Occupational Spine & MIS Surgery Philip A. Yazbak, MD, FACS
What are the two purposes of the spine?
To support the upper body To protect the spinal cord and the nerves
Gary Larson
The Disc
Vertebrae and discs
What leads to disc degeneration?
Living Breathing Doing
Tobacco abuse Physical labor Family history
Wear & tear
US Life Expectancy 1914: women 57, men 52 1964: women 67, men 74 2014: women and men, 79 2014: women and men, 80 (WI)
Back Pain in the USA On any given day (population): 10% In any given year (workers): 50% In any given lifetime: 80% 2nd most common reason for MD eval $50B per year spent Most pain is mechanical
Physical Therapy
Chiropractic
Spinal Decompression (aka Traction)
Bracing
Core
Plank
More Planks
Crunch
Crunch with Ball
V Sit
Run
Power Walk
Elliptical Training
Stair Climber
Adaptive Motion Trainer
Spinning
Swimming & Water Aerobics
What else beyond exercise? Burst of oral steroids Acute, severe symptoms 5-10 days Strongest oral anti-inflammatory NSAIDs Chronic symptoms Prophylactic GI symptoms, kidney disease
Injections ESI or NRB for extremity symptoms A mixture of anesthetic and steroid Diagnostic and therapeutic Facet blocks, medial branch blocks, or facet rhizotomy for back symptoms
Spine Surgery Only ~ 5% of back patients will come to surgery Urgent/emergent for substantial motor weakness and/or compromise of bowel and bladder function Elective for others– treatment of last resort
What is minimally invasive spine surgery?
Why did minimally invasive spine surgery evolve?
Paraspinal muscles
Classic lumbar exposure
MIS exposure
What specific equipment and techniques are used?
Mini open ALIF
MIS TLIF
PEEK cages
Sextant screws
Sextant screws
MIS TLIF with screws
TLIF with screws
MIS TLIF with screws
MIS TLIF with screws
Cases: MIS lumbar discectomy MIS lumbar fusion Cervical fusion
Tina
Tina
Jack
Jack
Jack
Jack
Susan
Susan
What can better back health do for people?
Get them back on the slopes?
Like this guy?
Who is that guy?
Or get you running marathons?
Neuroscience Group 1305 West American Drive Neenah, WI 54956 920-725-9373 www.neurosciencegroup.com