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.
Patients with isthmic spondylolisthesis may benefit from
a hyperextension brace. This extends the lumbar spine bringing the two portions
of the bone at the defect closer together and may allow for healing to occur.
For patients whose symptoms fail to improve with
conservative treatment surgery may be an option. The type of surgery is based on
the type of spondylolisthesis. Patients with isthmic spondylolisthesis may
benefit from a repair of the defective portion of the vertebra, or a pars
repair. If an MRI scan or PET scan shows that the bone is active at the site of
the defect it is more likely to heal with a pars repair. This involves removing
any scar tissue from the defect and placing some bone graft in the area followed by placement of
screws across the defect.
If there are symptoms in the legs the surgery may include
a decompression to
create more room for the exiting nerve roots. This is often combined with a
fusion that may be performed either with or without screws to hold the bone
together. In some cases the vertebrae are moved back to the normal position
prior to performing the fusion, and in others the vertebrae are fused where they
are after the slip. There is some increased risk of injury to the nerve with
moving the vertebra back to the normal position.
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.
Lumbar stenosis can be caused by degenerative arthritis (the most common cause), tumor, infection, or metabolic disorders (Paget's disease of the bone). Symptoms include low back pain, weakness, pain, numbness, and loss of sensation in the legs. Other conditions may cause similar symptoms of lumbar stenosis, including diabetic neuropathy, claudication, and peripheral vascular disease. Diagnosis, is a medical history and imaging studies. Lumbar stenosis may be treated with medication or surgery.
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.
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.
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