Spine Surgery News

4 Important Characteristics of the Best Spine Surgeon

When it comes time to choose a spine surgeon, it is important to be selective as not all spine surgeons are the same. In order to increase your chances of great results and a comfortable surgery, there are certain characteristics you should look for in a surgeon. Below is a brief list of the 4 most important characteristics you’ll find in the best spine surgeon.

  • Spine Specific Knowledge and Training

Rather than opting for a general orthopedic or neurological surgeon, you should find a surgeon who specializes in spine surgery. They should be board certified and fellowship trained to treat neck and low back surgical conditions. Finding a surgeon who is highly experienced with minimally invasive spine procedures is also a good idea as these procedures involve smaller incisions and minimal soft tissue damage.

  1. Experience

It’s crucial to ask a prospective spine surgeon how long they have been performing spine surgeries. You should feel comfortable with the level of experience they have with the specific spine surgery you’re considering. It’s vital that you gain an understanding of how many times the surgeon has conducted the surgery as well as the outcomes of the surgeries they’ve conducted.

  1.  Bedside Manner and Communication

Although you don’t have to feel like your surgeon is your close friend, you should feel comfortable asking them questions. Additionally, you want to make sure you receive the information you need to make informed decisions regarding your spine surgery. Refrain from having your surgery conducted by a doctor who rushes in to meet with you, fails to provide any type of introduction, and talks down to you. Surgeons who are always in a hurry and demonstrate bad manners can be hazardous to your health.

  1. Compassion

While a spine surgeon’s medical knowledge and experience is of utmost importance when you are receiving a spine surgery, compassion is also important. Compassion is defined as the ability of a surgeon to imagine what you are going through, connect with you on an emotional level, and be motivated to address your suffering and improve your situation.

When you are searching for the best spine surgeon for you, go with your gut feeling. If you don’t have a good feeling about a surgeon, meet with others until you find one that you like and trust. You can add unnecessary stress to your spine surgery if you are not confident in your surgeon’s abilities and turned off by their personality.

Contact Dr. Keenen of Pacific Spine Specialists Today

If you are searching for the best spine surgeon in the Portland area, we invite you to visit Pacific Spine Specialists. Dr. Timothy Keenen is a board certified and fellowship trained spine surgeon who has performed thousands of simple to complex spine surgeries.

With Dr. Keenen by your side, you can find the pain relief you’ve been longing for and enjoy the peace of mind of knowing your surgery is in the hands of a compassionate, experienced, and highly trained surgeon. Call Pacific Spine Specialists today at 503-885-9391 to schedule an appointment with Dr. Keenen.

Tips to Bend Properly Post Spine Surgery

Tips to Bend Properly Post Spine Surgery

If you have been suffering from spine pain and have made the decision to undergo spine surgery, you may be left with many questions. One of these questions is likely how to bend properly after spine surgery. Bending the wrong way could result in pain, or worse, further injury, causing a setback in your healing process.

Even if you opted for a minimally invasive procedure, it is still important to take precautionary measures post surgery, such as making sure to bend properly. If you follow the steps below and all goes according to plan, you should be as good as new in no time. However, remember that healing takes time, so follow the instructions of your surgeon and ease back into activities once given the go ahead.

Recovery from Spine Surgery
Recovery from spine surgery may require you to learn to sit, stand, and walk in a new manner. To ensure a proper recovery, prior to spine surgery, get your home ready by installing handrails, removing loose throw rugs, and adding a few mechanical “grabbers” to aid in reaching items from the floor or shelves. Following your spine surgery, a therapist from the hospital will begin physical therapy prior to discharge. Keep in mind that you may continue to experience radiating pain in your hips, knees or shoulders for a short time post surgery while you and your body figure out how to move with a tender spine.

While the goal of spine surgery is help the patient regain flexibility, immediately following surgery it is important not to bend. However, since bending is a large part of our daily activity — to tie shoes, stir a pot, open the car door, even to go up steps — it is important to learn how to bend properly after surgery.

4 Tips to Bend Properly After Surgery


  • Tip 1: Bend with your knees. When the time comes that you must pick something up off the floor, crouch down by bending at your knees. First, make sure your feet are shoulder-width apart for stability, then bend just your knees and slowly lower yourself down while keeping your spine straight and upright.
  • Tip 2: Put on socks in a recline position. If you can’t get away with going sockless after surgery, it is suggested to put on your socks while in the reclining position. Lay back on your bed, draw your knee to your chest, and carefully reach down to slip socks on over your feet.
  • Tip 3: Pivot instead of twist. Twisting your spine may cause pain post surgery. Therefore, try pivoting when you need to turn your upper body. Expert tip, rotate on your foot to turn your whole body to where you need to be. This may take some getting used to, but your spine will thank you.
  • Tip 4: Keep good posture: When standing at your kitchen or bathroom counter, resist the urge to bend or hunch over. One way to avoid hunching is to stand as close to the counter as you can while keeping your back straight. If you tend to lean over the sink while brushing your teeth, open the cabinet under the sink and put your foot on the cabinet ledge, which helps you keep your back straight while you brush.

The tips above are meant to help reduce spine pain through bending properly, however it is always suggested to speak with your spine expert and follow their suggestions for healing.

Learn More

If you are suffering from spine pain, contact Pacific Spine Specialists today. Dr. Keenen is board certified and an expert when it comes to diagnosing and treating spine pain. Learn more!

All About Diagnostic Imaging Tests

All About Diagnostic Imaging Tests

If you are experiencing spine pain, the first step in treatment is determining the source of your pain. Often times, your spine expert will order a diagnostic imaging test to aid in making an accurate diagnosis. Only with the proper diagnosis can a spine expert, such as Dr. Timothy Keenen of Pacific Spine Specialists, prescribe the appropriate treatment. For patients, there are many different types of diagnostic imaging tests available, so it is best to understand what these tests are and the purpose they serve.

Below is a detailed explanation of the 3 most popular diagnostic imaging tests used for spine pain. The type of test ordered by your spine expert depends on a number of factors since each diagnostic test can rel something new. If you are experiencing spine pain, you may receive one or more of the following:

  1. X-ray: In many cases, x-rays are often the first step to a diagnosis and work by taking pictures of your bones through the use of radiation.  X-rays are used to examine a patient’s vertebrae or spinal bones and identify any problems or conditions, such as misalignment or slippage of your bones. X-rays can be used to confirm a slipped disc or bone spur as the source of your pain.

  2. Magnetic resonance imaging (MRI): An MRI is used to exam soft tissue, revealing problems with your vertebral discs, inflamed nerves, or even ligament, tendon and muscle damage. The MRI images can aid your spine expert in determining the cause of your spine pain that may not have appeared on a x-ray, such as nerve damage and inflamed tissue. An MRI is performed through the use of an MRI machine, which resembles a giant tube into which the patient is inserted. The tube initiates a magnetic field and radio waves are sent through the tube at specific locations to capture a cross-sectional image of the body. When an X-ray doesn’t show any abnormalities, an MRI is often the next step in the diagnostic process.

  3. Ultrasound: Much like an x-ray uses radiation to produce an image, an ultrasound uses sound waves. An ultrasound can be used to examine soft tissue to identify conditions such as muscle inflammation or tears. In certain cases where an x-ray may not be a safe option, such as during pregnancy, an ultrasound may be ordered. An ultrasound is performed using gel on the surface of the skin and passing a handheld device back and forth across the gel. The live images are then sent to a monitor.

Learn More

When you visit Pacific Spine Specialists for your spine pain, first and foremost Dr. Keenen will perform a physical exam, take your medical history, and ask you questions pertaining to your pain. From there, he may recommend one of the tests above to isolate the cause of your pain. Rest assured at all 3 of these imaging tests are safe and painless. Contact us today for more information.

Spinal Fusion Recovery

Spinal Fusion Recovery

If you are scheduled to undergo a spinal fusion, it is only human to be worried about the recovery following the procedure. When you chose to work with Pacific Spine Specialists, your spine expert, Dr. Timothy Keenen, will go over the entire procedure with you from top to bottom and give you a chance to ask questions, such as specifics on recovery times, limitations, etc. However, to calm your nerves in the meantime, we have put together a few helpful pieces of information regarding spinal fusion recovery.


Keep in mind that a spinal fusion requires a bone graft, which keeps maturing for as long as 12 to 18 months following surgery. During this time, the attention you pay to your recovery is extremely important. We suggest following your surgeon’s instructions in order to guarantee a successful operation.


    • Remain as healthy as possible. Prior to surgery, there are a few measures you can take that may aid in decreasing recovery time, such as:
      • Quit smoking
      • Avoid use of steroids
      • Lose weight if overweight or obese
      • Manage chronic illnesses, such as diabetes
      • Avoid use of narcotics


  • Plan ahead. Support is an important part of a spinal fusion recovery. Plan ahead for family, friends, or a caregiver to provide support and assistance for the days following

4 Summer Spine Injuries to Avoid


4 Summer Spine Injuries to Avoid

With warm temperatures, blue skies, and blooming flowers, there is no better time to get outdoors and get active than the summer months. However, summer fun can be put to a halt when a summer spine injury occurs. Therefore, it is best to be aware of the most common summer spine injuries in order to save yourself and your spine from a summer of unnecessary pain.

Most Common Summer Spine Injuries are a result of the following summer activities:

  • Water Skiing: Although water skiing is a fun summer activity, one wrong fall and the fun is gone. Water Skiing has been linked to serious spine  injuries as a result of falling at awkward angles. Unless you are an expert skier, it is best to avoid advanced maneuvers and high speeds.
  • Yard Work: For spine pain sufferers, it is no secret that yard work and gardening can be hard on your back. Bending, lifting heavy items, and twisting can all cause stress on your spine, resulting in pain or injury. Additionally, mowing the grass can put stress on your spine due to leaning forward to push the mower and start the mower. When out in the yard, always practice good posture and remember to bend at the waist. Taking breaks throughout the day to rest your back is best practice for avoiding a summer spine injury.
  • Biking: Whether you prefer a beach cruiser or a mountain bike, practicing bike safety is critical. When biking, be sure to always practice good posture and avoid rough terrain which may cause unnecessary stress on your spine, resulting in pain or injury. Summer spine injuries from biking can be avoided when safety measures are taken.
  • Golfing: In order to avoid a spine injury while on the course, always warm up prior to hitting the green and ensure your swinging with proper techniques. Golf has been known to cause spine injuries as well as lower back pain. For those of you who already suffer from spine pain, be sure to utilize a golf cart or caddie and do not attempt to carry your golf bag around the course.

Contact Pacific Spine Specialists Today

Do not let a summer spine injury stop you from enjoying your summer days. If you are suffering from spine pain, contact Pacific Spine Specialists today. Dr. Keenen is board certified and an expert when it comes to diagnosing and treating spine pain. Learn more!

Is Boating a Spine Pain Friendly Summer Sport?



If you have been searching the internet for “spine pain friendly summer sports”, you may have been left wondering if boating and fishing have made the list. Afterall, there is nothing finer than spending your summer days out on the water. However, for spine pain suffers, the boat may be the last place you feel comfortable. It has been found that boating and fishing on the water are surprisingly hard on your spine and back muscles. If your legs and your knees don’t absorb the shock of the rolling deck beneath your feet, then your back does. And your spine can pay the price.

Before you decide if boating will make your list of spine pain friendly summer sports, we suggest you speak with your spine specialist, such as Dr. Timothy Keenen at Pacific Spine Specialists. This piece of advice is especially important if you have undergone spine surgery recently. After surgery, it is always best practice to follow your post-operative instructions and don’t try to do too much before you’re ready. Listening to the advice of your doctor will ensure you are back onboard the boat in no time.

Safety Tips to Help Avoid Spine Pain While Boating

Once you and you doctor decide you are ready to board the boat, keep these safety tips in mind. They can go a long way in preventing further spinal injuries while on the water.

1. Avoid alcohol use: It is no secret that alcohol can give you sealegs even on land. When you put alcohol and boating together, the chances of a fall or injury heighten.

  1. Avoid rowing: If a kayak or canoe is your boat of choice, you may want to think again. Rowing produces a high-intensity workout for your back, not something you should do during or shortly after your spine surgery.
  2. Stay in the boat: If skiing, wakeboarding, or tubing are of interest, we suggest opting out if you are experiencing spine pain or have undergone spine surgery. Although fun, these activities are usually performed at high speeds and increase your chance of a spine injury, especially if you are thrown off or performing stunts.
  3. Ride comfortably: Stay near the stern, close to the water level, where you’ll experience less bouncing. This is especially important with smaller vessels where movement is felt more.
  4. Change Positions: If you are spending the day on the boat or if you plan to fish, don’t sit in one place for hours. We recommend keeping your back loose by stretching frequently.

Contact Dr. Keenen Today

If you have experienced a spine injury while boating or if you have been living with spine pain, we invite you to learn more about Dr. Timothy Keenen of Pacific Spine Specialists. With his expert knowledge and minimally-invasive procedures, he will strive to have you back on the water–pain free, as quickly as possible. Schedule a visit today.

Risk Factors For Degenerative Disc Disease

Degenerative disc disease is a condition that occurs when discs that separate the spinal bones break down. If you are suffering from degenerative disc disease, you are likely experiencing pain in the back that radiates to the buttocks and thighs. You may find that your pain worsens when you bend, twist, or lift and appears and disappears over time. The most common risk factors degenerative disc disease include:

  • Aging
    The normal aging of the spine can prompt this condition. When your disc deteriorates as you get older, it may no longer be able to function properly and results in back pain and/or pain that radiates through the body.
  • Genetic Factors
    Studies have proven that genetics play a role in degenerative disc disease. Your disc height and disc bulging are both influenced by genetics and can lead to this condition.
  • Occupation
    If you have a career that requires you to lift heavy objects or operate heavy machinery, you are more likely to develop degenerative disc disease than someone who does not.
  • Smoking
    If you smoke, you are at high risk for this condition because smoking damages the blood vessels that the disc counts on for nutrients. Additionally, smoking produces a significant amount of free radicals which can trigger further damage in your disc.

Preventing Degenerative Disc Disease

The good news is that there are a variety of measures that may help you prevent degenerative disc disease. If you are overweight, you should make every effort to lose the excess weight in order to remove some of the strain from your discs.

Quitting smoking and drinking in moderation will also improve the health of your spine and ensure your body gets all of the essential nutrients it needs. Lastly, leading an active lifestyle by exercising and participating in sports on a regular basis will make it easier for your discs to support movement and absorb impact.

Although maintaining a healthy weight, quitting smoking, drinking moderately, and making it a priority to remain active does not guarantee that you will not develop degenerative disc disease, it will raise your chance of preventing or postponing this condition.

Contact Pacific Spine Specialists Today

If you believe you may be suffering from degenerative disc disease, you owe it to yourself to schedule an appointment at Pacific Spine Specialists today. We’ll evaluate your condition and provide you with an appropriate diagnosis and treatment plan that will help eliminate any pain or discomfort you are facing. Call us at 503-885-9391.

The Best Workouts for Spondylolisthesis Sufferers

Spondylolisthesis occurs when a bone in the lower portion of the spine slips out of its proper position onto the bone below it. Although you may never experience any obvious symptoms if you have this condition, there is a possibility that you may notice lower back pain, a stiff back, posture changes, and muscle spasms in your hamstrings.

In the event that a doctor does diagnose you with this condition, a number of spondylolisthesis exercises will likely be included in your treatment plan. Some of these exercises, which are designed to build strong muscles and stabilize the spine may include:

1. Child’s Pose
Child’s pose is a great exercise for stretching your lower back. To get into child’s pose position, you’ll get on all fours on the floor and rock back onto your heels while your arms are stretched out and your head is lowered to the floor. This exercise should be held for about 5 seconds and repeated once a day for at least 10 times.

2. Bird Dog
Just like child’s pose, bird dog starts with getting on all fours. Once you are on all fours, you’ll tighten your stomach and ensure your back is flat as you lift one arm and the opposite leg straight out and hold for 3 seconds. While you are holding this position, be sure to avoid arching your back and repeat 10 times per side once daily.

3. Pelvic Tilt
To perform a pelvic tilt, you’ll lie on your back with your knees bent and feet flat against the floor. Next, you’ll use your ab muscles to pull your belly button towards your spine and try to press your lower back flat against the floor. You should hold this position for about 15 seconds and complete at least 10 repetitions.

4. Gluteal Stretch
The gluteal stretch will require you to lie on your back with both knees bent. You’ll rest one leg’s ankle against the knee of the other and grab onto the thigh of your bottom leg to pull it toward your chest until you feel a stretch in your buttocks. This stretch should be held for about 30 seconds prior to switching legs. Your doctor will probably recommend repeating this pose three times for each leg.

All of these spondylolisthesis exercises can ease pain, increase function, and improve your quality of life. However, you should not engage in any of them until you have consulted a doctor.

Suffering From Spondylolisthesis? Call Pacific Spine Specialists

If you’d like relief from spondylolisthesis, it is in your best interest to call Pacific Spine Specialists at 503-885-9391 today. We’ll evaluate your condition and may prescribe spondylolisthesis exercises as well as other treatments to help you feel better.

The Importance of Pre-Habilitation

If you’ve scheduled your spine surgery, you are likely anxious and unsure of what to expect. You are probably wondering how long it will take you to recover and what exactly is involved in the recovery process. If this is how you’re feeling and you’d like to increase your chances of a healthy recovery, pre-rehabilitation can do wonders for you.

Pre-habilitation is defined as the educational and physical preparation that is intended to improve recovery following a surgery. If you have an upcoming surgery, pre-habilitation can help you mentally prepare for your procedure, reduce any inflammation or pain, restore your range of motion, and answer any questions or concerns you may have.

Benefits of Pre-Habilitation

Research has proven that patients who participate in pre-habilitation are able to return to their day to day activities and sports quicker and easier than those who do not. In addition, they experience less pain and have fewer complications during the surgery. By making pre-rehab a priority, you’ll become stronger and more flexible so that your body is stronger and more flexible when it’s time for you to recover from your operation.

What Does Pre-Habilitation Entail?

If your doctor has recommend a pre-habilitation program and you choose to participate in it, you can expect to engage in an exercise routine which will likely begin with a warm up such as stretching or light jogging. After the warm up, you will move on to some cardio like running or sprinting, strength training with weights and resistance bands, and flexibility exercises like yoga. You may also practice functional tasks like going up and down the stairs or sitting down and standing up. Additionally, you may familiarize yourself with how to use a walker, crutches, and other walking aids.

In addition to the exercise aspect of pre-rehabilitation, there is an education component which will inform you of what to expect after your surgery. You’ll gain a thorough understanding of when you can return to work and participate in certain activities like walking and driving. Pre-rehab education will give you the opportunity to set realistic goals and plan for your life post-surgery.

Call Pacific Spine Specialists for a Custom Pre-Habilitation Plan

If you are undergoing a spine-related surgery and believe you would benefit from pre-habilitation, we encourage you to call us at 503-885-9391 to schedule an appointment. With our pre-habilitation services, you’ll receive the exercise and education you need to maximize your strength and mobility so that you can return to your regular lifestyle as soon as possible once your surgery has been completed.

What You Need To Know About Lateral Lumbar Interbody Fusion (XLIF)

Lateral lumbar interbody fusion, or XLIF for short, is a minimally invasive procedure that is commonly used to relieve symptoms associated with degenerative disc disease, such as leg or back pain. Performed through an incision in the patient’s side, this procedure offers many benefits, such as avoiding the major muscles of the back, which means an easier recovery for many.

Benefits of Minimally Invasive Spinal Fusion

The benefits of approaching the spinal fusion from your side instead of from your front or back are significant and include:

  • Reduced time for the operation
  • Fewer recovery days
  • Minimal scarring
  • Less blood loss
  • Less postoperative pain
  • Quicker return to your daily activities
  • Minimal muscle and ligament tampering
  • No disruption to abdominal muscles

When Can XLIF Be Used?

A lateral lumbar interbody fusion can be used to treat a variety of conditions. Your spine expert may recommend a minimally invasive spinal fusion if you are suffering from one of the conditions below:

  • Degenerative disc disease
  • Thoracic disc herniation
  • Scoliosis caused by degeneration
  • Deformities
  • Lumbar disc herniation
  • Low-grade spondylolisthesis

Although an XLIF is a wonderful option when a minimally invasive spinal fusion is necessary, this outpatient procedure is not recommended for spinal issues such as:

  • High-grade spondylolisthesis
  • When a fusion is needed on a low-riding L4 or L5
  • When a fusion is needed too close to pelvic region and therefore inaccessible from the side
  • For deformities that cause rotation difficulties

Before recommending a lateral lumbar interbody fusion, your spine expert may first opt to try noninvasive treatment methods. If noninvasive treatment methods do not provide relief, your spine expert may administer extensive testing to determine if you are a candidate for XLIF.

Recovery from XLIF

Recovery from minimally invasive procedures is usually quicker and easier than recovery from more invasive procedures. However, as with any kind of surgery, minimally invasive spinal fusion or not, recovery time varies among individuals. Factors such as your general health before the surgery, as well as your willingness to follow postoperative instructions to the letter, aid in determining recovery time. For the most part, however, you can expect to:

  • Get up and walk immediately following the procedure
  • Feel some minor pain due to the operation
  • Notice a high level of pain relief from the affected area almost immediately

Thanks to the nature of minimally invasive spinal fusions, you should be able to notice right away that the lateral lumbar interbody fusion was successful.

Learn More

If you are suffering from back or spine pain, we invite you to learn more about Pacific Spine Specialists. Dr. Keenen is an orthopedic spine surgeon who specializes in minimally invasive surgical procedures. Take advantage of our free MRI review and request an appointment today.