Alaska Journal of Commerce

July 26, 2004

Just one shot was all it took - the right medication in the right place - and the patient from Bethel, who had suffered increasing back and leg pain for more than a year, walked out pain free.

It's all in a day's work for physicians at the Alaska Spine Institute, a one-stop medical shop for patients with spinal pain and injuries. The institute opened a new office June 7 on the campus of Alaska Pacific University.

"It's kind of like Baskin Robbins," said Larry Levine, one of the institute's seven physiatrists - specialists in physical medicine and rehabilitation. "You can find just what you need in our facilities."

In the case of the Bethel patient, an examination by a physiatrist and further evaluation with high-tech electrodiagnostic equipment quickly pinpointed the problem: a herniated disc.

The attending physiatrist gave an epidural injection of the anti-inflammatory drug, cortisone, into the problem area of the patient's lumbar spine, and the problem was resolved.

Epidural refers to the space outside the dura, or covering of the spinal cord, and inside the spinal canal. Inflammation or irritation of a nerve root most commonly originates from a herniated, degenerated, or "leaky" disc at the nerve root level. The discs themselves are cushions of cartilage which separate each vertebra in the spine.

Officials at the National Institute for Occupational Safety and Health, part of the Centers for Disease Control, note that back injuries account for nearly 20 percent of injuries and illnesses in the workplace and cost the nation an estimated $20 million to $50 million annually in time lost from work and medical fees.

Spinal injuries of all types, but primarily cervical and lumbar, are the specialty of the institute, with diagnostic and treatment facilities that include a spacious 1,100-square-foot physical therapy department.

The uniqueness of this facility is that the patient can meet with the physician, have diagnostic tests and be treated - all in the space of one day, said Michel Gevaert, a Belgium-born physiatrist. Gevaert said he moved from Colorado to Alaska in the late 1990s specifically to join the spinal practice group.

"It's like a big box store," said Michael James, another physiatrist who, like Levine, was born and raised in Anchorage. Patients returning to work may be monitored, with recommendations to increase their physical workload gradually, so further injury does not occur, he said.

The range of services provided by the institute include spine and sports injury care, physical therapy, rehabilitation, imaging and interventional pain management, all in one three-story, 60,000-square-foot building. The institute also offers pre-employment physical capacity evaluations, job site evaluations, workplace ergonomic consultations and lifting evaluations.

The institute's imaging center includes a state-of-the-art magnetic resonance imaging machine. The machine allows doctors to get diagnostic information faster and enables improved diagnosis of a wide range of conditions, ranging from cardiac and vascular disease, stroke, abdominal and brain disorders and musculosketetal conditions to joint problems. Exams are quicker and the quality of information received is better than less sophisticated MRIs, said Tom Forbus, the MRI technician in charge.

The new facility, completed this summer, brought together under one room the established medical practice, Rehabilitation Medicine Associates, and long-standing physical therapy clinic, OrthoSport/Bear Physical Therapy, now operating as the Alaska Spine Institute. Two new companies, Alaska Spine Institute Imaging and Alaska Spine Institute Surgery Center, also occupy the new facilities.

The agreement between Alaska Pacific University and the institute will, in the future, allow access to internships and APU students to learn all aspects of health care, including accounting, documentation, administration, radiology and physical therapy, said Lesa Johnson, the institute's administrator.