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Tom Reinsel, MD


Division of Spine Care

Reinsel Tom 213X311Marshall Orthopaedics’ Spine Division is led by Tom Reinsel, MD, a fellowship trained orthopaedic spine surgeon.   Dr. Reinsel looks forward to providing you with the latest treatments in Orthopaedic Spine services while providing the caring support you have come to expect from the physicians and staff at Marshall Orthopaedics.  Deciding to undergo spine treatment can be a long journey, but our staff will behere to guide you every step of the way.  Marshall Orthopaedics has developed this webpage to be used as a resource for your pre-procedure and post-recovery concerns. 

Q: What is a Spinal Cord Injury?

A: A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. The damage begins at the moment of injury when displaced bone fragments, disc material, or ligaments bruise or tear into spinal cord tissue. Most injuries to the spinal cord don't completely sever it. Instead, an injury is more likely to cause fractures and compression of the vertebrae, which then crush and destroy axons -- extensions of nerve cells that carry signals up and down the spinal cord between the brain and the rest of the body. An injury to the spinal cord can damage a few, many, or almost all of these axons. Some injuries will allow almost complete recovery. Others will result in complete paralysis.

Q: What are treatment options for a Spinal Cord Injury?

A: Treatment of spine injuries and conditions can vary. It is best to consult a doctor for a treatment plan that fits each unique situation.

Q: What is a Spinal Stenosis?

A:The spine, a row of 26 bones in your back, allows you to stand up straight and bend over. The spine also protects your spinal cord from being hurt. In people with spinal stenosis, the spine is narrowed in one or more of three parts.

  • The space at the center of the spine.
  • The canals where nerves branch out from the spine.
  • The space between vertebrae (the bones of the spine).

This narrowing puts pressure on the spinal cord and nerves and can cause pain.

Q: Who Gets Spinal Stenosis?

A: Spinal stenosis is most common in men and women over 50 years old. Younger people who were born with a narrow spinal canal or who hurt their spines may also get spinal stenosis.

Q: What Causes Spinal Stenosis?

Changes that occur in the spine as people get older are the most common cause of spinal stenosis. As people get older:

  • The bands of tissue that support the spine may get thick and hard.
  • Bones and joints may get bigger.
  • Surfaces of the bones may bulge out (these are called bone spurs).

Arthritis In some cases arthritis, a degenerative (gets worse over time) condition can cause spinal stenosis. Two forms of arthritis may affect the spine: osteoarthritis and rheumatoid arthritis.


  • The most common form of arthritis.
  • Most often occurs in middle-aged and older people.
  • Doesn't go away.
  • May involve many joints in the body.
  • Wears away the tough tissue (cartilage) that keeps the joints in place.
  • Causes bone spurs and problems with joints.

Rheumatoid arthritis:

  • Affects most people at a younger age than osteoarthritis.
  • Causes the soft tissues of the joints to swell and can affect the internal organs and systems.
  • Is not a common cause of spinal stenosis.
  • Can cause severe damage, especially to joints.

Inherited Conditions
Some people are born with conditions that cause spinal stenosis. For instance, some people are born with a small spinal canal. Others are born with a curved spine (scoliosis).

Other Causes
Other causes of spinal stenosis are:

  • Tumors of the spine.
  • Injuries.
  • Paget's disease (a disease that affects the bones).
  • Too much fluoride in the body.
  • Calcium deposits on the ligaments that run along the spine.

Q: What Are the Symptoms of Spinal Stenosis?

A: There may be no symptoms of spinal stenosis, or symptoms may appear slowly and get worse over time. Signs of spinal stenosis include:

  • Pain in the neck or back.
  • Numbness, weakness, cramping, or pain in the arms or legs.
  • Pain going down the leg.
  • Foot problems.

One type of spinal stenosis, cauda equine syndrome, is very serious. This type occurs when there is pressure on nerves in the lower back. Symptoms may include:

  • Loss of control of the bowel or bladder.
  • Problems having sex.
  • Pain, weakness, or loss of feeling in one or both legs.

If you have any of these symptoms, you should call your doctor right away.

Q: How Is Spinal Stenosis Diagnosed?

A: To diagnose spinal stenosis, your doctor will ask about your medical history and conduct a physical exam. Your doctor may also order one or more tests, such as:

  • X rays.
  • Magnetic resonance imaging (MRI)—a test that uses radio waves to look at your spine.
  • Computerized axial tomography (CAT)—a series of x rays that give your doctor a detailed image of your spine.
  • Myelogram—a test in which the doctor injects liquid dye into your spinal column.
  • Bone scan—a test in which you are given a shot of radioactive substance that shows where bone is breaking down or being formed.

Q: Who Treats Spinal Stenosis?

A: Because spinal stenosis has many causes and symptoms, you may require treatment from doctors who specialize in certain aspects of the condition. Based on your symptoms, your doctor may refer you to:

  • Rheumatologists (doctors who treat arthritis and related disorders).
  • Neurologists and neurosurgeons (doctors who treat diseases of the nervous system).
  • Orthopedic surgeons (doctors who treat problems with the bones, joints, and ligaments).
  • Physical therapists.

Q: What Are Some Nonsurgical Treatments for Spinal Stenosis?

A: There are many nonsurgical treatments for spinal stenosis. Your doctor may prescribe:

  • Medicines to reduce swelling.
  • Medicines to relieve pain.
  • Limits on your activity.
  • Exercises and/or physical therapy.
  • A brace for your lower back.

Q: When Should Surgery Be Considered?

A: Your doctor will likely suggest nonsurgical treatment first unless you have:

  • Symptoms that get in the way of walking.
  • Problems with bowel or bladder function.
  • Problems with your nervous system.

Your doctor will take many factors into account in deciding if surgery is right for you. These include:

  • The success of nonsurgical treatments.
  • The extent of the pain.
  • Your preferences.

Q: What Are Some Alternative Treatments for Spinal Stenosis?

A: Alternative treatments are those that are not part of standard treatment. For spinal stenosis, such treatments include chiropractic treatment and acupuncture. More research is needed on the value of these treatments. Your doctor may suggest alternative treatments in addition to standard treatments.

Q: What is Spina Bifida?

A: Spina bifida (SB) is a neural tube defect (a disorder involving incomplete development of the brain, spinal cord, and/or their protective coverings) caused by the failure of the fetus's spine to close properly during the first month of pregnancy. Infants born with SB sometimes have an open lesion on their spine where significant damage to the nerves and spinal cord has occurred. Although the spinal opening can be surgically repaired shortly after birth, the nerve damage is permanent, resulting in varying degrees of paralysis of the lower limbs. Even when there is no lesion present there may be improperly formed or missing vertebrae and accompanying nerve damage. In addition to physical and mobility difficulties, most individuals have some form of learning disability. The types of SB are: myelomeningocele, the severest form, in which the spinal cord and its protective covering (the meninges) protrude from an opening in the spine; meningocele in which the spinal cord develops normally but the meninges and spinal fluid) protrude from a spinal opening; closed neural tube defects, which consist of a group of defects in which development of the spinal cord is affected by malformations of the fat, bone, or meninges; and and occulta, the mildest form, in which one or more vertebrae are malformed and covered by a layer of skin. SB may also cause bowel and bladder complications, and many children with SB have hydrocephalus (excessive accumulation of cerebrospinal fluid in the brain).

Q: What are treatment options for Spina Bifida

A: There is no cure for SB because the nerve tissue cannot be replaced or repaired. Treatment for the variety of effects of SB may include surgery, medication, and physiotherapy. Many individuals with SB will need assistive devices such as braces, crutches, or wheelchairs. Ongoing therapy, medical care, and/or surgical treatments may be necessary to prevent and manage complications throughout the individual's life. Surgery to close the newborn's spinal opening is generally performed within 24 hours after birth to minimize the risk of infection and to preserve existing function in the spinal cord.

Sources consulted for this page: National Institute of Neurological Disorders and Stroke. (