When it comes to the back, there are many intricacies that need to be addressed to ensure you receive the best and most appropriate care. At Lehigh Valley Health Network (LVHN), specialists in a variety of disciplines are part of our Advanced Spine Center. They offer an array of options for relieving back pain or correcting abnormalities in the spine. “We have an integrated model that provides comprehensive care from the simplest strain to the most complex back surgery,” says fellowship-trained orthopedic surgeon Jeffrey McConnell, MD, with LVPG Orthopedics and Sports Medicine.
Scoliosis – Ahead of the curve
Among the conditions spine specialists treat is scoliosis, or abnormal curvature of the spine. “Scoliosis can be a symptom of something else,” McConnell says. “You need to know the underlying cause.”
Causes include at-birth abnormalities in vertebrae or growth plates, neuromuscular conditions like cerebral palsy or muscular dystrophy, and scoliosis due to age-related degeneration of joints and discs in the spine. “But most cases occur during adolescence in a form known as late-onset scoliosis,” McConnell says.
Late-onset cases often require no treatment. “We follow scoliosis during growth to make sure it doesn’t get worse,” McConnell says. But 20 to 30 percent of cases progress and need correction, typically with bracing that straightens the spine and guides growth – “like tying a sapling tree to a stake guides its growth,” McConnell says.
If curvature has significantly progressed, the condition can be treated surgically with rods, screws and cables, which pull or push the spine into a straight position that a bone graft fuses into place. Such orthopedic procedures are available at numerous locations including the Center for Orthopedic Medicine–Tilghman, Cedar Crest and Muhlenberg.
Physical therapy plays a key role in treatment as well. “Often with back conditions like scoliosis, the trunk is weak, so strengthening exercises are important,” says physical therapist Chris Johns, a rehab clinical specialist.
Broad spectrum of back and spine care
Other common conditions treated by Advanced Spine Center specialists include spinal stenosis, in which narrowing of spaces in the spine puts pressure on nerves; herniated discs, in which the soft center of a spinal disc pushes through a tear in the disc’s tougher exterior; and spondylolisthesis, in which damaged discs slip out of place.
“Advanced Spine Center has neurosurgical expertise in cases where nerves become involved,” says fellowship-trained neurosurgeon Chris Lycette, MD, with LVPG Neurosurgery. “Having a multidisciplinary team provides specialists with a broad base of knowledge and skills so you quickly get what you need from the appropriate people.”
Herniated disc – All options
If you are coping with back pain, care coordination can be important because underlying causes of back pain vary. “We follow protocols and assure that we appropriately triage patients to the right doctor as quickly as possible,” Lycette says. “Depending on the condition and what caused it, a patient may be referred immediately to a surgeon, however, we exhaust conservative measures before progressing to surgery.” Those measures may include physiatry, pain management and/or chiropractic care.
Advanced Spine Center surgeons specialize in procedures such as microdiscectomy, in which portions of a disc that impinge on a nerve are removed with the help of a powerful microscope. “This minimally invasive approach allows patients to bounce back quickly, often going home the same day,” Lycette says.
Microdiscectomy was a godsend to Melissa Thibault of New Tripoli. She’d developed a herniated disc that limited walking and activity. “It sent pain like razor blades down my legs,” she says. A preschool assistant and longtime dancer, she’d recently taken up belly dancing and performed at local restaurants. “I wanted my life back so I could dance,” Thibault says. She received a microdiscectomy in July. “When I woke after surgery, I had no more pain in my leg,” she says. “I felt like a new person.”
People with back pain often wonder if they should see a doctor specializing in orthopedics or neurosurgery, but Advanced Spine Center covers patients either way. “When people contact the Advanced Spine Center, our comprehensive care team works with patients to secure an appointment with the appropriate subspecialist as quickly as possible,” Lycette says.
– Richard Laliberte