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Spine Center at Magee-Womens Hospital of UPMC: Reason for Hope

J. William Bookwalter, MD

Optimism should be the key word where back- and spine-related problems occur. It’s important to understand that the natural history of these things is to get better and for people to resume normal life. Overall, only about 5 to 10 percent of the patients who experience back-related problems will ultimately require surgery, and the vast majority of that group of people are going to return to relatively normal lifestyles.

That means 90 to 95 percent of the people are going to be managed conservatively. Those conservative options include regular programs of stretching, core strengthening, and aerobic exercise. It’s also important to understand that lifestyle modifications like obesity and smoking cessation are critical to the success of your management program.

The most important thing to understand about the long-term management of spine problems is that it’s really the things that the patient does for themselves that truly makes the difference in their outcome.

When Surgery is Necessary

It’s critical to tailor the surgical option to the problem the patient is experiencing. There isn’t a one-size-fits-all procedure for patients with spine-related disorders.

It’s very important to understand that the vast majority of these problems are related to pressure on a nerve root and that the goal of surgery is to take the pressure off the nerve root. There are a number of minimally invasive options that allow us to do that successfully with relatively minimal tissue disruption and relatively small exposures.

Minimally invasive surgery can often be done with a short hospital stay. Indeed, many can be done as an outpatient. Less tissue disruption generally means less discomfort in the postoperative period and an early return to activities.

It’s critical that patients have the full benefit of conservative therapy and every option to get better without a surgical procedure. The most minimally invasive form of surgery is no surgery at all. 

Partner With Patients

The most important things about the spine program at Magee are that we will make every effort to educate the patients about their problems, help them understand the treatment recommendations, and help them pursue the approaches, be they conservative or surgical. It’s also important for the patients to understand that we view this as a partnership with the patient and that the patient is a very important part of a successful outcome.

And the overwhelming likelihood is that they are going to get better. It’s extremely important to understand that with proper management the vast majority of patients can return to active lifestyles with few restrictions.

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