Posts Tagged ‘spine surgery’

Patient Video Story: Back to Life after Spinal Tumor Surgery

Spine Tumor Patient Story VideoDoug House is an Emory Spine Center patient who had a large spinal tumor. Doug was in pain for over 10 years and had several problems performing basic daily activities including walking, sleeping, and controlling his bladder. He thought he would live the rest of his life unable to perform basic life functions. Doug was referred to our team at the Emory Spine Center and now is back to his old self and able to enjoy life again.

Watch Doug’s incredible story in the video below and learn more from Emory physicians Dr. Gerald (Rusty) Rodts and Dr. Daniel Refai on what makes spinal tumor treatment at Emory different.

Advancing the Possibilities in Orthopedic, Sports Medicine & Spine Care

Emory University Orthopaedics & Spine Hospital AtlantaEmory Healthcare is known for its strong focus on patients and families, as well as its sharp attention to detail in Orthopaedics, Sports Medicine and Spine Care. At Emory, we have the most highly trained orthopaedic and spine specialists in the country working together to diagnose and treat a wide variety of orthopaedic, spine and sports medicine conditions. Our physicians use innovative approaches to care – many of them pioneered via research right here at Emory – to ease your pain and get you back to the life you love. We bring all aspects of musculoskeletal diagnosis, treatment and rehabilitation together in one location – from state-of-the-art CT and MRI to a world-class outpatient surgery center and physical therapy suite– at the Emory University Orthopaedics and Spine Hospital (EUOSH).

Many of our musculoskeletal inpatient procedures occur at EUOSH, which is unlike any other facility in Georgia. When planning for this hospital, doctors, nurses and patients presented their wish lists, and we worked tirelessly to bring our patients the care that set the standards and raises the bar higher than ever. The hospital has been completely renovated to provide our orthopaedic, spine and sports medicine patients with access to exceptional service and the most advanced, sophisticated technology tailored specifically to their unique needs. The combination of our unique facility amenities at EUOSH and our team’s dedication to truly patient- and family-centered care allow us to provide an unparalleled level of musculoskeletal care to the Atlanta and Georgia communities. Find out more in the video below:

We pride ourselves on being uniquely focused on patient satisfaction and comfort. In fact, we call upon 75 various patient committees and have adopted listening practices to ensure that we fully understand the needs of the patient. Further, we make it a point to avoid being married to any sort of protocol; for example, there’s no limit on patient visiting hours, and family members are welcome to sit with patients right up until the time of surgery.

Our efforts have not gone unnoticed—we’re proud to say that we have over a 90% satisfaction rate among our patients. Every room is equipped with everything a patient could possibly need for a comfortable recovery, including an interactive television that offers hospital information, a “my education” feature, access to the patient’s chart, health notes, and of course, regular TV channels and movie options.

Emory truly strives to exceed patient expectations every day. Learn more about our Orthopaedic, Spine and Sports Medicine care by watching this short video.

Minimally Invasive XLIF Spine Surgery Can Speed Recovery Time

Dr. Tim Yoon, spine surgeonDr. Jim Rothermel, a retired ob/gyn, had been living with back and leg pain for more than three years. He was told that he needed extensive open spinal surgery. However, he came to the Emory Spine Center for another opinion and met with Dr. Tim Yoon, an internationally recognized spine surgeon and expert in minimally invasive techniques. Dr. Yoon diagnosed Jim with stenosis and scoliosis. His condition would typically require complex open spinal surgery, but Dr. Yoon determined that using a less invasive method, the XLIF technique, would reduce the stress on his body and reduce recovery time.

XLIF (eXtreme Lateral Interbody Fusion) is an approach to spinal surgery in which the spine surgeon accesses the intevertebral disc space and fuses the lumbar spine from the side rather than from the front or the back. By going through the side of the body with a small incision rather than through a large abdominal incision, much less soft tissue is traumatized, resulting in a faster recovery. XLIF may be an option for patients who have scoliosis, spondylolisthesis (where the vertebrae have slid in relation to one another), or spinal stenosis. These diagnoses typically causes leg pain and back pain.  When XLIF is used to perform a simple one-level fusion surgery, the patient often is able to go home the next day.

The XLIF technique can also be used to access multiple different discs and may be combined with other procedures, such as minimally invasive screws, to handle more complex cases, like Jim’s. This less-invasive approach can make surgery an option for people who, in the past, might not have been chosen surgery because of the prolonged recovery time or because the doctors thought the surgery was too invasive for a frail patient. Therefore, XLIF allows surgeons to treat more spinal conditions and different types of patients.

Emory spine surgeons have extensive experience performing a wide variety of spine surgeries. They know when the minimally invasive approach won’t be effective or should be combined with a bigger surgery. “Not everybody is going to be best treated by an XLIF, but I know who will be, and I choose those people,” Dr. Yoon says. “That way, you maximize the best results and minimize any likelihood of complications.”

Jim and his wife, Midge, couldn’t be happier with Dr. Yoon and their experience at the Emory University Orthopaedics & Spine Hospital. Jim says, “Dr. Yoon spent quality time with me. He thought he could do this XLIF procedure with a three-level fusion. He explained it in detail and then referred me to a website. I looked at the procedure carefully and thought it sounded like the proper way to go about doing it. He scheduled the surgery for two stages. We did the XLIF on a Monday, and he was able to do it in a manner that wasn’t muscle cutting. The recovery time was markedly improved.” Three days later, Dr. Yoon performed the second stage of the surgery, and a few days after that, Jim went home.

“Jim was extremely uncomfortable for over three years, and to see the difference in him now is just an absolute miracle. He’s happy. He’s always been a big teaser and silly, and I’ve got him back again,” Midge says.Have you had XLIF spine surgery, or would you like to learn more about spine surgery at Emory? We welcome your questions and feedback in the comments section below.

 

Collapsed Disc Spine Patient Races to Recovery

For years, triathlete Denise Novicki suffered from excruciating spinal pain in her lower back. Founder of Tri2Remember, a triathlon club that raises money to fight Alzheimer’s disease, Denise had always led an active lifestyle, but her back pain made it difficult, if not impossible, to enjoy her favorite pastime.

“I was in such immense pain that I was looking for some very trusted resources to manage my pain,” Denise says. She chose the Emory Spine Center at the Emory University Orthopaedics & Spine Hospital for assessment and a solution.

“What we’ve tried to do here at the Emory Spine Center is take the worry and the guessing out of a spine or back problem,” says Dr. Scott Boden (pictured left), director of the Center. “When people come here, we help them figure out what’s wrong and give them lots of different options.”

Before the spine doctors at the Emory Spine Center suggest surgery, they investigate all possible nonsurgical interventions, but they also know that, in some cases, a simple surgery may make the difference between experiencing debilitating pain and living pain free.

To find out the cause of her back pain, Denise met with spine surgeon Dr. John Heller, who discovered that she had a collapsed disc. It was clear to Dr. Heller that surgery would bring Denise relief and allow her to get her life back. “Denise came to us seeking advice on how to improve back pain that had really gotten in the way of her normal lifestyle,” says Dr. Heller. “She was an avid athlete and was having tremendous difficulty maintaining a training regiment, let alone a normal, everyday life.”

Before her spine surgery, Denise signed up for an upcoming Ironman distance race. She wanted to be sure she had a goal in place that would help her stay focused on recovery. She achieved her goal. “Coming into doing the Ironman, I had a different perspective than probably most athletes do, because I came to the table with thankfulness that I am actually able to compete. I did what I set out to do, and I couldn’t have done it without the team at Emory.” To learn more about Denise’s experience with spine surgery at Emory, check out the short video below:

Dr. Boden says, “The thing I love about taking care of patients with spine problems is that we have a real opportunity to help patients get their lives back, and that’s a very special thing.”

Dr. Scott BodenThe spine doctors at the Emory Spine Center are dedicated to excellent spine care. “Some places, people are part-time spine and part-time hips and knees, but what’s unique about our group is that everybody primarily focuses on taking care of patients with spine problems, teaching trainees who are learning about the spine, and doing research to try and explore new and better ways to treat spinal problems,” says Dr. Boden (pictured left). “If you end up coming to Emory University Orthopaedics & Spine Hospital, you’ll leave saying that you’ve never been in a hospital that’s anything like it.”

Have you had spinal surgery at the Emory Spine Center? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

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3 Cervical Spine Procedures that Reduce Recovery Times

John G. Heller, MDWhen people think about neck conditions requiring surgery, they usually think about cervical spine injuries. We’ve all seen those tense moments during football or other sports when a player is injured and lies motionless on the field. A dramatic example comes from a Boston Celtics basketball game back in February, when Marquis Daniels bumped into another player and then fell motionless to the floor.

Fortunately, these events are rare. Most cervical spine surgery is needed because of wear and tear that affects your discs over time. In younger adults, this tends to be a herniated disc, which compresses the nerve roots or spinal cord. And, as we age, we all develop bone spurs to varying degrees (the “gray hair of the neck”). These spurs can be a source of nerve root or spinal cord compression, as well.

Cervical spine procedures are typically performed through the front of the neck, or anteriorly. In the United States, the primary surgical technique for the past 50 years has been the anterior cervical discectomy and fusion (ACDF). Since bone spurs form at the margins of the discs as they degenerate, these operations involve a discectomy, or the removal of the entire cervical disc, plus any bone spurs that border the discs.

Over the last two decades, spine surgeons at Emory have been leading the way in performing several innovative cervical spine procedures: laminoforaminotomy, artificial cervical disc, and laminoplasty. These procedures are performed from the back, or posteriorly, and don’t require a spinal fusion, thereby allowing patients to retain range of motion in the neck and also get back to their normal activities more quickly.

How do surgeons at Emory determine if one of these procedures might be right for you?

The first, laminoforaminotomy, is reserved for disc herniations that sit far enough to the side of the spinal canal that they do not compress the spinal cord. This procedure has been performed for many years, but new technology is allowing it to now be done using a minimally invasive microsurgical technique.

The second, for patients who meet the right selection criteria, is an artificial cervical disc, which may be inserted in place of the traditional bone graft with a plate and screws. This artificial disc is a moving part that’s ready for use when the patient wakes from anesthesia. Essentially, this procedure is a “get up and go” operation that avoids most of the limitations we traditionally impose on fusion patients while they heal. The artificial cervical disc is a ground-breaking option that has been very successful in clinical trials, many of which took place at Emory. Like any novel technology, longer term follow-up is needed to fully assess the risks and benefits of artificial cervical discs. But the data thus far are quite promising.

The third procedure, laminoplasty, is most often used in patients who are older and have three or more levels of spinal cord compression that would usually take three or four fusions. During this procedure, which is performed from the back of the neck, the roof of the spinal canal is re-shaped to provide more room for the spinal cord without the need for fusion. A mini-plate device, developed by surgeons at Emory Spine Center, is used during this procedure – allowing patients to move their necks right away after surgery, speeding up rehabilitation.

If you have been told you need cervical spine surgery, I would encourage you to contact the Emory Spine Center for an appointment to learn more about these innovative procedures.

Have you had or are you going to have cervical spine surgery? We’d like to hear about your experience. Please take a moment to give us feedback in the comments section below.

About John G. Heller, MD:
John G. Heller, MD, Baur Professor of Orthopedic Surgery and spine fellowship director, specializes in the research and development of instrumentation in cervical spine surgery, including disc arthroplasty and laminoplasty plates. He is the past-president of the Cervical Spine Research Society. Dr. Heller started practicing at Emory in 1989.

As an Academic Medical Center, Emory Provides Superior Spine Care

Dr. Scott BodenI am often asked questions like “Will YOU actually be doing my surgery?” and “Does a teaching hospital mean someone will be practicing surgery on my back?” These questions made me realize that many patients don’t understand what it means to receive care in an academic medical center, so I thought I would try to explain this in more detail.

Most of the differences in a true academic medical center, especially for a spine center, represent benefits that the patient may not even realize. First, to be a physician at an academic medical center, the surgeon also must be a professor, usually in a School of Medicine. As part of the medical school faculty, these physicians, in addition to taking care of patients, are teaching surgical techniques to the future generation of surgeons and/or performing research that is allowing for new discoveries and advancements in the field. This means that patients are exposed to the latest advances in surgical techniques and technology.

In addition, because of the teaching process, the patient will likely have a second MD assisting (helping retract and hold tissues), rather than just one surgeon and a nurse or surgical assistant. I would liken it to a pilot and co-pilot flying an airplane. Spine surgery is serious business, with little room for error, so you can rest assured that at any reputable academic center (such as Emory), the key portions of the surgery will be performed by your surgeon.

A second benefit comes from the collaborative environment in a multidisciplinary spine center. At the Emory Spine Center, one of the largest in the U.S., there are physical medicine/rehabilitation, occupational medicine, psychology, orthopaedic surgery, and neurological surgery physicians all seeing patients side by side every day. This spectrum of physicians ensures that no matter what a patient’s spine problem may be, he or she is sure to find a true expert among the staff. This environment takes the worry away from the patient about which type of specialist to see.

All of the surgical and nonsurgical physicians working at the Emory Spine Center have been fellowship trained (which means they’ve received extra training to specialize in spine care) and spend the majority of their clinical practice diagnosing and treating only patients with spine problems. This level of sub-specialization is harder to find outside an academic center. In addition, academic medical centers usually have the resources to have the latest and highest quality imaging technology—which is also very helpful in spine care.

A third benefit comes from the fact that some of the toughest cases are referred to academic centers. As a result, these physicians have more experience with the toughest problems and rarest complications, so that in the unlikely event you do experience a complication, they are very comfortable diagnosing and managing it to minimize any long-term impact on your outcome.

Most of these and other advantages of an academic medical center typically go on behind the scenes, which is probably why so few people truly understand the difference.

How have you benefitted from spine treatment in an academic medical center? We welcome your questions and feedback in the comments section below.

About Dr. Boden
Scott D. Boden, MD, Director of the Emory Orthopaedics & Spine Center and Professor of Orthopaedic Surgery, is an internationally renowned surgeon, lecturer, and teacher and the driving force behind the Emory University Orthopedics and Spine Hospital (EUOSH). Dr. Boden started practicing at Emory in 1992.

Ironman Triathlete Back on Track after Lumbar Laminectomy

Dr. Tim YoonWhen it comes to spinal disorders, there’s good news for the weekend warrior who enjoys vigorous athletic training and competitive sports activities. Being in great physical shape plays a large role both in your recovery and getting you back to an active lifestyle.

Joann Pope, one of my current patients, has an impressive athletic resume. She completed the half Ironman in Panama City, Florida, 21 times straight. She qualified for the world-famous Hawaiian Ironman seven times and finished four times. But two years ago, at the age of 74, her back started hurting and she had to stop racing due to lumbar spinal stenosis.

Lumbar spinal stenosis is a degenerative condition that causes a narrowing of the spinal column in the lower back, known as the lumbar area. This narrowing occurs when the growth of bone or tissue or both reduces the size of the openings in the spinal bones. This narrowing can squeeze and irritate the nerves that branch out from the spinal cord. It can also squeeze and irritate the spinal cord itself, causing pain, numbness, or weakness, most often in the legs, feet, and buttocks.

You might think that the physical stress of being a triathlete took its toll on Joann’s back, but that isn’t the case. In fact, if she hadn’t been in such great shape, her spine might have begun degenerating long before it did. For more than 20 years, Joann has been running, biking, and swimming. She was 47 when she started running, back in 1984. After she ran the Boston Marathon, her daughter talked her into doing a triathlon, the ultimate endurance test – a grueling three-part race with no stops.

So, thanks to her level of fitness, it’s as if Joann has the body of someone 20 years younger. Despite her active lifestyle , the lumbar stenosis progressed, and Joann’s pain, which came on slowly, continued to get worse.

Before Joann came to see me, she’d been experiencing lower back pain for a year. To address it, she’d been taking pain pills twice a day and was undergoing physical therapy, the first line of defense for lumbar stenosis. But when therapy didn’t ease her pain, her physical therapist told her she needed to see a surgeon. She chose to come to the Emory Orthopaedics & Spine Center.

In July of 2010, I performed a lumbar laminectomy and fusion on Joann. This procedure, also called a decompression, relieves pressure on the spinal cord or spinal nerve by widening the spinal canal. In Joann’s case, I removed the portion of the bony roof of the spine, or lamina, that was pressing on her lumbar nerves. Then I fused the two lowest lumbar vertebra, L4 and L5, with screws. When she woke up, the pain she had before surgery was gone.

Because Joann had been in such great physical shape before the surgery, she recovered rapidly and was swimming and walking again quickly. Now she’s walking two miles a day and is working up to getting back on her bike. Joann remains pain free and plans to go back to racing.

Have you had a lumbar laminectomy, or would you like to learn how spine surgery at Emory can get you back to the active life you enjoy? We welcome your questions and feedback in the comments section below.

About S. Tim Yoon, MD:
S. Tim Yoon, MD, PhD, specializes in minimally invasive surgery and cervical spine surgery. He is board certified in orthopedic surgery. Dr. Yoon started practicing at Emory in 2000.

Outpatient Spine Surgery? You Bet!

Dr. Tim YoonMany people have misconceptions about spinal surgery. They think spinal surgery has to be a big operation or that the recovery time after surgery has to be long. The truth is that there’s a common spinal surgery we perform as an outpatient procedure here at Emory, and with it we get great results. It’s called a lumbar microdiscectomy.

A lumbar microdiscectomy may be right for you if:

  • You have leg or foot pain, weakness, or numbness.
  • You’ve tried epidural steroid injections and they just don’t work.
  • An MRI has shown that you have a disc herniation that needs surgery.

What happens during a lumbar microdiscectomy? A lumbar microdiscectomy takes an hour or less of surgical time. In most cases, you can go home the same day you have surgery—usually within a few hours after the procedure. During the procedure, your surgeon removes the small portion of the disc that has herniated (protruded) and is compressing the nerve root to relieve the neural impingement causing your pain or weakness.

Lumbar MicrodiscectomyTo reduce surgery and recovery time, we use minimally invasive techniques, including:

  • anesthesia designed for outpatient surgery
  • x-ray guidance to make the most ideal incision
  • the smallest incision possible
  • a powerful microscope for better visualization through that small incision

After the surgery, you’ll be able to walk and do non-strenuous activities right away.

Our success rate at Emory for a lumbar microdiscectomy is very high, with patients often experiencing complete relief of pre-operative leg pain immediately after surgery.

Have you had a lumbar microdiscectomy, or would you like to learn more about minimally invasive spine surgery at Emory? We welcome your questions and feedback in the comments section below.

S. Tim Yoon, MD, PhD, specializes in minimally invasive surgery and is assistant professor of orthopedic surgery and chief of Orthopedics at the Veterans Administration Medical Center at Atlanta. He is board certified in orthopedic surgery. Dr. Yoon started practicing at Emory in 2000.

Been Told you Need Spine Surgery? Be Sure to Get a Second Opinion

If you’ve been told you need spine surgery, here are some thoughts to consider first:

1) 90% of back/neck problems will resolve without surgery.

2) Rates of recommending surgery for the same problem vary widely in different parts of the country (and world), suggesting that the indications for surgery are not always clear.

3) Some spinal conditions have a high success rate after surgery, while other spinal conditions have less predictable success rates following surgery.

4) 98% of all spine surgery is technically elective surgery, meaning it should be the choice of the patient, not something mandated by the surgeon.

Patients should always take an active part in the decision-making process for spine surgery. You need to be sure you understand the likelihood of success, the possibility of residual or worsened symptoms, the risks of anesthesia, the risks of the spine surgery itself, and chances of recurrence in the future. If your surgeon has insisted that you must have an operation or has not discussed all of the points above with you, then you may benefit from a surgical second opinion.

Have you been told you need spine surgery? Have you already had spine surgery? Let us know about your experience. We welcome your questions and feedback in the comments section below.

About Scott D. Boden, MD:

Dr. Boden is the Director of the Emory Orthopaedics & Spine Center and Professor of Orthopaedic Surgery, an internationally renowned surgeon, lecturer, and teacher and the driving force behind the Emory University Orthopedics and Spine Hospital (EUOSH). Dr. Boden began practicing at Emory in 1992.

Minimally Invasive Spine Surgery

Many patients ask me if they are a candidate for minimally invasive surgery or laser surgery or video-assisted surgery. The answer is that it really depends. It depends on the diagnosis, the number of levels of discs involved, the specific anatomy of the individual patient…the list of issues to consider is very long. However, whenever possible, I use minimally invasive techniques to reduce the pain and overall recovery time after the surgery.

A wonderful illustrative case involves Billy Rider, a 77-year-old gentleman who had been very physically active his whole life. Mr. Rider’s pleasures in life included taking walks and gardening. Unfortunately, he developed spinal problems and had so much pain in his back and legs that he just couldn’t do the things that gave him joy. He could stand or walk only for very short intervals. Conservative treatments had failed, and things were getting worse. His x-rays showed a significant curvature (scoliosis), and his MRI showed multiple areas of spinal narrowing (lumbar stenosis), causing nerve pinch.

At his age and considering the extent of Mr. Rider’s problems, some surgeons may have said no to surgical treatment or compromised and performed only part of the necessary surgery. However, I thought that by combining minimally invasive surgery methods with traditional surgery, it would be possible to reduce the overall “hit” to Mr. Rider’s body. Mr. Rider, his family, and I carefully went over the options and risks and potential benefits and decided to go ahead with the surgery.

The surgery was divided into two separate days to decrease the overall stress on Mr. Rider. On the first day, we performed “anterior spinal fusion” from L1 to L5. This was done in a minimally invasive manner to place “cages” between the vertebra to regain the height that he had lost and straighten out his scoliosis significantly. Mr. Rider recovered well from this and was able to get out of bed right away. His spirits were high.

About three days later, we did the bigger surgery on Mr. Rider’s back. This involved doing the traditional laminectomies to decompress his nerves that were “pinched” by the lumbar stenosis. We then placed in screws, rods and cages to stabilize the whole curve– from T10 down to the sacrum (part of the pelvis). We were able to reduce the amount of soft-tissue injury because we had already completed much of the fusion work on the first day. It was tougher for him to recover from the second surgery, but he did much better because of the less invasive techniques we used. As a result of the surgery, he has excellent curve correction and overall alignment. He recovered nicely and was discharged to go home.

Now, when I see him in the office, Mr. Rider is one of my happiest patients because he can walk without pain, and can work in his garden again.

Have you had or are you considering having minimally invasive spine surgery? We welcome your questions and feedback in the comments section below.

About S. Tim Yoon, MD, PhD:

Dr. Yoon specializes in minimally invasive surgery and is assistant professor of orthopedic surgery and chief of Orthopedics at the Veterans Administration Medical Center at Atlanta. He is board certified in orthopedic surgery. Dr. Yoon started practicing at Emory in 2000.