Scenarios of Causes

Scenarios of Causes

Scenarios of Causes
Transcript

If the imaging is normal, some patients may respond to injections. Some patients may respond to bracing. Some patients may respond to physical therapy. Some patients may respond to Chiropractic, some patients may respond to nerve stimulation. Some patients may respond to tens units. Notice that I've used the same language for all of those. And the reason is is that some patients is this small amount of patients who respond to each one of those, but we don't really have anything that tells us what will predict the response of each individual patient to each of those individual scenarios. And so it can be tough and it can be enormously frustrating for the patients because here they go from one thing to the next, looking for the holy grail to make their back pain better when indeed medicine may only be able to take a chunk out of it with one thing or another, and not actually as people would want curate. So it can be enormously tough.

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Risk Factors of Obesity

So, what's the data on obesity? Because we always hear, well, if you'll just lose some weight, your back pain will be so much better. The answer to that is fairly nebulous and that is, is that probably patients who are morbidly obese, if they do lose some weight, will do better. And there are certain pathologic processes where people have the slips and their spines that if they lose weight that they will do better because they'll have less sort of traction to make the slip go. But it's not a one to one correlation and that again is one of the major problems that it's not just who here take these pills for two weeks and your urinary tract infection will be gone. Obesity is a predisposing factor, but it's interestingly enough, not necessarily as strong as what your average citizen would like to believe and just losing weight may not make you back pain all that much better. Which again makes it frustrating because if we are overweight we should be losing some weight and doing better for other reasons too. Not just simply for the back pain. Patients who have obesity and are obese who come to surgery have certain risk factors and interestingly enough, most of those risk factors are not the outcomes of the surgeries. The outcomes of the surgeries generally, and you can always find a paper here or there that might say otherwise, but the vast majority of the papers are saying that your weight doesn't matter in terms of your outcome for any of these things that get operated on. But you risk factors for developing a blood clot in the legs and pneumonia, a urinary tract infection might be higher and certainly if you're morbidly obese, then airways and pneumonias and things, really those things come to the fore. Those things are really important. It doesn't mean you can't have a good outcome from surgery, but you're at a higher risk of developing a complication because of your weight. And same thing is true for instance, if you're diabetic, you have a higher risk. So we can try to mitigate those risks, waiting for people to lose weight. We can get their sugars under better control in case you're diabetic, and that's the way we look at it in medicine, we tried to lessen the risk.

Risk Factors of Occupation

Kurt Schroeder, MD

Neurosurgeon

Certified by the American Board of Neurological Surgery
Chief of Neurosurgery at St. Joseph’s Hospital
Former Chief of Surgery at Tucson Medical Center

Kurt Schroeder, MD

Neurosurgeon

Certified by the American Board of Neurological Surgery
Chief of Neurosurgery at St. Joseph’s Hospital
Former Chief of Surgery at Tucson Medical Center

Jonathan Nissanoff, MD

Orthopedic Surgeon

Certified by the American Board of Orthopaedic Surgery
A leading orthopedist, specializing in Orthopedic minimally invasive sports medicine
Recognized nationally as a top healthcare provider

Kurt Schroeder, MD

Neurosurgeon

Certified by the American Board of Neurological Surgery
Chief of Neurosurgery at St. Joseph’s Hospital
Former Chief of Surgery at Tucson Medical Center

Jonathan Nissanoff, MD

Orthopedic Surgeon

Certified by the American Board of Orthopaedic Surgery
A leading orthopedist, specializing in Orthopedic minimally invasive sports medicine
Recognized nationally as a top healthcare provider

Kurt Schroeder, MD

Neurosurgeon

Certified by the American Board of Neurological Surgery
Chief of Neurosurgery at St. Joseph’s Hospital
Former Chief of Surgery at Tucson Medical Center

Kurt Schroeder, MD

Neurosurgeon

Certified by the American Board of Neurological Surgery
Chief of Neurosurgery at St. Joseph’s Hospital
Former Chief of Surgery at Tucson Medical Center

Kurt Schroeder, MD

Neurosurgeon

Certified by the American Board of Neurological Surgery
Chief of Neurosurgery at St. Joseph’s Hospital
Former Chief of Surgery at Tucson Medical Center

Kurt Schroeder, MD

Neurosurgeon

Certified by the American Board of Neurological Surgery
Chief of Neurosurgery at St. Joseph’s Hospital
Former Chief of Surgery at Tucson Medical Center

Kurt Schroeder, MD

Neurosurgeon

Certified by the American Board of Neurological Surgery
Chief of Neurosurgery at St. Joseph’s Hospital
Former Chief of Surgery at Tucson Medical Center

Kurt Schroeder, MD

Neurosurgeon

Certified by the American Board of Neurological Surgery
Chief of Neurosurgery at St. Joseph’s Hospital
Former Chief of Surgery at Tucson Medical Center

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