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Winter Sport Safety

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Reno / Tahoe is a Winter Wonderland

For most living in the Reno/Tahoe region, the highlight of winter is the ski and snowboard season. The Reno/Tahoe region is the prime place to live for winter sport enthusiasts with ample space and opportunity to ski and snowboard. With the vast array of mountain lodges in close proximity, a day on the slopes is just a short drive away. Many winter sport enthusiasts spend nine to ten months of the year preparing for the short-lived ski and snowboard season. Unfortunately, each year thousands of slope goers find themselves severely injured on the mountain in ski or snowboard related accidents.

Skiing and Snowboarding Popularity Has Skyrocketed

Over the past two decades the popularity of skiing and snowboarding has skyrocketed among the American population. Skiing and snowboarding events have replaced ice skating as the highlight events of the Winter Olympic Games, and extreme sporting events like the Winter X Games and the Mountain Dew Action Sports Tour have become popular television broadcasts. Professional skiers and snowboarders like Bode Miller, Johnny Mosley, Seth Wescott, and Shaun White have become regular household names with millions regularly watching television and internet broadcasts of them racing down the slopes before attempting death defying stunts. Additionally, recent technological advances have allowed ski and snowboard manufactures to develop both skis and snowboards that allow their riders to go faster, turn sharper, and jump easier. However, to prevent injury it is important to realize that not everyone has the skill, training, ability, and/or equipment to ski or snowboard like professional winter sport athletes.

But There Are Risks

Many fail to realize the severity of the risks associated with skiing and snowboarding injuries. The skiing related deaths of both Michael Kennedy and Sonny Bono in the Winter 1997/1998 heightened the public awareness of the dangers on the slopes. Common injuries sustained on the slopes range from mild injuries like cuts, bruises, sunburns, and muscle soreness to severe injuries like joint strains, sprains and dislocations, concussions, bone fractures, hypothermia, and death. Statistically the most common, yet most severe, ski/snowboard related injuries are injuries to the ligaments and cartilage of the knee, traumatic head injuries, and spinal cord injuries. Fortunately many experts believe that severe injuries like traumatic head injuries and spinal cord injuries could be easily prevented or reduced with the use of proper safety equipment. A very small percentage of regular slope goers regularly wear a ski/snowboard approved safety helmet. Most experts feel an appropriately rated helmet is the single most important piece of equipment that could provide the most adequate protection for both traumatic brain and spinal cord injuries. The use of helmets in skiing and snowboarding has become such an important topic that the American Association of Orthopaedic Surgeons (AAOS) has actually instituted a position statement urging the use of appropriate ski and snowboard helmets. Appropriately rated ski and snowboard helmets can be purchased at most major sporting stores, are available in many styles, and cost on average $50-$300.

Safety Steps You Can Take

Other important safety factors when preparing for a day on the slopes include:

  • Begin exercising 4-6 weeks before start of ski/snowboard season to build up strength, stamina, balance, and agility
  • Before each season check that your equipment (skis, snowboard, boots, bindings, gloves, and jacket) still fit properly, and before each trip out check equipment for any signs of damages that could lead to accidents
  • Dress in layers and ensure all warm clothing fits properly
  • Apply sunblock with a high SPF before leaving your house and wear UV filtering goggles or sunglasses once on the mountain
  • Just like any other exercise begin a day of skiing/snowboarding with a mild warm-up and then gradually work up to those high-skilled runs or paths
  • Don’t attempt any runs or paths that you know you are not skilled for and always stay on groomed paths.

Be Safe, Be Fit, Be Careful

Skiing and snowboarding are popular recreational and competitive activities that have the potential for severe injury. Regular skiers and snowboarders will spend thousands of dollars each winter to pay for lift tickets, travel fees, and ski and snowboard equipment. Unfortunately, safety and safety equipment are not always at the top of the list for most winter sport enthusiasts. Experts urge skiers and snowboarders to spend the extra money to purchase appropriate safety gear, replace damaged gear, and ensure all gear fits properly. Those extra couple hundred dollars could be the difference in preventing ski or snowboard related severe injury, paralysis, or even death on the slopes.

Article written for “We’ve Got Your Back Magazine”
By Derek S. Drake, RN

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Artificial Disc Replacement

At Sierra Regional Spine Institute, we believe that the future is restoration of anatomy and function through motion. The artificial disc replacement is the answer to that problem. Sierra Regional Spine Institute continues to be a leader in Nevada when disc replacement surgery is needed.
It is a surgical procedure in which degenerated intervertebral discs in the spinal column are replaced with artificial disc implants in the lumbar or cervical spine.

The procedure is used to treat chronic, severe low back pain and cervical pain resulting from degenerative disc disease.

Artificial disc replacement has been developed as an alternative to spinal fusion, with the goal of pain reduction or elimination, while still allowing motion throughout the spine. Another possible benefit is the prevention of premature breakdown in adjacent levels of the spine, a potential risk in fusion surgeries.

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Revision Spine Surgery

Revision spine surgery is a surgery procedure performed in certain patients to correct the problems of earlier spine surgery. Revision surgery is only when working with patients who experience chronic pain or any worsening symptoms even after the initial surgery.
Other factors that can indicate the need for revision spine surgery include:
  • Post-surgical Complications
  • Scar Tissue Formations
  • Improper Diagnosis
  • Unsuccessful Initial Surgery

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Decompression

At Sierra Regional Spine Institute we use Decompression in a few ways to treat and make the process of recovery smoother for people with fractures: Microdiscectomy, Microendoscopic Laminectomy, Minimally Invasive Cervical Foraminotomy (MICF), Vertebroplasty and Kyphoplasty.

Microdiscectomy

Microdiscectomy, also called microlumbar discectomy (MLD), is a very common MIS decompression procedure performed in patients with a symptomatic lumbar herniated disc. The operation consists of removing the portion of the intervertebral disc that is herniated and compressing a spinal nerve root.

Minimally Invasive Cervical Foraminotomy

This is a MIS cervical foraminotomy decompression procedure that enlarges the space in which a spinal nerve root exits the cervical spinal canal (intervertebral foramen). This narrowing can be caused by a herniated disc, bone spurs, thickened ligaments or joints, which may result in pinched nerves.

Vertebroplasty

Vertebroplasty for the treatment of vertebral compression fractures (VCFs) was introduced in the United States in the early 1990s. The procedure is usually done on an outpatient basis, although some patients stay in the hospital overnight. The procedure may be performed with a local anesthetic and intravenous sedation or general anesthesia.

Using x-ray guidance, a small needle containing specially formulated acrylic bone cement is injected into the collapsed vertebra. The cement hardens within minutes, strengthening and stabilizing the fractured vertebra. Most experts believe that pain relief is achieved through mechanical support and stability provided by the bone cement.
Kyphoplasty
Kyphoplasty involves an added procedure performed before the cement is injected into the vertebra. First, two small incisions are made and a probe is placed into the vertebral space where the fracture is located.

The bone is drilled and one balloon (called a bone tamp) is inserted on each side. The two balloons are then inflated with contrast medium (which are visualized using image guidance x-rays) until they expand to the desired height and removed. The spaces created by the balloons are then filled with the cement. Kyphoplasty has the added benefit of restoring height to the spine.

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Cervical Fusion

Cervical Fusion is an operation that creates a solid union between two or more vertebrae in the upper spine (neck) area. This procedure may assist in strengthening and stabilizing the spine and may thereby help to alleviate severe and chronic back pain.
The best clinical results are generally achieved in single-level fusion, although fusion at two levels may be performed in properly selected patients.

Bone grafts may be taken from the hip or from another bone in the same patient (autograft) or from a bone bank (allograft). Bone graft extenders and bone morphogenetic proteins (hormones that cause bone to grow inside the body) can also be used to reduce or eliminate the need for bone grafts.

Fusion sometimes involves the use of supplemental hardware (instrumentation) such as plates, screws, and cages. This fusing of the bone graft with the bones of the spine will provide a permanent union between those bones. Once that occurs, the hardware is no longer needed, but most patients prefer to leave the hardware in place rather than go through another surgery to remove it.

Fusion can sometimes be performed via smaller incisions through MIS techniques. The use of advanced fluoroscopy and endoscopy has improved the accuracy of incisions and hardware placement, minimizing tissue trauma while enabling an MIS approach.

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Lumbar Fusion

This is a MIS technique that is performed in patients with refractory mechanical low back and radicular pain associated with spondylolisthesis, degenerative disc disease, and recurrent disc herniation. The procedure is performed from the back (posterior) with the patient on his or her stomach.

Using x-ray guidance, two 2.5-cm incisions are made on either side of the lower back. The muscles are gradually dilated and tubular retractors inserted to allow access to the affected area of the lumbar spine.

The lamina is removed to allow visualization of the nerve roots. The disc material is removed from the spine and replaced with a bone graft and structural support from a cage made of bone, titanium, carbon-fiber, or a polymer, followed by rod and screw placement.

The tubular retractors are removed, allowing the dilated muscles to come back together, and the incisions are closed. This procedure typically takes about 3 to 3 1/2 hours to perform.

Outcome & Benefits

  • Quicker Recovery & Body Fusion
  • Less Blood Loss
  • Shorter hospital stay
  • Shorter Operative Time
  • Less Trauma

Pioneers of both surgical and non-surgical techniques

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Minimally Invasive Spine Surgery

MIS was first performed in the 80s but has recently seen rapid advances. Technological advances have enabled surgeons to expand patient selection and treat an array of spinal disorders, such as degenerative disc disease, herniated disc, fractures, tumors, infections, instability, and deformity.
This can result in quicker recovery, decreased operative blood loss, and speedier patient return to normal function. In some MIS approaches, also called, “keyhole surgeries,” surgeons use a tiny endoscope with a camera on the end, which is inserted through a small incision in the skin. The camera provides surgeons with an inside view, enabling surgical access to the affected area of the spine.

Benefits of Minimally Invasive Surgery

  • Smaller incisions
  • Decreased postoperative narcotics
  • Shorter hospital stay
  • Quicker return to work and activities
  • Less Scar Tissue
  • Faster recovery
  • Less pain

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