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Occupational Spine & MIS Surgery
Philip A. Yazbak, MD, FACS
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What are the two purposes of the spine?
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To support the upper body To protect the spinal cord and the nerves
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Gary Larson
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The Disc
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Vertebrae and discs
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What leads to disc degeneration?
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Living Breathing Doing
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Tobacco abuse Physical labor Family history
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Wear & tear
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US Life Expectancy 1914: women 57, men 52 1964: women 67, men 74
2014: women and men, 79 2014: women and men, 80 (WI)
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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
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Physical Therapy
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Chiropractic
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Spinal Decompression (aka Traction)
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Bracing
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Core
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Plank
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More Planks
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Crunch
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Crunch with Ball
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V Sit
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Run
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Power Walk
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Elliptical Training
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Stair Climber
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Adaptive Motion Trainer
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Spinning
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Swimming & Water Aerobics
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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
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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
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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
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What is minimally invasive spine surgery?
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Why did minimally invasive spine surgery evolve?
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Paraspinal muscles
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Classic lumbar exposure
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MIS exposure
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What specific equipment and techniques
are used?
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Mini open ALIF
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MIS TLIF
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PEEK cages
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Sextant screws
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Sextant screws
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MIS TLIF with screws
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TLIF with screws
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MIS TLIF with screws
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MIS TLIF with screws
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Cases: MIS lumbar discectomy MIS lumbar fusion Cervical fusion
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Tina
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Tina
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Jack
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Jack
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Jack
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Jack
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Susan
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Susan
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What can better back health do for people?
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Get them back on the slopes?
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Like this guy?
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Who is that guy?
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Or get you running marathons?
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Neuroscience Group 1305 West American Drive Neenah, WI 54956
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