 An accomplished spinal surgeon and two-time U.S. News and World Report Top Doctor, Constantine Toumbis, MD, has delivered orthopedic care as a practicing physician at Citrus Spine Institute in Crystal River, Florida, since 2015. A member of the American Board of Orthopedic Surgery, Dr. Constantine Toumbis specializes in treating spinal conditions such as scoliosis.
While scoliosis is often diagnosed in children and adolescents, it is also possible to develop a scoliotic curve later in life. Spinal curves can be the result of weak or paralyzed muscles or a degenerative condition. Adult scoliosis often causes pain and physical deformities. In extreme cases, patients may experience difficulty walking or breathing. However, these types of complications are rare. For mild cases, patients are often treated with noninvasive methods to manage pain and improve posture. Doctors may recommend physical therapy, analgesics, or exercise. Rarely, patients may need to undergo surgical procedures such as spinal fusion or decompression. Surgery is usually recommended for patients whose condition has worsened over time or is not responsive to noninvasive treatments.
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At his practice in Crystal River, Florida, spine surgeon Constantine Toumbis, MD, cares for patients with health problems that impact the spine. To address compression fractures, Constantine Toumbis, MD, performs the kyphoplasty procedure.
When people have osteoporosis, the bones can become so compromised that they collapse under pressure. In osteoporosis of the spine, the vertebral body itself thins out and crumbles. The fractured bone can no longer provide protection to the nerves that reside in and around the spinal column. These spinal compression fractures can cause a great deal of pain. Nonsurgical treatments for spinal fractures include pain management drugs and braces to allow the bone to heal, which can take roughly three months. Candidates for surgery include those who exhibit spinal instability, those with fractures that cause spinal cord pressure, and those who do not have symptom relief from nonsurgical measures. Some patients may benefit from kyphoplasty, a minimally invasive option often performed under local anesthetic. In this procedure, the physician uses a thin instrument that contains a special balloon. The instrument is inserted into the back at the location of the fracture, and then air is pushed into the balloon so that it opens a space in the bone. Into the space, the surgeon injects a mixture that buttresses the bone to prevent further collapse. Usually, kyphoplasty takes less than 60 minutes and requires no stitches.  Dr. Constantine Toumbis, a fellowship-trained spine surgeon, treats patients at Citrus Spine Institute in Crystal River, Florida. He earned his MD with distinction in biomedical research from the Wayne State University School of Medicine. At Citrus Spine Institute, Dr. Constantine Toumbis performs a variety of surgeries, including spinal fusion.
The spinal fusion procedure aims to join two or more vertebrae together permanently in order to prevent them from moving against one another. The procedure mimics the natural bone healing process, achieving fusion through the strategic placement of bone tissue or a similar synthetic substance between the vertebrae. During the procedure, surgeons may also implant rods and screws to keep the vertebrae in place as they heal together. Spinal fusion is used to treat problems like spinal deformities, as in the case of scoliosis, or structural issues like herniated disks or spinal instability. The procedure can also address chronic back pain. Oftentimes, spinal fusion follows a regimen of less invasive, more conservative treatment options that fail to address the underlying problems.  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.  A Florida-based spine surgeon at Citrus Spine Institute, Constantine Toumbis, MD, brings more than two decades of experience to his practice. To better serve his patients, Dr. Constantine Toumbis maintains membership with multiple professional organizations, including serving as a fellow of the American Academy of Orthopaedic Surgeons.
Each year, the American Academy of Orthopaedic Surgeons (AAOS) hosts its Annual Meeting, and in 2020 it will take place in Orlando from March 24 to March 28. Here’s a quick guide to getting the most from the event. The AAOS Annual Meeting furnishes numerous opportunities to learn as well as hands-on access to educational tools. Three important aspects of the event program are the Academy Hall, Education Sessions, and the Exhibit Hall. The Academy Hall is one of the main educational hubs, and it is open to attendees throughout the duration of the event. Some of the key resources at Academy Hall include membership specialists who will provide an in-depth look at AAOS membership benefits and an orthopedic video theater featuring a range of surgical videos. The education sessions take place in the form of two-hour classes during four of the Annual Meeting's five days and include everything from "Ask an Expert" discussions to instructional courses covering well established techniques in orthopedics. Additionally, the Exhibit Hall is open for three days, connecting attendees with the latest industry products through activities such as bio-skills sessions. One last program to know about is Specialty Day, which takes place only on Saturday. Specialty Day features scientific programs led by organization members of the Board of Specialty Societies.  The owner of the Citrus Spine Institute in Crystal River, Florida, Constantine Toumbis, MD, is an accomplished spine surgeon who has completed a range of significant research projects. Dr. Constantine Toumbis served as a designer for the Arsenal, a next-generation pedicle screw from the spinal fusion technology company Alphatec.
Although surgeons have been employing bone screws to correct spinal anomalies since the 1960s, the specific hardware and modalities that they use have changed a great deal. A specific type of bone screw, the pedicle screw has multiple characteristics to facilitate implantation into the vertebral pedicle, the stem-like structure that protrudes from the back of each human vertebra. Surgeons can implant pedicle screws to address instances of deformity and trauma by affixing spinal implants in place and/or immobilizing specific spinal sections. After using fluoroscopy or x-ray equipment to determine the ideal screw placement, surgeons drill receiving channels with the appropriate angles and depths before installing pedicle screws within the bone.  Constantine Toumbis, MD, has been practicing as a spinal surgeon for more than 13 years. Now the owner of Citrus Spine Institute in Florida, Dr. Constantine Toumbis welcomes patients with spinal tumors.
A spinal tumor can develop in or around the spinal cord or vertebrae. These growths can be difficult to diagnose because one of the primary symptoms is back pain, which is often indicative of a different and less serious condition. Pain from spinal tumors may be distinguishable because it is specific to a particular spot and worsens when that spot is directly manipulated. The pain may also be worse at night. Furthermore, because spinal tumors can develop anywhere along the spine, they can cause a varied set of symptoms that are inconsistent from one patient to the next. For most patients, the initial pain precedes neurological issues such as numbness or weakness of the limbs. Some patients may experience changes in their gait or trouble walking in the dark. Many patients notice a change in bowel or bladder habits, paralysis, or spinal curvature. Fortunately for patients, spinal tumors are much less common than other causes of back pain. A visit to a specialist and an MRI can usually determine whether a tumor is present.  Dr. Constantine Toumbis has nearly 30 years of experience as an MD. A spine surgeon at Citrus Spine Institute in Crystal River, Florida, Dr. Constantine Toumbis understands when spinal surgery is warranted.
If a patient has been living with back pain, the time will come when he or she will wonder if surgery could provide relief. However, for a spinal surgeon to consider a patient as a candidate, testing must reveal an anatomical cause of the pain. Common causes include bulging discs, ruptured discs, bone overgrowth, an unstable spine segment, or a structural deformity. Even in the presence of a visible anatomical abnormality, a surgeon will postpone surgery until conservative treatments have failed. Such treatments include physical therapy and pain relief medications. If the pain remains persistent and disabling despite these interventions, surgery may be an option. The exception to this rule is when a patient experiences particular symptoms, such as fever, loss of neurological function, or acute bladder or bowel incontinence. These symptoms may be a sign that damage to the back has become a medical emergency.  Practicing in Crystal River, Florida, Constantine Toumbis, MD, offers patient-focused care at the Citrus Spine Institute. In his capacity at Citrus Memorial Hospital, Constantine Toumbis, MD, has extensive knowledge of the spine and how it relates to low back issues.
The various lumbar spine conditions tend to be interrelated, with muscle issues such as strain related to repetitive use, bending, and heavy lifting. While they can cause extreme pain, muscle strains tend to get better within days or weeks of proper rest. A more serious issue involves degenerated discs, where the spongy “shock absorbers” that separate each vertebrae within the spine experience wear and tear and displacement that results in pain within the disc space. The lower back is where most disc herniations occur, with the intense pain causing damage cumulatively, with time, or all at once. A major symptom of the latter event, which may require surgical intervention, is sciatica, or leg pain that persists.  Constantine Toumbis, MD, is a respected Crystal River, Florida-based medical practitioner who leads Citrus Spine Institute and provides patient-centered care for a variety of conditions. Experienced in treating osteoporosis and osteoarthritis, Constantine Toumbis counsels patients on osteoporosis prevention.
While osteoporosis is associated with aging, steps to prevent its occurrence can begin from an early age. With the skeleton developing throughout the teenage years, adequate intake of calcium, vitamin D, and protein is vital in ensuring optimal bone growth. Other aspects of bone health include getting regular exercise and avoiding exposure to secondhand smoke. Peak bone mass is acquired in the mid-20s, and thereafter bone loss begins to occur. Slowing this natural process as an adult involves carrying on good habits developed as a youth, with proper nutrition paired with activities that require the bearing of weight. Strength training should ideally be combined with aerobic activities such as jogging and swimming, as well as disciplines such as yoga and tai chi. |
AuthorA surgeon focusing on spinal care, Dr. Constantine Toumbis treats patients at Citrus Spine Institute. Archives
November 2021
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