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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, CINN’s electronic newsletter, takes us beyond our typical work injury services and pays special tribute to CINN’s twenty year history in providing excellent care to the greater Chicagoland area. As founder of CINN’s physiatry program over ten years ago, I have personally witnessed CINN’s evolution from a successful purely neurosurgery practice to a large multidisciplinary program providing a comprehensive continuum of care for patients suffering from back or neck pain, brain tumors and other cranial pathologies. The CINN commitment to doing what’s right for our patients has remained strong throughout our history. As a testament to this philosophy, CINN has continually investigated and added new devices, procedures, and approaches to our treatment armamentarium. From artificial discs for back and neck pain, to new minimally invasive and image guided spine procedures, to the use of highly focused beams of radiation to treat brain tumors, to treating pathologies in the brain through the body’s blood vessels, our promise of providing effective solutions for our patient’s well being holds true. Today, we are developing an integrated medicine program that brings together the expertise of a leading acupuncture practice with the physiatric and neurosurgical care provided at CINN. I invite you to read the acupuncture article included in this issue which provides an overview of acupuncture therapy and its applicability for patients suffering from back pain. These advances are just examples of the CINN philosophy in practice. I am optimistic that the years ahead will bring further opportunity to take better care of our patients. On behalf of my colleagues, I wish you a joyous holiday season and best wishes for a prosperous New Year. Daniel J. Hurley, M.D. |
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CINN Celebrating Twenty Years of Services to Chicagoland
When neurosurgeon Dr. Leonard Cerullo founded the Chicago Institute of Neurosurgery and Neuroresearch (CINN) Medical Group in 1987, little did he know that his brainchild would someday become a Chicago leader in providing patients with unprecedented brain and spine care. His philosophy was and still is, to offer patients an environment that is fresh, unique and unequalled anywhere. A skilled neurosurgeon and compassionate man, Cerullo believes that patients with specialized neurological conditions not only need state-of-the-art technology, but extraordinary emotional care as they often battle cancer and other debilitating conditions.
During CINN's first year, Cerullo and two other neurosurgeons performed approximately 450 surgical cases. Twenty years later, CINN physicians treat 10,000 brain and spine patients every year, believed to be more than any other neurosurgical practice in Chicago. Currently, CINN has 10 neurosurgeons, five physiatrists, two neurologists and one neurointerventionalist on staff who care for more than 5,500 new patients and perform 2,000 surgical cases and 4,000 spinal injections each year.
CINN Physicians and Specialized Procedures
Some of the most advanced neurosurgical and neuromedical care in Chicago are offered by CINN doctors. They were the first in the Chicago area and second in the country to adopt the Gamma Knife technology. To date, their expertise spans over 3,000 cases.
Continuing with the tradition of exploring new technologies, CINN neurosurgeons helped pioneer the Charité Lumbar Artificial Disc several years ago, and are currently pioneering new motion preserving devices, including the cervical artificial disc and a facet replacement system. All of these advances provide patients suffering from back and neck pain with more options.
CINN also has a team of world-renowned, multi-disciplinary specialists who tend to patients with aneurysms, strokes and other neurovascular disorders using highly effective endovascular and cerebrovascular therapies. These physicians use revolutionary, minimally invasive procedures for preventing and treating strokes, wide-neck aneurysms, carotid and intracranial stenosis, and other brain blood vessel conditions. They are recognized as being among the world’s leading providers of complex aneurysm repair.
Neurological and Orthopedic Hospital of Chicago
As an extension of CINN's philosophy to present personalized care to patients, the Neurologic & Orthopedic Hospital of Chicago (NOHC) opened its doors in 2002. Recognized as the country’s first freestanding acute care facility dedicated exclusively to neuroscience and orthopedic services, over 2,000 neurosurgical and orthopedic surgeries were performed in 2007.
Top-notch care continues to be CINN's hallmark. The brain and spinal fusion surgeries at NOHC have been acknowledged by many of Chicago’s well-respected insurance companies as having the fewest complications. A similar level of excellence is seen on the orthopedics side of the hospital. The total joint program at NOHC boasts zero infections, perhaps the lowest infection rate of any hospital in the nation.
As today's baby boomers continue to age yet want to stay active, NOHC continues to expand services. Over the past year, orthopedic surgeons began using customizable implants for knee replacements and offering minimally invasive hip resurfacing for patients with hip pain who want to maintain an active lifestyle.
CINN Prevention Programs
CINN is regarded for its trailblazing approach to patient advocacy, which was keenly reflected in earlier business models and continues today. This philosophy permeates CINN services and has resulted in a new campaign embracing prevention. Examples include:
- Development of the back pain information booklet, Back on Track, that is available free to consumers through www.cinn.org. Since its introduction in May 2007, over 2,000 copies have been distributed.
- Offering MRIs to breast cancer patients who are at risk for developing brain metastases through a clinical study funded by The CINN Foundation
- Using endovascular therapies to prevent stroke and offering complimentary screenings to patients at risk.
Announcing plans to bring a leading acupuncture practice to NOHC by the end of 2007. Oriental medicine will be available to reduce a patient’s pain, eliminat
e anxiety before and after surgery, and provide comfort to family members waiting for a loved one in surgery.
About Dr. Leonard Cerullo
Leonard J. Cerullo, M.D., is the founder and medical director of the Chicago Institute of Neurosurgery and Neuroresearch (CINN), Chicago, Illinois. A board certified neurosurgeon with over 30 years of experience, Dr. Cerullo is considered one of the nation's prominent leaders in neurosurgery. He is continuously praised for his skill in the diagnosis and treatment of brain tumors and spine disorders. Moreover, he has been instrumental advancing the use of non-invasive and minimally invasive treatments for a wide range of neurological disorders.
In 2002, Dr. Cerullo founded The CINN Foundation, a 501(c) 3 nonprofit organization, as a vehicle to support clinicians and researchers’ research, education and outreach activities targeted at improving the lives of individuals afflicted with neurological disorders. Since its inception, the Foundation has provided almost $2 million in funding for such initiatives.
A visionary surgeon and researcher, Dr. Cerullo is credited with pioneering the use of lasers in neurosurgery. He has published several articles and books on this subject. As medical director of CINN, Dr. Cerullo oversees many clinical and basic research studies. The goals of these investigations are either to develop techniques that reduce the risk and recovery time associated with surgery or to develop revolutionary therapies that eliminate the need for invasive surgery.
Having earned the admiration and respect of both his patients and his peers, Dr. Cerullo has been featured repeatedly in Chicago Magazine's Top Doctors issues.
Dr. Cerullo is a member of the Society of Neurological Surgeons, the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. He is past president of the American Society of Laser Medicine and Surgery, Laser Association of Neurological Surgeons International, and Midwest Bio-Laser Institute.
Location and Information
CINN offices are located in Chicago, Vernon Hills, Elmhurst, Skokie and Harvey. For more information on CINN, log on to www.cinn.org; and for NOHC, log on to www.neuro-orth.org.
Acupuncture: Applying 5,000 Years of Knowledge to Relieving Back Pain
Acupuncture practitioner Kellylee Whiteside explains the simple concepts underlying acupuncture and oriental, or Chinese, medicine, and how they relieve pain very effectively.
It’s all about the movement of blood and energy in the body, she explains. In oriental medicine, this energy is known as Qi (pronounced chee). Qi is the vital life force and energy that nourishes and promotes the body’s natural healing process, Whiteside says. According to traditional Chinese medical theory, pain and illness arise when the cyclical flow of Qi or blood becomes unbalanced or blocked. Acupuncture restores the proper balance of Qi and blood, allowing the body to correct itself, she explains.
Like fellow licensed acupuncturists Krishna Bader and Brian Manuele, Whiteside has earned board certification in oriental medicine from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). The three professionals are part of an expanding trend for practitioners of oriental medicine to work closely with medical doctors. The Chinese medicine approach is in some ways a deeper, more comprehensive approach to pain management, says Daniel J. Hurley, MD, CINN physiatrist. He has been instrumental in integrating the acupuncture practitioners into the CINN team. “They look at your body with a whole different map,” Dr. Hurley explains, using the analogy of two different types of telescopes. “In Western medicine, we look at the universe with a regular telescope and we can see all the stars and the galaxies. An acupuncturist trained in Chinese medicine might say, ‘we use a radio telescope -- we listen to the universe.’”
Manuele adds: By applying both methods (Western and Chinese), we can help people who weren’t getting anywhere with either method. The two are very synchronistic; they work well together.
How Acupuncturists Treat Pain
Only after a great deal of questioning, listening and observing do acupuncturists place needles on a patient’s body. Unlike a hypodermic needle, which is hollow to allow for fluid exchange, acupuncture needles are filaments that are disposable and individually sealed for sterility. Some of the needles are as thin as a hair and, in most individuals, cause little or no pain even though they puncture the skin.
The needles relieve the stagnation or weakness of blood and Qi. Blood stagnation may be caused by local trauma, such as heavy lifting, a sports injury, or an accident. In these cases, inflammation or br
uising will occur at the site of the trauma. Qi stagnation can be caused by stress, diet, lack of exercise, arthritis or emotional factors. A long history of Qi stagnation can also cause blood stagnation. In some cases, blood or Qi stagnation may signal infections or other pathologies.
Like flowing water that travels through rivers and streams, Qi flows through channels of the body known in oriental medicine as meridians. Whiteside explains that the network of 12-plus major meridians roughly corresponds to the location of major organ structures. Acupuncturists insert needles near the location of the pain and at other strategic locations to stimulate blood and Qi movement, thereby relieving pain. The acupoints are located on the meridians where nerve endings are located, says Bader, explaining that the stimulation of these nerve endings causes the brain to release endorphins. When you release those endorphins and remove the stagnation through meridians, pain is relieved.
Closely Observing Each Patient
Before beginning treatment, acupuncturists trained in oriental medicine do an extensive health intake and evaluation with each patient. This process can last for an hour to an hour and a half, with the acupuncturist asking an extensive series of questions and reading pulses corresponding to the different meridian systems. They also closely observe each patient, paying special attention to the patient’s mental outlook and the color of his or her complexion and tongue -- key health indicators in oriental medicine.
Oriental medicine originated 5,000 years ago, Whiteside says. Autopsies were not performed, as it would have been sacrilegious to be invasive. Instead, they studied living people. In oriental medicine, observation is key, she emphasizes. We observe all aspects of a person - mannerisms, emotions, coloring, lines on the face, constitution, and the functions of body systems that can impact the problem.
Treatment is a two-step process, Whiteside says. Improve the circulation of stagnant Qi and blood to reduce pain and then, very importantly, strengthen the underlying weak areas to prevent or reduce the re-occurrence of stagnation. There is no miracle, one-treatment cure; consistency is key to treatment, she emphasizes.
A Focus on Back Pain
While 70 percent of Bader’s patients have back pain as a primary concern, “it makes no sense to me to just treat a symptom. Not everyone with pain originating at the base of the spine will get the same treatment,” she says.
For example, Bader says that back pain is commonly treated by addressing the kidney meridian, which starts at the bottom of the foot and goes up the shin and leg through the stomach and ends near the clavicle bone. Whiteside adds that back pain is sometimes associated with the bladder meridian or liver meridian. While the meridian names have the nomenclature of Western organ systems and correspond to the systems to a certain extent, the meridian names are “metaphorical, not necessarily an anatomical description,” says Dr. Hurley.
The acupuncturists often become involved before surgery, to see if acupuncture treatment can help patients to manage the pain and avoid surgery. If surgery is required for back pain, acupuncture can significantly reduce recovery time by making patients more receptive to healing. “There’s also increased anxiety when preparing for and recovering from surgery,” Whiteside says. “Acupuncture can ease this anxiety and the side effects of medications, improve the circulation to speed healing, and make patients more receptive to recovery.”
Overcoming Skepticism or Lack of Information
While some skepticism still exists, acupuncture’s benefits are now well documented and backed by research. Several controlled studies have demonstrated acupuncture’s effectiveness in decreasing pain. Research shows that acupuncture helps produce natural steroids and endorphins that kill pain, Bader says. She adds that acupuncture can decrease inflammation, help to avoid surgery and costly interventions, and reduce need for medications and painkillers.
The training and expertise provided by Bader, Manuele and Whiteside bring considerable value to patients, Dr. Hurley says. Our mindset is always ‘who else is available to help,’ he explains. Our approach is that we can do something. You have to be creative and look for what’s possible. This mindset, coupled with a belief that there are many different ways to approach a problem, led him to learn more about acupuncture and establish working relationships with the acupuncturists.
“I haven’t had a back pain patient that hasn’t gotten some relief in some way with dedicated treatment,” says Bader. Adds Whiteside, “we live and function because blood and Qi circulate.” She and Bader both believe strongly in this statement and how acupuncture can cause optimal circulation of blood and Qi. “When you struggle with pain, it affects every aspect of your life,” Whiteside says. “Acupuncture gets to the root of pain by balancing the entire body, mind and spirit. Balance is healthy.”