Disc Disease
Problems with spinal discs occur most commonly in the neck and lower back. Injured discs may put pressure on nerves as they exit the spine, causing pain along the limb where the nerve travels. Muscle weakness and numbness may also occur from this nerve compression. The diagnosis and treatment of disc disorders is carried out by many of the specialists at New England Neurological Associates. The initial diagnosis is often made by the neurologists or neurosurgeons. Imaging tests, such as CAT scan or MRI, may be ordered to confirm their clinical impression. Electrodiagnostic tests such as an electromyelogram (EMG) may be employed. Once a certain diagnosis is established, treatment can begin.
For most people, the initial treatment of disc disease involves rest, medication, and physical therapy in some combination. The physical medicine and rehabilitation specialist, or physiatrist, is frequently consulted to assure that the maximal benefit is achieved in this phase. For a majority of patients, improvement occurs and no further treatment is needed. If the symptoms persist despite aggressive non-surgical care, a referral to the surgeon may be indicated.
Cervical and Lumbar Disc Disorders/Outpatient Disc Surgery -- The physicians of New England Neurological are experts in both conservative and surgical management of ruptured discs in the cervical and lumbar spine. Patients with cervical and lumbar disc problems can often be treated on an outpatient basis. Hospital length of stay following a surgical procedure is determined primarily by a patient’s need for nursing services for pain management.
With this in mind, the surgeons and pain management specialists of New England Neurological Associates have developed a protocol for the management of patients which assures a smooth post-operative course, with freedom from post-op pain and the possibility of early discharge from the hospital. Utilizing this approach, eight out of ten laminectomy patients are able to leave the hospital on the day of their operation.
Our model incorporates several aspects of patient care: (1) patient education about pain during a pre-operative visit to the surgeon; (2) preempting pain through the use of long acting anesthetics and anti-inflammatory medicines at the time of the operation; (3) nursing protocols are in place that provide a detailed plan for the patient’s post-operative course on an hour by hour basis; (4) follow-up by the nurse treating the patient on the morning after discharge and by the surgeon when needed. There has been no increase in complications and no problem associated with “same-day” disc surgery. In fact, early mobilization and freedom from pain has allowed an early return to work and full activity for many patients.
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