WORKUP AND DIAGNOSIS
Surgery is typically offered only as a last resort after the exhaustion of less invasive treatments has occurred. Infrequently however, acute fractures-dislocations, worsening neurologic status, or advanced cancer, may require urgent or emergent surgical intervention. Having trained at the top tertiary care hospitals in the country with level 1 trauma and advanced cancer centers, Dr. Long has the expertise to perform complex surgeries on the spinal column to treat the patient's disease and allow the best chance for recovery. When possible, he performs minimally invasive and robotic spinal surgery to reduce the insult of surgical manipulation, hasten recovery, and limit scarring. A detailed surgical plan is offered to the appropriate patient candidates with a discussion of the risks, benefits, and alternatives so that the patient is an educated partner in the process. Dr. Long prefers to follow his patient's recovery for at least 1 year from the surgery.
Commonly, a number of treatment options will be offered by Dr. Long to help manage the patient's symptoms and complaints, based on the spinal disease and extent of pathology. First line suggestions typically revolve around maintaining good conditioning, with an emphasis made on recognizing posture and improving core strength, and undergoing a course of physical therapy. Oral medications will commonly be prescribed to alleviate pain and dysfunction which can frequently accompany spine pathology. Anti-inflammatories, muscle relaxants, and corticosteroids are commonly prescribed by Dr. Long to address patient discomfort. A conscientious effort is made to avoid prescribing narcotic medications. Trigger point injections or epidural injections might be offered in the setting of advanced disease.
The initial visit begins the critical patient-doctor relationship, which is characterized in Dr. Long's practice by honesty, prudence, and confidentiality. A thorough history is obtained to understand not only the musculoskeletal and neurologic complaints of the patient, but also other aspects of the patient's health which may impact care. A focused and comprehensive spine neurologic examination is performed, followed by a radiographic evaluation that may include xrays, CT scans, and MRI. Additional neurologic testing like EMG or nerve conduction studies may be obtained to further clarify the patient's disease. Lastly, an educated discussion on the diagnosis and various treatment options available is had, to place the patient in the best scenario to make an informed decision on their care.