May 10th, 2018
Photo Courtesy of Jeffrey Beall, Flickr
Most Americans experience back pain/injury at some point during their lives. However, there are also many examples of celebrities from professional athletes to actors/actresses that have also experienced and recovered from a spinal or brain injury. Peyton Manning, two-time Super Bowl champion and five-time MVP award recipient, suffered a prolonged neck injury, which caused him to miss the entire 2011 NFL season. His neck injury was treated with a number of surgeries including a spinal fusion to help repair the damage.
As a professional quarterback in the NFL for over 18 seasons during his career, Manning’s body experienced significantly more wear and tear and intense physical activity compared to the average Joe. His injury of nerve damage and neck pain occurred from prolonged use of his throwing arm. Manning received a spinal fusion, specifically an anterior cervical discectomy, to address his neck injury. Essentially, an anterior cervical discectomy and fusion “ is a type of neck surgery that removes a herniated or degenerative disc to relive spinal cord or nerve root pressure, which can alleviate corresponding pain, weakness, numbness and tingling,” according to Spine-Health. However, it is important to note that each patient’s experience is different and surgery, such as an anterior cervical discectomy, is not always the answer to treat a neck injury.
The purpose behind an anterior cervical discectomy and fusion is to relieve the spinal cord or nerve root pressure caused by either a herniated disc or to treat cervical degenerative disc disease. It can also address bone spurs sometimes caused by arthritis. Peyton Manning’s anterior cervical discectomy and fusion was successful and he was able to return to playing football in the NFL. He missed an entire season to properly heal and strengthen his body for his physically intense profession. Any person receiving this treatment will have to be dedicated to their post-surgery recovery as well as understand and accept the risks that come with surgery for their specific medical situation.
An anterior cervical discectomy or any spinal surgery is always a treatment option to be considered for those suffering from prolonged effects of a back/neck injury or pain. A neurosurgeon, such as Dr. Todd Kuether, can assist in the diagnosis and treatment of neck and back injuries and/or pain. He will guide those suffering through various alternatives like physical therapy, acupuncture and possibly injections before deciding whether or not surgery is the appropriate approach. If you are interested in making an appointment with Kuether Brain & Spine, please visit our website for more information: https://kuetherbrainandspine.com/.
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April 26th, 2018
Kuether Brain & Spine’s goal is to find the right treatment for patients to help them achieve an active, high-quality life, free of pain. The majority of patients at Kuether Brain & Spine come to Dr. Kuether and his team for the diagnosis and treatment of chronic back pain or back injuries. Back pain and/or back injuries are one of the most common health complaints among Americans.
Fortunately, Dr. Kuether and his team are committed to finding the least invasive treatment option as possible. Part of Dr. Todd Kuether’s mantra is treat each patient’s recovery differently and his practice advocates for the implementation of medical alternatives including physical therapy, acupuncture, injections, and of course, surgery, if necessary. In many cases, physical therapy and acupuncture are commonly explored and used alternatives for those struggling with back pain.
Photo Courtesy of M. Pit, Unsplash
Physical therapy can be integrated into a pain management regimen as the solution or part of the pain management process. Physical therapy aims to help patients building or rebuild strength in their backs, core or other body parts’ weak spots. A physical therapist will tailor a specific exercise program for each patient’s condition and pain level using a variety of mechanisms including: stretching, strengthening exercises, aerobic conditioning, manual therapy techniques, and pain management modalities. Physical therapy also often strives to help patients find natural ways to manage or resolve their pain without the use of prescription painkillers. Please find more information on the benefits of physical therapy here.
Acupuncture is a recognized alternative treatment option for pain relief. It is an ancient form of Chinese medicine that has been used for over 2,000 years. Acupuncture can be helpful to those suffering from back or neck pain because its process stimulates the central nervous system by strategically inserting approved needles into the body’s surface. In most instances, correctly administered acupuncture treatments are pain free for patients. It is believe acupuncture can assist the body and brain with its own pain management. Acupuncture is an explored alternative for neck and back pain as well as for other neuromuscular issues such as headaches and fibromyalgia. Please find more information on acupuncture here.
As mentioned, Dr. Kuether and his team strive to find patients the right and best treatment for their individual recovery journey. We advocate exploring all options including alternative treatments like physical therapy and acupuncture in addition to more traditional options like injections or surgery, if necessary. If you feel like you could benefit from a conversation with Dr. Kuether and his team, visit our website for more information on how to make an appointment.
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April 12th, 2018
Photo Courtesy of Jesper Aggergaard, Unsplash
Most Americans suffer from back pain at some point in their lives. In fact, back pain is the most common reason for missed workdays and doctors visits. The human back consists of over 200 muscles; an estimated 120 of those muscles support the spine. There is no denying the connection between a healthy back and our wellbeing, movement and survival. Just like we take care of our brains, there are easy ways to protect the spine and back from injury and prolonged pain.
Watch your Posture
Posture can be the determining factor between placing excess pressure on the back and spine or not. Proper sitting posture should support the back. This can be achieved by sitting up straight with the spine aligned, shoulders back, knees bent, feet flat on the floor and weight evenly distributed. Training the body to sit properly may feel uncomfortable at first; however, your back and body will thank you by not being sore from excess strain.
Get Up and Stand Up
The body is not designed to sit in the same position for extended periods of time. Even with proper sitting posture, it is important to get up and move throughout the day. Ideally, a person should stand up and briefly walk around after 30 minutes of sitting. However, if this is not an option, it can be helpful to set an alarm or a reminder to move around throughout the day.
Exercise, especially your Core
Exercise generally improves all elements of health. A daily exercise routine of walking, running or approved weight or body-weight lifting regime can help improve back strength and spinal support. Besides building back muscles, it is important to also strengthen the core muscles, which help support the spine as well. Click here for a few core exercise ideas.
Exercise and stretching go hand and hand. Muscle strengthening is only beneficial if the body also receives the necessary stretching and recovery it deserves. Stretching benefits the body as well as the mind. Taking 15 minutes to stretch daily when you wake up or before you go to sleep can be a great time to reflect and take a mental break. Please find examples of helpful backstretches here .
Kuether Brain & Spine wants to be a resource to any person suffering from back pain or those wanting to protect their backs and spines. Dr. Kuether will work to find the right solution for any patient’s back pain by analyzing and diagnosing each patient uniquely. Medically regulated and recommended exercise, physical therapy, medications, alternative medicine and finally, surgery can all be possible solutions for treating back pain. If you suffer from back pain, it might be time to talk to us-reach out here!
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March 29th, 2018
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Minimally invasive spinal surgery (MISS) is a relatively new technology to the ever-evolving spinal health industry. MISS capitalizes on the latest and most advanced technology and techniques to treat back and/or neck pain caused by various spinal disorders. There are reasons for and against MISS options as well as limitations to what it can treat. Dr. Kuether of Kuether Brain & Spine specializes in the diagnosis and treatment of spine disorders, which can benefit from MISS technology. However, it is also important to remember surgery is a major medical decision and every case is treated differently based on the patient’s individual medical history.
What is it?
Minimally invasive spinal surgery aims to eliminate unnecessary trauma or tissue injury while attempting to treat back or neck pain caused by a spinal disorder by entering the body through a small incision. It typically uses computer-assisted technology or specialized tools. There are three common techniques: mini-open, tubular and endoscopic. Each technique aims to reduce blood loss, risk of infection and muscle damage by minimizing the size of the surgical incision. These techniques can be used to help accomplish either decompression, “the release of pressure off the spinal cord or nerve roots to relieve pinch nerves and pain”, or stabilization, “the stabilizing of spinal tissues commonly completed through fusion.”
What are the reasons for and against MISS?
Some of the most influential benefits of MISS is the smaller risk to infection during or after surgery due the smaller incision size compared to open back surgery; the decreased blood loss since the incision size is much smaller (can be less than one inch in some cases); typically minimal pain during and after the procedure; and a quicker expected recovery period post-surgery. Despite these great potential benefits, MISS is not suited for all back or neck injuries and cannot treat severe spinal trauma. MISS is commonly used in many spinal surgeries like discectomy, foraminotomy, laminectomy and laminotomy. There is also the challenge of finding a trusted neurosurgeon skilled to perform the procedure—not all practices and surgeons perform MISS.
Fortunately, Dr. Kuether at Kuether Brain & Spine performs both open and minimally invasive surgeries to try to provide the best solutions for his patients. His expertise in brain and spinal disorders with minimally invasive surgical techniques and his experience as the Director of Neurotrauma at Legacy Emanuel Hospital and Chair of Neurosurgery at Legacy Good Samaritan Hospital differentiate him from other surgeons in our area. Ultimately, MISS is an incredible advancement to brain and spinal surgery and Kuether Brain & Spine is committed to staying as technologically advanced as possible to provide the highest quality care to our patients.
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March 15th, 2018
Since this week is international Brain Awareness Week, we wanted to share three easy, everyday ways to encourage better brain health. Our brains like many other parts of our bodies can improve from preventative care and benefit from exercise. However, training and caring for your brain may be one of your easiest health routines.
Our brain loves and needs social interaction; loneliness can possibly lead to a 65 percent increased risk of dementia, according to the Journal of Neurology, Neurosurgery and Psychiatry. As humans, we need to talk, bond and make connections with new friends while maintaining and cherishing old friendships. The connection made between humans stimulates our emotional connectivity and intellectual capabilities. If there was ever a reason to plan a trip, go to dinner or even just give an old friend a call, it’s for your brain. Socialization improves your brain health and betters your life.
Photo Courtesy of Kelsey Chance, Unsplashed
Just like your body, your brain also benefits from a daily or weekly exercise regime. Exercise whether it’s swimming, running, jogging or even a brisk walk outside promotes the development of nerve cells and strengthens the number of synapses or brain cell connections. Additionally, regular physical exercise and a healthy diet are correlated with lower blood pressure, improved cholesterol levels, reduced stress levels and managed blood sugar levels. These factors not only improve brain health, but overall bodily health.
Photo Courtesy of Arek Adeoye, Unsplashed
Discover a New Love for Music
Music is a definitely a fun way to increase more brain activity. Participating in musical activities such as singing or playing an instrument is shown to activate both hemispheres of the brain at the same time, which is an incredibly healthy activity for your brain. The cross-communication that occurs in your brain while engaging in musical activity is believed to increase or encourage growth in the number of brain synapses. Singing on your commute, digging up your old band drum or trying to learn the piano are all activities that can enrich your life and deepen your brain’s health. While your musical activities may not sound great at the beginning, it’s an entertaining way to keep your brain young and potentially find a new passion.
Photo Courtesy of Sladjana Karvounis, Unsplashed
We at Kuether Brain and Spine hope these easy tips inspire you to live healthy for both your brain and your body. Happy Brain Awareness Week!
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March 5th, 2018
Photo Courtesy of Johannes Waibel, Stock Snap
Every four years, the world stops and comes together to celebrate world-class athletes as they compete at the highest level. As spectators, it is awe-inspiring to watch the best of the best break records and win the highest prize: an Olympic gold medal.
The recently concluded Winter Olympic Games in Pyeongchang showcased some of the most dangerous sports in the world. Slope-style snowboarding, freestyle skiing, bobsled and skiing/snowboard half-pipe have some of the highest injury rates per athlete of all sports. Famed American winter athletes such as Lindsey Vonn and Shaun White expose themselves to potential injuries like broken bones, torn ligaments and cranial and spinal trauma in each training session and competition.
Two of America’s most decorated winter athletes, Lindsey Vonn and Shaun White, both have experienced several severe injuries in their careers including spinal and cranial trauma. Lindsey Vonn, Olympic skiing medalist, faced a major injury in her back with an acute facet (spinal joint) dysfunction before the 2017-2018 World Cup while Shaun White, Olympic half-pipe snowboard medalist, suffered a cranial and facial injury in October 2017 that required 62 stitches, hospitalization and concussion monitoring. Fortunately, Vonn and White recovered from these injuries and have sustained lengthy careers in their specialty sports.
However, there are countless of other athletes whose careers have ended short due to increasing pressures to perform trickier jumps and reach higher speeds even while still recovering from injury. The 2018 Winter Olympics emphasized how much Olympic athletes’ bodies endure throughout their careers and how each run down a slope or half-pipe is a chance for a potentially lethal accident.
Untreated spinal and/or cranial injuries can lead to severe and life-altering repercussions. For example, ex-snowboarder Kevin Pearce, experienced a career-ending crash, in which he sustained a traumatic brain injury that caused him to be in a coma for weeks. Two weeks prior to this horrible crash, Pearce suffered a separate incident. He showed the signs of head trauma including nausea, sluggishness and mental fogginess; yet, he continued to compete despite the warning signs. Pearce has since spoken out about the dangers of competing while injured with head trauma.
In most cases of traumatic spinal and brain injuries, immediate action is needed and more importantly, time for the body to heal is critical. World-class snowboarder, Iouri Podladtchikov, took the appropriate precautions for recovering from a traumatic brain injury by pulling out the 2018 Winter Olympics completely. Podladtchikov crashed in an event prior to the Olympics, which left bruising and contusions on his brain. He released a statement saying it would not be responsible or safe for him to compete. His decision not only saved his brain and body from more damage and long-term consequences, but set a positive example for other athletes to allow their bodies to heal after spinal and/or head trauma.
It was a pleasure to watch all of the Winter Olympic athletes compete and we, at Kuether Brain & Spine, wish to see all athletes succeed in their careers injury free. Additionally, for our local community members and athletes, Kuether Brain & Spine works to find the best solutions for each individual patient’s spinal and brain health needs. We strive to help our patients live a happy, healthy, active and pain-free life, just like we wish for all of the Olympians who competed.
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February 2nd, 2018
The tingling in your hand is worse today. Yesterday it seemed fine and you could shake off the numbness and get back to work. Icing your wrist and taking anti-inflammatories gave you some relief. Youâ€™ve tried wearing a wrist splint at night, but itâ€™s uncomfortable and makes it tough to sleep. The good days have been fewer over the last month. You may have carpal tunnel syndrome.
Carpal Tunnel Syndrome
At the base of your hand is a narrow passageway, about one inch wide, called the carpal tunnel. The floor and sides of the tunnel are made up of bones and the top of the tunnel is a strong ligament. Because itâ€™s constructed of rigid bones and ligaments, the carpal tunnel canâ€™t stretch or increase in size.
The carpal tunnel protects one of the main nerves of your hand. This nerve, the median nerve, provides feeling to your thumb, index, middle and ring fingers and controls some of the thumb muscles. The carpal tunnel also protects the nine tendons that bend your fingers and thumb.
If the tendons become irritated or you have swelling in this area from an injury or other conditions such as arthritis, then the space within the carpal tunnel can narrow and pinch the median nerve. This causes the numbness and pain youâ€™ve been feeling in your hand and wrist.
Carpal Tunnel Symptoms
Most patientsâ€™ symptoms usually start out gradually. Hereâ€™s how a typical carpal tunnel case begins:
- The numbness and tingling occurred occasionally. It started in your thumb, then shifted to your index and middle fingers.
- Sometimes the numbness moves from your wrist up to your arm, when youâ€™re holding a box, your phone or your tools. The tingling can wake you from a sound sleep.
- Now youâ€™re having trouble gripping and have been dropping objects. Itâ€™s more difficult to use the keyboard or cash register at work.
A visit to your doctor, who ordered an x-ray, MRI, or other tests to measure how well your median nerve is working, confirmed you have carpal tunnel syndrome. Your carpal tunnel symptoms have stopped responding to home treatment and your pain is getting worse. These may be signs you need endoscopic carpal tunnel surgery.
Endoscopic Carpal Tunnel Surgery Overview
When your symptoms, including the amount of pain and numbness in your hand, become severe, your doctor may recommend surgery to prevent irreversible damage. The surgical procedure is called a carpal tunnel release and its goal is to relieve the pressure on your median nerve.
During endoscopic carpal tunnel surgery, one or two incisions will enable your doctor to use a miniature camera called an endoscope to see inside your wrist and make a cut to divide the carpal ligament. This increases the size of the carpal tunnel and reduces pressure on your median nerve.
Most patients see symptoms of carpal tunnel syndrome diminish after surgery. Recovery, particularly your ability to grip objects, will take time, so you may have to adjust your activities until your strength returns.
An Experienced, Exceptional Surgeon
Making the decision to have any surgery can be difficult. Working with an experienced surgeon you trust can ease your apprehension. Dr. Kuether has more than 15 years of experience performing minimally invasive procedures like endoscopic carpal tunnel surgery. Â Contact him in Portland, Oregon at (503) 489-8111.
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December 31st, 2017
There’s a myriad of types of brain surgeries used to diagnose and treat a range of brain diseases and infections. Here’s an overview of some of the most common types of brain surgery and what they’re used to treat:
A surgical biopsy is a simple procedure used to diagnose a number of conditions. The two most common forms of brain biopsies are a needle biopsy and an open biopsy. During needle biopsies, a neurosurgeon drills a small hole into the skull while a patient is under anesthesia. A piece of tissue is then removed with a large needle, usually a piece of a brain tumor. The other procedure, an open biopsy, is a far more invasive operation. A neurosurgeon removes a piece of the skull so that a brain tumor can be more easily accessed and potentially removed.
Reasons for a Brain Biopsy
These surgical biopsies are used to diagnose a number of brain diseases. The most common reason for brain biopsies is typically done to identify and diagnose brain cancers. In addition, these procedures can diagnose Creutzfeldt-Jakob disease or a number of brain infections.
Also called “ventric,” a ventriculostomy is a catheter-type device used to drain excess fluid from the brain. This procedure does not require general anesthesia and can be completed in about an hour. The ventric will stay in place as long as the neurosurgeon deems it necessary. The removal process only takes about a minute.
Reasons for Ventriculostomy
A ventric is used most often after brain surgery or a major brain injury. As brain fluid gathers and fills up in the brain, extreme pressure can build and slow blood flow, cutting off essential nutrients to the organ. A ventric drains this excess fluid to keep the brain healthy after major physical trauma.
During a craniotomy, a neurosurgeon makes an incision in the skull and creates a hole, known as a bone flap. This exposes the part of the brain that needs to be treated. After the procedure, the bone flap can be held in place with plates or wires. In the case of brain tumors or swelling, it can be left open. When a bone flap is left open, this is called a craniectomy.
Reasons for Craniotomy
There a multitude of purposes for a craniotomy. A neurosurgeon may want to clip off a brain aneurysm, drain fluid from a brain infection, or to remove large brain tumors.
A neuroendoscopy a minimally invasive procedure in which the neurosurgeon removes a brain tumor through small holes in the skull, mouth or nose. The benefits of this procedure over traditional surgical methods is that there’s less cutting involved, shortening both recovery time and pain intensity. A neuroendoscopy is completed with an endoscope, a small tool with an attached camera that allows the surgeon to navigate through the body and locate the tumor.
Reasons for a Neuroendoscopy
This procedure is done to remove smaller brain tumors and certain types of cysts. In addition, a brain biopsy can be completed during a neuroendoscopy.
Brain surgery in Portland OR
Dr. Todd Kuether at Kuether Brain and Spine is one of the most knowledgeable and professional neurosurgeons in the greater Portland area. Contact his office through this contact form for more information or to set up an appointment today.
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December 28th, 2017
The most common reason for spinal surgery is unresolved back pain, neck pain, leg and arm pain, and pain in the hands or feet due to compression of the spine from cervical or other spinal cord issues. Diseases of the spine, such as spinal stenosis, bulging discs, and sciatica, are also common reasons for an aching back, arms, or legs, and are included among the top reasons a spinal surgeon may recommend spinal surgery.
Four of the most common types of spinal surgery are outlined below. Each of these procedures is a minimally invasive, non-fusion, micro- or endoscopic type of spinal surgery, and all are relatively short operations that allow the patient to leave the surgical facility the same day (outpatient).
Treats: Herniated discs, compressed nerves, and pain associated with herniated discs
How it’s Done: The smallest incision necessary and possible is made, and a tiny camera (endoscope) is inserted, to help tiny surgical tools remove part of the herniated disc that is pressing on spinal nerves and causing pain.
Fun Fact: Lumbar herniated discs are the top reason working adults in the United States undergo spinal surgery.
2. Posterior Cervical Microforaminotomy (PCMF)
Treats: Compressed nerves in neck and spine and associated discomfort, arm and hand pain due to cervical disc protrusion.
How it’s Done: Through a minimal incision in the back of the neck, excess scar tissue, bone, and disc material are cleared, and spinal nerve root exits (neural foramen) are enlarged.
Fun Fact: Cervical disc problems are one of the most common types of spinal problems requiring spinal surgery.
Treats: Compressed spine.
How it’s Done: This surgery removes all or part of the thin, bony layer covering the top of the spinal cord (the lamina) to resolve bone spurs in the spine and to relieve pressure on the spinal cord and spinal nerves.
Fun Fact: A lamina can be flattened or arched and forms part of the covering of the spinal cord and spinal nerves.
4. Open Endoscopically Assisted Tubular Retractor Surgery
Treats: Herniated, protruding, extruded, or torn lumbar and cervical discs and associated nerve compression in spine
How it’s Done: A needle, dilator, guidewire, and thin tube are inserted into a vein to open a small 1/4-inch or seven-millimeter portal. In that space, an endoscope is inserted and tiny instruments are used to remove the small portion of the disc compressing the spine.
Fun Fact: Open endoscopically assisted tubular retractor surgery is not technically regarded as surgery; it is simply a small procedure.
Spine surgeons in Portland Oregon
Minimally invasive, outpatient, non-fusion, endoscopic and microscopic spinal surgery types are frequently the more hoped-for spinal surgery types of most neurosurgical patients. Patients and doctors prefer these types of spinal surgery, when they are an option, over open, inpatient, fusion, and macroscopic types of spinal surgery.
Spinal surgery is more commonplace than ever, so if you need spinal surgery, know that you are one of millions who have undergone the same type of procedure that has been recommended for you. Today’s spinal surgery types, even when not minimally invasive, are more safe and effective than ever. If you are experiencing unusual back, neck, arm, or leg pain, especially if this pain radiates to other parts of the body, you may wish to have your doctor refer you to a qualified neurosurgeon like Kuether Brain and Spine, so Dr. Kuether and his team can have you feeling better as soon as possible.
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December 4th, 2017
Back pain is one of those hidden injuries that can range anywhere from mild discomfort to debilitating pain. One of the most difficult things about managing back pain is knowing the difference between common ailments that can be treated with non-invasive methods, and serious back issues that require surgery. So how can you figure out if you need to see a’spine surgeon?
While surgeons often have differing opinions on what requires spinal surgery and what doesn’t, a general rule of thumb is simply if non-invasive methods don’t do the trick, spinal surgery is maybe the best option to give you some relief. Take a look below for things to try to relief your back pain before considering serious back surgery.
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