Herniated Discs: New Treatment Option Relieves Pain, Preserves Mobility

Posted by Brigham and Women's Hospital July 19, 2016

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In artificial disc replacement (ADR), the damaged disc is removed and replaced with an artificial one that moves and shifts like a real disc.

Contributor: John H. Chi, MD, MPH, Director of Neurosurgical Spine Cancer and a spine surgeon in the Department of Neurosurgery at Brigham and Women’s Hospital. Dr. Chi is also an Assistant Professor of Neurosurgery at Harvard Medical School.

If you are experiencing numbness and pain in your arms and shoulder, it may be a sign of a herniated disc in your neck (the cervical region of the spine).

“A herniated disc occurs when the soft inner gel that cushions the spine’s vertebrae protrudes into the spinal canal, placing pressure on nearby nerves. This pressure can lead to pain, tingling, numbness or weakness in the shoulders and arms,” says Dr. Chi.

A herniated cervical disc may be managed with medication, physical therapy, and pain management. When patients continue to experience symptoms, surgery may be recommended .

Balancing Pain Relief versus Mobility

Until recently, patients requiring surgery for cervical disc herniation had one option, anterior cervical disc fusion (ACDF), in which the damaged disc is removed and repaired to help relieve pressure on the nerves and the spinal cord. The ACDF procedure also requires the bones above and below the repaired disc to be fused together.

Though ACDF relieves the pain caused by a herniated cervical disc, some patients may experience a reduction in their range of motion due to the fusion of discs in the neck. Furthermore, there is a chance that discs adjacent to the fusion may later herniate, requiring a second surgery.

 Artificial Disc Replacement to Preserve Range of Motion

Today, spine surgeons can offer certain patients with cervical disc herniation another option – artificial disc replacement (ADR). During the ADR procedure, the damaged disc is removed and replaced with an artificial one that moves and shifts like a real disc, preserving a patient’s range of motion.

Recently, Dr. Chi performed an ADR procedure on a patient who had previously undergone disc fusion (ACDF). Though the disc fusion initially relieved the patient’s pain, a disc adjacent to the fusion also herniated. The patient started experiencing significant pain again. This time, the patient opted to undergo ADR. Compared to his first surgery, Dr. Chi’s patient had a shorter hospital stay, a faster recovery, and maintained his full range of motion while finding relief from his chronic pain.

Are You a Candidate for Artificial Disc Replacement?

Artificial disc replacement is not for everyone. You may be a candidate for ADR if you are younger than 55 years and have been experiencing symptoms for at least three months but not longer than 18 months.

It’s not known how long artificial discs will last; however, they have been in worldwide use for almost 20 years and for 12 years in the U.S. So far, there has been no evidence to suggest that artificial discs will require replacement after a certain period of time.  Research also indicates that ADRs may lead to better outcomes than fusion.  Dr. Chi advises checking with your insurer to verify coverage if you are considering ADR.

Learn more about the Comprehensive Spine Center at Brigham and Women’s Hospital.

-Jamie R.

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What Can Genetic Sequencing Tell You about Your Health?

Posted by Brigham and Women's Hospital June 21, 2016

Have you ever wondered what your genes can tell you about your health – today or in the future? Genes are instructions that tell the body how to grow and develop properly. Found inside each cell, genes are made up of DNA. The genome is someone’s complete set of DNA, including all of its genes.

Scientists examined DNA gel as it is used in genetics, medicine, biology, pharma research and forensics.

Genomic sequencing may indicate your risk for developing a disease in the future.

People have their genome sequenced for a variety of different reasons. They may be looking for the genetic cause of an existing disease, or they may be concerned about the risk of developing a disease later in life. Some people may want to find out if they are a genetic carrier for a disease that may be passed on to a child, or they may simply want to understand their ancestry.

When analyzing a person’s genome, geneticists examine the entire genome or look at certain sections of the genome for variants in the genetic code that have been tied to a specific disease. In about ten percent of seemingly healthy individuals who have their genome sequenced, geneticists find information that indicates someone is at risk for developing a particular disease. This genetic information can be used by the patient and their provider to take steps to address or reduce their risk of disease.

Establishing the likelihood that the individual may develop the disease, however, is challenging. For example, if genetic sequencing identifies a breast cancer variant, geneticists can say the patient is at risk because their genetic variant has been linked to disease in patients who already have the disease but they can’t estimate if the patient has a 10 percent chance, a 50 percent chance, a 90 percent chance of developing breast cancer because the healthy population with this genetic variant has not been studied. Read More »

Brain Cancer Patient: Can Access to Medical Data Save Lives?

Posted by Brigham and Women's Hospital May 24, 2016

The MRI image above shows a tumor in Steven Keating’s frontal left lobe.

The MRI image above shows a tumor in Steven Keating’s frontal left lobe.

After participating in a brain research study, Steven Keating avidly collected and examined his personal medical data. Steven’s curiosity ultimately helped to identify his own brain tumor, a glioma, which was removed in the Advanced Multimodality Image Guided Operating Suite (AMIGO) at Brigham and Women’s Hospital in 2014.  Based on this experience, Steven is now a vocal advocate of providing patients with open access to their medical information. In this video, Steven shares the incredible story of how his life-long curiosity helped identify his brain tumor – and how curiosity about medical data also can help others.

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Treating and Preventing Kidney Stones

Posted by Brigham and Women's Hospital December 17, 2015

Drinking water is one practice that helps to prevent kidney stones.

Drinking water is one practice that helps to prevent kidney stones.

Contributor: Dr. Gary Curhan is a nephrologist who specializes in renal (kidney) disease within Brigham and Women’s Division of Renal Medicine.

Kidney stones are very common and can cause significant pain and discomfort. Fortunately, there are things you can do to lower your risk of developing stones. If you do develop a kidney stone, there also are effective treatment options.

Twenty percent of men and ten percent of women will form at least one kidney stone during their lifetime. White men between the ages of about 40 and 60 are more likely to develop kidney stones, but men of other ages and ethnicities can form stones as well. The likelihood of stone formation is slightly less in women, with younger women at increased risk.

Kidney stones form when there is an excess of certain substances in the urine relative to the amount of water. These substances crystallize when they can no longer stay dissolved in the urine, resulting in a kidney stone.

Patients with kidney stones usually don’t experience symptoms until the kidney stone breaks off and drops into the ureter, the tube that connects the kidney to the bladder. Once this happens, people may experience significant pain.

Causes and Prevention of Kidney Stones

There are a number of dietary risk factors for the development of kidney stones, including lower calcium intake and lower consumption of fruits, vegetables, and potassium-rich foods. Also, when people have lower fluid intake, their urine becomes more concentrated, increasing the likelihood that certain substances in the urine will crystallize and form kidney stones. However, the type of beverage consumed can be important; for example, sugar-sweetened beverages increase the risk of kidney stones. Family history, certain lifestyle conditions, and some medical conditions also may play a role in the development of kidney stones. Nephrologists (medical kidney specialists) can help patients prevent stones through dietary modifications and medication.

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TEDMED 2015: Breaking Through to Create a Healthier World

Posted by Brigham and Women's Hospital November 20, 2015

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Brigham and Women’s Hospital sponsored the Innovation Lounge at TEDMED 2015.

Technology: implantable electronics as an alternative to medication in treating serious illness.

Entertainment: adapting the rules of improvisational acting to help caregivers interact with Alzheimer’s patients.

Design: transforming trash and sewage into clean drinking water through the creation of a novel water purification plant.

What do these topics have in common? They were among the fifty presentations made at the annual TEDMED conference, exploring how technology, entertainment and design are transforming health and medicine.

Brigham and Women’s Hospital (BWH) was an innovation sponsor at the 2015 TEDMED conference. This year’s conference focused on how visionary physicians, researchers and performing artists are breaking through the status quo to create a healthier world.

Several speakers with connections to BWH also were among the featured speakers:

  • Vivek Murthy, MD, MBA, is the U.S. Surgeon General. Prior to his appointment in 2014, Dr. Murthy was a physician at BWH. Dr. Murthy discussed how happiness can help people lead healthier, more fulfilling lives. He cited research that shows happiness can lead to improvements in many health measures, such as heart rate and inflammation levels. He also recounted a recent visit to a San Francisco middle school that has been able to boost self-reported happiness levels among its teachers and students through the use of meditation. Since beginning the program, the school has seen reductions in school violence and lower absenteeism rates among faculty. Read more about the program.
  • Suzy Brown, MD, MS, is a former BWH intern and resident in internal medicine. She currently practices at Vanderbilt University Medical Center as a heart failure specialist. Dr. Brown is also a musician who performs with her songwriter husband, Scott Sax. Dr. Brown has discovered that being a musician helps her manage the demanding emotional aspects of treating patients with heart failure.
  • Thomas H. Lee, MD, is a practicing internist/cardiologist at BWH. Dr. Lee is exploring how to deliver compassionate patient care through empathy in order to reduce patient suffering. Dr. Lee has previously written about reducing patient suffering in the New England Journal of Medicine.
  • Sangeeta Bhatia, MD, PhD is a biomedical engineer at BWH and MIT. Dr. Bhatia’s laboratory is adapting technologies developed in the computer industry for medical applications such as tissue regeneration, stem cell differentiation, medical diagnostics and drug delivery. Read more about her transformative work.

Presentations from TEDMED 2015 will be available for viewing over the coming months. In the meantime, we hope you’ll be inspired to look for creative ways to improve health in your home, office, or community. As Dr. Murthy noted, complex problems don’t always require complex solutions.

– Jamie R.

Partners HealthCare Biobank – Advancing Personalized Medicine

Posted by Brigham and Women's Hospital November 19, 2015

20140404; Friday, April 4, 2014, Boston, MA, USA; Partners HealthCare Biobank leaders Susan A. Slaugenhaupt, MD, and Elizabeth Wood Karlson, MD, talk about the promise of the Biobank project in Dr. Slaugenhaupt's lab space inside the Massachusetts General Hospital Simches Research Building Friday morning April 4, 2014. background: "The Partners HealthCare Biobank is a large research program designed to help researchers understand how people’s health is affected by their genes, lifestyle, and environment. The Biobank collects and maintain samples and information from individuals who receive their care at Brigham and Women's Hospital, Spaulding Rehabilitation Hospital, and Massachusetts General Hospital. These materials will be used in research to better understand many different diseases." ~ adapted from Partners website Partners HealthCare annual report project with Hill Holliday ( 2014 © lightchaser photography )

Partners HealthCare Biobank leaders Dr. Elizabeth W. Karlson (left) and Dr. Susan A. Slaugenhaupt.

The Partners HealthCare Biobank is a program designed to help researchers at Brigham and Women’s Hospital, Massachusetts General Hospital, and other Partners HealthCare institutions understand how people’s health is affected by their genes, lifestyle, and environment.

By understanding a patient’s genetic makeup, physicians can screen more aggressively for diseases that their patients are predisposed to and develop plans to reduce the chances of developing specific diseases. Ultimately, the goal is to define and classify subgroups of patients based on how they respond to certain treatments, which will help physicians choose the best medications for individuals. This is known as personalized medicine.

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Every Second Counts – Diagnosing and Treating Acute Aortic Syndrome

Posted by Brigham and Women's Hospital November 10, 2015

Acute aortic syndrome is a serious heart condition where the aorta, the main blood vessel that supplies blood to the rest of the body.

Acute aortic syndrome is a serious heart condition that affects the aorta, the main blood vessel that supplies blood to the rest of the body.

Acute aortic syndrome is a serious heart condition where the aorta, the main blood vessel that supplies blood to the rest of the body, malfunctions due to a tear (dissection), bleeding in the wall of the aorta (a hematoma), or an ulceration. Acute aortic syndromes are life-threatening and require immediate medical care. Statistics suggest that the risk of mortality increases quickly after the onset of an acute aortic dissection, so rapid diagnosis and treatment is critical.

Acute aortic syndromes occur in two groups of people. Most tend to be older people (65 years+) who have conditions such as high blood pressure or atherosclerosis. Another group is younger patients who may have a genetic predisposition, such as a connective tissue disorder like Marfan syndrome, or have experienced trauma. In cases where a patient has a genetic predisposition, physicians may recommend that family members also undergo screening and genetic testing to assess their risk of developing an acute aortic syndrome.

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Impact of Precision Medicine on Health Care

Posted by Brigham and Women's Hospital November 5, 2015

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Identifying the most important mutations in cancer cells can help to develop targeted therapies.

The goal of precision medicine is to gather, analyze, and synthesize information about a person’s genes, proteins, microbes, environment, and health and combine this with data from the medical literature, clinical trials, and population health studies, to predict, prevent, and treat diseases for individual patients and populations of patients.

Researchers at Brigham and Women’s Hospital (BWH) are applying precision medicine concepts to three areas to improve patient care.

  • Cancer: Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) has been a leader in research to systematically test large numbers of mutations and identify the genetic culprits in cancer cells. This genetic information can help determine the best way to care for cancer patients by using targeted therapies to attack tumor cells with specific abnormalities.

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Preterm Birth and Brain Development: A New Frontier of Newborn Care

Posted by Brigham and Women's Hospital October 29, 2015

One in nine babies in the U.S. is born prematurely.

One in nine babies in the United States is born prematurely. Thanks to innovations in medical care, more than 90 percent of these babies survive. However, nearly half of preterm infants may be at risk for learning problems later in life. Dr. Terrie Inder, Chair of the Department of Pediatric Newborn Medicine at Brigham and Women’s Hospital (BWH), is working to overcome this challenge.

Dr. Inder, who is dual-trained in pediatric neurology and neonatology, is expanding BWH research programs to study newborn brain development. One area of her research is the use of brain imaging to predict the likelihood of future learning problems. In 25 percent of preterm babies, Dr. Inder explains, brain imaging mirrors that of full-term babies, indicating a low risk for the development of learning problems. However, in about 20 percent of preterm babies, researchers see changes in brain imaging that suggest an increased risk for learning problems later in life. Based on these findings, additional therapy and support services may be recommended to positively influence brain development.

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Think Pink – Schedule Your Screening Mammogram

Posted by Brigham and Women's Hospital October 20, 2015

Stop by Brigham and Women’s/Mass General Health Center, next to Gillette Stadium in Foxborough, before or after your mammogram, to view pink gear worn by members of the New England Patriots.

Stop by Brigham and Women’s/Mass General Health Center, next to Gillette Stadium in Foxborough, before or after your mammogram to view pink gear worn by members of the New England Patriots.

If you’ve watched a professional football game over the last few weeks, you’ve probably noticed players sporting pink socks, wristbands, and other items of pink clothing.

Throughout October, which is Breast Cancer Awareness Month, NFL players, coaches, and referees are wearing pink game apparel to remind women and their loved ones about the importance of regular breast cancer screening via mammography. Early detection of breast cancer improves a woman’s treatment outcomes.

Screening mammography is indicated for a woman who has no symptoms, such as a mass in the breast or nipple discharge. The American College of Radiology recommends that asymptomatic women begin screening mammography beginning at age 40, with yearly examinations recommended thereafter.

Digital 3-D mammography, a new advanced imaging technology for detecting breast cancer, offers a clearer, more complete three-dimensional view of a woman’s breast tissue compared with traditional mammography, which creates two-dimensional images. This technology enables radiologists to see tumors when they are very small and differentiate them  from abnormalities that look like tumors, but  are often overlapping breast tissue. When radiologists are able to identify malignant tumors at an early stage, it usually means that the cancer has been found before it has spread to other parts of the body. Read More »