 A spine surgeon caring for patients in and around Crystal River, Florida, Constantine Toumbis, MD, performs spinal procedures at Citrus Spine Institute. To train for his career, Dr. Constantine Toumbis completed a fellowship in spine surgery at Cleveland Clinic Florida.
As part of the central nervous system, the spine partners with the brain in acting as the communication hub of the human body. The spinal cord begins at the bottom of the brain stem, in the area referred to as the medulla oblongata, and ends at the conus medullaris in the lower back. Signals from the brain travel down the spinal cord and spread to their destination in the body via the peripheral nervous system. Signals also travel from the peripheral nervous system to the spinal cord, and from there to the brain. The spinal cord itself is roughly a foot-and-a-half long and is contained within the spinal column, which is composed of 33 bones, called vertebrae, stacked on top of one another. The spinal column is subdivided into five regions. The 24 vertebrae of the cervical, lumbar, and thoracic regions are movable, while the nine vertebrae of the coccyx and sacrum regions are not. Though the spinal column protects and supports the spinal cord, serious injuries can nonetheless occur. Damage to the spinal cord can, for example, frustrate or block communication from the brain to the extremities, and vice versa. It manifests as the inability to feel or to move the arms, legs, trunk, or all of these, depending on the precise location of the spinal cord damage.
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 A noted spine surgeon at the Citrus Spine Institute in Crystal River, Florida, Constantine Toumbis. MD, specializes in cervical, thoracic, and lumbar surgeries. In addition, Dr. Constantine Toumbis and his colleagues treat spine related conditions including osteoporosis.
Bones naturally undergo a cycle of breaking down and building up. As one ages, bones may have trouble keeping up with this process, resulting in lower bone density and a weakened bone structure. The loss of bone density results in osteoporosis. The condition is most common in women who have completed menopause, but men over 70 are also susceptible. Treatment options for osteoporosis vary based on a patient’s risk in breaking a bone within the next ten years. Patients at low risk may be able to slow the disease’s progression with medications and lifestyle changes. High risk patients require a more aggressive response. Common lifestyle changes to prevent the advancement of osteoporosis include smoking cessation, decreasing the amount of alcohol a patient consumes, and a healthy lifestyle that includes good nutrition and regular weight bearing exercise. Experts also recommend taking steps to reduce falls such as wearing good, sturdy shoes and removing tripping hazards from a patient’s home. The most common medications prescribed for osteoporosis are bisphosphonates such as ibandronate and alendronate. These are oral medications that are taken daily. Unfortunately, they can prove to be harsh on a patient’s digestive system, causing discomfort and stomach upset. When a patient can’t tolerate a bisphosphonate or in advanced cases of osteoporosis, a doctor may recommend injectable medications such as denosumab (Prolia, Xgeva), teriparatide (Forteo), or abaloparatide (Tymlos). Each has the potential to rebuild bone. In some cases, hormone replacement therapy may be recommended to patients with osteoporosis. No matter the treatment plan, a patient suffering from osteoporosis should remain under the care of a qualified physician who can monitor the disease’s progression and the patient’s response. |
AuthorA surgeon focusing on spinal care, Dr. Constantine Toumbis treats patients at Citrus Spine Institute. Archives
November 2021
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