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  1. 1. Public Relations for DDD Degenerative Disc Disease FROM ‘GRIN AND BEAR IT’ TO SPINAL FUSION TO ARTIFICIAL DISC REPLACEMENT: Navigating the Treatment Options for Degenerative Disc Disease (DDD) With so many millions of Americans suffering from back pain and degenerative disc disease (DDD) it’s no wonder the news media is so interested in the subject, which has been a cover story for Newsweek and the focus of thousands of news stories in newspapers, television, the Internet and radio. Treatment options for back pain are expanding and the data supporting or in some cases, refuting the benefits of these treatments, is mounting. You have surgeons who can help decipher the various treatments: “grin and bear it,” conservative treatment, physical therapy, pain medications, traditional and minimally invasive spinal fusion and artificial disc replacement. Each of these treatments may be appropriate for back pain sufferers. The question becomes which back pain sufferers and which treatments and when. For example, surgery is the last resort for back pain sufferers, but how long should they wait? This is an important story your experts can tell your community about through the media. Materials for media outreach on “navigating the treatment options” have been developed to help you tell the story. The materials are prepared in template form so that you can customize the pieces to reflect the unique perspectives and experiences of your surgeons and patients. The following components are included: • Telling and building the treatment option story • Customizable press release, pitch letter, and media advisory • Fact sheets • Suggested reporter questions • List of back pain medical organizations and glossary People need to understand their options. Your experts can help and the local news media needs to know they can and how important this story is! -1-
  2. 2. Public Relations for DDD NAVIGATING THE TREATMENT OPTION STORY: TELLING THE STORY Many institutions, companies and individuals constantly battle for media attention. Some will get it, most will not. So, how do you get your story about treatment options for back pain to spark the interest of a reporter who has hundreds of medical stories to choose from each month? How do you tell the story in a way that provides accurate and responsible information? How do you tailor the story to the reporter’s needs? This section discusses ways to approach local media about the treatment options story. From making initial contact to preparing for an interview and follow-up, it explores ways to work with the media to obtain coverage. Discussion topics include: • The Media Sensibility • Media Selection • Selecting Spokespersons • Preparing for Media Interviews • Pitching the Media • Media Follow Up -2-
  3. 3. Public Relations for DDD THE MEDIA SENSIBILITY The media is always looking for great stories. However, there are several story elements they typically look for before deciding to cover a story. When pitching the media about treatment options, the following fundamental questions will always come up: Is it new? Back pain isn’t new. Some say it’s been around since cavemen starting lugging around rocks. However, the thinking on back pain is new and there are more options for treating it than ever before. More questions are being asked about which treatments really work and for whom. When should someone with severe back pain consider surgery; which surgery and will it work? New data and new techniques are offering additional clarity to doctors and patients on which treatments to employ and when. Your surgeon is familiar with all the treatment options and the latest data on spinal fusion, minimally invasive spinal fusion and artificial disc replacement. You have patients who have been treated with all these options, as recently as last week. More are being treated every day at your institution. These elements make your story fresh. What makes it compelling? Why is it important? Several factors make this story compelling, including: • Treatment options are expanding and the back pain sufferer may not know where to turn • There are more than 12 million people suffering from degenerative disc disease (DDD), many in your community and you may be able to provide local statistics about this problem • More than 400,000 people are already turning to back surgery • Straight talk about the pros and cons of each treatment • More than 65 million Americans experience low back pain every year • Your surgeons are leaders in spine surgery and have patients with dramatic stories of life before and after treatment Why cover it now? The media in your area should cover it now because your institution considers severe back pain to be a significant health issue in the community. Most people don’t know what to do when they get back pain, who to see, how to treat it and if surgery is necessary, which surgery to get. In addition, many may have misconceptions about what’s involved in treating back pain. This is an important feature story that the media could develop with your surgeons and patients that could help a lot of people in your community who are suffering. Has this story been covered before? Please review past media coverage to determine if media in your area has covered this story before. If they have, you need to figure out an angle of the story that they haven’t covered. If they have not, you have a great story to tell them. -3-
  4. 4. Public Relations for DDD MEDIA SELECTION: TV, RADIO OR PRINT? While the media generally welcomes health and medical story ideas, television, radio and print reporters have different approaches and perspectives that make the story right or wrong for them and their audiences. TELEVISION What are the visual elements to the treatment option story? Here are a few: • Back pain sufferers whose professional, home and social life is limited by their pain • The ways back pain sufferers deal with their pain from physical therapy to chiropractics to prescription medications and steroids • Medical evaluation/exams of back pain sufferers • Visuals of the various surgeries including traditional and minimally invasive spinal fusion and artificial disc replacement; animation of these procedures • The physical activity of patients who have been treated; images of playing golf, tennis and family life, depending on the patient • A model of the spine When pitching a television reporter, vividly describe the kinds of pictures that can be made available to him or her. For instance, you can make special arrangements for a reporter to bring a video camera inside the operating room during a spinal fusion surgery. Of course, patient permission and hospital clearances must be obtained prior to surgery. TV REPORTER IN THE OR FOR SURGERY If permission is granted, brief the reporter on what they can and cannot do in the operating room, including the limited or non-use of lights, not showing the patient’s face and staying outside the sterile field. In addition, describe what the reporter and crew can expect to see during the operation so they are mentally prepared for viewing surgical incisions, blood and the operating room environment. Arrange a time before the surgery for the reporter to talk to the surgeon. During an interview, your surgeon can provide a description of how the surgery will be performed and identify key moments in the surgery. Additionally, an interview prior will help establish a rapport between the surgeon and the reporter so things run smoothly once inside the operating room. Also arrange for the reporter to talk to a patient who has already had the procedure. This patient can provide real-life insights about their own experience and provide context to a reporter who may underestimate the severity of back pain and what drove the patient’s decision to have surgery. If agreeable to the patient, a television crew can interview the patient at his/her home or at the hospital. -4-
  5. 5. Public Relations for DDD Another option for a reporter is to follow a patient before, during and after surgery. The patient must be willing to allow a camera crew to follow them through their daily activities and struggles with back pain and then for several weeks after the surgery. PRINT Print reporters generally cover health stories in more depth than radio and television reporters. Provide them with comprehensive information and reference treatment options including the fact sheets in this guide as well as studies and papers your surgeons have been involved in. RADIO Most radio stations throughout the country do not have a reporter dedicated exclusively to medical stories. In many cases however, there are opportunities to get medical stories covered through other means. If you can get the news director or assignment editor interested in the story, he or she will assign it to a general assignment reporter. Additionally, many radio stations have public affairs and community service programs that welcome guest experts like your doctor. You need to convince the station that your doctor can maintain a listener’s interest for the length of the program, is well-spoken and articulate and can discuss all aspects of back pain and treatment options and provide guidance to listeners on how to navigate these options. Provide the station with the list of suggested reporter questions to show the range of questions they can pose to the doctor and patient. -5-
  6. 6. Public Relations for DDD SELECTING SPOKESPERSONS – INVOLVING THE SURGEON & PATIENT The surgeon spokesperson chosen for the media relations campaign will become the “face” of your institution. The surgeon should be comfortable speaking to the media in layman’s terms and should be reminded to use non-technical, patient-friendly language, as they would with patients and their families. It is important to conduct your own interview with the surgeon to hear how they discuss the topic. To be most effective, the surgeon should deliver a focused and balanced message about issues related to severe back pain and treatment options. To ensure a great interview with the surgeon, consider the following: • Has the surgeon carefully reviewed the information you have provided to the reporter and are their views consistent with the material? • Are you in agreement on the key messages of the story? • Is the surgeon familiar with key statistics regarding back pain and its conditions? • Is the surgeon familiar with how you characterize the hospital and expertise to the community? • Have the surgeon done media interviews before? • Does the surgeon know what to expect from media interviews? • How does he/she feel about the media? • Does he/she need media training? -6-
  7. 7. Public Relations for DDD ENGAGE THE PATIENT Choose patient-spokespersons carefully. The patient is being asked to discuss his/her personal experience suffering from back pain, their treatment and recovery. Determine if the patient is comfortable relating his/her story and that he/she remembers important details of the experience. If you sense the patient is reluctant in any way, identify another patient. If the patient is nervous or awkward talking to you about his/ her experience, chances are he/she will be even more uncomfortable with a reporter. A surgical patient is a good choice because this patient has usually tried many things and endured significant pain before moving on to surgery. To ensure a great interview with the patient, consider the following: • Can he/she clearly articulate his/her pain and all the things he/she did to try to find relief? • Can he/she describe the kind of surgery he/she had? • What types of non-surgical treatments were tried prior to surgery? • What led to the decision to have spine surgery? • What was the “breaking point” or key event that triggered the surgical option? • Was the back pain resolved after the procedure? Is he/she satisfied with the procedure? • What was recovery like? How long before he/she returned to normal activities? • Was it a positive experience with the hospital overall? • Did the patient have problems with insurance or payment? • Is the patient comfortable allowing a television crew to videotape them at home or at work? • Is he/she comfortable with the public knowing about his/her back pain and the surgery? • What advice would he/she give other patients? • How does this person feel about the media? • Why is he/she motivated to tell his/her story to the media? Note: Once a patient-spokesperson is chosen, he or she should sign a release from, enabling any footage or quotes to be used by the media. -7-
  8. 8. Public Relations for DDD PREPARING FOR MEDIA INTERVIEWS Once spokespersons are selected, prepare them for media interviews. Keep the following in mind prior to the interview: • Prior to the interview, get as much information from the reporter as possible. The reporter may be willing to share some of his/her questions with you. • What angle will the reporter take? • How much time do they anticipate is needed from the physician and the patient? • Where will the interview take place and in what kind of setting? • What medical stories has the reporter covered in the past? • Has the reporter interviewed other doctors at your institution? • Is the reporter interviewing anyone else for the story? Knowing these details in advance will help you prepare your spokespersons appropriately. -8-
  9. 9. Public Relations for DDD PITCHING THE MEDIA The Initial Telephone Pitch Most reporters will decide if they want to cover the treatment option story within the first minute or so. You must be able to articulate the essence of your story within the first minute of the call. If you can get them interested in less than a minute, they will listen further or schedule time later to get more information. Grab Them with Key Points! • It’s really difficult for people to understand their treatment options – there are more options now than ever • Back surgery isn’t what it used to be, people have misconceptions • Different things work for different people; how do people know which will work for them and when might it be time to consider surgery and which one • Back pain is a huge issue in America and in your city (supplement the material in this guide with statistics from your community) • Briefly describe your patient Follow up with a brief pitch letter or media alert and reference your telephone discussion. Also, include the press release and fact sheets in your correspondence for additional background. However, be careful not to overwhelm the reporter. Base the information you send them on your telephone conversation. The discussion on the phone increases the likelihood that the reporter will be receptive to the information you send. If you have not heard back from the reporter in a few days, call them back to follow up and keep the story top of mind. Maintain Contact: Back pain treatment options is not necessarily a “breaking news story” so you may not be able to get reporters to do the story on the first, second or even third phone call. However, keep in contact with them on an intermittent basis to maintain a good working relationship and to keep the story a priority. -9-
  10. 10. Public Relations for DDD MEDIA FOLLOW UP Follow up with the reporter after the interview to get a sense of where the reporter is going with the story and to clarify any issues. Discuss the story further and provide any additional information. Reiterate the key messages to further ensure the reporter took away from the interviews what you hope they did. Get a sense of timing as to when the story will appear so you can alert spokespersons and hospital staff to be prepared for inquiries from the public. Once the story airs or is published, review it for fairness and accuracy. Analyze the story to determine if appropriate expectations for the procedure were set, if any information or key points were missing and if the story accomplished your public health goals. If there are any deficiencies or factual errors with the story, contact the reporter and offer clarification. If the story was done fairly and accurately, commend the reporter for his/her work. Over time, you may also inform the reporter of the impact their story had on patients. -10-
  11. 11. Public Relations for DDD Degenerative Disc Disease (DDD) Press Materials Sample Press Release Sample Pitch Letter Sample Media Advisory Fact Sheet Suggested Reporter Questions DDD Resources DDD Glossary -11-
  12. 12. Public Relations for DDD ON YOUR LETTERHEAD FOR IMMEDIATE RELEASE CONTACT: (((Name of Hospital Contact)) (((Phone Number))) NAVIGATING TREATMENT OPTIONS FOR BACK PAIN FROM ‘GRIN AND BEAR IT’ TO SPINAL FUSION TO ARTIFICIAL DISC REPLACEMENT Latest Thinking on Back Pain and Degenerative Disc Disease (DDD) (((INSERT NAME OF YOUR CITY))) (((INSERT RELEASE DATE))) – Back pain continues to plague millions of people each year and while there seems to be no cure, new and improved treatments are helping those with the most severe pain have new hope. However, which surgery and when remain big questions for many people. “Not all treatments work for everyone or are appropriate for everyone,” said (((INSERT DOCTOR NAME AND AFFILIATION))). “Patients and their doctors have to weigh very heavily the pros and cons of each option and have realistic expectations for pain relief and function.” Degenerative disc disease (DDD) affects about 12 million people in the U.S. and Americans spend more than $50 billion each year on back pain, the most common cause of job-related disability and missed work. According to the National Institutes of Health (NIH), the only neurological ailment more common than back pain is headaches. Most get by with conservative treatments like physical therapy or over-the-counter pain medications or it goes away by itself. Others require powerful prescription narcotics for pain and as a last resort, about 5 percent turn to surgery. Last year, there were more than 400,000 spinal fusion surgeries performed in the U.S. Today, options for severe back pain sufferers include traditional spinal fusion surgery, minimally invasive spinal fusion surgery (create hyperlink to section) and most recently in the U.S., artificial disc replacement (create hyperlink to section). -more- -12-
  13. 13. Public Relations for DDD -2- For nearly (((INSERT NUMBER OF MONTHS OR YEARS))) year, (((NAME OF PATIENT, age))), (((INSERT DESCRIPTION OF PATIENT, I.E. WORKING MOTHER OF FOUR))), lived with a chronic, intense lower back pain that affected every aspect of her life. (((HE/SHE))) had been diagnosed with DDD and (((NUMBER))) of (((HIS/HER))) spinal discs, the “shock absorbers” between bones in the back, had deteriorated causing the bones to rub against each other resulting in severe pain. “I would wake up every morning having to will myself out of bed. I had done physical therapy for (((INSERT TIME PERIOD))) and taken powerful prescription medications for the pain and I just felt I couldn’t live like this anymore,” said (((INSERT NAME OF PATIENT))). (((NAME OF PATIENT))) reluctantly considered back surgery and was torn about which procedure (((HE/SHE))) should have. (((HE/SHE))) consulted various doctors and spine specialists and even backed out of surgery a few times before deciding that spinal fusion surgery would be most appropriate. “I did a lot of research and while I heard some bad things about back surgery, the pain I was suffering from was far worse,” said (((PATIENT’S LAST NAME))). “Many patients are scared of surgery and rightly so. No one wants back surgery. However, improvements in spinal fusion techniques, instrumentation and patient selection are available today,” said (((NAME OF SPINE SURGEON, MD AND AFFILIATION))). A combination of newer metal screws and rods creates a solid "brace" that holds the vertebrae in place after spinal fusion surgery. These devices are intended to stop movement from occurring between the vertebrae. These metal devices give stability to the fusion site. After a thorough medical exam including x-rays, MRIs, advanced imaging and other tests, Dr. (((INSERT NAME))) performed spinal fusion surgery, a procedure that immobilizes the affected area of the spine by joining vertebrae together using bone grafts, screws and rods. (((NAME OF PATIENT))) spent (((INSERT NUMBER))) days in the hospital and in a period of (((LENGTH OF TIME))), (((HIS/HER))) pain had dramatically subsided. -more- -13-
  14. 14. Public Relations for DDD -3- “I’m a completely different person,” said (((PATIENT’S LAST NAME))). “Whereas before surgery, on a scale of 1 to 10, I had daily pain that was about a nine. Today, it’s about a three. It hasn’t completely gone away, but it’s nothing like it was before.” (((INSERT ACTUAL PATIENT EXPERIENCE))) “Years ago, the chances for significant pain relief were much less than they are today. The key, however, is matching the right patient to the right procedure and using instrumentation that improves the chances for success,” said (((INSERT NAME OF DOCTOR))). A minimum of three months is needed for the bones to fuse together and become solid. However, the bone graft will continue to mature for up to two years. Most patients are able to return home when their medical condition is stabilized, usually within one week after fusion surgery though patients are advised to avoid bending, lifting, twisting, and driving for at least six weeks. A doctor may recommend physical therapy after surgery for a minimum of six weeks. Like all surgical procedures, operations on the spine may have complications. Because the surgeon is operating around the spinal cord and nerves, back operations are always considered extremely delicate and potentially dangerous. These potential risks and complications should be discussed thoroughly with a spine specialist. (((INSERT BACKGROUND INFORMATION ABOUT THE SURGEON))) (((INSERT BOILERPLATE FOR HOSPITAL))) ### -14-
  15. 15. Public Relations for DDD ON YOUR LETTERHEAD SAMPLE PITCH LETTER (((DATE))) (((NAME))) (((TITLE))) (((MEDIA OUTLET))) (((ADDRESS))) (((CITY, STATE, ZIP CODE))) Dear (((NAME))): People have a lot of questions about back pain, particularly chronic pain which affects millions of people in the U.S. How should they treat it? How long before they should consider surgery? Which surgery should they have? Should they just grin and bear it and hope it goes away? Does surgery really work? New options and new thinking on back pain helps some avoid surgery and others get the surgery they need. In the U.S., about 400,000 people get back surgery every year. Do they all need it? Did they get the right one? (((INSERT NAME OF DOCTOR))), MD, is a leading expert in back and spine surgery who can help people navigate their choices when it comes to treatment and has patients who can describe their decision making process and how they decided to deal with their back pain whether it was just waiting for it to go away, physical therapy, powerful pain medications, traditional spinal fusion surgery, minimally invasive surgery or even one of the newest techniques, artificial disc replacement. People suffering with debilitating back pain need to know their options and have realistic expectations for the available treatments. Dr. (((INSERT NAME))) can discuss the following: -15-
  16. 16. Public Relations for DDD • Treatment options in clear, simple language • Pros and cons of each procedure • Which treatment is right for which patient • New data and new thinking on which procedures to perform According to the National Institutes of Health (NIH), back pain is the second-most common neurological ailment behind headaches. Back pain was a Newsweek cover story. People want to know. Americans spend more than $50 billion each year on back pain. Back pain is the second most common neurological ailment – second only to headaches! Please consider developing this important story. I will give you a call later to follow up, or feel free to contact me at (((INSERT PR CONTACT PHONE NUMBER))). Sincerely, (((INSERT PR CONTACT INFO))) -16-
  17. 17. Public Relations for DDD ON YOUR LETTERHEAD SAMPLE MEDIA ADVISORY DEGENERATIVE DISC DISEASE (DDD) AND SEVERE BACK PAIN: GRIN AND BEAR IT OR HAVE SURGERY? THE STORY: Back pain continues to plague millions of people each year and deciding how to treat it can be difficult. Will it just go away? Should surgery be considered? If so, which one? Spinal fusion? Minimally invasive spine surgery? Artificial disc replacement? WHAT: Get the latest thinking on treating back pain, the most common cause of job-related disability and missed work and the second most common neurological ailment (second only to headaches!) Degenerative disc disease (DDD) affects about 12 million people in the U.S., 400,000 of whom turn to back surgery for relief. But who’s right and who’s wrong for surgery? What’s the latest data on all the procedures? How big a problem is back pain in (((NAME OF YOUR CITY)))? What are the latest techniques and technologies and are things getting better or worse for back pain sufferers? WHO: (((INSERT NAME OF DOCTOR, TITLE, SPECIALTY))), a recognized expert in the methods used to treat back pain and XX-year-old patient who suffered with back pain for (((INSERT TIME PERIOD))) and had to make some difficult choices before deciding to have (((INSERT KIND OF SURGERY))). (((ADD BRIEF DESCRIPTION OF THE PATIENT’S PAIN AND LIMITATIONS, THEN BRIEFLY DESCRIBE HIS/HER LIFE NOW))) WHY: New thinking on back pain and surgery is helping the right patients get the right procedure resulting in better outcomes and improved quality of life WHERE: (((INSERT NAME OF INSTITUTION))) (((ADDRESS))) CONTACT: (((INSERT PR CONTACT INFO))) ### -17-
  18. 18. Public Relations for DDD ON YOUR LETTERHEAD FACT SHEET CONTACT: DEGENERATIVE DISC DISEASE (DDD) AND BACK PAIN OVERVIEW • DDD occurs when spinal discs deteriorate by losing moisture, height and integrity of the tissues causing vertebrae to rub against each other resulting in severe pain • 65 million Americans suffer from lower back pain every year1 • People between the ages of 30 – 50 are most likely to experience low back pain2 • Americans spend about $50 billion each year on low back pain, the most common cause of job-related disability and lost work days2 • Disabling condition affects 12 million people. Lumbar DDD accounts for 62 percent of all spinal DDD; cervical DDD accounts for 36 percent3 • Leading cause of disability in the people under the age of 45 in the U.S.4 • More than 400,000 spinal fusion surgeries performed in the U.S. to treat the condition in the lumbar (lower back) and cervical (neck) regions • Back pain is the second most common neurological ailment in the U.S. behind headaches5 • Women reported low back pain more often than men (29% vs. 25%) according to the National Health Interview Survey • Back symptoms are among the top ten reasons for medical visits (National Business Group on Health) CAUSES 1 American Association of Neurological Surgeons (AANS) 2 National Institute of Neurological Disorders and Stroke (NINDS) 3 4 American Association of Neurological Surgeons (AANS) 5 National Institute of Neurological Disorders and Stroke (NINDS) -18-
  19. 19. Public Relations for DDD • Natural effects of aging can include osteoporosis, arthritis, disc disease, decrease in strength and elasticity of muscles or ligaments • Injury or trauma caused by heavy lifting can result in a sprain, strain or spasm on the muscles or ligaments in the back • Poor conditioning and overuse COMMON CONDITIONS • Bulging disc (or protruding, herniated, ruptured disc) occur when the disc cracks or weakens causing it to protrude into the space containing the spinal cord or nerve root • Disc degeneration occurs when spinal discs deteriorate causing vertebrae to rub against each other resulting in severe pain -more- -19-
  20. 20. Public Relations for DDD -2- RISK FACTORS • Smoking • Being overweight or obese • Improper posture when standing or sitting • Heredity • Professions requiring heavy lifting and exposure to vibrations caused by vehicles or industrial machinery • Race: African-American women may be more susceptible to certain conditions of the spine DIAGNOSIS • Physical examination • Common diagnostic methods include: X-ray; CT scans (computerized tomography); MRI (magnetic resonance imaging) and discography • Bone scans to diagnose and monitor infections, fractures or bone disorders • Electrical tests (EMG) determine if back pain has caused nerve or muscle damage OVERVIEW OF TREATMENTS • Conservative o Pain medications; anti-inflammatory drugs o Decreased activity o Weight loss; exercise to strengthen the back and abdominal muscles • Physical therapies o Stretching; muscle strengthening; and spinal manipulation by trained specialists including, chiropractors, massage therapists, osteopaths o Electrical nerve stimulation sends mild electric pulses along nerve fibers to block pain signals to the brain -20-
  21. 21. Public Relations for DDD o Acupuncture to trigger release of painkilling molecules • Prescription pain medications including narcotics to ease significant pain • Surgery o Discectomy, involves removing part of the damaged disc to relieve nerve pressure and eliminate pain o Spinal fusion joins two or more vertebrae together using bone grafts, rods and screws to prevent them from possibly rubbing against each other; each year more than 400,000 people undergo the surgery o Minimally invasive surgery requires smaller incisions causing less tissue damage and usually leads to a less painful and quicker recovery compared to traditional surgery o Artificial disc replacement surgery with the CHARITÉTM Artificial Disc, helps reduce back pain while maintaining movement in the spine ### -21-
  22. 22. Public Relations for DDD ON YOUR LETTERHEAD FACT SHEET CONTACT: DEGENERATIVE DISC DISEASE (DDD) SURGICAL TREATMENT OPTIONS POSSIBLE CANDIDATES FOR SURGERY • Constant pain or frequently recurring pain that interferes with sleep and ability to perform daily activities • Diagnosis of herniated disc: painful problem in which hard outer coating of the discs are damaged, allowing the discs’ jelly-like center to leak, irritating nearby nerves • Spinal stenosis: narrowing of the spinal canal due to overgrowth of the bone caused by osteoarthritis of the spine • Spondyloisthesis: condition in which a vertebra slips out of place pinching nerves; can also cause severe sciatica leg pain • Degenerative disc disease (DDD): condition where spinal discs, the “shock absorbers” of the spine, deteriorate and become damaged POSSIBLE SURGICAL TREATMENTS • For spinal stenosis – Laminectomy: surgery involving the opening up the spinal column; surgeon makes large incision and removes the lamina and any bone spurs, requires short hospital stay and physical therapy afterwards • For spondylolisthesis – Laminectomy and spinal fusion: two or more vertebrae joined using bone grafts, screws and rods to immobilize affected area of spine • For DDD – Traditional (most common) or minimally invasive spinal fusion surgery – can be performed through the abdomen, anterior lumbar fusion or through the back, posterior fusion. Minimally invasive surgery requires smaller incisions, that usually result in less post-operative pain, scarring, hospitalization and quicker recovery • For DDD – Artificial disc replacement: Replaces damaged disc with an artificial one; used to treat patients with single-level DDD intended to reduce back pain while attempting to maintain movement in the spine -22-
  23. 23. Public Relations for DDD ### -23-
  24. 24. Public Relations for DDD ON YOUR LETTERHEAD CONTACT: SUGGESTED REPORTER QUESTIONS NAVIGATING THE TREATMENT OPTIONS: DEGENERATIVE DISC DISEASE (DDD) FOR DOCTOR • How big a problem is back pain in our area? • What is DDD? What causes it and who does it affect? • What are some common symptoms? Does DDD always cause pain? • How can DDD be prevented? • What are the latest techniques and technologies for treating DDD? How have surgical treatments improved over the past 5, 10, 20 years? • How should patients decide whether or not to have surgery? • How long should they wait? How long do they typically wait? • How do you determine which treatment is right for you? • How does a patient know if he/she is making the right decision? • Why does back surgery have a bad name? • If a patient sees a surgeon won’t he just recommend surgery? • Who is spinal fusion best for? • Who is minimally invasive spine surgery best for? Shouldn’t everyone get that? • Who is artificial disc replacement for? -24-
  25. 25. Public Relations for DDD • What questions should a patient ask their doctor about their pain and their treatment options? FOR PATIENT • How long did you suffer with back pain before seeking treatment? • What types of physical limitations did your back pain cause? • Describe your back pain. How painful was it on a scale of 1 to 10? • How did you treat it? For how long? • If you had surgery, what led you to that decision? How long did you wait? Why did you wait? • How effective were the various treatments for you? Were there any treatments that you didn’t like? How costly were the treatments? • How do you feel now? Do you have any limitations? • What advice would you give to other back pain sufferers? ### -25-
  26. 26. Public Relations for DDD DEGENERATIVE DISC DISEASE (DDD) RESOURCES American Association of Neurological Surgeons (AANS) 5550 Meadowbrook Drive Rolling Meadows, IL 60008 American Academy of Orthopaedic Surgeons (AAOS) 6300 North River Road Rosemont, Illinois 60018-4262 DePuy Spine, Inc. 325 Paramount Drive Raynham, MA 02767 National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) National Institutes of Health (NIH) Bldg. 31, Room 4C02 31 Center Dr. - MSC 2350 Bethesda, MD 20892-2350 National Institute of Neurological Disorders and Stroke (NIH) NIH Neurological Institute P.O. Box 5801 Bethesda, MD 20824 North American Spine Society (NASS) 22 Calendar Court, 2nd Floor LaGrange, IL USA 60525 123 West Madison St. Suite 1450 Chicago, IL 60602 ### -26-
  27. 27. Public Relations for DDD DEGENERATIVE DISC DISEASE (DDD) GLOSSARY Bone Graft – Small pieces of bone placed in a porous box-like structure between two vertebrae that stabilizes the bone and promotes tissue growth during spinal fusion surgery. Degenerative Disc Disease (DDD) – Gradual deterioration of a spinal disc that may be associated with wear and tear, aging, and/or injury. Herniated Disc (Also called slipped disc) – Displacement of the “gel-like” center of a disc through a crack on the outer layer. Displaced material can press on the nerves in the spine causing pain, numbness, tingling or weakness of the leg. Magnetic Resonance Imaging (MRI) – A radiology technique which uses magnetism, radio waves, and a computer to produce images of an internal organ or structure, especially the brain and spinal cord. Minimally Invasive Spinal Fusion Surgery – Technique using specially designed surgical instruments resulting in smaller incisions, less tissue trauma, minimal scarring and typically shorter recovery compared to traditional spinal fusion. Motion Preservation Technology – Surgical treatment for degenerative disc disease that aims to stabilize the spine and also retain some degree of movement and flexibility. Spinal Disc (Also known as vertebral discs) – Cartilage located between each pair of vertebrae that act as “shock absorbers” for the spine; allows spine to flex, bend, and twist. Spinal Fusion Surgery – Procedure used to remove a damaged disc, joins vertebrae together with a bone graft to stabilize the spine and help reduce back pain. Total Disc Replacement (also known as artificial disc replacement) – Procedure used to replace a damaged disc with an artificial one that is intended to reduce back pain while maintaining movement in the spine. Vertebrae – Twenty-four small bones in the back that make up the spine and protect the spinal cord. X-ray – A type of radiation used in diagnostic imaging to help diagnose diseases. ### -27-