I've Got Your Back : The Truth about Spine Surgery, Straight from a Surgeon

by Tindel, Nathaniel L.; Haspel, Tamar

• ISBN13: 9780451220219
• ISBN10: 0451220218
• Edition: 1st
• Format: Paperback
• Copyright: 2007-01-02
• Publisher: NAL Trade

Summary

A prominent surgeon and a veteran health writer deliver an authoritative and plain-spoken guide to what back surgery can and can't do. It tells the behind-the-scenes story of back pain, back doctors, and back treatments-a story that is rarely delivered so candidly to patients. It arms you with the information and the courage to ask the right doctors the right questions so that you can make the right decisions.

Author Biography

Dr. Nathaniel L. Tindel is Chief of Spinal Surgery at Jacobi Medical Center and the former director of the Spine Service at the Montefiore Medical Center.

Tamar Haspel has written for Health, Prevention, Men's Health, and other publications.

Table of Contents

INTRODUCTION	xv
AUTHOR'S NOTE ON SCIENTIFIC EVIDENCE AND BACK PAIN	xxv
Section I: THE BACK STORY: The Basics of Spines and Surgery
CHAPTER 1: A SPINE TUTORIAL	3
The Spine in Full	4
The Sum of Its Parts	5
The Parts That Are Holes	8
The Disc	9
The Spinal Cord	10
Muscles	12
Ligaments	12
CHAPTER 2: THE PROBLEM OF PAIN: WHAT WE DON'T KNOW	14
The Appendicitis Model	16
Pain and Your Brain	20
CHAPTER 3: FINDING A DOCTOR	24
Meet Your Doctor	29
Questions, Questions	30
The Two-way Information Street	33
Second Opinions	35
Choosing Your Doctor	37
Red Flags	38
Section II: THE CAUSES OF BACK PAIN
CHAPTER 4: MY BACK HURTS: THE VARIETIES OF PAIN	43
Other Types of Pain	49
CHAPTER 5: SPINE-ONE-ONE: EMERGENCIES AND URGENCIES	52
Emergencies	53
Urgencies	59
CHAPTER 6: TESTING, TESTING: X-RAYS, SCANS, AND MORE	68
Magnetic Resonance Imaging (MRI)	75
X-rays	77
Computerized Tomography (CT) Scan	79
Myelogram	80
Nuclear Bone Scan	81
Electromyography (EMG)	82
Discogram	85
CHAPTER 7: THE USUAL SUSPECTS: COMMON BACK DIAGNOSES	90
Herniated Disc	92
Spinal Stenosis	98
Spondylolysis	102
Spondylolisthesis	104
Kyphosis (Fixed Sagittal Plane Deformity, Flatback Syndrome)	108
Facet Joint Syndrome	110
Scoliosis	111
Sacroiliac (SI) Joint Problems	117
Discogenic Low Back Pain	119
Degenerative Disc Disease and Black Disc	120
Internal Disc Disruption (IDD)	123
Acute Low Back Pain	125
Section III: DODGING THE KNIFE: Alternatives to Surgery
CHAPTER 8: EXERCISE	131
Making Sense of the Options	134
CHAPTER 9: ALTERNATIVE TREATMENTS	139
No Risk	141
Small Risk	145
Significant Risk	149
CHAPTER 10: MEDICATIONS	154
Acetaminophen	157
Aspirin	159
Nonsteroidal Anti-inflammatory Drugs (NSAIDs)	159
Opiates	164
Muscle Relaxants	166
Antidepressants	168
Antiseizure Medications	168
Steroids	169
CHAPTER 11: SPINAL INJECTIONS	170
Types of Injections	172
Risks of Injections	177
Section IV: GOING UNDER THE KNIFE: Surgical Procedures
CHAPTER 12: LUMBAR LAMINECTOMY	181
The Varieties of Laminectomy	182
Why a Laminectomy?	184
When Not to Get a Laminectomy	195
What Can Go Wrong	196
Laminectomy and Fusion	198
When You Should Consider Fusion with a Laminectomy	200
Recovery	203
CHAPTER 13: SPINAL FUSION	206
Why Fusion?	207
Fusion for Instability-Related Pain	208
Section V: AFTER THE SURGERY: Care and Complications
CHAPTER 17: GENERAL COMPLICATIONS	283
During Surgery	284
After Surgery	288
Summary	290
CHAPTER 18: REVISION SURGERY	292
Revision Laminectomy	293
Hardware Failure	297
Fusion Non-Union (Pseudarthrosis)	298
Adjacent Level Disease	299
Postoperative Instability	301
EPILOGUE: IT STILL HURTS! WHAT DO I DO?	303