By Becky Wiese
If you were to conduct a random survey of people on the street and ask them to explain the difference between a neurosurgeon and a neurologist, you’d probably get a fair amount of answers asserting either: a) they are the same; or b) neurosurgeons do brain surgery and neurologists treat all the other issues of the nervous system.
While those beliefs may be widely held, they aren’t completely accurate.
A common misconception about neurosurgeons is that they only do brain surgery. In fact, neurosurgeons treat all parts of the nervous system, including the spine. According to Dr. Jason Seibly, one of the neurosurgeons at Central Illinois Neuro Health Sciences (CINHS), that means anything and everything from head to toe, “because we have nerves to the ends of our toes to the top of our head.”
Dr. Seibly goes on to explain that neurosurgeons treat structural problems, or the anatomy, of the nervous system, whereas neurologists deal with the function, or the physiological, aspects of the nervous system.
While it is true neurosurgeons and neurologists occasionally overlap and consult with each other depending on the problem, typically neurologists treat with medication and neurosurgeons treat issues surgically. “Most neurosurgery is done relatively quickly, probably within two weeks of being evaluated,” says Dr. Seibly. Most surgeries provide immediate relief for the patient.
Carpal Tunnel to Brain Surgery
When Dr. Ann Stroink launched the neurosurgical practice in the community 29 years ago, no other neurosurgeons were offering services in this area. Offering immediate local care is one of the main benefits of having a neurosurgical practice such as CINHS in the community. “We provide 24/7 coverage for the community, so trauma cases and stroke victims can receive immediate care,” says Dr. Stroink.
CINHS is the only neurosurgical practice in the area, and their presence here in Central Illinois has literally saved lives because patients receive care locally instead of having to be transported to a larger city.
Other non-trauma but emergency related situations involving neurosurgical care consist of seizure disorders, brain tumors, herniated discs, or infections of the spine that cause crippling pain. Additionally, other issues such as carpal tunnel, cervical disc problems, lumbar spine surgeries — any surgical treatment of the neck and spine — are also performed by neurosurgeons.
According to Dr. Emilio Nardone, many surgeries on the spine, including those in the cervical (neck) and lumbar regions, disc herniation, and even some fusion procedures, can be done using minimally invasive techniques which limit the surgical trauma while optimizing outcome. The benefits of minimally invasive techniques are that the patient has less pain, a shorter hospital stay, and a quicker return to work. Decompression in the lumbar spine can be performed with a soft-tissue-sparing technique that allows preservation of important structures, and reduces pain and blood loss from the procedure.
CINHS has a unique approach in managing patient care, as they seek to provide patients with high quality and prompt attention. Dr. Nardone emphasizes the comprehensive service available at CINHS. “Patients can see the doctor and get their diagnostic imaging such as MRI, X-ray, and CT scan, and have a bone density test done if needed, all at the same facility.” This allows for faster diagnosis and allows issues to be addressed more quickly.
CINHS also offers post-surgical follow-up care through Dr. Won Jhee of Bloomington Rehabilitation Associates. Dr. Jhee is a physiatrist who coordinates the patient’s rehabilitation to maximize recovery from surgery or from any type of injury.
Patients can call directly to the CINHS office without the need for a primary care physician referral. According to Dr. Nardone, specific symptoms the neurosurgeons pay attention to include arm, leg, neck, or back pain with associated numbness and tingling or severe headaches with seizures and weakness.
Dr. Stroink adds, “We can usually tell over the phone by the description of symptoms whether they need to be seen [by a neurosurgeon].” Patients with a constellation of symptoms that necessitate a fast track trip to the neurosurgeon’s office may be able to save precious time in treating a herniated disc, spinal stenosis, or brain tumor.
The Bone Health Clinic
The Bone Health Clinic is the most recent addition to the CINHS family of services. Open since February of this year, the clinic has been designed to meet a need in the community for treating osteoporosis and promoting better bone health. Although the relationship to neurosurgery seems small, the Bone Health Clinic complements the surgical practice as healthy bones increase the success rate for neurosurgeries that require screws to be used to attach a plate to bone. Better bone, better result, according to Dr. Seibly, who is the overseeing physician of the Bone Health Clinic.
Shannon Laesch, APN and bone health consultant, runs the clinic and shares some of the challenges of her job. “Osteoporosis is very much a silent disease, as pain is not necessarily a signal. Many patients do not realize they have osteoporosis or osteopenia (low bone mass) until they have experienced several broken bones and have undergone a bone density test.” Many people think they are not at risk, when in fact 1 in 2 women develop some level of osteoporosis.
Patients at the Bone Health Clinic undergo a thorough evaluation, which includes a bone dexa test (an X-ray that measures bone density), and blood work to determine secondary causes of osteoporosis, such as thyroid and kidney disease, diabetes, celiac disease, Paget’s disease, and low vitamin D and calcium levels. Laesch also obtains information regarding the patient’s medical history, as well as family medical information (such as having a parent who has had a hip fracture). Finally, she completes both a nutrition assessment and a fall assessment, which helps to discover possible fall hazards in the patient’s home.
Another helpful diagnostic tool that Laesch sometimes uses is an online program called FRAX (fracture risk assessment analysis). The FRAX results tell her if the patient is at risk for major fractures due to osteoporosis. Because of the association to CINHS, Laesch may also get a clinical diagnosis from one of the surgeons as a result of their visual inspection of the bone during surgery.
If the results point to osteoporosis, Laesch recommends appropriate treatment, which may include physical therapy, low impact aerobic exercise, calcium and vitamin D supplements, and medication that either builds bone mass or bone. “Ideally, we’d like to get people in here before they develop osteoporosis, so we could do more prevention. Right now, patients are typically coming in after neck or spine surgery to prevent further fractures.”
Laesch specializes in secondary fracture prevention and is Fracture Liaison Service certified, which means she can do follow-up care to osteoporosis related bone injuries.
Patients can also self-refer to the Bone Health Clinic, especially if they feel they are a high risk for osteoporosis.
A Patient’s Story
Nadene Dillman of Bloomington enjoyed an active and physical lifestyle. A kindergarten teacher at Cornerstone Christian Academy,
her job involved a lot of bending to listen to a student or to better see a paper on a student’s desk—plus a myriad of other twists and turns that happen through the course of a normal day of activities. She was also a very active walker and enjoyed walking several days every week. Nothing specific happened that she can think of, but in October of last year, she began to experience pain in her lower back and down her right leg.
She went to her doctor, who gave her three cortisone shots. Those worked for about two weeks, and then the pain came back with a vengeance. She tried a variety of other treatments, including acupuncture and chiropractic, and eventually discovered through MRI imaging that her primary problem was that two vertebrae (numbers 4 and 5) were 10 mm off, and the disc between was bulging and hitting the nerve causing her pain, along with a burning sensation in her foot.
After living with chronic and worsening pain for six months, Dillman called Dr. Nardone based on a recommendation from a student’s parent. “I talked with him and explained what I had been experiencing. He had me do an MRI, found the problem, and told me what would fix it.”
Immediately after surgery, Dillman felt no pain in her foot, ankle, leg, or hip. “Walking is therapy for me — and now I can walk again.” Dillman is thrilled to be able to go back to teaching full time in the fall, and she’s very thankful for the relief from pain. “People I work with could tell immediately that I was feeling better — they told me they had seen the pain in my eyes. It’s a miracle — God used Dr. Nardone’s hands to heal me.”
Although the surgeon often gets the credit, Dr. Stroink points out that CINHS is based on teamwork. “At CINHS, we believe teamwork makes the best medicine. Patients are not coming to just one individual doctor, but to a team, including great nurses, administrators, and support staff, whose goal is to provide the whole package of health care.”
At Central Illinois Neuro Health Sciences, providing services such as on-site imaging, physical therapy, osteoporosis management, and behavior modification education, in addition to surgical consultation, allows them to increase the quality and effectiveness of patient care while decreasing the time patients spend either waiting to have these services done or for the results and subsequent treatment. The end result is offering patients the best care possible at a facility that is close to home.
Central Illinois Neuro Health Sciences is located at 1015 S. Mercer Ave. in Bloomington. For more information or to schedule a consultation, you may contact them at 309-662-7500 or through their website, www.cinhs.com.
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