CONCORD — Emerson Hospital recently expanded its capabilities in spine surgery, a field that has advanced during the past decade thanks to sophisticated diagnostic tools, innovative surgical techniques and the use of new devices. In addition to welcoming several highly-trained spine surgeons, the hospital has invested in state-of-the-art operating room technology, including neuro-monitoring, specialized instrumentation and fluoroscopy.
Richard Ozuna, M.D., Jeremy Shore, M.D., and John Sledge, M.D., who joined the medical staff in fall 2006, represent a new clinical interest in spine surgery at Emerson, as well as an approach that emphasizes collaboration with other specialists, a clear benefit to the individual with back pain. “Today we take a more interdisciplinary approach that involves pain management specialists, chiropractors, physiatrists and physical therapists,” said Ozuna. “We focus on understanding the precise source of the pain. As a result, we’re much better at managing the patient with back pain than used to be true.”
Managing those patients often means conservative treatment, such as a combination of medication and exercise, notes Bernard Pfeifer, M.D., an orthopedic spine surgeon who also joined Emerson last fall and, along with neurosurgeon Peter Dempsey, M.D., divides his time between Emerson and Lahey Clinic. “In deciding whether or not someone is a candidate for back surgery, we consider more than the presence of pain,” Pfeifer explained. “We look for clear evidence, such as nerve compression that causes weakness or numbness, spine instability or a slipped vertebra.”
While relatively few individuals with back pain are candidates for surgery, those who are often have an easier experience than they anticipated. The surgeons specialize in minimally-invasive spine surgery, which is associated with less pain and a faster recovery. “For example, we now perform microdiscectomy — surgery to repair a damaged disc — through a small tube,” said Sledge. “We accomplish the same surgery on the inside, but with far less trauma to the surrounding tissues.”
Spine surgery is being shaped by innovation. For example, Ozuna participated in the clinical trial that led to FDA approval of the first artificial disc, a metal-and-plastic device that provides the shock-absorbing properties of a natural disc. Emerson’s spine surgeons also offer innovative approaches to spinal fusion — surgery that fuses two or more vertebrae in order to limit motion and reduce pain.
“Today we often operate through 2-inch portals, and we often perform fusion surgery through the belly,” Ozuna noted. “Since we avoid disrupting the back muscles, patients typically recover more quickly.” Rather than retrieve the necessary bone graft material from a person’s pelvic bone, which can cause pain that lasts for months, today surgeons often use alternative sources, including the patient’s own stem cells, easily obtained through a needle.
Learning what works — and what doesn’t work — is as important as the advances in technology, Pfeifer said. “By performing outcomes research, where we gather and interpret data from patients who have had spine surgery, we are gaining a great deal of perspective on who should receive what kind of spine surgery.”
Emerson’s spine surgeons, including Robert Cantu, M.D., chief of neurosurgery and chairman of the department of surgery, offer “gold standard” procedures, as well as cutting-edge treatments, for fractures, degenerative discs, herniated discs, spinal cord compression, spinal stenosis and tumors. In addition to providing 24-hour spine care for emergencies, the hospital recently established an Interventional Pain Clinic that offers relief in the form of nerve blocks and epidural injections.
“We are pleased to bring additional expertise in spine surgery to the community,” said Sledge. “By being available at Emerson, we hope to save area residents from having to drive to Boston.”