Panorama Orthopedics & Spine Center has been a trusted provider of orthopedic care in metro Denver for more than 70 years. With more than 30 orthopedic surgeons, we are one of the largest and most specialized orthopedic groups in the United States and are known as a leader in orthopedic care. We offer highly trained surgeons and
specialists in sports medicine, spine, joint replacement, orthopedic trauma, foot and ankle, hand and wrist and non-operative pain management. We are committed to excellence in everything we do. That’s why patients of all ages — from children to seniors — trust Panorama Orthopedics to help them get them back to doing the things they love.
Have Questions? Contact Our Office Today! (303) 233-1223
At Panorama Orthopedics & Spine Center, our comprehensive approach to spine care means patients receive world-class, individualized treatment from a team of providers who are committed to delivering the highest-quality care. Whether it’s a pulled muscle, a herniated disk or a complex deformity, we understand spinal conditions can be extremely debilitating. Panorama is committed to reducing pain and improving function so patients can get back to doing what they love — whether that’s work or play.
Our spine care team includes orthopedic spine surgeons, a neurosurgeon, pain management doctors (known as physiatrists) who specialize in non-surgical care; and spine-specific physical therapists.
Together we offer a range of treatments, and the vast majority of patients receive relief from such non-surgical options as activity modification, anti-inflammatory medications, physical therapy, or steroid injections.
Same Day and Next Day Appointments for Back Pain. If Your Back Hurts, Call Us Today – 303-233-1223
Back pain can get you down and it can bring life to a screeching halt. If you have injured your back – call us. Our team will fit you in for an evaluation that day or the following day and help you get on the path to feeling better. Your initial evaluation will include an assessment of your back pain and a recommended treatment plan to help you feel better again.
Understanding the Common Causes and Treatments for Back Pain
If you suffer from back pain, you’re not alone. According to the National Institute of Health, back pain is one of the most common medical conditions in the United States. Fortunately, a number of non-surgical treatment options are available. Many conditions that cause back pain get better by themselves within weeks to months. and ultimately, fewer than ten percent of all spine patients seen at Panorama Orthopedics require back surgery.
Here are the most common reasons people suffer from back pain along with their treatment options:
1. Lumbar Strains and Sprains: common soft tissue injuries that may require a long time to heal, even with treatment. Strains occur when you stretch the muscles and/or tendons in your back abnormally. Sprains occur when you stretch a ligament abnormally. Ligaments are the tough bands of tissue that attach bones to bones and stabilize your back. Treatment for both strains and sprains are similar – short periods of rest followed by activity such as physical therapy, cardiovascular exercise, stretching and core strengthening to restore mobility. Ice, heat, massage, and traction can also help. Your doctor may also recommend anti-inflammatory medications to relieve your pain. Neither sprains nor strains require surgery.
2. Herniated (“Bulging”) Disc: a condition in which the intervertebraldiscs between the bones of your spine bulge beyond their hard outer shell. When lower back and leg pain (sciatica) occur together, a herniated disc is most often the cause. Treatment options include exercise, avoiding painful positions, physical therapy, muscle relaxants, over-the-counter pain medications, prescription drugs and corticosteroid injections. Less than two percent of patients require surgery to remove the herniated disc material. This is often done through a minimally invasive approach.
3. Spine Arthritis (Arthritic Disc & Facet Joint): a condition that involves the breakdown of cartilage, the cushioning material between your joints and bones. Because discs function like shock absorbers between your facet joints and bones, breakdown of this cushioning material can cause pain and stiffness, especially when you bend and twist.
Treatment of arthritis often focuses on reducing inflammation and relieving pain through over-the-counter medications, prescription drugs and cortisone or hyaluronic acid injections. Exercise therapy may also be recommended to decrease stiffness and strengthen muscles around the joint. Surgery is only recommended for certain types of facet joint and disc arthritis that affect the stability of the spine.
4. Spine Alignment Problems: the two most common forms of “misalignment” in the spine are conditions called spondylolisthesis and scoliosis.Spondylolisthesisis a condition in which one of the bones in your spine (vertebra) slips forward and out of place compared to the adjacent bone. The condition can cause back and leg pain ranging from mild to severe, although many people experience no symptoms.Treatment includes exercise, physical therapy, anti-inflammatory medications and steroid injections. Surgery may be recommended if less invasive treatments do not provide lasting relief.
Scoliosis is a sideways curvature of the spine that most often occurs in young patients. However, as people age, the degenerative spine can begin to curve and twist due to weakened discs and joints. As the curvature worsens, arthritic pains in the back and sciatic pains in the lower back and legs can develop from narrowing of nerve channels within the spinal column. Treatment includes all of the previously mentioned non-surgical options. In the proper setting, surgery can be done to correct alignment problems, which address instability of bones, joints and disks. Surgery also relieves nerve compression.
If you suffer from back pain, you can take comfort in knowing you have treatment options. When you come to Panorama for back pain, we will meticulously analyze your situation and make the proper recommendation for your condition. Panorama is know for their conservative spine doctors who want to provide the right treatments for each individual. Surgery is typically not the first option unless it is the best option.
Fewer than 10% of all spine patients seen at Panorama Orthopedics and Spine Center needed back surgery
Minimally Invasive Spine Surgery
However, if conservative treatments fail, our highly experienced team is able to offer the most advanced surgical treatments, including microscope-assisted surgery and surgical navigation for improved precision. We are also able to offer minimally invasive spine surgery, which is a popular option for patients facing back surgery because it uses smaller incisions than traditional, “or open,” surgery. For the patient, this means less pain, shorter hospital stays and less scarring. There is also less disruption to surrounding muscle and tissue and a smaller risk of infection.
Dr. Lonnie Loutzenhiser talks about Minimally Invasive Spine Surgery
Despite its benefits, minimally invasive spine surgery is not performed by all spine surgeons. Doctors who perform this type of surgery must undergo additional training on the procedure. Dr. Lonnie Loutzenhiser at Panorama Orthopedics & Spine Center is specially trained in minimally invasive (microscopic) surgical techniques. He uses these techniques to treat patients with herniated disks, pinched nerves, spondylolisthesis, scoliosis and traumatic instability of the spine. Back surgery can now be done through incisions that are measured in millimeters.
Although minimally invasive spine surgery has many advantages for patients, there are some back and neck conditions that cannot yet be treated through this approach. Together we will find the best solution to treat your back pain.
Patients sometimes ask about laser spine surgery, with the impression that it offers the most up-to-date technology. Though there has been a large marketing push behind the procedure – you may have seen the TV ads – the clinical benefits are questionable. At Panorama, we remain committed to using the latest proven techniques and technologies.
Most of our surgeries are performed at OrthoColorado Hospital, the only orthopedic specialty hospital in the region. Like Panorama, OrthoColorado only treats orthopedic patients, and that focus means higher satisfaction and shorter hospital stays for patients. The average length of stay for spine fusions at OrthoColorado is 2.4 days, compared to a national average of 3.2 days. Working in conjunction with Flight for Life and St Anthony Hospital, Panorama serves Colorado and the Rocky Mountain region as the state’s premier spine, trauma and complex deformity referral center.
Do you experience tingling or burning sensations in one or more of your arms or wrists? Is it sometimes challenging to button your clothes or hold coins in your hand? Do you feel numbness or shooting pains in a leg or even experience trouble walking? You may be surprised to learn that any one of these symptoms could be caused by a problem in your neck.
People with neck conditions can experience a wide variety of strange sensations in addition to pain. Some patients report feeling as if ants are crawling on their skin or as if someone is pouring hot or cold water over an arm or a leg. Others describe a profound sense of weakness in one isolated muscle.
Because your neck is connected to your spine, it can send signals down your spinal column to other parts of your body. Pain that originates in one part of your body but is felt in another is called “referred pain.” The top two neck conditions that trigger referred pain are cervical, also known as neck, herniated discs and cervical spinal stenosis:
1.Cervical Herniated Disc (also called a slipped or ruptured disc): a condition in which one of the discs in your spine bulges beyond its hard outer coating, irritating nearby nerves. Herniated discs are usually caused by injury, arthritis or aging. Patients with a herniated disc often experience pain, tightness or cramping in the neck and shoulder areas or tingling, burning or numbness in their arms, wrists or hands.
2.Cervical Stenosis (also called cervical spinal cord compression): a condition in which the spinal canal in your neck is narrowed due to injury, arthritis or aging.
This narrowing causes pressure on your spinal cord or on a nerve root, which can result in a combination of numbness, tingling, weakness or pain in one or both arms, hands or legs.
Treatment for herniated discs and cervical stenosis are diagnosed and treated in a similar way. At your first appointment, Panorama spine doctors will order an X-ray to rule out a fracture. They often will also recommend physical therapy (PT) and medications designed to reduce inflammation or to calm nerve hyperactivity. Approximately 60 to 70 percent of patients respond to this treatment within six to twelve weeks.
If you don’t respond to PT or medications, often we will recommend a corticosteroid epidural injection to relieve pain and reduce inflammation. We may also order an MRI (magnetic resonance imaging) to learn more about the condition.
If corticosteroid shots don’t work within five to six weeks, at that point we will consider surgery to relieve the pressure on the nerves. Surgery for both a herniated disc and for stenosis is minimally invasive and involves inserting a small wedge of bone through a tiny incision in the front of your neck. The bone is then fused into place to permanently decompress the area. (In the case of a herniated disc, the damaged disc is removed first.) Both procedures require an overnight stay in the hospital and recovery can take from two to twelve weeks.
Whether you suffer from a herniated disc, stenosis or another orthopedic condition, the doctor will take the time to listen and answer all of your questions carefully. It’s very important that our patients understand their condition and all of their treatment options.
Paralyzed in a Mountain Bike Accident - Matt Talks About His Miraculous Recovery and The Invisible Injury
Jack's Story of Minimally Invasive Spine Surgery
Linda's Story about Scoliosis Surgery with Dr Agarwala
Learning About Low Back and SI Pain with Dr. Desai
Up to 85% of Americans experience low back pain at some point in their lives. There are many causes of lower back pain that range from injury to deformity. There is, however, a commonly overlooked cause that is responsible for chronic low back pain in 15-30% of the cases – SI joint dysfunction, also known as sacroiliac joint pain, and sacral pain. The sacroiliac joint or SI joint, as it is more commonly known, is the link between the upper and lower body, it is the joint between the sacrum (bottom of spine) and the iliac (pelvis). The SI joint is actually has two joints, on either side of the spine that hold the weight of your body as it shifts when you walk.
Si joint pian can be caused by trauma or injury to the low back, childbearing, degeneration from arthritis or may develop in individuals who had undergone a previous lumber fusion. When your pain is caused by the SI joint, it can appear in many different places from the low back to the pelvis, hips, glutes and even radiate down to your calves. Sometimes the pain is a dull, aching pain and other times it can be a sharp, stabbing pain. It is estimated that up to 30% of this kind of pain is caused by SI Joint dysfunction. Unfortunately, these symptoms mimic many other problems of the spine, legs, and hips therefore it is really important to find a proper diagnosis for your pain.
The first step in diagnosis is a physical exam, your doctor may also uses diagnostic imaging and diagnostic injections to help determine the source of your pain and determine if it may be caused by your SI joint.
There are many treatments available today to help stabilize the joint and eliminate the pain caused from SI joint dysfunction. Therapies can range from over-the-counter medication, injections, physical therapy to SI joint fusion, which is a minimally invasive procedure. If you suffer from low back pain, visit a specialist who can determine what is the root cause may be and help you get back to living an active, healthy, pain-free life.
The Panorama Difference - Our surgeons are committed to quality and constant improvement.
That’s why education, research and training are hallmarks of our spine specialists, who are known as experts in their field both nationally and internationally. Twice a month our surgeons meet to review major cases with the entire spine team to determine the best course of treatment for individual patients. This peer review enables us to maintain the highest standard of care for all our patients. Patients can rest assured they have a whole team of doctors working to find the best treatment plan for them.
Dr Drewek Reviews the Most Common Causes of Back Pain
Learning About Back Pain
Knowledge is power. Watch these videos to learn more about how to keep your back healthy and strong – watch a demo on how to lift properly to keep from straining your back, and find out why exercise is an important ingredient in keeping your back healthy.
Find out what you can do, at home, if you are unexpectedly hit by back pain – should you use heat or ice, what’s the best way to get up from lying down and learn simple stretches you can do to help calm the pain and stretch the back muscles.
Lindsey completed her Bachelors Degree in science at William Penn University in 2004 where she was a member of the volleyball team. She went on to get he Masters Degree in Science with an emphasis in Physician Assistant at Des Moines University in 2008. Once she was a Physcian Assistant she joined the spine team at Panorama. where she has been specifically trained in all aspects of spine ailments and fractures by Dr. Wong, Dr. Agarwala, Dr. Puschak and Dr. Loutzenhiser. Away from work, Lindsey enjoys sharing time with her husband and watching her two young daughters learn and grow. As a Colorado native she enjoys skiing, hiking, camping, playing piano and volleyball, and rooting for the Colorado Avalanche.
Katie Spight, PA
Katie grew up in Lakewood, Colorado. She attended college at CSU where she majored in Health and Exercise Science with a minor in Biomedical sciences. After college she worked in a Physical Therapy office as an aide and then at Panorama as a medical assistant before attending PA school at Red Rocks. While in PA school at Red Rocks, she also earned a Masters of Medical Science from St. Francis University in Pennsylvania. In her spare time she enjoys running, going to the mountains and spending time with her husband and German Shepard, Jax.
Nathan Youmell, PA
Nate received his bachelors in sports medicine from SUNY Brockport in NY. He then became an Athletic Trainer working for Health South before being independently employed by a local high school. He then joined Panorama as a medical assistant before he went to school to become a physician assistant. He attended PA school at Red Rocks and received a masters in medical science from St Francis University in Pennsylvania. After becoming certified in 2010, he began working with the spine team at Panorama.
Kathleen Rouzier, PA
Kathleen Rouzier is a certified Physician Assistant who obtained a Master in Health Sciences while completing the Physician Assistant Program at Duke University School of Medicine. She received her BS in Molecular Biology at University of Kansas. Prior to embarking on her medical career, she worked as a Healthcare IT Consultant. She has interest in interventional pain management and spine health, which grew after participating in and teaching Pilates. Kathy has additional hands-on training on performing ultrasound guided injections. She believes in best practice, a whole person approach, and connecting with her patients in order to provide the best possible care.
Kathy and her husband and two young boys are happy to call Colorado home. Although she grew up in Nebraska, she’s lived in Europe and Australia for extended period of time. Kathy enjoys anything active, especially outdoors, and spends much of her time with her family hiking, biking, picnicking, traveling, baking and crafting. She’s very happy to be part of the Non-operative Spine/Interventional Pain Medicine team at Panorama.
Hannah Strauss, PA
Hannah completed her undergraduate degree from the University of Vermont in Nutrition and Food Sciences with a minor in Chemistry. She went on to get her Master’s Degree in Physician Assistant Studies from Northeastern University in Boston, MA. Hannah has a passion in clinical nutrition and prior to PA school, she worked as a Registered Dietician at the University of Colorado Hospital with the solid organ transplant team and the bariatric surgery team. Today, Hannah works with Dr. Agarwala, Dr. Drewek, Dr. Wong, Dr. Loutzenhiser, Dr. Puschak, and the rest of the surgical spine team. In her free time Hannah enjoys any activities and sports that take place in the mountains or on water.
Burton Elrod, PA
Burton is a third generation medical provider, who has an innate love for medicine and is fascinated with the human body and how it works. He obtained an undergraduate degree from Lipscomb University with a Psychology major and Biology, Chemistry, and Health minors. Burton then went on to complete the Emergency Medical Technician Program at Community College of Denver in 2012. As of August 2017, Burton has graduated from the Physician Assistant Program at Trevecca Nazarene University.
Burton enjoys watching and playing all sports including football and track which he competed in at the colligate level. He loves hiking, snowboarding, Crossfit, fishing, golfing, movies and cooking. Burton has a great wife, Rebecca, and their dog, Koda.