Miscellaneous
The general public’s understanding of spinal fusion often starts with a misconception. When Dr. Hunter Dyer talks to people about lumbar fusion, many think that it’s the screws doctors place that are the fusion. But that’s not true — the hardware just holds the spine in alignment until the vertebrae or spinal elements grow back together. As an expert in spinal fusions, Dr. Dyer is familiar with what people get wrong or just don’t understand about caring for their spine and fixing spinal issues. It’s a complicated field of medicine and, as such, patients considering surgery like a fusion should consult with an expert first. For example, Dr. Dyer says that most patients with back pain don’t actually need surgery. Rather, alternative care like physical therapy is often a better starting point before committing to the sometimes-extensive recovery from a fusion procedure. In addition, there are myriad risk factors to consider: Does the patient smoke? What’s their surgical history? How old are they? What’s their body type? All these things and more, Dr. Dyer says, can influence whether a patient is a good candidate for a spinal fusion. On this episode of Back Talk Doc, Dr. Dyer explains all things spinal fusion with host Dr. Sanjiv Lakhia. ? Featured Doc ?Name: Dr. Hunter Dyer What he does: Dr. Dyer is an expert in degenerative spine disease, endoscopic spine surgery, minimally invasive spine surgery, skull base surgery, spinal fusion, transsphenoidal surgery and vascular neurosurgery. He is the President at Carolina Neurosurgery & Spine Associates. Company: https://www.cnsa.com/ (Carolina Neurosurgery & Spine Associates) Words of wisdom: “The key to any great job, or being good at what you do, is I absolutely love what I do. I wake up every single day excited to see what I've got for the day and see if I can help people surgically, to see if I can help people in the clinic. And that's why we love being physicians and we love being in health care, because it's just so rewarding.” Connect: https://www.linkedin.com/in/e-hunter-dyer-3b472952/ (LinkedIn) ⚓ Anchor Points ⚓Top takeaways from this Back Talk Doc episode ★ Most spinal issues probably don’t need surgery. Even as a surgeon, most patients Dr. Dyer sees can address their issues with conservative care — physical therapy, spinal traction, or injections. “The only people that we need to consider for spinal fusion are typically those that have problems where they require so much bone removal that they require stabilization of the spine,” he says. ★ Smoking is a major risk factor for spinal issues. It can affect people with problems in either the neck or back. “We typically do not like to even consider spinal fusion if somebody is using tobacco,” Dr. Dyer says. “If they've used it in the past, it's likely that they get degeneration of the disk and that can lead to accelerated adjacent-level problems.” ★ The direction of spinal surgery can influence the healing process. Dr. Dyer explains that when a surgeon uses a lateral approach, patients don’t often experience a lot of pain. When the best course of action involves the posterior or anterior approach, patients can experience more pain after surgery. “In general, there's more pain with the posterior approach, but it's still the most common way because it does provide that direct view of the nerves,” he notes. ★ Spinal fusion techniques are advancing rapidly — which is good for patients. In the past five years, technology has advanced so that surgeons can be more precise with placing screws, thanks to MRI and CT images. In addition, robotic tools have made surgery much safer and much easier to heal from. “For many people, it’s just a better thing all around,” Dr. Dyer says. ⚕️ Episode Insights⚕️[00:00] Mobile-based solutions for clinical practice: Check out...