Monday Medical: Small steps to a healthy spine |

Monday Medical: Small steps to a healthy spine

Even with cutting-edge technology and the latest surgical advancements at his fingertips, Dr. Henry F. Fabian Jr. is the first to say that, often, surgery isn’t the answer. Fabian, an orthopaedic spine specialist based out of Steamboat Springs, treats patients from across the country and around the world and serves as medical director of the SpineHealth program at Yampa Valley Medical Center.

“Probably 85 to 90 percent of the patients I see in my office actually don’t need surgery,” Fabian said. “You exhaust everything you can do, conservatively, before you consider anything operative.”

Fabian promotes conservative care, or using non-surgical treatments to address back pain, neck pain and related spinal issues. For instance, physical therapy can be helpful to increase core strength.

“Patients will get excellent results with a core strengthening program,” Fabian said. “We’ll spend 80 to 90 percent of the visit, where I’m showing them how to do most of the exercises, just to make sure they get off to the right start.”

Most people are relieved to learn they can address their pain with physical therapy instead of surgery. But then, the challenge becomes the follow through.

“The average American wants the instant fix,” Fabian said. “They’ll say, ‘Can’t you just give me a pill?’ And there really aren’t any good pills for this.”

Once a base of core strength is in place, it can be maintained with a 15-minute session of core strengthening exercises three to four times a week.

It’s also important to have balanced strength in the glutes, quads and hamstrings. And, yoga and Pilates are great practices for building core strength and improving spinal health.

One of the worst activities for spinal health is one of the most common: sitting. Sitting puts extra load on the discs and facet joints, causing stress to the back. Fabian recommends standing and moving at work and home as often as possible.

“We’ve kind of chained ourselves to our desks, we’ve chained ourselves to our laptops and the Internet and that’s what’s causing us to have this problem with low-back pain,” Fabian said.

Conservative care can include other non-surgical techniques, such as steroid injections or blocks, which can help reduce swelling and inflammation and relieve pain.

But sometimes, surgery is required. Of the several hundred surgeries Fabian performs each year, most are for nerve issues. The telltale sign that a nerve has been damaged is that a patient has pain, numbness or weakness radiating down a leg or arm.

With continuing advancements in the field of spinal surgery, it’s now easier and faster to recover from spinal surgery.

Fabian also uses the XYcor, the first clinically proven, horizontally expandable spinal implant. The XYcor, which Fabian designed, is inserted through a tiny incision and expands once it’s in place. Since the surgery is minimally invasive, patients are able to quickly return to their regular activities.

Whether a patient requires surgery or simply a strengthening program, Fabian suggests a positive attitude and willingness to do the work are crucial to any patient’s success.

“We all come up with our excuses. It’s only human,” Fabian said. “You really have to get over that and say this is important and can pay dividends.”

To learn more about neck and back pain and the services offered by SpineHealth at Yampa Valley Medical Center, visit

Susan Cunningham writes for Yampa Valley Medical Center. She can be reached at

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