SPINAL CARE Continued from page 3
Carmen Petraglia,
being an orthopedic spine
making rounds on patients who had herniated discs. “Their pain was
surgeon, and he is exceptionally
unforgettable,” he says. “Nothing helped relieve it. Now I do surgery on
well qualified for this specialty.
people with herniated discs and they are pain-free on the first post-op
M.D., M.S.
He is one of an elite, specialized
night. It’s amazing to be able to help them.”
When Dr. Petraglia was a medical student at Temple, he recalls
Dr. Carmen Petraglia loves
Disc herniations occur when there is a tear in the outer portion of
group of surgeons who perform
“revision surgery” — large, complex operations to correct spinal
the disc, formally known as the annulus, and the inner watery tissue,
deformities, such as scoliosis, which may be congenital or acquired.
the nucleus pulposus, extrudes through the tear. There are two kinds
Dr. Petraglia is a graduate of Duquesne University, who had a master’s
of herniated discs: a simple tear, in which the fragments of the tear
degree in biology when he enrolled in medical school at Temple University.
are contiguous, and an extruded herniation, in which fragments have
During his residency in orthopedic surgery at MedStar Union Memorial
broken off and are free, floating around in the spinal canal. “We don’t
Hospital in Baltimore, he completed a rotation with experts in scoliosis
really know why some discs herniate,” Dr. Petraglia says. “They tend
and spinal deformity surgery at The Johns Hopkins Hospital. He then
to be strong in the center and weaker at the outer parts. The typical
completed a fellowship in spine surgery at the Shock Trauma Center at
patient is a young adult whose discs have not yet begun to degenerate.
the University of Maryland Medical Center, one of the nation’s leaders
As you age, the discs dehydrate and shrink, the disc space narrows and
in trauma care, research and training, where he was exposed to the
you are less likely to have a herniation. Factors that contribute to disc
advanced care of spine injuries.
herniation are sedentary lifestyle or work that requires prolonged sitting,
“
such as long distance driving. One might assume that standing and walking put more pressure on the discs, but the opposite is true — the highest pressure occurs
Today we have
when you’re sitting. Those who work with heavy,
‘smarTer spine surgery,’
jarring machinery, like a jackhammer, have a
wiTh beTTer diagnosTic Tools and finely Tuned surgical skills.
”
higher incidence. Smoking is a factor; nicotine constricts the blood vessels and decreases blood supply to the disc.” Disc herniation typically occurs in the lower L4-L5 and L5-S1 region of the spine, producing pain in the buttocks, thigh, leg and foot. It’s pain that patients describe as feeling like electrical shocks
CARMEN PETRAGLIA, M.D., M.S. ORTHOPEDIC SURGEON ST. CLAIR HOSPITAL
or burning. “The pain is created by both mechanical and chemical means,” Dr. Petraglia says. “The physical pressure of the herniated tissue
compresses the spinal nerve and the body’s immediate reaction to this is a massive inflammatory response; the body releases inflammatory markers which inflame the nerve root.” Patients may also experience
Spine surgeon Carmen Petraglia, M.D., M.S. prepares to scrub in before surgery.
4 I HouseCall I Volume VII Issue 3