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Limitations on Mobility after Spinal Fusion

Back pain is one of the most prevalent complaints among adults. It is estimated that 8 out of 10 adults experience some form of chronic back pain during their lifetime. Chronic back pain is frequently cited as a reason for missing work, resulting in lost wages and a decline in productivity in the workplace. It is not surprising that people who are faced with back problems would go to great lengths to try invasive treatments such as spinal fusion, hoping to permanently get relief from chronic back pain.

Understanding the Spinal Fusion Procedure

The goal of spinal fusion is to connect adjoining vertebrae by using techniques developed from researching the actual healing process that broken bones undergo. Bone-compatible materials made from bone grafts or bone substitutes will be inserted between the vertebrae targeted for fusion. Surgical screws, rods or metal plates are used to hold the vertebrae together. In more complex cases, two or more interlocking vertebrae may be involved in the spinal fusion procedure. The results of a fusion are permanent. When the bones fuse as intended, it changes the natural mobility of your spine, affecting the area around the surgical site and in various body parts as well. By immobilizing sections of the spine, nerves, ligaments, and tissues that may have been causing or exacerbating your back pain will no longer stretch or even more.

Complications and Downsides to Spinal Fusion

This permanent solution cannot be reversed or modified at a later date, although corrective interventions often become necessary down the road. Immobilization of the spine in this manner exerts pressure on the bones above and below the fused segment, introducing new issues. Over time, this stress on the vertebrae will increase spinal degeneration, leading to the need for corrective surgery. Spinal fusion, by its very nature, involves extensive bone work. The procedure includes exposing the sides of the vertebrae, which means the surrounding muscles will have to be dissected and repaired, leading to extended downtime and a lengthy recovery process. Since the procedure involves the introduction of bone grafts and/or bone substitutes to the body, there is a very real possibility that inflammation may occur with subsequent scarring and creating new pain the surrounding area. Failed back surgery syndrome is a term used to describe the condition where lower back pain persists after surgery. Experts estimate that over 20 percent of spinal fusion surgeries may result in failed back surgery syndrome, and the risk is higher when the spine surgery involves fusion of three or more vertebrae segments. The risk for lumbar pseudoarthrosis resulting from a failed lumbar spinal fusion is low at 5 to 10 percent of spinal fusion surgeries, but remains a possibility for some patients. This is a condition where vertebrae fusion does not occur due to various conditions such as smoking or pre-existing conditions unrelated to the lower back issues. Repeat surgery is also a possibility in cases when the pedicle screws embedded to support the fusion process break or become loose or when anterior grafts shift position. Nerve damage, although rare, is also a possibility for patients who have undergone spinal surgery. This may compromise strength and mobility of the legs along with other conditions such as loss of bladder control. The biggest concern that is often overlooked when discussing spinal fusion as a solution for chronic back pain is that immobilizing sections of the spine will affect overall mobility of the individual. You may feel like a new person after recovering from the surgery, but in time, the effects of altering the natural structure of your spine will show in different ways, depending on the extensiveness of the spinal surgery and your body’s ability to adapt to the changes. These effects may include limited ability to bend over to perform normal torso movements, including rotations and stretches. These restrictions may limit your ability to enjoy your favorite activities and other physically demanding everyday tasks for the rest of your life. The typical candidate for a spinal fusion would be someone who has already tried other options with little or no success. Before committing to treatment that permanently alters the flexibility of your vertebrae, it may be prudent to discuss alternative treatments with your medical team.

Alternative Treatments

If you are faced with degenerative disc disease, you should be aware that spinal fusion may compound the problem as fused segments may exert new pressure on adjacent sections of the spine. Ask your physician about options such as posterior dynamic stabilization, which is a treatment that aims to preserve vertebral motion while relieving pressure off the affected disc. Other possible treatments include disc replacement, disc regeneration and intradiscal electrothermal coagulation or annuloplasty. Studies published by the U.S. National Library of Medicine under the National Institutes of Health indicate modest outcomes for surgical procedures intended to alleviate back problems. In terms of pain relief and improved functionality, randomized controlled trials suggest that patients experience moderate improvements that could possibly be achieved through less invasive therapies. Deciding on the best treatment for your condition takes cooperative effort. Listen to your medical team’s input and don’t be shy about asking questions regarding side effects and long-term impact.

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Matthias H. Wiederholz, M.D.

  • 4126 Southwest Freeway Suite# 1300 Houston, TX 770275
  • (346) 217-1111
  • 903 US-202 Ste A Raritan, NJ 08869
  • (908) 751-0980

Founding Partner, Triple Board Certified – Physical Medicine & Rehabilitation; Sports Medicine; Anti-Aging, Regenerative & Functional Medicine

Dr. Matthias H. Wiederholz is cofounder of Performance Spine & Sports Medicine, LLC. He is a fellowship-trained interventional pain physician whose clinical interests include: Interventional Pain Management, Sports Medicine, Musculoskeletal Medicine, Minimally-Invasive Spine Surgery, Non-Surgical Orthopedics, and Anti-Aging / Functional Medicine.

He received his specialty training in Physical Medicine and Rehabilitation at Baylor College of Medicine in Houston, Texas where he served as chief resident. He completed fellowship training in Interventional Pain Management in Marietta, Georgia. He is board-certified in Physical Medicine & Rehabilitation and Sports Medicine. He also received advanced fellowship training through the American Academy of Anti-Aging Medicine and is board-certified in Anti-Aging, Regenerative & Functional Medicine.

Dr. Wiederholz performs a myriad of interventional pain procedures including, but not limited to the following: epidural steroid injections, facet joint injections, radiofrequency ablation, sacroiliac joint injections, discography, percutaneous disc decompression, epidural lysis of adhesions spinal cord stimulator implants, and minimally-invasive discectomies. Endoscopic spine surgery is a very unique and valuable tool in his armamentarium and makes Dr. Wiederholz one of the most specialized physicians in the field of Pain Medicine.

Dr. Wiederholz uses musculoskeletal ultrasound in the diagnosis of musculoskeletal injuries. He incorporates ultrasound for precise injection therapy including cortisone injections, prolotherapy, and PRP (platelet rich plasma). This technology is also utilized to perform the Tenex procedure, a percutaneous procedure for treating chronic tendon pain (tennis elbow, rotator cuff, plantar fasciitis, etc).

Dr. Wiederholz is the fellowship director for the sports and spine fellowship at Performance Spine & Sports Medicine. Dr. Wiederholz holds an affiliation with Capital Health System and JFK Johnson Rehabilitation Institute.

Being advanced fellowship trained in Anti-Aging, Regenerative & Functional Medicine means that Dr. Wiederholz has the most advanced training in Anti-Aging Medicine available. He is a leading expert in Bio-Identical Hormone Restoration and helps patients achieve wellness through nutrition, lifestyle, and hormone therapies.

Kevin Pauza, M.D. - Texas Spine and Joint Hospital

Prior to attending Penn State University, Dr. Pauza earned his undergraduate degree from Lehigh University, and furthered his training with a Surgical and Medical Internship at Columbia University College of Physicians and Surgeons. He continued his specialty training at the University of Pennsylvania, followed by an Interventional Spine Fellowship. In addition to his research, philanthropic, and clinical endeavors, Dr. Pauza remains a motivated educator. He established a Spine Fellowship program and continues training physicians from around the world. He heads international committees responsible for establishing standards and educating surgical and non-surgical physicians.

  • 801 Turtle Creek Dr., Tyler, Texas 75701
  • 903-593-2222

SPECIALTY

  • Disc Biologics
  • Interventional Spine

EDUCATION & DEGREES

  • Fellowship: Interventional Spine, University of Pennsylvania
  • Residency: PM&R, University of Pennsylvania
  • Internship: Surgery & Medicine, Columbia University College of Physicians and Surgeons
  • Medical Doctorate: Pennsylvania State University College of Medicine
  • Bachelor of Arts: Biology, Lehigh University
  • Bachelor of Arts: Psychology, Lehigh University

CERTIFICATIONS & LICENSES

  • Texas State Medical and Surgical License
  • New York State Medical and Surgical License
  • Florida State Medical and Surgical License

HONORS

  • Lehigh University Four-year Academic Scholarship
  • Magna Cum Laude, Lehigh University
  • Lehigh University President’s Award
  • Lehigh University Tower Society
  • Distinguished Alumnus, Penn State University (selected from 500,000 Penn State alumni)
  • North American Spine Society, Outstanding Paper of the Year, 2003
  • President-Elect, International Spine Intervention Society
  • Founding Partner, Texas Spine and Joint Hospital
  • Commencement Speaker: Penn State University College of Medicine
  • Advisory Board, AMA
    Keynote Speaker, Harvard Pain Center Commencement
  • Founding Chairman, Standards Committee, International Spine Intervention Society
  • Chairman, Spine Committee, Amercian Academy of Physical Medicine & Rehabilitation
  • Appointed Spine Advisor, Japanese Prime Minister
  • Appointed Spine Advisor, Allied Royal Families

EXPERIENCE

  • Founding Partner & Principal, Texas Spine & Joint Hospital

Wendi Lundquist, D.O. - Active Life Physical Medicine & Pain Center

Dr. Lundquist is the Medical Director and founder of Active Life Physical Medicine & Pain Center, Innovative Surgery Center, and Regena Spa. She is dual board certified in Physical Medicine and Rehabilitation along with Pain Management and a diplomat with the American Board of Pain Medicine. She completed her training at Loyola University in Chicago, Illinois in July of 2005. During her time there, she served as Chief Resident and was involved in several research projects. Prior to, she completed medical school at Midwestern University at the Arizona College of Osteopathic Medicine campus in Glendale, Arizona and internship at Doctors Hospital in Massillon, Ohio. She also has a Bachelor of Science in Biology and minor in Chemistry from the University of New Mexico in Albuquerque. She has a special interest in sports medicine, pain and spine. With 17 years experience, she has great enthusiasm towards regenerative medicine.

  • 13575 W. Indian School Road, Litchfield Park, AZ 85340
  • 623-535-9777

Maxim Moradian, M.D. - Interventional Spine Care & Orthopedic Regenerative Experts

Dr. Moradian is triple-board certified in Physical Medicine and Rehabilitation (PM&R), Sports Medicine and Pain Management. Dr. Moradian’s clinical practice is devoted to the comprehensive care of spine, joint, muscle, tendon, ligament, and peripheral nerve disorders. He is proficient in performing advanced, minimally-invasive procedures under fluoroscopic and/or ultrasound guidance in the entire spine. Dr. Moradian performs electrodiagnostic testing (EMG/NCS) for the accurate diagnosis of muscle and/or nerve disorders. He has a special interest in regenerative medicine, sports concussions, neuromuscular ultrasound, medical education, and clinical research. His true passion is to treat his patients like his family and friends.

  • 51 N. 5th Ave, Suite 301., Arcadia, California 91006
  • 626-460-1096

Haley Burke, M.D. - Mile High Sports and Rehab

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

  • 2490 W. 26th Ave. Suite A-10., Denver, Colorado 80211
  • 303-331-6744

Desmond Hussey, M.D. - NASA Neuroscience and Spine Associates. P.L

Dr. Hussey earned his undergraduate degree from Dartmouth College, and proceeded to earn his Medical Degree from The University of Miami School of Medicine. He then attended Northwestern University Internal Medicine Program, followed by a Neurology Residency Program at Emory University. Dr. Hussey continued his specialty training at John Hopkins University pain clinic. A member of The Spinal Injection Society and The American Academy of Neurology and Psychiatry.

  • 130 Tamiami Trail North, Ste. 250., Naples, Florida 34102
  • 239-631-7150

Dmitry Buyanov, M.D. - IV Infusion Treatment Center

Dr. Buyanov is originally from Kiev, Ukraine. He received his training in Anesthesiology and his Interventional Pain Management Post-Doctoral at Penn State Medical Center, PA. Dr. Buyanov moved to San Antonio in 2003 at which time he was part of a multi-specialty group before he founded Premier Pain Consultants in 2004. His practice has over 5000 active patients in his practice. Dr. Buyanov treats his patients in a cost-effective manner although giving them the best care with interventional pain treatments/procedure to help each patient improve their quality of life. Dr. Buyanov strongly believes in an individualized and multidisciplinary approach to pain management, he believes in the Buddhist saying: “pain is inevitable but suffering is optional”. He works closely with the area internists, physical therapists, chiropractors, psychiatrists, neurologists, and spine surgeons to insure that each patient has the most optimal individualized treatment plan. Dr. Buyanov enjoys spending his spare time with his children.

  • 831 Coral Ridge Drive, Coral Springs, Florida 33071
  • 2102989004

Mark Reecer, M.D. - Fort Wayne Physical Medicine

Dr. Mark Reecer is board certified in Physical Medicine & Rehabilitation and Pain Management. He has over 20 years of work comp experience, and he routinely provides Independent Medical Examinations (IMEs) for the Indiana Workers’ Compensation Board. Dr. Reecer has lectured extensively and has authored multiple publications that promote his specialty and the use of treatment modalities to eliminate pain, improve function and avoid surgery.

  • 5750 Coventry Lane, Suite 101, Fort Wayne, Indiana 46804
  • 260-436-9337

Travis Foxx, M.D. - Premier Anesthesiology & Pain

  • 6500 W.143rd St., Overland Park, Kansas 66223
  • 913-626-4633

Janet Pearl, M.D. - The Boston Stem Cell Center

Dr. Janet Pearl has been in practice since 1999 and is the Medical Director of The Boston Stem Cell Center. She is also the Medical Director of  Complete Spine and Pain Care  an interventional integrated Pain Management practice, both located in Framingham, Massachusetts. Dr. Pearl is Triple Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology and has over 20 years experience in doing these procedures.

Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Pain Management Fellowship program.

After graduating from Harvard College with an A.B. in Applied Mathematics with Economics, Dr. Pearl received a M.Sc. in Health Planning and Financing at the London School of Hygiene and Tropical Medicine. She then received her M.D. from the Columbia College of Physicians and Surgeons, where she represented the Medical School as a senator in the Columbia University Senate.

Watch Dr Pearl give an introduction to The Boston Stem Cell Center

Dr. Pearl completed her internship in Internal Medicine at New England Deaconess Hospital, her residency in Anesthesiology at the Massachusetts General Hospital, and her fellowship in Pain Management at the Brigham and Women’s Hospital. Dr. Pearl was the first resident ever to serve on the Accreditation Council for Graduate Medical Education (ACGME)’s Residency Review Committee for Anesthesiology. She is a Joseph Collins Scholar and a Rotary Scholar and was awarded the AMA/Glaxo Welcome and AMA/Burroughs Welcome Resident Leadership Awards.

From 2004 to 2010, Dr. Pearl served on the University of Massachusetts Board of Trustees. While there she chaired the Committee on Science, Technology and Research, was a member of the Committee on Academic and Student Affairs and the Governance Committee and also served as Vice Chair of the Advancement Committee, and as a member of the Committee on Athletics.

Dr. Pearl is Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology with the American Board of Regenerative Medicine and the American Board of Anesthesiologists.

  • 600 Worcester Rd, Ste 301, Boston, Massachusetts 01702
  • 508-231-2700

Memberships:

  • The American Pain Society;
  • The Massachusetts Medical Society;
  • The Massachusetts Society of Anesthesiologists;
  • The Massachusetts Society of Interventional Pain Physicians;
  • The American Society of Anesthesiologists;
  • The American Society of International Pain Physicians;
  • The American Institute of Ultrasound in Medicine; and,
  • The American Board of Regenerative Medicine.

PUBLIC SERVICE:

  • Member, Massachusetts Department of Industrial Accidents, Health Care Services Board 
  • Member of the Association of Harvard College Class Secretaries and Treasurers
  • Past Member of the Board of Directors of the Harvard Alumni Association
  • Former Member of the Board of Trustees University of Massachusetts. (10/2010 – 10/2014) 

Kevin Pauza, M.D. - Regenerative Sportscare Institute

  • 62 E 88th Street, New York, New York 10128
  • 646-870-7997

SPECIALTY

  • Disc Biologics
  • Interventional Spine

EDUCATION & DEGREES

  • Fellowship: Interventional Spine, University of Pennsylvania
  • Residency: PM&R, University of Pennsylvania
  • Internship: Surgery & Medicine, Columbia University College of Physicians and Surgeons
  • Medical Doctorate: Pennsylvania State University College of Medicine
  • Bachelor of Arts: Biology, Lehigh University
  • Bachelor of Arts: Psychology, Lehigh University

CERTIFICATIONS & LICENSES

  • Texas State Medical and Surgical License
  • New York State Medical and Surgical License
  • Florida State Medical and Surgical License

HONORS

  • Lehigh University Four-year Academic Scholarship
  • Magna Cum Laude, Lehigh University
  • Lehigh University President’s Award
  • Lehigh University Tower Society
  • Distinguished Alumnus, Penn State University (selected from 500,000 Penn State alumni)
  • North American Spine Society, Outstanding Paper of the Year, 2003
  • President-Elect, International Spine Intervention Society
  • Founding Partner, Texas Spine and Joint Hospital
  • Commencement Speaker: Penn State University College of Medicine
  • Advisory Board, AMA
    Keynote Speaker, Harvard Pain Center Commencement
  • Founding Chairman, Standards Committee, International Spine Intervention Society
  • Chairman, Spine Committee, Amercian Academy of Physical Medicine & Rehabilitation
  • Appointed Spine Advisor, Japanese Prime Minister
  • Appointed Spine Advisor, Allied Royal Families

EXPERIENCE

  • Founding Partner & Principal, Texas Spine & Joint Hospital

Gregory Lutz, M.D. - Regenerative Sportscare Institute

Dr. Gregory Lutz is the Founder and Medical Director of the Regenerative SportsCare Institute (RSI). In addition, he currently serves as Physiatrist-In-Chief Emeritus at Hospital for Special Surgery (HSS) and a Professor of Clinical Rehabilitation Medicine at Weill Medical College of Cornell University. Dr. Lutz is one of the world’s leading experts in the field of regenerative interventional orthopedic medicine, appearing annually on Castle Connolly’s and New York Magazine’s “Top Doctors” lists.

  • 62 E 88th Street, New York, New York 10128
  • 6468707997

Thierry Bonnabesse, M.D. - Champlain Spine and Pain Management

  • 294 Tom Miller Rd, Plattsburgh, New York 12901
  • 518-324-7246 Ext 127

Boris Terebuh, M.D. - Regenerative Spine & Joint Center

Boris Terebuh, MD specializes in providing personalized nonsurgical solutions for spine problems that interfere with the function patients desire and the independence they deserve. Dr. Terebuh completed his Physical Medicine & Rehabilitation residency training at The Ohio State University in 1997 and has been in solo practice in Ohio since 2001 because he is committed to providing accessible, individualized and attentive care to his patients. His regenerative approach to solving spine problems enhances the body’s natural ability to heal itself. His guiding principle is integrity – doing what is right for patients in a conscientious manner with the motivation of helping them become fully functional, independent and satisfied. Dr. Terebuh is a very unique Medical Doctor because he has earned seven Board Certifications in the field of musculoskeletal medicine and nonsurgical spine care. Boris Terebuh, MD is delighted to be a Discseel® provider because this revolutionary new technology aligns perfectly with his preferred regenerative treatment approach and patient care philosophy. Dr. Terebuh is also grateful to Discseel® developer, Kevin Pauza, MD, for all the years of diligent and meticulous research to create this innovative, paradigm-shifting intervention, which will certainly spare countless individuals the prospect of avoidable spine surgical procedures.

  • 6860 Perimeter Drive, Suite A., Dublin, Ohio 43016
  • 614-689-0466

Brandon Tolman, D.O. - Integrity Center for Regenerative Medicine

  • 5114 Old Hickory Blvd. Suite 201B, Nashville, Tennessee 37076
  • 615-846-9969

Yasuyuki Nonaka, M.D. - ILC International Lumbago Clinic

  • 1-1-35 Nishiawaji, Higashiyodogawa-ku, Ōsaka-shi, Ōsaka-fu 533-0031
  • +81-6-6210-1905

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Michael Wolff, M.D. - Southwest Spine & Sports

  • 9913 N 95th St., Scottsdale, Arizona 85258
  • 480-766-8255