Dr. Yuska and His Work
I have been a general orthopedic surgeon for many years and have been pleased to be
involved with a variety of surgical problems such as arthroscopy, back pain and joint
reconstruction. At this time in my life I enjoy placing my focus on back pain with all its
variations and challenges. And yet I find it hard to give up all of the variety that has
served me so well for so long.
The Back: Solving the Back Pain Puzzle
For me the favorite part of caring for back pain patients is the solving of the puzzle.
To me this means figuring out where the pain is coming from. What is the pain generator?
Is it a nerve pain and what level? Is it back pain? How many segments are involved?
Solving the puzzle means finding out what is wrong. What is the diagnosis?
Solving the puzzle also means finding a personal solution for you as an individual
patient. Each patient has his own individual characteristics and needs. As a doctor I must
take each person’s attitudes and personal needs
into account to make a treatment plan.
Solving the problem means applying technology and doing the surgery to eliminate
the pain. The benefits come from removing the pain and stabilizing the situation by doing
surgery to free the nerves and rebuild a stable spine. Only when healing is complete will
the patient be able to go on with life, work and the pursuit of happiness.
Minimally Invasive Disc Surgery
One solution for some types of
back pain is an anterior lumbar inter-body cage fusion. Here, you see bone forming within
and around the implants. This patient is pain free and ready to return to full work. This
is an effective way to treat back pain at one or two levels in adults. The hospital stay
is 
four days. With the exception of
the bone donor site pain, patients are comfortable right away. Leg pain is often gone too.
Find the Pain Generator and Eliminate It
My preference is to be as conservative as possible while relieving pain. For a disc
rupture I use the microscopic technique. This results in delicate, smaller incisions; less
dissection and less pain. My goal is to use the least invasive technique to remove the
problem at hand. As new techniques are developed I will be including them in my surgical
practice.
Older patients - even in their 70’s and
80’s - can have the same benefits of least invasive
surgery when treating their spinal stenosis. Spinal nerve decompression can be a blessing
for patients with chronic leg pain while walking. Some of my happiest patients are those
who were able to get around again because their leg pain was gone.
For spinal stabilization we have entered the era where fusion is an accepted mainstream
treatment. Age is not necessarily a factor as long as there is adequate need and adequate
strength. The anterior BAK operation provides superior pain relief for both back pain and
leg pain for many patients. Is very fulfilling and personally gratifying to be able to
relieve pain and restore function.
We are entering the time of placing needle probes, the IDET procedure for chronic
discogenic back pain. This is a procedure that needs to be tried. This is best suited for
young adults who have had back pain for over six months. If a discogram shows an annular
tear and a fusion is not a consideration, then an IDET procedure is a reasonable choice.
Sixty percent of patients can expect a sixty percent reduction in pain.
The Knee
Sometimes there is no puzzle. Such is the case with knee arthritis. Most commonly the
diagnosis is obvious, and the treatment usually is equally clear. A knee replacement is
often the most direct, most permanent cure for the aging knee. Satisfaction comes from
putting in the best knee possible and watching the patient return to pain-free walking.
While back surgery is fun, I have been too close to the evolution and development of total
knee surgery to be able to pass one up.
There’s a special place in my mind and heart
reserved for those people around age 50. These are people who are a little too young for a
knee replacement. They can be helped in a more delicate, more noninvasive way by replacing
only a portion of the knee joint. This surgery is gone through a smaller incident with
quicker recovery and better preservation of movement. I find the Biomet Repicci II
hemi-arthroplasty a very satisfactory way to provide good knee function and move the need
for total knee replacement farther into the future. This surgery corrects the bowleg,
relieves pain and can almost be done as an outpatient. For more information about this
product, visit Biomet’s Uniknee site.
A younger person with a torn cartilage is another opportunity for
improvement. When the knee is
clicking and popping and there is pain in the joint line, then arthroscopy is
a
wonderful thing. It is simply fun to scope a knee to clean out a torn cartilage. People
get back to walking in a day or two. Once I had a farmer who milked his cows on the
same day after his surgery. With results like that, I just have to love that operation.
A knee scope can be a real service to the middle-aged person with an achy knee as well.
Smoothing on the cartilage surfaces can relieve pain and keep someone going for a long
time. While these take patience they are a valuable service that I enjoy, and a service
that is appreciated by the patients as well.
Joint Replacement Surgery
There are so many joint replacements that are fun to do and a blessing for the patient.
Shoulder replacements, hip replacements, finger and toe replacements; while I would do
these, now they are the sweetness rather than the main meal for me.
Page Updated: 8/2002
