Physical Medicine and Rehabilitation (PMR) specialists
diagnosis, treat and rehabilitate individuals suffering from a wide variety of
neuromuscular and musculoskeletal conditions.
As the complexities in medicine have grown, many PMR specialists
subspecialize with additional fellowship training in the area of brain injury,
spinal cord injury, pain management, sports medicine and interventional spine.
Interventional spine specialists receive advanced training
in the diagnosis, interpretation of advance imaging studies such as MRI,
treatment, rehabilitation and utilization of minimally invasive fluoroscopically
guided spine procedures in the management of painful spine disorders. This is a relatively new subspecialty. The goal is to provide more accurate
diagnosis of painful spine conditions to provide better and more specific
treatment.
An individual with chest pain will often see an
interventional cardiologist. The interventional cardiologist will make a
diagnosis and determine the best way to manage the patient cardiac condition.
An individual with back or neck pain will want to see an interventional spine
specialist to obtain the correct diagnosis and treatment. Treatment may be as simple as activity
modification and medication to working with a physical therapist to correct
biomechanical deficits and develop muscle memory to dynamically stabilize the
spine—to fluoroscopically guide spinal injections to promote healing to
ablative procedures for degenerative conditions. Kyphoplasty is a procedure
utilized to restore height of osteoporotic compression fractures and injection
of cement to stabilize the fracture.
A study published in Spine 2013 found those individuals
scheduled to undergo surgery who consulted with a PMR specialist were often
able to avoid surgery and were satisfied with their care (Fox, et al. Spine
2013).
Minimally invasive procedures are constantly being developed
to relieve pressure off of nerves for both disc herniations and stenosis. These
procedures will need continued development before more generalized use in the
population.
Gene therapy to rebuild discs using recombinant DNA has been
performed in animals. The future in the
treatment of degenerative disc disease will probably utilize interventional
procedures to introduce gene therapy into a diseased disc to allow the disc to
repair or regenerate.
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