• Patient Handbook

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    The Bassett Spine Care Institute is dedicated to educating the community and treating patients with a variety of spinal conditions. The Institute’s providers share a common mission and vision developed to achieve the most favorable outcomes.

    Mission: The Bassett Spine Care Institute strives to provide compassionate, ethical, efficient and effective spine care to patients of Bassett Healthcare Network and the surrounding communities.

    Vision: Shared principles of patient centered care will be a foundation for efforts related to ongoing education, research and individual treatment options. Members of the Bassett Spine Care Institute share a common goal and foresight, such that the Institute will be respected as a leader in comprehensive spine care for central New York.

    Members of the Spine Care Institute represent multiple specialties and locations within Bassett Healthcare Network: Primary Care, Neurosurgery, Orthopedics, Anesthesia Pain Services, Pain Psychology, Physical Medicine & Rehabilitation, and Physical Therapy. In addition, as a means of enhancing services provided to the community, members of the Institute are actively involved in continuing medical education, clinical trials, and spine related outcomes research.

    The following is a brief introduction to the services and departments that are part of our Institute and how they may aid in your diagnosis, treatment and recovery. This material may also be found on our website: www.bassettspine.org.

    Primary Care - Back pain is a very common problem, and usually resolves on its own within days to weeks. Initial treatment generally involves staying active, but avoiding those activities that tend to aggravate the pain, and using over- the-counter pain medicine such as acetaminophen, ibuprofen (Motrin) or naproxen (Aleve). Bed rest is not recommended and X-rays or MRIs are generally not needed. Seeing your primary care physician or nurse practitioner can be helpful to evaluate the cause of the back pain and guide therapy. For back pain that lasts longer, or for worrisome symptoms such as weakness or difficulty moving your bowels or urinating, further evaluation is indicated. This may involve X-rays, referral to physical therapy or massage therapy, referral to physiatry (doctors who specialize in physical medicine, such as back injections and rehabilitation), or surgery. Surgery is generally not indicated since the majority of cases resolve with time. It is common for back pain to wax and wane. Regular, life-long back exercises can strengthen your back and help you function better, with less pain and decreased frequency of flares. Effective positive coping skills are as important as physical exercise, and your practitioner can help you with both or refer you to others.

    Neurosurgery - The Neurosurgery Division of the Department of Surgery is proud to be a key part of the Bassett Spine Care Institute. Our dedicated neurosurgeons and physician assistants are skilled at diagnosing and treating a wide variety of diseases of the central and peripheral nervous systems. We try to improve pain and restore neurologic function whenever possible. We take a conservative approach, performing surgery only when necessary, and usually after trying non-operative treatments. We strive to make each patient visit informative, worthwhile and pleasant.

    Orthopedics - Most spinal conditions relate to the function of muscles, bones (vertebra), tendons, ligaments and adjoining intra-vertebral discs. Members of the orthopedic team, including physicians, physician assistants and support staff, address spine concerns on a daily basis with great compassion and concern for you and your family. The vast majority of patients with spinal complaints do not require surgery. A thoughtful conversation following thorough evaluation allows for a better understanding of your condition and options available to you. Spinal conditions may involve all regions of the spine – cervical, thoracic, lumbar or sacral. Participation within Bassett’s Spine Care Institute allows for the orthopedic team to consult with other team members. While most patient concerns can be addressed without surgery, only a member of the surgical team can truly answer questions when surgery seems necessary. The Bassett Spine Care Institute provides an environment for information to be shared between specialties with your best interest as the primary concern. Orthopedics is proud to be a member of this team.

    Anesthesia Pain Services – A number of patients with chronic pain will have to undergo an elective surgery and the Anesthesia Care Team is ready to provide the necessary quality patient care and pain control for anyone during their operation. Preoperatively an epidural steroid injection may be requested by a selective group of back pain patients. This is a core skill of our Pain Therapy Anesthesiologist. These same epidural steroid injection skills can also be provided by some members of the Physical Medicine & Rehabilitation group.

    Pain Psychology - Pain psychology takes a holistic approach – looking at the person as a whole – for treating patients with spinal disease or injury. This approach requires careful assessments of both physical and emotional capacities to manage illness in partnership with medical practitioners.

    A psychological assessment is helpful in this process, which gives us information about a patient’s coping style and ability and also identifies other life stressors that may be positively affected by psychological support. Cognitive Behavioral Therapy (CBT), which can help a person develop new and effective coping skills, is often the recommended treatment.

    Physical Medicine & Rehabilitation – Also known as Physiatry or PM&R. Physiatrists provide a broad range of medical and non-surgical care for patients, including those with musculoskeletal problems, such as back, hip, or knee pain, as well as patients with neurologic conditions strokes, brain injuries, or spinal cord injuries.

    The Physical Medicine and Rehabilitation Division of the Department of Surgery at Bassett is pleased to have four physiatrists, all of whom are Board Certified by the American Board of Physical Medicine and Rehabilitation. These physicians specialize in the non-surgical care of musculoskeletal issues with a special focus on the non-surgical care of spine problems. Additionally, this division also provides electrodiagnostic evaluations (EMG’s) and sports medicine care.

    As contributing members of the Bassett Spine Care Institute our physiatrists take great pride in the care of patients with back pain bringing many unique skills and techniques to the non-surgical management of cervical and lumbar region pain. Common spine region problems managed by our physiatrists would include: disc degeneration, disc herniation, spinal stenosis, facet joint arthritis, and sacroiliac joint dysfunction. Additionally, our physiatrists also evaluate patients with musculoskeletal conditions such as hip, knee, or shoulder pain.

    Treatment methods include targeted physical therapy prescriptions and interventional procedural treatments. Interventions are typically performed with the use of either x-ray or ultrasound guidance and include: epidural steroid injections, facet injections, radiofrequency ablations, sacroiliac joint injections, large joint injections, and peripheral nerve blocks, as well as other procedures.

    These interventional procedures frequently provide both a therapeutic as well as a diagnostic benefit. The therapeutic benefit may provide relief of your symptoms and often facilitates fuller participation in other aspects of your rehabilitation, such as physical therapy, and may allow you to decrease medication needed to manage your symptoms. The diagnostic benefit of the various procedures is often useful to assist the physiatrist in making a more accurate diagnosis of the source of pain and dysfunction.

    Our collective goal is to use our unique skill set to maximize patient outcomes and improve patient function. To these ends we make full use of non-surgical treatments and coordinate care with other providers including spine surgeons, primary care providers, and physical therapy. If after thoughtful consultation with surgical services, surgery is ultimately deemed necessary, our further goals include assisting our surgical team with the most accurate diagnosis to facilitate the best possible surgical outcome for you.

    Physical Therapy - Because the nature of back pain is often cyclical (episodes of acute pain, followed by a gradual decrease in symptoms) the role of physical therapy is often primarily educational.

    The purpose is not to necessarily provide a quick fix to the onset of acute back pain, but rather to help you understand some of the factors that have caused your pain, and provide you with exercises and lifestyle changes that may offer more control over your symptoms.

    We promote an active approach to therapy – that is, we want our patients to perform exercises not just in our clinic, but during your busy daily lives, so that the chances of back pain returning lessen as you take a ‘self-directed’ approach to your care.

    Therapists will select the most appropriate exercises for you, based on the diagnosis, and periodically alter the program based on your response to treatment. If you have undergone interventional or surgical procedures to reduce pain, care is coordinated with the attending physician so that a progression of activity can be determined – including return to work and/or recreational pursuits.

    Conditions such as spinal stenosis, sciatica, facet joint arthritis, and disc herniation all require specialized knowledge of anatomy in order for treatment to be effective. Therapists in the Bassett Spine Care Institute have continuous access to the team of specialists who diagnose, and treat patients with these conditions, ensuring care is consistent across the spectrum of all specialists.

    Bassett therapists practice in Cooperstown at the Railroad Ave. facility, as well as in Oneonta at both Oneonta Specialty Services and FoxCare Center; in Delhi at O’Connor Hospital, Cobleskill Regional Hospital, Little Falls Hospital and Valley Health Services in Herkimer. Aquatic therapy for patients with spinal conditions is offered in Cooperstown and Oneonta. Return to work assessments can be arranged at O’Connor Hospital, Little Falls Hospital or Bassett Medical Center. Visits are normally arranged on a one to two times per week basis, at the convenience of the patient.