Dr. Eck received a Bachelor of Science degree from the Catholic University of America in Biomedical Engineering, followed by a Master of Science degree in Biomedical Engineering from Marquette University. Following this he worked as a research engineer conducting spine biomechanics research. He then attended medical school at University of Health Sciences. He is board eligible in orthopaedic surgery.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
The lumbar spine is the lower portion of the spine found at the center of the
curve of the low back. This area can be a common source of pain.
Low back pain
is the second most common reason for visits to the family physician, behind only
the common cold. As people become older, various changes occur in the lumbar
spine that can cause pain. In most cases these changes are normal
degenerative arthritis (wear of cartilage over time). The physician must also rule out other
more serious conditions including tumor, infection, or fracture.
Fortunately, more than 90% of patients with low back pain will have
improvement in their symptoms regardless of treatment within six weeks. During
that time the physician has various treatment options including medications,
physical therapy, or injections that can help ease the symptoms. Some of those
patients that do not improve during the first six weeks may be candidates for
surgery. The spine surgeon has different types of surgical options available
based on the specific cause of pain.
What is lumbar spinal fusion?
Lumbar spinal fusion is an operation that causes the bones of the spine in the lower back to grow
together. The goal of the lumbar fusion is to have the two vertebrae fuse (grow
solidly together) so that there is no longer any motion between them. Removing
the intervertebral disc or bone spurs can reduce some of the pressure on the
nerves, helping to reduce pain. Additionally, by fusing the two vertebrae
together this will stop the formation of bone spurs at that location, further
reducing pain and potential nerve injury.
There are many different specific techniques to try to fuse the vertebrae
together. The surgery can be performed either through an incision in the back,
the abdomen, or a combination of both. In many cases metal screws and rods are
placed from the back into the bones to hold them steady while the fusion occurs.
During an interbody fusion, the surgeon removes the intervertebral disc and
places either a piece of bone or a metal or plastic cage in its place. The
decision on what type of fusion is best for each patient is based on their
specific complaints and the cause of symptoms. Spinal fusion can be very
effective in the properly selected patient.
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, muscles of the low back, internal organs of the pelvis and abdomen, and the skin covering the lumbar area.
A pinched nerve can be caused of a variety of conditions, for example, carpal tunnel syndrome, herniated disc, sciatica, arthritis, spinal stenosis, trauma, and more. Common symptoms of a pinched nerve include pain, numbness, tingling, and weakness. Treatment of a pinched nerve depends on the cause of the pinched nerve.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of
cartilage in the joints. Also known as degenerative arthritis. Osteoarthritis
can be caused by aging, heredity, and injury from trauma or disease.
Degenerative disc disease makes the disc more susceptible to herniation (rupture) which can lead to localized or radiating pain. The pain from degenerative disc or joint disease of the spine is usually treated conservatively with intermittent heat, rest, rehabilitative exercises and medications to relieve pain, muscle spasm and inflammation.
The five types of spondylolisthesis include 1) dysplastic, 2) isthmic, 3) degenerative, 4) traumatic, and 5) pathologic. The most common symptom of spondylolisthesis is lower back pain. Treatment depends on the type and severity of spondylolisthesis. Surgery is required in some cases of spondylolisthesis.
Pain management and treatment can be simple or complex, according to its cause. There are two basic types of pain, nociceptive pain and neuropathic pain. Some causes of neuropathic pain includes: complex regional pain syndrome, interstitial cystitis, and irritable bowel syndrome. There are a variety of methods to treat chronic pain, which are dependant on the type of pain experienced.
Chronic pain is pain (an unpleasant sense of discomfort) that persists or progresses over a long period of time. In contrast to acute pain that arises suddenly in response to a specific injury and is usually treatable, chronic pain persists over time and is often resistant to medical treatments.
Spondylolisthesis (spon + dee + lo + lis + thee + sis) is a condition of the spine whereby one of the vertebra
slips forward or backward compared to the next vertebra. Forward slippage of one
vertebra on another is referred to as anterolisthesis, while backward slippage
is referred to as retrolisthesis. Spondylolisthesis can lead to a deformity of
the spine as well as a narrowing of the spinal canal (central
spinal stenosis)
or compression of the exiting nerve roots (foraminal stenosis).
What causes spondylolisthesis?
There are five major types of lumbar spondylolisthesis.
Dysplastic spondylolisthesis: Dysplastic spondylolisthesis is caused by a defect in
the formation of part of the vertebra called the facet that allows it to slip
forward. This is a condition that a patient is born with (congenital).
Isthmic spondylolisthesis: In Isthmic spondylolist...