Spinal Disorders and Rehabilitation Unit


“SPINAL DISORDERS REHABILITATION" OUTPATIENT CLINIC


Emel OZCAN , MD, Professor
Aysegul KETENCI, MD, Professor

Spinal Diseases Outpatient Clinic operates within the body of Spinal Diseases Rehabilitation Unit.

"SPINAL DISORDERS REHABILITATION" UNIT


The core structure of Spinal Diseases Rehabilitation Unit was formed by Prof. Dr. Emel Özcan and colleagues with the establishment of first Spine School (spine protection training program) in our country in 1990 within the body of our department. With accumulating studies and experience, various programs such as Dynamic Lumbar Stabilization Exercise Program (DLS), which is an intense exercise program specific to the spine, Neck Therapy School (neck protection training program) and multidisciplinary case conferences were developed and implemented, which resulted the establishment of our unit in 1997.


Purpose of Establishment

  • To diagnose and implement up-to-date treatment and rehabilitation methods with multidisciplinary approach to the patients with low back and neck pain, which constitute a significant health problem and an economic burden by causing functional restriction, disability and labour loss once it has reached chronic state,
  • To provide academic training,
  • To train public and employees by raising the awareness about protection against low back pain, to prevent recurrence and progression to chronic state, therefore, to reduce the economic burden to the public,
  • To conduct researches on the diagnosis and treatment.
Scope
  • Outpatient clinic
  • Spine School
  • DLSE (Dynamic Lumbar Stabilization Exercises)

Outpatient Clinic

The purpose is to diagnose and plan a treatment for patients with low back and neck pain.

Patient characteristics: Chronic patients exhibiting diagnostic challenge, unresponsive to conventional treatment methods (medical and physical therapy) and those with having post-operative problems


Evaluation and follow-up: Evaluation is performed by a team comprising lecturers and research residents by the completion of examination and evaluation forms; required investigations are requested, a diagnosis is established and treatment is planned. The patient is followed with certain intervals at the end of the treatment.

Spine School (Lumbar protection training program):

Purpose: To enable patients to learn pain sources and how to protect their lumbar spine in order for them to take the responsibility of their own lumbar spine in daily life and professional life, to prevent recurrences and progression to chronic disease state. The program was initiated in 1990 by modelling the Swedish Spine Centre and Istanbul Faculty of Medicine Spine School was established, considering the patient characteristics and the circumstances of our country combined with our experience.


Patient characteristics: Patients with disc herniation in whom pain control has been achieved, patients with myofascial pain syndrome, degenerative osteoarthritis, spinal stenosis, post-operative cases and those with failed low back surgery syndrome are included in the program.


Scope: In spine school, trainings are provided to the groups of 8 to 10 patients two days in a week in total 4 lessons and the program is conducted by a research resident. The patients are evaluated by completing a form prior to entrance to the spine school. Spine anatomy, biomechanical features, structures forming the spine, main sources and signs of low back pain and the treatments that the patients would apply themselves are explained in the first lesson of this program. In the second lesson, correct and wrong activities in the daily life are discussed individually; use of correct body mechanics and the basic exercises are taught. In the third lesson, the content of the second lesson and exercises are practiced. In the fourth lesson, questions about all lessons and unclear points are reviewed and the patients watch a movie covering the training content. At the end of the program, patients are provided with a hand book covering the all content of the training.


Dynamic Lumbar Stabilization Exercise Program

Purpose: To accelerate healing by maintaining truncal stabilization after finding the neutral position with physiological positioning of the lumbar spine. This program was developed by Saal et al. in 1990 and used extensively in USA, and initiated in our Unit with a thesis study in 1997.

Scope:
This is an intensive spine-specific exercise program which is performed by a trained physician in a group of 8 to 10 patients 2 times in a week for total 8 weeks after improving truncal and lower extremity flexibility and teaching how to find the neutral position.


Patient characteristics: Patients with disc herniation, degenerative osteoarthritis, spinal stenosis and spondylolisthesis attending low back and neck pain outpatient clinic are included in the program. The patients are evaluated by completing a form prior to entering the program.


On-going Studies


Training Programs

Training for protection against low back pain:

  • Patient education (Spine School and Neck School)
  • Training Employees and Students
  • Training for Medical Students at Istanbul Faculty of Medicine,
  • Training for the nurses and other health care personnel of Istanbul Faculty of Medicine
Public Training
Raising public awareness through visual and print media, and conferences conducted by non-governmental organizations.


Academic Training

  • Resident training: Training of the research residents in Physical Medicine and Rehabilitation Department of Istanbul Faculty of Medicine by 3-month rotations,
  • Training of physicians from other hospitals: Physicians from Samsun 19 Mayıs University, Izmir 9 Eylül University Faculty of Medicine, Konya Selçuk University, Göztepe SSK Hospital, Şişli Etfal Hospital and Rize State Hospital participated the programs in our unit; they afterwards initiated programs and conducted various studies in their original hospital.