CLEVELAND CLINIC BACK AND NECK CENTERS

1 CLEVELAND CLINIC BACK AND NECK CENTERS . Comprehensive Care for Back and Neck Problems Tips to Help You Maintain a Healthy Back The CLEVELAND CLINIC back and neck CENTERS offer A medical approach focusing on non- surgical treatment and physical therapy. A medical spine specialist who coordi- nates the evaluation and treatment of each patient. Prompt initiation of active therapy. An emphasis on patient involvement in Back to normal the treatment plan. Comprehensive services to address a wide variety of disorders, from acute back strain to chronic, complex Nearly everyone experiences back or neck pain at problems. some time during their life. Pain or disability can be caused by injuries sustained at home or work, while involved in Our purpose Convenient consultation with specialized spine surgeons, if recommended. sports or recreation, during accidents or falls, or from The CLEVELAND CLINIC An outpatient physical therapy program.

2 Medical conditions, such as arthritis, osteoarthritis or Back & Neck CENTERS have An outpatient rehabilitation program osteoporosis. Factors that increase your risk of back or been established to provide specifically designed to return employ- neck pain include heavy lifting, being overweight, sitting the most advanced and ees to work and prevent work-related for long periods, driving and smoking. effective care for spinal injuries. The CLEVELAND CLINIC Back and Neck CENTERS , which (back and neck) problems, diagnose and treat more than 9,000 patients annually, utilizing a comprehensive Specialists in Spine Problems offer a team of experts skilled in all aspects of managing range of medical specialists Our team of specialists includes: and treating back- and neck-related problems. Care is and treatment modalities. Medical spine specialists who have available at The CLEVELAND CLINIC or at our suburban Our specialists are training in rheumatology, physical family health CENTERS .

3 In most cases, back and neck pain dedicated to patient care, medicine, neurology, internal medicine, can be resolved through medical management, exercise, patient satisfaction and to or family medicine plus additional physical therapy and other related treatments. On occa- advancing the science of training in the medical management sion, surgical treatment is appropriate. spine of our efforts of spine problems Our objective is to quickly return you to your are directed toward improving Orthopaedic surgeons and neurosur- normal routine and full can minimize the quality of life for people geons, who specialize in the surgical your chances of being debilitated by back and neck with spinal disorders. treatment of back and neck disorders. pain by addressing it your physician or Physical therapists who are experts in therapist what you can do to keep your back and posture and body mechanics neck have provided information in this Pain medicine specialists with special brochure on page 7 that may be helpful.

4 Training in diagnosis and treatment of chronic pain Behavioral medicine professionals who direct the chronic pain rehabilitation program Radiologists with expertise in viewing and interpreting scans of the spine 1. Comprehensive and When pain is persistent accessible services Board-certified pain management specialists offer a thorough assessment of your pain. Diagnostic tests may include nerve blocks, thermography, discography, and MRI and CT scans to determine the source of the pain. Behavioral health and Physical Therapy nutritional counseling are also offered. Physical therapy may include spinal A treatment plan is developed after mobilization, posture or exercise training, the diagnostic evaluation. It may include heat, cold, ultrasound or aquatic therapy both traditional and newer techniques, to diminish pain and improve function. such as therapeutic nerve blocks, spinal Exercise & Posture Education cord stimulation, spinal endoscopy and Your Initial Evaluation Since poor posture can contribute drug-delivery systems, acupuncture, When you are evaluated in one of to back pain, you may be taught how to bioelectric treatment, and physical and our back and neck CENTERS , you will first perform certain exercises to help cor- occupational therapy.

5 Undergo a comprehensive assessment of rect poor posture and strengthen the In some cases, people are referred your back or neck expert diag- muscles of the will also be to our chronic pain rehabilitation program. nostic evaluation is a necessary first step given practical advice on how to sit, Team members include experts in pain in planning the best possible treatment. stand, lift heavy loads, get in and out of a management, physical and occupational When indicated, X-rays or other advanced car and bend without aggravating a back therapy, biofeedback training, vocational imaging techniques, including computed problem. Swimming, walking or cycling rehabilitation, nursing, nutrition and tomography (CT) and magnetic resonance may be recommended to increase gener- coping skills training. imaging (MRI), as well as electrodiagnostic al fitness and decrease muscle tension. testing, will be obtained. Medication Individualized Treatment Plans Anti-inflammatory drugs and A customized treatment plan may other medications may provide relief include physical therapy, exercise, pos- of symptoms and reduce inflammation ture education, medication, and lifestyle of arthritic joints.

6 Appointments changes at home and at work as well as and information and surgical consultation. Our treatment Rehabilitation and Physical Medicine philosophy emphasizes self-management. Back and neck services are To help keep you active, mobile and The goal is to help you regain your provided at The CLEVELAND CLINIC healthy, our individualized rehabilitation health so you can manage the care of and at our suburban family health program includes nutritional counseling, your back independently. CENTERS . Please see the insert in this dietary adjustment, occupational therapy, pamphlet for a list of our team of vocational rehabilitation, equipment pre- experts, locations and phone scription and environmental assessment. numbers. For more information, Special rehabilitation strategies can call 800/545-7718; or visit us on the be developed. For example, women with Internet at osteoporosis may benefit from a pro- gram that helps reduce their risk of falls and fractures.

7 2 3. When surgery is required Of all the patients seen in our back Minimally Invasive Spine Surgery and neck CENTERS , less than 5 percent Approximately 20 percent of need or will benefit from patients undergoing spinal surgery are surgery is necessary, we offer state-of-the- candidates for a minimally invasive pro- art surgical facilities and equipment and cedure. CLEVELAND CLINIC spine surgeons a broad range of surgical procedures. are innovators in the application of Our surgeons work closely with your laparoscopic and endoscopic techniques. referring physician and physical therapist. Today, more procedures can be per- Routine and innovative procedures are formed laparoscopically or endoscopically Osteoporosis and Vertebral Compression Fractures offered to relieve pain, deformity and because of advancements in surgical The CLEVELAND CLINIC is one of disability resulting from degenerative, techniques and only a few medical CENTERS offering a infectious, traumatic or congenital spinal procedures result in a shorter hospital special procedure called kyphoplasty conditions.

8 Stay and faster recovery. for patients with pro- Two common surgical procedures cedure restores collapsed vertebrae to that can be done alone or in combina- nearly normal height, corrects the mis- tion are: alignment of the spine, helps relieve Laminectomy/discectomy:The ruptured pain and improves function. It can be disc is exposed and any material imping- performed using a minimally invasive ing on the nerve root is technique on an outpatient procedure is used only when ruptured procedure has been very successful as discs causing leg pain (sciatica) do not measured by patient satisfaction and respond to conservative or non-surgical improvement scores. treatment. More than 80 percent of patients with ruptured discs do Program for Failed Spine Surgery respond to conservative therapy. This program is for the small Fusion: Spinal fusion may be performed minority of people who have under- when there is excess motion in the gone back surgery and are still not spine due to wear and tear on the functioning at an optimal level.

9 Our Pediatric and Adolescent discs and unstable portion specialists are among the most experi- Spine Surgery of the spine is fused with bone from enced in Ohio in assessing and manag- Children and teenagers with elsewhere in the body or with metal ing the complex problems of spinal re- scoliosis or other spinal conditions rods to stabilize it. operations. Success rates, measured by can usually be treated with return to normal daily activities and minimally invasive techniques. Image-Guided Spinal Navigation pain reduction, are high. Our surgeons were among the CLEVELAND CLINIC neurosurgeons pio- Prior to making a recommenda- first in the country to use these neered the application of image-guided tion for re-operation, the team address- techniques to help correct some spinal navigation in technique es all of the issues that may have con- forms of curvatures. improves the accuracy, precision and tributed to the failure of the prior sur- safety of spinal instrumentation and gery.

10 Patients who are not appropriate reduces operative time. It is used in com- candidates for re-operation are referred plex reconstruction procedures related for rehabilitation. to trauma, degenerative disease, tumors and deformity. 4 5. Keep your back healthy through exercise and lifestyle habits A program of combined strengthen- ing, stretching and aerobic exercise, and elimination of cigarette smoking can Occupational contribute to the development of a rehabilitation How to maintain stronger, healthier back, making you program for a healthy back more resistant to back injuries and pain. Check with your physician before injured workers Once treatment is under way, we urge our patients to keep their backs you begin any exercise program to make sure it is right for you and your back. This program helps injured workers strong and following tips are Strengthening exercises increase mus- return to their jobs quickly through useful for almost everyone with back or cle tone and improve the quality of early intervention of work-related neck pain.