From left, James Iatridis, director of spine research, The Mount Sinai Hospital; Dr. Stuart Khan, chief interventional spine physiatry at The Mount Sinai Hospital; Dr. Andrew Hecht, chief of spine surgery for the Mount Sinai Hospital and the Mount Sinai Health System; and Dr. Sheeraz Querishi, spine surgeon-fellowship director at The Mount Sinai Hospital.
As chief of spine surgery, chief of interventional spine physiatry, and spine fellowship director at the Spine Hospital at Mount Sinai, Dr. Andrew Hecht, Dr. Stuart Khan, and Dr. Sheeraz Qureshi have a combined 40 years’ experience treating damaged spines. Dr. James Iatridis is the director of spine research. The Spine Hospital at Mount Sinai opened to the public on June 8.
WHO’S AT RISK
After upper respiratory problems, back pain is the second most common complaint that drives patients to the doctor’s office. “When something goes wrong with the spine, most patients have either neck and arm pain or back and leg pain, which can dramatically impair day to day function,” says Hecht. “Most of us will experience back pain at some point in our lives. The good news is that conservative care can get patients back to function 75% of the time, and that when surgical treatment of neck and arm pain or back and leg pain is needed, it has over a 90% success rate.”
The spine is a column of 33 bones separated by rubbery discs that act as cushions to the stacked bones. “Some of the most common spine problems include spinal stenosis, scoliosis, arthritic disorders of the spine, and herniated discs, which are the single most common problem,” says Qureshi. “We say that a disc is herniated when the outer covering of the disc tears and as the inner tissue begins coming out, it pushes on a nerve, causing nerve pain either in the arms or legs.”
There’s a lot doctors don’t yet understand about why one person develops back problems and someone else doesn’t. “Although we know that there are certain problems that run in families, the genetics of spinal disorders are poorly understood,” says Hecht. “A lot of spinal damage is acquired as the result of wear and tear over time. Accidents, falls and trauma can also be the root cause, but usually, it’s just the accumulation of daily living.”
SIGNS AND SYMPTOMS
How can you tell the difference between garden variety neck and back pain that will go away on its own, and something more serious? “You want to look out for any symptoms that radiate down the arm and leg, especially if they are accompanied by tingling or weakness,” says Hecht.
Another red flag to look out for is any impairment of function. “Some patients experience weakness in the hands — they can’t write, they can’t hold a bottle, or their legs are buckling and it’s not safe to walk around,” says Khan. “These symptoms involve key functions, so don’t delay seeking medical attention — in fact, these symptoms are grave enough that they call for seeing a spine specialist.”
The course of treatment for spine problems varies widely depending on the individual patient. “Generally speaking, the options are physical therapy and medication, injections, and ultimately, if necessary, surgery,” says Qureshi. “Our hospital places an equal emphasis on nonoperative care and conservative treatments as it does on surgery — our goal is always to find the find the best targeted treatment plan for the individual patient.”
One of the benefits of a specialized hospital setting is the long-practiced expertise of all the health care practitioners. “Our surgeons, nurses, anesthesiologists, physiatrists, pathologists, social workers and other health care professionals all specialize in treating spine patients — so the person doing your epidural might have done more than 50,000 in his or her career,” says Khan. “Our team has years and years of experience under their belt, and everyone is focused solely on getting you back to your quality of life.”
Back pain isn’t something you just have to suffer through in silence. “Spine problems tend to affect almost all of us at one time or another,” says Hecht. “If your neck or back pain is also radiating down the arm or leg, you should consult a spine specialist. Many patients will get better from a nonoperative approach, and when surgery is warranted, the latest technology means that a minimally-invasive approach is often possible.”
You want to look out for any symptoms that radiate down the arm and leg, especially if they are accompanied by tingling or weakness.
It’s a promising time for researchers investigating the spine. “Researchers are working closely with clinicians to develop minimally invasive interventions to prevent and repair painful disc degeneration,” says Dr. James Iatridis. “Part of this research seeks to improve our understanding of why spinal discs become damaged, which we hope will help us figure out how to reverse this process.”
QUESTIONS FOR YOUR DOCTOR
You have a better chance of maintaining a healthy back for the course of a lifetime if you’re a proactive patient. Ask, “What can I do to keep my spine healthy?” And if you are experiencing back problems, ask, “Should I see a spine specialist?” and “Would I benefit from physical therapy?” There’s more and more doctors can do to repair damaged spines, and many of the treatment options are nonsurgical. “Neck pain accompanied by arm or back pain with leg pain can be extremely debilitating, but don’t despair — seeing a spine specialist doesn’t necessarily mean having surgery,” says Hecht. “At specialist centers like the Spine Hospital at Mount Sinai, we’re committed to finding the least invasive treatment possible to get you back to your quality of life.”
WHAT YOU CAN DO
Get informed .
For patient-friendly information including diagrams, videos, and search engines, check the North American Spine Society (Spine.org) and Mount Sinai (mountsinai.org/spine).
Treat your back right.
Part of protecting your spine is practicing better body mechanics, doing strengthening exercises, and keeping fit in general. “There are hundreds of theories of how to do it, but what they all have in common is good ergonomics and good nutrition,” says Khan.
Build a strong core.
The muscles around the back help take pressure off the spine. Be sure to work the sides and back along with the abs.
Protect your neck.
Especially when you’re working, it’s important to balance your head in a neutral position over your shoulders. Don’t hunch over a computer screen, bow your head over a book, or cradle the phone; instead, your shoulder blades should be touching the back of the chair and your computer should be set at eye level.
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