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Physiatrists Surgeons |
CINN
has specialists available to evaluate job requirements and susceptibility
to back injuries. If you are interested in this service, please contact
Lisa Dombro at ldombro@cinn.org
Editor’s MessageThis issue of the Discussant focuses on education. As part of our commitment to providing the most advanced and compassionate neurological care, we continually look for new ways to share with the community of professionals we work with, as well as our patients, programming and materials which will demystify and define great cranial and spine care. It is our pleasure to offer two CME/CEU programs this spring, which will discuss causes of and treatment for neck pain. As part of this program we will review the cervical artificial disc and its clinical relevance for our patients. Recognizing that certain shoulder disorders, for example, may unveil themselves as neck pain, we have invited an orthopedic surgeon to join the faculty to discuss the differential diagnosis for such pathology. In conjunction with The CINN Foundation, we have developed a 27-paged spine health reference tool for patients. "Back on Track" is available to all those interested at no charge. We already have been actively distributing the booklet to retail outlets, large corporations, and physician offices. Please use the CINN website (www.cinn.org) to request copies. The spine anatomy section of the booklet has been extracted and included in this newsletter — both as a resource to you — as well as a glimpse into the content of the booklet. I am also pleased to share with you that the Neurologic & Orthopedic Institute of Chicago, home for many of the CINN physicians, has been ranked #1 by Blue Cross Blue Shield and Aetna for brain and spine surgery when compared with other leading Chicagoland hospitals. This ranking, the details of which are available on their respective websites, reflects that brain and spine procedures performed at the Institute consistently have fewer numbers of complications, shorter lengths of stay, and lower associated mortality rates. Finally, we have included an overview of a clinical study being conducted at CINN aimed to better understand the benefits of detecting brain metastases from breast cancer at an early stage. Our experience and inclination suggests that earlier detection benefits the patient's quality of life and longevity, but good data in the neurosurgical literature on this point is sparse. Please take a moment to review the synopsis of the study and pass the information along to others that might be interested. I welcome you to take advantage of the educational resources described
in this issue. It is our hope that by working together we can take
better care of our patients. Kenneth Heiferman, M.D. |
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Advances in the Treatment of Neck Pain CME
CINN spine specialists, Daniel Hurley, M.D. and Noam Stadlan, M.D., will be joined by their orthopedic colleague, John Cherf, M.D., to discuss the diagnosis and treatments available for neck pain. Daniel Hurley, M.D., CINN physiatrist, will review appropriate diagnostic tactics along with available conservative treatments. John Cherf, M.D., will discuss those orthopedic disorders that may present as neck pain. The evening will conclude with Noam Stadlan, M.D., reviewing the surgical options for intractable neck pain, including the cervical artificial disc. The program is accredited by the Chicago Medical Society and the Illinois Nurses Association for continuing medical and nursing education credits, respectively. The free program will be presented on April 11th at the Botanic Gardens in Glencoe, as well as on April 24th at Maggiano's in Oakbrook Center. Please call 773 250-1009 to register or for more information.
Spine Care Health: Back on Track
CINN has created a new spine care health booklet, "Back on Track" which provides an overview of basic back pain facts, treatments, as well as detailed instructions for proper posture and body mechanics. Did you know that smoking and obesity contribute to the incidence of back pain? Did you know that exercises, especially those focused on strengthening core abdominal muscles can help alleviate back pain? A primer on basic spine anatomy and conditions along with easy to read diagrams is also provided. Through the generosity of The CINN Foundation, we are able to provide you and your clients copies of this booklet free of charge. If you are interested, please log onto the CINN website at www.cinn.org and click on "Back on Track."
Spine Anatomy
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The spine is a complex structure of bones and cartilage that encases the spinal cord. Its network of nerve tissue carries sensory and motor impulses between the body and brain. The following information is designed to provide a basic overview of the anatomy and function of the spine and spinal cord.
Vertebrae (1)
(sing., vertebra) The 33 bones that form the spine, or vertebral column. These bones provide structural support for the spine and encase the spinal cord. Each vertebra has a front and a back. The front is called the vertebral body. The back part of the vertebra is called the arch.
Facet Joints (2)
The joints that connect a vertebra to the vertebra above or below it. Facet joints are paired, meaning that there is a left and a right joint, and are located to the sides and behind the discs. Facet joints control the amount and direction of spinal movement.
Spinal Cord (3)
A cylinder of nerve tissue, about 18 inches long and roughly the thickness of a finger, that runs down the central canal in the spine. It carries both sensory and motor information between the body and the brain.
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Discs (4)
Fibrous pads of cartilage that separate vertebrae. The discs allow for flexibility in your spine, assist the muscles as shock absorbers, and provide cushioning between the vertebrae. The center of the disc is called the nucleus pulposus, a jelly-like substance. It is surrounded by tough rings of tissue called annulus fibrosus, which are similar to ligaments.
Ligaments (5)
Strong, fibrous bands of tissue that connect vertebra to vertebra. Ligaments prevent excessive movement of the joint.
Intervertebral Foramina (6)
(sing., foramen) The spaces within the vertebral column through which the spinal nerves pass.
Spinal Nerves (7)
These 31 pairs of nerves, located on each side of your spinal cord, transmit sensory and motor impulses between your brain and the rest of your body. They branch off the spinal cord and exit into your muscles through the intervertebral foramina (see 6).
Arch (8)
Bony structures, which make up the arch, are the transverse processes (9), lamina (10) and spinous processes (11). Muscles and ligaments attach to the arch to help support and stabilize the spinal column.
Muscle
Elastic tissue that is able to contract and relax, allowing parts of the body to move. (Not shown in diagrams.) Muscles of the spine attach vertebrae to each other or to other bones, such as the ribs, in order to allow movements like bending, rotating, and stretching.
Tendons
Fibrous tissue that joins muscle to bone. (Not shown in diagrams.)
CINN Seeking Breast Cancer Patients for Clinical Trial on Screening for Brain Metastases
CINN is seeking patients with breast cancer to participate in a clinical trial to assess the potential value of routine screening to detect brain metastases.
Because early diagnosis and treatment have increased longevity in breast cancer patients, clinicians have detected an increase in the number of cancer patients with brain metastases, or cancer that has spread from the breast to the brain. Research indicates that approximately 20 percent of breast cancer patients suffer from brain metastases.
Although this disease progression is well known, many doctors do not screen for this in their breast cancer patients, according to Gail Rosseau, MD, neurosurgeon at CINN and lead investigator of the trial. The CINN clinical trial attempts to determine if MRI screening of breast cancer patients can reduce mortality of this group of patients from brain metastases, she said.
Eligible patients must have an initial primary diagnosis of high-risk and/or HER-2 positive breast cancer, defined as stage IV disease or HER-2 positive Stage III disease. Once enrolled, patients will receive one free Magnetic Resonance Image (MRI) of their brain. All costs associated with the initial brain MRI are covered by the study. Results of the MRI will be shared with the subject. CINN will conduct annual follow up with each patient for five years.
To enroll in the study, call 773.250.0500. The study is funded by The CINN Foundation.
Neurologic & Orthopedic Institute of Chicago Ranked #1 by Blue Cross Blue Shield and Aetna
We are pleased to announce that the Neurologic & Orthopedic Institute of Chicago (the Institute) was ranked #1 by Blue Cross Blue Shield and Aetna for brain and spine surgery when compared with all other leading Chicagoland hospitals. This ranking, the details of which are available on their respective web sites, reflects that brain and spine procedures performed at the Institute consistently have the fewest number of complications, lowest length of stay and lowest associated mortality rate.
We recognize that the idea of hospital report cards is relatively new. While patients may find it difficult to understand exactly how these report cards should be utilized, professionals, such as yourself, are uniquely qualified to effectively use these data. The information now available through these leading insurance companies provides yet another perspective when making decisions regarding neurological and neurosurgical care.
Over 5,000 patients annually choose the CINN neurosurgeons, physiatrists and neurologists at the Institute to treat their back or neck pain, remove a brain tumor or a neurovascular condition. With your continued support, more patients can benefit from the unique model of care that has been refined at the Institute. We believe the data published by Blue Cross Blue Shield and Aetna validate the effectiveness of this focused approach.
To facilitate your ability to contact us and access any of our seven locations, CINN has a separate phone number for professionals. Please do not hesitate to contact us at 866.211.6808. We look forward to our continued collaboration.