articular cartilage defects of the knee. J Bone Joint Surg Am. 2010 Oct 20;92(14):2470-90.

Easy as kyphoplasty: End back pain with a simple procedure

Why does my back hurt? A spine surgeon’s analysis

Dr. James Califf is an orthopaedic surgeon at AppOrtho, a member of Appalachian Regional Healthcare System. Over his more than 25 years in practice, he has further refined his treatment of spinal disorders, offering non-surgical as well as minimally invasive surgical techniques. His clinical focus includes spine, shoulder, hip, hand, joint replacement and arthroscopic surgery. Learn more about Dr. Califf >

Back pain will affect 80 percent of humans at some point in their lives. It is the most common cause of job-related disability and a leading contributor to missed work days.¹ Sometimes leg pain and weakness can originate in the back. Fortunately, the majority of back pain will resolve itself in 6 to 8 weeks, but it’s important to determine if the pain is coming from a severe underlying condition. An orthopedist can evaluate the cause and recommend the best treatment for your particular condition. Your treatment plan should also include preventing a recurrence of your injury. Surgery is recommended only if other measures fail or the issue is severe enough. If you are suffering from back pain, please contact AppOrtho online or call (828) 386-2663.

Muscle/soft tissue injury or strain

One of the most common causes of pain, this injury is commonly associated with poor physical conditioning. Muscle strain can affect people of any age or activity level.

Symptoms: The pain is usually a grabbing, localized pain that can radiate to the knees and down the back of the legs

Treatment options: Exercises, minimal medication, or physical therapy.

Degenerative arthritis

Also called Osteoarthritis (OA), or “wear and tear” arthritis, this condition can be part of the aging process which begins around age 30. With OA, the cartilage within a joint begins to break down and the underlying bone begins to change.²

Symptoms: Degenerative arthritis usually causes back pain that does not radiate down the legs past the knees unless the spurs from arthritis compress the spinal cord or a nerve. The pain is usually worse with activity and when getting up from a sitting position.

Treatment: Exercises, physical therapy, medication, activity modification and injections, or fusion surgery (rare).

2. Osteoarthritis (OA). (2017, September 6). Centers for Disease Control. Retrieved from https://www.cdc.gov/arthritis/basics/osteoarthritis.htm

 

Spine Fracture

Injury or osteoporosis can cause spine fracture.

Symptoms: Pain can be moderate or severe. If the fracture is displaced it can compress the spinal cord or nerves and cause radiating pain or nerve damage.

Treatment: Bracing, physical therapy, medication, possible kyphoplasty for osteoporotic fracture

Bulging or herniated disc

The lower back, where most back pain occurs, includes the five vertebrae (bones) in the lumbar region and supports much of the upper body’s weight. The spaces between the vertebrae are maintained by round, rubbery pads called discs that act like shock absorbers in the spine to cushion the bones as the body moves. Most people have a bulging disc, and usually they do not cause a problem.

Symptoms: When the disc compresses the spinal cord or nerve, radiating leg pain and or weakness can occur. Most disk herniation symptoms resolve without surgery. To diagnose herniated discs, an orthopedist uses an MRI or CT scan. Progressive weakness and bowel or bladder problems can be signs of a dangerous condition.

Treatment options: Exercises, medication (steroids, NSAIDs), epidural injections, physical therapy, or surgery.

Spinal stenosis

Arthritis and disc problems sometimes cause narrowing of the spinal cord. This can occur if the bone spurs are large enough to compress the nerves or spinal cord.

Symptoms: Numbness and weakness in the legs, usually with activity, that improves with sitting or bending forward.

Treatment: Exercises, physical therapy, medication, activity modification, injections, or surgical decompression

Sacroiliac Joint Damage

Pain in these joints on each side of your pelvis can be caused by arthritis, wear and tear or injury.

Symptoms: Produces pinpoint pain in the low back that occurs with sitting and activity. It can be severe.

Treatment: medication, physical therapy, injections, or possible minimally invasive fusion surgery

Treatment options

 

Anti-Inflammatory Medication– Taking a medication such as Naproxen that reduces inflammation just like you would take a vitamin – twice a day with food and water – is a great way to help the body calm down and allow itself to heal, though this may cause stomach issues as a side effect.

Physical Therapy – Physical therapy is a crucial part in recovery of a tendon tear or rupture. In order to regain motion and strength in the shoulder, one must perform exercises specifically tailored for their injury. Regaining strength takes time, and positive results should start after 4-6 weeks of physical therapy.

Injections – A steroid injection done in-office can help reduce inflammation and calm down the injured joint. Usually, these injections can only be performed every 3-4 months in order to avoid any further damage to the joint. Relief can last anywhere from weeks to months.

Arthroscopy – If you have a large or a small injury and it is not getting better with treatment, minimally invasive arthroscopic surgery might be an option for treatment and repair.

Surgery – Chronic issues such as arthritis might result in the need for surgery. X-Rays, CT scans or MRI should always be performed before moving to surgery.

Do you have joint and muscle pain?

AppOrtho can help. Schedule an appointment with one of our highly skilled providers today.

Navio Robotic-Assisted Knee Surgery

Navio Robotic-Assisted Knee Surgery

Are you ready to address your knee pain?

Call us at (828) 386-2663

AppOrtho is the first and only orthopedics practice in western NC to offer robotics-assisted partial and total knee replacement using the NAVIO® surgical system, only at Watauga Medical Center.

How do I know if I am a candidate for robotics-assisted partial or total knee replacement using the NAVIO® system?

Although each patient must consult with a physician individually, typical partial knee replacement candidates share the following characteristics:

  • Knee pain that limits your activities regularly
  • Knee pain due to osteoarthritis
  • Non-surgical treatments are no longer effective

Meet with a NAVIO® trained orthopedic surgeon at AppOrtho today to see if robotics-assisted surgery is right for you. 

Partial Knee Replacement

Total Knee Replacement

NAVIO®-Trained Surgeons

Patient Testimonials

Individual results may vary. There are risks associated with any surgical procedure including NAVIO-enabled Knee Replacement. NAVIO is not for everyone. Children, pregnant women, patients who have mental or neuromuscular disorders that do not allow control of the knee joint, morbidly obese patients, or any other patients contraindicated for UKR, PFA, or TKA should not undergo a NAVIO procedure. Consult your physician for details to determine if NAVIO is right for you.

Why does my shoulder hurt? An orthopedic surgeon weighs in

Why does my shoulder hurt? An orthopedic surgeon weighs in

Dr. Benjamin Parker is an orthopedic surgeon at AppOrtho and orthopedic medical director for App State Athletics. AppOrtho is the official sports medicine provider for App State Athletics, Watauga High School, and the High Country Soccer Association. Learn more about Dr. Parker >

Many people experience shoulder discomfort or pain at some point in their lives. Why does your shoulder hurt? The shoulder is a complex joint, made up of multiple muscles, tendons, and bones that work together to allow us to perform everyday activities – from playing basketball, to working in the garden.  When just one of these components is disrupted by overuse or injury, the shoulder can become painful. Pain in the shoulder can present itself in many different ways, which can be overwhelming and confusing. Do you need shoulder surgery? Maybe, but there are some non-surgical options to consider first. This article’s purpose is to provide information and possible treatment options for common causes of shoulder pain. If you are suffering from shoulder pain, please contact AppOrtho online or call (828) 386-2663.

Arthritis

As we age, our bodies go through some wear and tear, which can result in an arthritic shoulder. This is a normal process that middle-aged to elderly individuals begin to experience.

Symptoms: Shooting and catching pain that originates in the shoulder and stops at the elbow is a common sign of an arthritic shoulder. Overuse of an arthritic shoulder can cause inflammation to enter the shoulder resulting in stiffness and worsening pain.

Treatment Options: anti-inflammatory medication, injection, possible arthroscopy or replacement

Subacromial Bursitis

Bursa are fluid filled sacs that reside inside joints all over the body, including the shoulder below a bone called the acromion. These sacs help reduce friction between muscles sliding over bones and can sometimes become inflamed and irritated due to day-to-day use.

Symptoms: The arm may feel weak or painful, especially when it is lifted to the side.

Treatment Options: anti-inflammatory medication, physical therapy, injection, possible arthroscopy or cleanup

Rotator Cuff Tendons/Muscles

The rotator cuff is made of four main muscles and associated tendons. These muscles and tendons can tear or avulse (pop off the bone) during physical activity or a traumatic event such as a fall. Chronic wear and overuse can also cause a tear.

Symptoms: Stiffness, pain and weakness of the shoulder are common symptoms as well as feeling a ripping or popping sound during the time of the injury.

Treatment Options: anti-inflammatory medication, physical therapy injection, possible arthroscopy and repair

Biceps Tenosynovitis

The biceps tendon lies within a groove in the front of your shoulder and sweeps in a “windshield wiper” motion across this groove during day-to-day activities. This repetitive motion can irritate the tendon and cause inflammation in the shoulder.

Symptoms: A biceps tendon problem can be associated with pain in the front part of the shoulder. If rubbing or massaging the front shoulder is sensitive or painful, this might be an indication of biceps tenosynovitis.

Treatment Options: anti-inflammatory medication, physical therapy, injection, possible tendon reattachment arthroscopically

Treatment options

 

Anti-Inflammatory Medication– Taking a medication such as Naproxen that reduces inflammation just like you would take a vitamin – twice a day with food and water – is a great way to help the body calm down and allow itself to heal, though this may cause stomach issues as a side effect.

Physical Therapy – Physical therapy is a crucial part in recovery of a tendon tear or rupture. In order to regain motion and strength in the shoulder, one must perform exercises specifically tailored for their injury. Regaining strength takes time, and positive results should start after 4-6 weeks of physical therapy.

Injections – A steroid injection done in-office can help reduce inflammation and calm down the injured joint. Usually, these injections can only be performed every 3-4 months in order to avoid any further damage to the joint. Relief can last anywhere from weeks to months.

Arthroscopy – If you have a large or a small injury and it is not getting better with treatment, minimally invasive arthroscopic surgery might be an option for treatment and repair.

Replacement – Chronic issues such as arthritis might result in the need for replacement. X-Rays, CT scans or MRI should always be performed before moving to surgery.

Do you have joint and muscle pain?

AppOrtho can help. Schedule an appointment with one of our highly skilled providers today.

Is a non-surgical treatment approach right for you?

Is a non-surgical treatment approach right for you?

Depending on your needs, your non-operative treatment approach might include injections, rehabilitation (Physical and Occupational Therapy) or a combination of both. The Rehabilitation Center at ARHS offers a comprehensive array of services from highly trained orthopedic physical therapists whose patients’ functional outcomes rank in the top 5% in the nation. For more information on joint specific outcomes at The Rehabilitation Center click here.