Maggie McKay (Host): If you've ever had trouble or pain with your spine, you know how debilitating it can be. So how do we navigate spine health? Let's find out with Dr. Justin Millard, Orthopedic Spine Surgeon at Community Memorial Healthcare. This is Wise and Well presented by Community Memorial Healthcare. I'm Maggie McKay.

Welcome, Dr. Millard. It's so good to have you here. Thanks for making the time.

Justin Millard, MD: Thanks for having me.

Maggie McKay (Host): So let's just get right to it. The spine is often considered the core of the body. So could you please explain some of the common issues and conditions that people might experience in relation to spinal health?

Justin Millard, MD: The most common reason people go to see a primary care physician is the common cold. That's what drives most people to see their doctor. But the second most common reason is low back pain. And this is usually musculoskeletal in nature, meaning that the junction between the muscle and the bone has been strained or sprained.

And this is typically the cause of low back pain. And the good news for most people, 90%, is that it resolves fairly quickly in approximately 6 to 9 weeks. So, conservative treatment is usually the first option. But there can be other, more serious issues, including disc herniation that might cause back or leg pain, if it happens in the lumbar spine, cervical disc herniation, which might cause neck pain or arm pain, if it happens in the cervical spine.

And then arthritis of the spine, can cause a variety of symptoms, including low back pain, and or leg pain the longer you stand or walk. So those are some of the most common issues that happen.

But by far and wide, back strain or sprain is the most common injury, and it typically resolves without surgical treatment.

Host: Well, that's encouraging. You emphasize the significance of forming connections with your patients. How does this physician philosophy influence how you diagnose and treat spine related issues?

Justin Millard, MD: It is essential to have a good connection with your patient. So from the moment I walk in the exam room, I am hands on, making good eye contact, laying my hands on the patient, examining the patient closely and making the patient feel comfortable so that they can give me their entire story of how their pain started, when it started, where it is, what they do for a living, what they do for enjoyment in life, and how much this problem is affecting their quality of life. Without good communication, if a physician just is brief with the patient or doesn't listen completely, you can't elicit a good story to make a diagnosis.

Host: That's so true. I hear you a hundred percent. I once went to an eye doctor and he was just rushing me and I left feeling like I did not get a thorough eye exam. There's no way because he didn't ask me all the questions, you know? So, yeah, I think that's so crucial. And your focus includes minimally invasive spine surgery and motion preservation. Could you shed some light on these approaches as advancements in spine treatment and how these options benefit patients?

Justin Millard, MD: Minimally invasive surgery involves quicker surgery times with smaller incisions. And the technology has advanced pretty significantly in the last 15 years. So, in the old days, fusion was the only option for large problems in the spine.

Today, we're able to do the same type of procedures quicker, with smaller incisions, and that is basically what minimally invasive surgery entails. As far as motion preservation, we have 20 year data now on cervical artificial disc replacement, and we have good 15 year data on lumbar artificial disc replacement. And those technologies are similar to total knee replacement or total hip replacement in that, 60 years ago, we were just fusing the knee so that it didn't have any motion.

You would have a peg leg or fusing the hip when a patient came in with severe arthritis. And the technology came along for the hip and the knee, that was motion preservation, meaning we were able to design total hip replacement and total knee replacement that allowed motion through the joint and that was revolutionary.

Those are some of the most successful elective surgeries performed in the world. So the same is now happening in the spine where we can put a metallic joint into the cervical spine or lumbar spine and allow movement at that level versus putting a block of bone in there and fusing it so that it's one unit.

Host: I bet that's a game changer. Communication, as we were saying, between physician and patient is always important. Could you share an instance where truly listening to a patient's concerns led to a specific diagnosis, treatment strategy, or solution?

Justin Millard, MD: I have a great example. I have a patient that came in with complaints of difficulty walking and low back pain. After talking with the patient, it was clear that she was also having difficulties with fine motor coordination, buttoning buttons, opening jars, and dropping objects. And after a thorough physical exam and then obtaining imaging, it was clear that she had compression of the spinal cord in the cervical spine in the neck, despite coming in with initial complaints of loss of balance and low back pain. But if I hadn't talked her through neck issues, I would never have gotten the diagnosis right.

Host: Wow, isn't that amazing? That just shows how important those conversations are, that you get really detailed.

Justin Millard, MD: Agreed.

Host: Dr. Millard, if you could offer one piece of advice for our listeners to proactively care for their spinal health and to know when to seek a specialist's help, what would it be?

Justin Millard, MD: So the best advice I can give is that an ounce of prevention is worth a pound of cure. And what does that mean? It means it is important to take care of your body physically, in that keeping your core strong, keeping in relatively good shape, hitting that benchmark of 7,000 steps a day, goes a long way towards preventing long term degenerative problems, whether it's in your neck, your low back, your hips, or your knees.

Host: And in the realm of spine surgery and patient care, what advancements or trends do you foresee shaping the future of treatment and recovery?

Justin Millard, MD: We're certainly continuing to advance in spine technology. The spine has complicated anatomy. At every level, there are three different joints. There are two facet joints in the back and a disc in the front. It is more complex than the knee or the hip or any joint in the body, quite frankly.

And we have advanced already. We moved from fusion to motion preservation and minimally invasive surgery, which is artificial disc replacement and some of the technologies we've spoken about already. Ultimately, I think the holy grail for any joint in the body, including the spine is biological regeneration.

So using stem cells or other technology to encourage the body to rebuild its own native structure versus placing metal into the body to solve the problem. We are not there yet, but if you ask me what the future holds in the next 50 years, that would be my best guess as to the successful technology for patients.

Host: Thank you again so much for joining us today.

Justin Millard, MD: Thank you very much for having me.

Host: That's Dr. Justin Millard, and for more information, please visit mycmh.org/findadoctor/justin-millard-md. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. I'm Maggie McKay. This is Wise and Well presented by Community Memorial Healthcare. Thank you for listening.