center for spine health · 2013. 12. 20. · spinal stenosis is a condition that results from...

Center for Spine Healthn e u r o l o g i c a l i n s t i t u t e

Our mission is to improve the quality of life for people with problems

of the spine. We offer comprehensive diagnosis and treatment options

for all types of spine problems, from the most common to the most

obscure. Whether your treatment is to be medical or surgical, we are

dedicated to applying leading-edge technology, the latest techniques

and the most effective therapies to help you feel, move and live better.

The Center for Spine Health staff includes some of the leading medical and surgical spine

specialists in the United States, backed by the reputation of Cleveland Clinic. In its annual

“America’s Best Hospitals” survey, U.S.News & World Report has ranked Cleveland Clinic

neurosurgical and orthopaedic services the best in Ohio and among the 10 best in the

nation for more than 14 years in a row.

Our physicians work closely with physical therapists and occupational therapists to develop a

complete, individualized treatment plan for each patient that considers his or her diagnosis,

lifestyle and treatment goals. We take pride in working as a team to achieve the best possible

outcomes for our patients.

Thank you for choosing Cleveland Clinic’s Center for Spine Health for your care.

Sincerely,

Gordon Bell, MD

Director, Cleveland Clinic Center for Spine Health

WelCome to Cleveland CliniC’S Center for Spine HealtH.

WelCome to Cleveland CliniC’S Center for Spine HealtH.

More than 21,000 patients from all over the world come to cleveland clinic’s center for spine Health each year for

help with conditions of the back and neck, ranging from the most common to the most complex.

the center for spine Health brings together the expertise of nationally recognized cleveland clinic specialists in

orthopaedic surgery, neurosurgery and medical spine, offering patients with back and neck problems the latest, most

innovative, most effective medical and surgical treatments.

treatment optionS

From your first visit to Cleveland Clinic’s Center for Spine Health

to your final follow-up, our specialists are ready to offer you the

most appropriate and effective treatment for your problem from

among a full range of available options.

ConServative treatment

Whenever possible, your Center for Spine Health physician

will explore nonsurgical treatments first. These treatments may

include medication, pain management, manipulation, acupunc-

ture, bracing or physical therapy. All of these medical services

are available through experts at Cleveland Clinic’s Center for

Spine Health.

SurgiCal treatment

For some problems, surgery is the only possible solution. Al-

though spinal surgery is often delicate and complex, Cleveland

Clinic Center for Spine Health surgeons have one of the highest

success rates in the country for even the most complex proce-

dures. They also are skilled in the latest minimally invasive

techniques that are associated with less postoperative pain and

a faster recovery. In the hands of a skilled, experienced surgeon,

the benefits of surgical treatment usually far outweigh the risks.

Whatever your diagnosis, our specialists are dedicated to restor-

ing your function and relieving pain to the greatest degree pos-

sible by applying their knowledge and skill, combined with the

latest techniques and advanced technology.

BaCk to BaSiCS

Your spine is made up of 24 vertebrae: circular

bones linked together by ligaments and muscles.

When the vertebrae are lined up to form the spinal

column, their central holes form a long, bony

canal, the spinal canal. the spinal canal is uniquely

designed to protect and support the spinal cord,

a bundle of nerves that connects your brain with

the rest of your body.

Starting at the base of the skull are seven cervical

vertebrae. the 12 thoracic vertebrae make up the

middle of your spine, and the five lumbar vertebrae

are at the lower end, forming the bottom curve of

the spine. the soft, cushiony discs between the

vertebrae act like shock absorbers and prevent the

vertebrae from rubbing against each other. all of

these sections are interrelated, and together they

let you move, walk and stand up straight.

the spinal cord, running from the brain to the

lumbar region, contains millions of nerve fibers

that carry messages from your brain to the rest of

your body. it extends from the brain to the area

between the end of your first lumbar vertebra and

the top of your second lumbar vertebra. the spinal

cord branches into 31 pairs of nerve roots that pass

through small openings in the left and right sides

of the vertebrae. the nerves in each region of the

spinal cord connect to specific parts of your body.

tHe trueSt teSt of a Spine Center iS itS reputation among patientS WHo Have Been tre ated tHere.

in tHe folloWing pageS, patientS from Cle vel and CliniC ’S Center for Spine He altH tell tHeir StorieS,

and e xpl ain HoW tHe tre atment tHeY reCeived Here CHanged tHeir l iveS.

Brad H e n n e S S e Y

Center for Spine HealtH

“ i feel aBSolutelY no effeCtS from tHe SurgerY, and it doeSn’t

reStriCt mY pitCHing aBil it Y at all,” SaYS mr. HenneSSeY.

faSt-groWing, Benign tumor

Part way through his “short season” — the abbreviated first

season new players have when they are first drafted into the

majors — mr. Hennessey started feeling odd twinges and

pains. He tried to mask the pain with ibuprofen, but it gradu-

ally became more than he could deal with.

after his short season, the plan was for mr. Hennessey to go

through an extended training period. “But the pain was so bad,

i couldn’t pitch and had to quit two weeks early,” he recalls.

He went through extensive therapy and rehabilitation in the

off-season, but when it was time for spring training in arizona,

“i came to terms with the fact that i couldn’t do it,” he says,

facing the possibility that his dream might be cut short. team

doctors ordered an mri and discovered a fast-growing, benign

tumor on mr. Hennessey’s spine, wrapping around his spinal

cord. Shocked at the news, his girlfriend erin, a registered

nurse, flew to Arizona to consult with the doctors. Under her

influence, Mr. Hennessey decided to come home and seek a

second opinion at Cleveland Clinic.

A Cleveland Clinic Center for Spine Health surgeon confirmed

the diagnosis and recommended surgical removal of the tumor,

because even a benign tumor on the spinal cord can cause

extensive damage, pain and disability. the tumor needed to be

removed to restore mr. Hennessey’s function and prevent more

serious problems.

in february 2002, the tumor was removed, carefully snipped

away from the spinal cord in a delicate operation that left mr.

Hennessey’s spinal cord and nerves intact. Within five months,

though, he was back at Cleveland Clinic. “i was not recover-

ing as the doctors expected. When they took another mri, the

tumor had come back.”

that meant another major surgery for mr. Hennessey, to

remove the tumor. a minimally invasive technique pioneered

at Cleveland Clinic was used, designed to spare the important

muscles and joints of the neck and upper back. “this time, i

recovered so quickly, i knew that it was over,” mr. Hennessey

says. “i was ready to go.” He hit spring training in 2003 raring

to get on the field, but “it was like starting from Day 1,” he

says ruefully. “i had to get back into shape.”

Young and healthy, he bounced back quickly, and by the sec-

ond half of the 2003 season mr. Hennessey was playing lower

a ball in Hagerstown, maryland. in 2004, he received the all-

important invitation to the giants’ big league camp, started in

aa play, got promoted to aaa and was called up to the majors

after just four games. after another quick trip to aaa and back,

he broke into the Giants’ starting rotation, finishing the 2004

major league season with a 2–2 record.

mr. Hennessey and erin, now his wife, have put his physical

problems behind them and are enjoying their toddler, emma,

and getting accustomed to the demands of a baseball player’s

schedule. “i feel absolutely no effects from the surgery, and it

doesn’t restrict my pitching ability at all,” says mr. Hennessey,

looking forward to a long career in the game he loves. play ball!

“strike!” For 21-year-old san Francisco giants pitcher Brad Hennessey, that was one of the sweetest

sounds on the planet in the summer of 2001. Drafted out of Youngstown state university, the young

athlete was living his dream, playing his first season in major league baseball.


david m a r S H a l l , J r . , o d , p h d


Spinal StenoSiS

When pain from stenosis left him immobile, he turned to Cleve-

land Clinic’s Center for Spine Health.

Spinal stenosis is a condition that results from degeneration and

arthritis of the spine. thickening of the bone and ligaments of

the vertebrae cause the spinal canal to narrow. nerves, which

are housed in the spinal canal, become damaged, resulting in

severe pain, numbness and weakness. dr. marshall’s stenosis

was located at the C-3 and C-4 cervical vertebrae — meaning

it affected the third and fourth discs at the base of the head.

“it was a triad,” he says. “tingling, pressure and unbearable pain.”

dr. marshall had previously undergone surgery to receive a spi-

nal cord stimulator — an implanted device that treats chronic

pain by generating electric impulses — to ward off the pain

from rSd. it didn’t do the trick for the stenosis, though.

the pain, he says, radiated from his sternum to his shoulder

and prevented him from doing so much as lifting his chin from

his chest.

“there wasn’t much i could do,” he says. “i could lift my head

for a second, but the pain would drop it back down again.”

Relief finally came. Dr. Marshall underwent a C3-4 discectomy

and revision spine surgery at Cleveland Clinic’s Center for

Spine Health.

the results were noticeable immediately.

“the next day i felt the best i had in four years,” he says, noting

that the surgery had relieved him of much of the pain associ-

ated with rSd as well.

leading up to the procedure, dr. marshall says his spinal cord

stimulator had been on “24 hours a day, seven days a week.”

Since that day, however, he says the device is on only about

50 percent of the time, and, with his surgeon’s blessing, he

currently is working to wean himself off the device completely.

dr. marshall is looking forward to starting back to occupational

therapy to regain the strength in his arm and hand that he

lost to rSd. though he had made moderate gains in prior

occupational therapy sessions, the stenosis left him unable to

keep up his exercises, and he lost the progress he had made.

He says he is confident he will get better, with lasting results

this time around.

dr. marshall says he is grateful to return to a “normal life” since

his surgery. He is enjoying spending time with his loved ones

and is glad to be able to sleep again. He says he is thankful to

the Cleveland Clinic staff who got him back on track.

“my spine surgeon, his residents and fellows, and everyone

associated with my care was great,” he says. “i’m so pleased.”

“tHe ne xt daY i felt tHe BeSt i Had in four Ye arS,” He SaYS, noting tHat tHe SurgerY

Had relie ved Him of muCH of tHe pain aSSoCiated WitH rSd aS Well.

David Marshall, Jr., oD, PhD, is no stranger to cleveland clinic. With a range of health problems, including

reflex sympathetic dystrophy (RSD), a painful and progressive nerve disorder that can eventually lead to

crippling and permanent damage, Dr. Marshall had become very familiar with 9500 euclid avenue over the

course of four years.


mary g a n n o n


oCCaSionallY, SHe feelS tired if SHe StandS for a long time, But, “otHer tHan tHat,

i don’t tHink too muCH aBout mY BaCk,” marY SaYS.

SColioSiS

the school nurse caught the problem in a routine back check

and contacted mary’s parents. the news that she had early

scoliosis was a surprise to mary. “i didn’t realize that i had

scoliosis because i couldn’t feel it or see it, and it didn’t seem

to be causing me any problems.”

A visit to her pediatrician confirmed that Mary’s spine had a

54-degree curvature, and he recommended surgery to correct

it. mary, born without arms, relies on her feet for most of her

regular daily tasks. She was eager to have her back problem

corrected as soon as possible, before it interfered with the flex-

ibility she needs to function.

a Cleveland Clinic Center for Spine Health surgeon discussed

all of the surgical options with mary and her family. treating

scoliosis requires a fusion of a portion of the spine to correct

the curve with a system of hooks, rods and screws implanted

to hold the spine in the correct position. in mary’s case, her

spine surgeon decided to end the fusion at a higher-than-usual

level in her spine so that she would retain her flexibility. “That

sounded good to me. my doctor understood how important it

is to me to be able to use my feet,” mary says.

an anterior fusion was performed on mary, which markedly

improved the spinal deformity and still allows her the complete

mobility and flexibility that are so essential to her life. Even

now, she continues a regular program of stretches, recom-

mended by her surgeon, to keep her back flexible. Occasionally,

she feels tired if she stands for a long time, but, “other than

that, i don’t think too much about my back,” mary says.

this active teen is busy getting on with her life. after conquer-

ing her back problem, mary recently scored another victory —

she passed driver’s education and now she’s ready to conquer

ohio’s highways.

Whether she’s running cross country for the rocky river High school team, playing French horn in the

school marching band or jumping on her trampoline at home, Mary Gannon seldom gives a thought to the

operation she had at age 12 to correct scoliosis, curvature of the spine.


Josephine S t e i n H u r S t


“notHing did for me WHat tHe f irSt go at aCupunCture did,” SHe SaYS, reCommending it to otHer

patientS. “mY BaCk HaS not Been aS ComfortaBle for moSt of mY adult l ife aS it iS noW.”

Spinal pain

“it just became an important part of my life — it’s like a second

career,” says mrs. Steinhurst, who paints primarily oriental

watercolors on rice paper and recently had a one-woman show

in Judson park at the Howson gallery.

the problem was she had to paint standing up, as mrs. Stein-

hurst suffers from spinal pain and couldn’t sit for long periods

of time comfortably.

She had injured her spine about 50 years ago when she was

chasing her 4-year-old son and fell down the stairs. that’s when

the pain began. mrs. Steinhurst went through years of physical

therapy, but nothing seemed to do the trick. in fact, while at

work she would wear a leather and metal brace to ease the pain.

it did seem to get better as she got older, “but it didn’t mean

there was no pain,” she says. “And if you’re in pain, it’s difficult

to be pleasant; it’s difficult to be a nice person.”

the mother of three was inhibited by the spinal injury. not

only did she stand a lot, but she couldn’t go to concerts or

any place she had to sit for long periods of time. “It definitely

impacted my life,” she admits.

Less than a year ago, she asked her doctor about the benefits

of acupuncture and whether it would help in her situation.

Her doctor encouraged her to try it. and when the pain got

bad enough, mrs. Steinhurst decided she had nothing to lose.

So she turned to Cleveland Clinic’s Center for Spine Health

for relief.

to her pleasant surprise, she had immediate results. after her

very first treatment, it was like a miracle, says Mrs. Steinhurst,

who describes the treatment as a slight pinch but not painful

enough to merit a mention. “Nothing did for me what the first go

at acupuncture did,” she says, recommending it to other patients.

“my back has not been as comfortable for most of my adult life

as it is now. i go back every six to eight weeks for a ‘tune-up.’”

to mrs. Steinhurst, getting the treatments at Cleveland Clinic

is very reassuring. “my physician and his primary nurse are

wonderful people,” says mrs. Steinhurst, who takes only over-

the-counter arthritis pills for her spinal injury because of the

success of acupuncture. “and, i have a physician doing it,

which adds a feeling of security.”

today, mrs. Steinhurst and her husband live at Judson manor

in university Circle. originally from Boston, the couple moved

to Cleveland a year ago because it was time for a lifestyle

change, says mrs. Steinhurst, who serves on various commit-

tees within the Judson manor communities. “it’s a wonderful

place to live, with lots of music and interesting people. Coming

to this part of Cleveland was like coming back to Boston. it’s

very similar and we felt immediately comfortable, and having

Cleveland Clinic here is a marvelous advantage.”

the acupuncture treatments have given mrs. Steinhurst her life

back. “now i don’t have to stand while painting, and i can sit

at a computer and write poetry for a length of time that i never

could before. the only regret i have is that i waited until i was

84 to do this.”

Josephine steinhurst discovered a hidden talent late in life. after retiring in her mid-60s, she decided to try

art classes at a nearby Japanese museum in Florida, where Mrs. steinhurst and her husband, Hyman, lived

during the winters. not only did she discover the gift of painting, but she loved the hobby and the people

involved in the art.


“i do not Have anY pain. i Can Walk, i Can tYpe, i direCt mY CHoir, and mY voiCe iS normal. i am 100 perCent.”

Bulging diSCS

His torment began subtly, when he awoke one morning and his

hands were numb. the rev. Becker dismissed the sensation,

thinking he had “slept wrong.” When the numbness continued

for several weeks, he consulted his primary care physician.

the doctor recommended the rev. Becker resume taking his

thyroid medicine, which he had discontinued.

When the strange symptoms persisted despite the thyroid

supplement, the rev. Becker started to worry. a 55-year-old

diabetic, he began to wonder if he was experiencing the

beginnings of diabetic neuropathy, a form of nerve damage

unique to people with diabetes.

next, his knees started to hurt. When he took his summer vaca-

tion, “i felt constantly fatigued and didn’t feel like going any-

where,” he recalls. after he returned home, his symptoms

continued to worsen, and his worry continued to grow.

“By this time, the numbness was so severe that i couldn’t feel

the change in my pocket. my legs started to tingle and feel

numb, too,” he says, remembering the panic that was starting

to build.

Within a month, “I had great difficulty getting out of bed or out

of a chair. i was feeling more and more weak. it was an effort

to walk from one end of a room to the other. i was unsteady and

falling on the stairs.”

The Rev. Becker was now virtually unable to fulfill his responsi-

bilities as choir director, church administrator and twice-monthly

liturgy celebrant, although he kept trying. His choir members

were very concerned about his rapid decline, and one of them,

a physician, finally insisted on having him admitted to a local

hospital for a thorough evaluation. finally, doctors there pin-

pointed the problem — bulging discs in his neck.

Discs, composed of a jelly-like material surrounded by a fibrous

case, act as cushions between the vertebrae. three discs in the

rev. Becker’s neck were bulging into the spinal canal and

compressing his spinal cord, causing all of his symptoms.

the doctors advised him to consult a neurosurgeon to have

the damaged discs removed.

Easier said than done — the Rev. Becker could not find a

neurosurgeon in Youngstown willing to take on such a complex

case. a tricky procedure at best because of the location of

the discs, the procedure was complicated even more by the

rev. Becker’s diabetes. finally, the rev. Becker’s physician

friend suggested that he make an appointment with a friend of

hers from medical school, a Cleveland Clinic Center for Spine

Health surgeon.

The Rev. Becker remembers the stress and anxiety of that first

appointment all too well. “my surgeon said i had a severe

problem because the discs had been exerting pressure on the

spinal cord for such a long time. even worse, he told me that

there was a risk i would lose my voice permanently as a result

of the vocal cords having to be pushed aside during the proce-

dure. How could i live if i could not speak or sing?

“But, when i came face to face with my options, i realized i really

had no choice. the Center for Spine Health team has worked

together a long time, and I was confident in their abilities.”

three weeks later, in a four-hour operation, a three-level anterior

cervical discectomy was performed, removing the deteriorated

discs. to the rev. Becker’s joy and relief, “that same night, my

voice was raspy, but it was there.” Within a couple of weeks he

was driving, and he returned to work in a month. today, “the

feeling has come back in my hands, although some numbness

still remains. i do not have any pain. i can walk, i can type, i

direct my choir and my voice is normal. i am 100 percent. i

thank god for giving my surgeon the hands and the skill to make

me whole again.”

the rev. gregory Becker is singing the praises of cleveland clinic’s center for spine Health. an orthodox

priest at sts. Peter and Paul church in Youngstown, ohio, where his duties include teaching and directing

the 20-voice adult choir, the rev. Becker is back to virtually full strength after an ordeal with a neck

problem that left him nearly helpless and hopeless.


gregory B e C k e r


Spinal inStaBilitY

“You know how the nurse asks you how your pain is on a scale

of one to 10? i was at an 11,” says the sprightly eastlake, ohio,

resident. the pain progressed so quickly that within a month

from when it began, “I had to lay flat or I experienced severe

pain in my neck and head,” she says.

mr. Jancigar took his wife to her primary care doctor at Cleve-

land Clinic. Beginning with the least-invasive approach for mrs.

Jancigar’s problems, her physician prescribed pain medication.

unfortunately, the pain medication gave mrs. Jancigar an intoler-

ably upset stomach. determined to seek another answer to her

problem, she made an appointment with her Cleveland Clinic

rheumatologist, who treats her for arthritis. “When i went to see

him, i was in such bad shape i had to use a walker, and i was

down to 100 pounds from the nausea,” mrs. Jancigar recalls.

Her rheumatologist referred her to a Cleveland Clinic Center

for Spine Health surgeon. “He went right to the top of my list

when he called me that evening and asked if i could come to

[Cleveland] Clinic at 6 o’clock the next morning,” mrs. Jancigar

says with a chuckle. Her spine surgeon determined that her

pain was caused by spinal instability, high up in the spinal

column between the first and second vertebrae in her neck.

He recommended surgery to stabilize those vertebrae, but “he

emphasized that my age was against me,” says mrs. Jancigar.

in her favor, though, was her otherwise good health. Still a

little bit undecided, “i awoke one morning and was in such

excruciating pain that i screamed,” she says. “that was it.

i decided to go ahead with the surgery.”

a cervical laminectomy was performed, a complex surgery that

involved removing a ring of bone from the first vertebra in her

neck, followed by a bone fusion. Her surgeon placed a metal

plate on her skull, held in place by screws, then placed screws

into the second vertebra and, finally, attached the screws and

the plate to bring the spine into proper alignment. “this pro-

cedure, while technically challenging, especially in the upper

neck, is excellent for relieving pain caused by spinal instability,”

notes her surgeon.

at home again with her husband, mrs. Jancigar recovered rap-

idly with the assistance of a Cleveland Clinic physical therapist

who came to the house. “for my years, i did very well,” she

says with pride. So well, in fact, that less than three months

after the surgery, mrs. Jancigar was again driving, shopping,

visiting and participating in social activities — and shining up

her bowling ball. “i am absolutely glad that i had the surgery,”

she says. “i am enjoying life again.”

Theresa Jancigar and her husband, Rudolph, enjoy the simple things in life — taking a drive, keeping up

their home, bowling. so when severe neck pain forced Mrs. Jancigar, a lively 86, to slow down, she knew

she had to do something about it.

at Home again WitH Her HuSBand, mrS. JanCigar reCovered rapidlY WitH tHe aSSiStanCe of a

Cl iniC pHYSiCal tHerapiSt WHo Came to tHe HouSe. “for mY Ye arS, i did verY Well,” SHe SaYS WitH pride.


theresa J a n C i g a r


kYpHoplaStY for oSteoporoSiS

“the pain did not limit my activity, but it hurt to do normal

things,” she says, “like standing at the stove cooking dinner,

or if i would raise my arms to peel potatoes, the pain was

so bad i had to go sit down for a while.”

the last straw came when she had a fall that left her in

even more pain. “i didn’t realize until then that i had osteo-

porosis,” she says. “the fall certainly made things worse.”

fortunately, she recovered from her accident, but the back

pain persisted, and mrs. Coburn was getting frustrated with

not being able to enjoy taking care of the home the couple

has shared for decades.

at the urging of her husband, she made an appointment with

a Cleveland Clinic Center for Spine Health surgeon.

“He did a very thorough examination, including a bone density

test,” mrs. Coburn says with satisfaction. “from the results,

he suggested that i undergo kyphoplasty. He believed it would

help me move better and relieve the severe pain.”

Cleveland Clinic was one of the first hospitals in the nation

to use kyphoplasty for osteoporosis patients. the minimally

invasive procedure involves depositing acrylic bone cement

into vertebral bone that has collapsed from osteoporosis.

the material raises the bone’s upper section and supports

it in position, restoring the vertebra to near-normal height.

this not only relieves the pressure and pain, but it also

helps stabilize the spine and prevents further compression

fractures.

after the discomfort related to the procedure itself subsided,

mrs. Coburn was amazed at the results. “i was so much

better after the procedure,” she says with obvious pleasure.

“i am now pain-free and can do anything i want.”

at 80 years of age, elaine coburn is willing to put up with a few minor aches and pains. “it’s part of being

my age,” she says, half joking. But, when she started to experience major pain doing housework, walking,

even raising her arms, she and her husband, Donald, a retired thoracic surgeon, started to get concerned.

“ i WaS So muCH Bet ter af ter tHe proCedure,” SHe SaYS WitH oBviouS ple aSure.

“ i am noW pain-free and Can do anY tHing i Want.”


elaine C o B u r n


main CampuS 9500 Euclid Ave.

Cleveland, Ohio 44195

216.636.5860 or 866.588.2264

lutHeran HoSpital 1730 West 25th St.

Cleveland, Ohio 44113

216.363.2410

independenCe familY HealtH Center

5001 Rockside Road

Independence, Ohio 44131

216.986.4000

Solon familY HealtH Center 29800 Bainbridge Road

Solon, Ohio 44139

440.519.6800

StrongSville familY HealtH and SurgerY Center 16761 SouthPark Center

Strongsville, Ohio 44136

440.878.2500

WeStlake familY HealtH Center 30033 Clemens Road

Westlake, Ohio 44145

440.899.5555

WillougHBY HillS familY HealtH Center 2570 SOM Center Road

Willoughby Hills, Ohio 44094

440.943.2500

loCationS

Cleveland Clinic’s Center for Spine Health is loca-

ted on the main Cleveland Clinic campus and at

Lutheran Hospital. Many Center for Spine Health

specialists also have office hours at Cleveland

Clinic family health centers, which are conveniently

located in surrounding suburbs. If you require sur-

gery, the operation will be performed at the main

campus or Lutheran Hospital, but you may be able

to have your pre- and postoperative doctor appoint-

ments at one of our family health centers.

Whether your goal is to get back to sports, work, hobbies or just enjoying life, the specialists at

cleveland clinic’s center for spine Health can help.


c l e v e l andc l i n i c . o r g / sp in e

08-neu-017

the cleveland clinic Foundation9500 euclid avenue / ac311cleveland, oH 44195

Pain Management

Chronic pain can rule your life, interfering with your ability to work, sleep and enjoy your family and friends. When chronic pain disrupts your quality of life and does not improve with standard treatments such as aspirin or ibuprofen, Cleveland Clinic Pain Management is here to help. There are many safe, proven effective treatments available that can eliminate or reduce chronic pain. The sooner you seek treatment, the sooner you can start enjoying life again.

Cleveland Clinic Pain Management specialists are among the most experienced in the world, treating more than 10,000 patients each year. Our Board-certified physicians are dedicated to the goal of helping people with chronic pain return to a normal, productive lifestyle. Using the latest in diagnostic technology, paired with medical and interventional therapeutics, they will work with you to identify the source of your pain, eliminate or reduce the pain and teach you to manage it.

To make an appointment with a Pain Management specialist, please call:

216.444.PAIN (7246) or 800.392.3353

Cleveland Clinic Pain Management’s Mission

The mission for our department is to be the leader in patient care, education, and outcome oriented clinical and basic research in pain medicine. We believe that when you understand the nature of your pain, you are better prepared to manage it. That is why we devote ourselves to:

• Determining the cause of your pain through advanced diagnostic tests.

• Easing or eliminating pain using state-of-the-art medical and interventional treatments.

• Improving functional capabilities through aggressive, personalized physical therapy programs.

• Teaching skills that will make coping with pain easier and will help you regain control of your body and your life.

Due to the highly specialized nature of our department, we are able to offer patients the latest, most effective treatments for pain. Most of the treatments that are available through Pain Management are not widely available through community-based, general practice physicians. We recommend that people experiencing chronic pain start with their primary care physician. When pain is not relieved with standard treatment, Cleveland Clinic Pain Management should be the next step.

Cleveland Clinic Pain Management

1 • Cleveland Clinic Department of Pain Management 800.392.3353

Problems We TreatCleveland Clinic Pain Management treats chronic pain related to any type of disease, injury or accident including:

• Back and neck pain, including herniated discs, spinal stenosis, tumors and arthritis

• Chronic abdominal pain and pelvic pain

• Complex regional pain syndrome (also known as reflex sympathetic dystrophy or RSD)

• Muscle and joint pain and arthritis

• Headache

• Sports injuries

• Disorders of the nervous system, including shingles and trigeminal and occipital neuralgia (facial pain)

• Pain associated with AIDS

• Sickle cell anemia

• Cancer pain

• Intractable spacticity associated with multiple sclerosis or spinal cord injuries

• Pain associated with osteoporosis and vertebral compression fractures

Patients who have chronic back pain due to problems such as herniated discs, arthritis or spinal stenosis are surprised to discover the many non-surgical options are available to treat their pain.

A Pain Management specialist evaluates the patient, determines or confirms the source of pain and discusses treatment goals with the patient to determine the most appropriate treatment. For some patients, a prescription pain medication and physical therapy are enough to control the pain. But many patients also need to consider other options for pain management. Some of the latest treatments and technology that we offer for back pain include:

• Transforaminal epidural steroid injection

• Facet nerve blocks and radiofrequency ablation

• Intradiscal ablation procedures

• Tunneled epidural catheters for continuous infusions

• Spinal cord stimulator

• Minimally invasive disc decompression

• Intraspinal drug delivery

• Osteopathic manipulation

• Alternative medicine

www.clevelandclinic.org/painmanagement • 2

Shingles

This painful rash, caused by the herpes zoster (chickenpox) virus in adults, ranges from mild to severe. In some people,

the pain continues long after the rash has disappeared, a condition known as postherpetic neuralgia. These patients require

more intensive treatment to relieve pain and restore quality of life.

HeadachesPain Management and headache specialists work with the patient to determine the type of headache — tension, migraine, cluster or cervicogenic — and identify potential causes. This holistic approach to treating headaches may include prescription medication to abort or reduce the frequency and/or severity of headaches, psychotherapy and stress reduction.

When the type of headache is diagnosed correctly and the factors that contribute to it are identified, treatment can be highly effective in reducing the frequency and severity of headache and helping people return to their normal activities.

Pain Management offers:

• A variety of neuroblock techniques

• Radiofrequency ablation

• Implant of peripheral nerve stimulators

Back Pain

TENSION MIGRAINE CLUSTER CERVICOGENIC


Cancer experts estimate that 50 percent

of cancer patients experience pain, and in

people with advanced cancer the percentage

is as high as 90 percent. Yet, cancer pain

is often undertreated, mainly because

patients and physicians are not aware of

all of the effective options available.


specialists work hand-in-hand with

oncologists and palliative care specialists

in the Cleveland Clinic Taussig Cancer

Institute to diagnose and treat cancer-

related pain. They also treat patients

referred by other hospitals, cancer centers

and community-based physicians.

Cancer Pain

Complex Regional Pain Syndrome (CRPS)

This condition is characterized by severe, chronic pain usually following an injury

which may be trivial. The symptoms start as local pain in one part of a limb and

spreads to another region adjacent to that area. The resulting pain is out of

proportion to the original injury or illness. An accurate diagnosis is crucial to

treatment and managing the pain of this disorder. Using the latest technology

and other innovative procedures, Cleveland Clinic Pain Management provides

sophisticated diagnosis and the management of pain.

Chronic Abdominal and Pelvic Pain

Chronic abdominal and pelvic pain can be caused by a number of diseases or disorders.

The Department of Pain Management and Digestive Disease Institute have collaborated to

create a multidisciplinary center to treat chronic pain patients, the Chronic Abdominal Pain

Clinic (CAPC). A similar collaborative approach between pain management, urology, gynecology

and rehabilitation medicine is being developed to help chronic pelvic pain patients.

Pediatric Pain

According to The American Pain Society, 15 to 20 percent of children experience

chronic pain. This includes children with chronic diseases such as cancer or cystic

fibrosis who experience pain related to their disease or its treatment.

Treating pediatric pain is complex. The most effective programs target the underlying

disorder causing the pain, relieve symptoms such as sleep disturbances, anxiety or

depression and restore function so that children can return to normal activities.

Our pediatric pain management specialists understand the special needs of children

with chronic pain and involve the entire family in treating these young patients.

“Referral to a pediatric pain program

should be considered for children with

complex or refractory [pain] problems.”

ThE AMERIcAn PAIn SOcIETy

While complex regional pain syndrome

(cRPS) is a mysterious and sometimes

misdiagnosed disorder, there are doctors

who understand and know how to treat

it. This is most likely to happen if the

doctor is fellowship trained and board-

certified in Pain Medicine. Ideally, the

doctor works in a recognized pain clinic

that includes several types of treatment.

Integrative Medicine

Integrative medicine is a healing-oriented medicine that looks at all aspects of

a person (body, mind and spirit), and its popularity is rising. A 2002 survey of US

adults 18 years and older conducted by the CDC indicated that 74.6% had used

some form of complementary and alternative medicine. Acupuncture, manipulation,

anti-inflammatory diet, reiki and psychology are a sampling of the integrative programs

offered by the Cleveland Clinic Department of Pain Management.

body, mind & spirit

www.clevelandclinic.org/painmanagement • 4


Cleveland Clinic pain management specialists are dedicated to treating each patient

individually, to listening to patients, explaining all of the treatment options and creating

a customized treatment plan that fits the patient’s goals and lifestyle. More than half

of our patients come from outside Ohio. Part of what brings them here is our “Patients

First” philosophy — the dedication of our team to improving quality of life for each

patient we see.

Our physicians are in the forefront of the field, recognized nationally and internationally

for their clinical program, research and education in pain management. Patients

have the opportunity to participate in departmental clinical trials, seeking better,

more effective treatments for managing pain. Our physicians regularly publish in

leading medical journals and are invited lecturers at medical education seminars

across the country and the world.

Patients First

Most insurance plans cover pain management services including doctor visits, devices such as spinal cord stimulators, physical and occupational therapy and psychotherapy. You should contact your plan about coverage for complementary therapies such as acupuncture.

Please call 216.444.5433 for questions related to pain management services and Workers Compensation claims.

The Chronic Pain Rehabilitation Program is a specialized, intensive three-week treatment and education program that helps people with chronic pain learn to manage their pain more effectively. The program offers a continuum of care ranging from medical interventions and outpatient therapy to psychological counseling and psychiatric therapy. The program is accredited by the Commission on Accreditation of Rehabilitation Facilities. Patients may be referred by a physician, but a physician referral is not necessary to enter the program. For appointments and more information, call 216.444.5556. For questions related to insurance or reimbursement, call the Admissions Coordinator at 216.444.5433.

Our Myconsult service offers secure online second opinions for patients who cannot travel to Cleveland. Through this service, patients enter detailed health information and mail pertinent test results to us. Then, Cleveland Clinic experts render an opinion that includes treatment options or alternatives, and recommendations regarding future therapeutic considerations. To learn more about Myconsult, please visit clevelandclinic.org/myconsult.

FAQs

Are Pain Management services covered under Workers Comp?

Are Pain Management services covered by insurance?

What is the Chronic Pain Rehabilitation Program?

I live outside of northeast Ohio. How can I obtain a second opinion from a Pain Management specialist?

Cleveland Clinic Pain Management accepts patients by referral from other physicians or on a self-referral basis. Check with your insurance plan to determine if a referral is necessary.

To make an appointment with a Pain Management specialist:

216.444.PAIN (7246) or 800.392.3353

Making an Appointment

Main Campus

Cleveland ClinicPain Management Center9500 Euclid Avenue, C25Cleveland, OH 44195216.444.PAIN (7246)

Cleveland Clinic Regional Locations

Ashtabula County Medical Center a Cleveland Clinic affiliate2420 Lake AvenueAshtabula, OH 44004440.997.6700

Avon Lake Family Health Center450 Avon Belden RoadAvon Lake, OH 44012440.930.6800

Beachwood Family Health & Surgery Center26900 Cedar RoadBeachwood, OH 44122216.839.3000

Broadview Heights Pain Management Center2001 E. Royalton RoadBroadview Heights, OH 44147216.587.8830

Brunswick Family Health Center3574 Center RoadBrunswick, OH 44212330.225.8886

Chagrin Falls Family Health Center551 E. Washington StreetChagrin Falls, OH 44022440.893.9393

Elyria Family Health Center at Chestnut Commons303 Chestnut Commons DriveElyria, OH 44035440.366.9444

Euclid Hospital18901 Lakeshore BoulevardEuclid, OH 44119216.692.7543

Fairview Hospital18099 Lorain Avenue, Suite 404Fairview, OH 44111216.476.7331

Hillcrest Hospital6803 Mayfield Road, Suite 200Mayfield Heights, OH 44124440.312.7246

Lakewood Hospital14519 Detroit AvenueLakewood, OH 44107216.529.7246

Lorain Family Health & Surgery Center5700 Cooper Foster Park RoadLorain, OH 44053440.204.7400

Lutheran Hospital1730 W. 25th Street, Suite 4ACleveland, OH 44113216.363.2391

Marymount Hospital12300 McCracken Road, Suite 259Garfield Heights, OH 44125216.587.8830

Medina Hospital1000 E. Washington StreetMedina, OH 44256330.225.8886

Solon Family Health Center29800 Bainbridge RoadSolon, OH 44139440.519.6925

South Pointe Hospital20000 Harvard Road, Building AWarrensville Heights, OH 44122216.491.6433

Strongsville Family Health & Surgery Center16761 SouthPark CenterStrongsville, OH 44136440.878.2500

Twinsburg Pain Management Center2365 Edison Boulevard, Suite 100Twinsburg, OH 44087330.888.4000

Westlake Pain Management Center850 Columbia Road, Suite 120Westlake, OH 44145440.835.8233

Willoughby Hills Family Health Center2570 SOM Center RoadWilloughby Hills, OH 44094440.943.2500

CONvENIENT NORTHEAST OHIO

Cleveland Clinic Pain Management Centers


216.444.PAIN (7246) or 800.392.3353clevelandclinic.org/painmanagement

David Brown, MD

Chairman, Anesthesiology Institute

Jianguo Cheng, MD, PhDDirector, Pain Medicine Fellowship ProgramMain Campus

Emad Daoud, MD, PhDVice Chairman, Western Region

Teresa Dews, MDVice Chair, Eastern Region

Nagy Mekhail, MD, PhDDirector, Evidence-Based Pain MedicineMain Campus and Regional

Cleveland Clinic Pain Management Staff

Kenneth Grimm, DORegional

Philippe Berenger, MDMain Campus and Regional

John Hill, MDRegional

Sumit Katyal, MDMain Campus

Riad Laham, MDRegional

Manu Mathews, MDMain Campus

George Girgis, DOMain Campus and Regional

For additional information about the program, including the latest departmental news and staff directory, visit us online at clevelandclinic.org/painmanagement.

Beth Minzter, MDMain Campus

Fady Nageeb, MDRegional

Paul Shin, MDMain Campus and Regional

Lokesh Ningegowda, MDMain Campus and Regional

Marc Soloman, MDMain Campus and Regional

Timothy Rhudy, MS, LAcAcupuncturistRegional

Michael Stanton-Hicks, MDMain Campus

Pasha Saeed, MDRegional

Bruce vrooman, MDMain Campus and Regional

Samuel Samuel, MDMain Campus and Regional

Hong Shen, MDRegional

William Welches, DO, PhDRegional

Sameh Yonan, MDRegional

MedinaHospital

Cleveland ClinicBrunswick

TwinsburgPain Management

Center

Cleveland ClinicSolon

Cleveland ClinicWilloughby Hills

Cleveland ClinicBeachwood

Cleveland ClinicAvon Lake

LakewoodHospital

LutheranHospital

FairviewHospital

Cleveland ClinicStrongsville

Broadview HeightsPain Management

Center

MarymountHospital

HillcrestHospital

EuclidHospital

South PointeHospital

WestlakePain Management

Center

Cleveland ClinicChagrin Falls

Medina County

Cuyahoga County

Lorain County

Summit County

Lake CountyLake Erie

Geauga County

Cleveland Clinic Pain Management Center

9500 Euclid Avenue, C25

Cleveland, OH 44195

216.444.PAIN (7246) or 800.392.3353clevelandclinic.org/painmanagement

Cleveland Clinic Pain Management Locations

Ashtabula CountyMedical Center

Cleveland ClinicElyria

Cleveland ClinicLorain

center for spine health · 2013. 12. 20. · spinal stenosis is a condition that results from...

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