Current Guest Guru: Paul E. Kraemer, M.D.

Indiana Spine Group

With spine injuries, people treat it as if it were one problem. Many times, the spine is only one component of the problem. Some may lose sight of the bigger picture. In the end, my goal is to work out a system that helps bring specificity to the situation.
As an orthopedic surgeon, I find the technical challenges in work comp are fascinating. If you can handle the big stuff, the “easy” stuff is really simple. One of the greatest challenges in work comp is  determining if the injury is truly work comp related. In making this determination, I need to look at all outside factors-at varying levels. Not every injury is the same.

Issues in work comp can be a challenge. When you hear one thing from the case manager, something else from the patient, and another thing from the physical therapist, it is hard to decipher what the true issue is sometimes. But not all patients are like that. Keeping the communication consistent can be an issue. I treat all of my patients the same (whether work comp or not). I don’t overpromise. I make sure they have the proper mindset and realistic expectations. The mindset of the patient is a huge issue.

My philosophy is simple; be specific and know what you are treating and why you are treating. I make sure everyone is on the same page. To manage the expectations of the patient, two things are needed; good communication and an effective WC program. We have a great program in place, managed by a  former adjustor. We make sure our program works.

We also stress education, and talk with employers and patients about preventative measures. In fact, I call it the prevention of failed surgeries. I think of it as "How to avoid what the next operation is going to be". With spine injuries, people treat it as if it were one problem. Many times, the spine is only one component of the problem. Some may lose sight of the bigger picture. In the end, my goal is to work out a system that helps bring specificity to the situation.

Spotlight: My Treatment Philosophy

Good spine care requires both a broad and narrow focus.  A broad range of technical and clinical expertise to effectively treat the patient, combined with a narrow focus to identify the specific problem, and solution.  When examining patients, I take the time to be very specific and detailed with the patient about where their pain is, in what position(s) it hurts and ultimately determine what the source of the pain is. Working with a minimally invasive spine specialist, the exact source of a patient’s pain can most often be isolated. This is critical, and only then can we design a treatment plan. Additionally as a spine surgeon, I use scientific research to apply fact to surgical evaluations.  We now have very good objective data, including in work comp patients, on most common clinical problems, including herniated discs, stenosis, spondylilisthesis, and axial back pain.  Having a wide view of everything available with modern spine care, but a narrow focus on what can realistically be accomplished are elements of quality spine care. Facts, mixed with experienced opinion, help patients make the decision that is right for them.


Infectious Pin Complication Rates in Halo Vest Fixators Using Ceramic Versus Metallic Pins
Journal of Spinal Disorders and Techniques Vol 23(8) December 2010.
•    Retrospective review of complications associated with ceramic pins.
•    Fellow research project.

Cervical spine injury severity score. Assessment of reliability.
Spinal Trauma Study Group. Journal of Bone & Joint Surgery- American Volume. 89(5):1057-65, 2007 May.
•    Observer for reliability analysis.
•    Classified 40 CT’s utilizing  novel  4 column system for original paper.

Correlation of Microdiscectomy Outcomes with Apolipoprotein E and Catechol-O- Methyltransferase Genotype. 

•    Currently collecting genotype data on Microdisc patients
•    Prospective trial of all herniation patients being constructed

Complications : Failure of Cervical Spine Instrumentation  In “Arthritis and Arthroplasty, Spine” 

BF Morrey, ed,  2009 P Kraemer, RJ Bransford, JR     Chapman.

Cervical Spine: Static Vs Dynamic Plates In “Controversies in Spine Surgery”
AR Vaccaro, JC Eck ed  2010 P Kraemer, RC Sasso.
Complications related to the management of odontoid fractures In “The Cervical Spine, 5th Edition” 

CR Clark Ed, 2011 P Kraemer, RC Sasso

Spine Surgery Tricks of the Trade Vol 2 – Pub 2011 Management of Metastatic Disease
P Kraemer RC Sasso

Spine Surgery Tricks of the Trade Vol 2 – Pub 2011 En Bloc spondylectomy for Primary Spinal Tumors
P Kraemer, RC Sasso


Spine Research

Our physicians work with other nationally and internationally recognized spine surgeons on a variety of medical spine studies including FDA-approved studies. Exciting developments include Indiana Spine Group performing the first cervical (neck) disc implant in the U.S. in May 2002.

Our goal is to provide a full-continuum of comprehensive care for patients with spinal disorders and abnormalities. Through our continuing research, educational programs and development of innovative procedures, Indiana Spine Group is a leader in the study and treatment of the spine.  We are dedicated to providing the best care to our patients and unsurpassed communication to the medical community.
Philosophy of Care
Compassionate caregivers at Indiana Spine Group understand the challenges facing patients with spinal disorders. We treat each patient as an individual with unique needs, and use a team approach to enable fast and effective diagnoses and treatment recommendations.

We believe in educating the patient as much as possible on his or her condition and the available treatment alternatives. Our physicians and staff are dedicated to providing this information and answering questions, so that patients can take an active part in their own care decisions.

More about Dr. Kraemer

Dr. Kraemer is a board-certified orthopaedic surgeon with Indiana Spine Group, specializing in spine surgery. Additionally, he is an assistant professor of orthopaedic surgery at Indiana University Medical School, and the fellowship director for spine surgery with Indiana Spine Group and IU Orthopaedics.  Dr. Kraemer performs all types of spine surgery, and specializes in redo, or revision surgery, treatment of previous failed spine surgery, and complex disorders including scoliosis and deformity.  Additionally, he performs minimally invasive procedures when indicated.  Dr. Kraemer speaks nationally and internationally.  His research interests focus on long term outcomes of spinal fusion and prevention of failed surgeries.