Spine

Lawrence + Memorial Hospital has a long history of specializing in advanced, minimally invasive spine surgery and is certified by the Joint Commission for cervical, thoracic, and lumbar spinal surgery. Spine Center neurosurgeons bring a high rate of successful outcomes to patients, reducing their pain and allowing them to live a more active life.

Spinal fusion surgery is an option for patients who no longer get relief from other treatments, and are experiencing chronic pain or impairment due to spinal instability, unstable fractures, deformities of the spine or spondylolisthesis.

The Lawrence + Memorial Hospital neurosurgery team delivers exceptional clinical care in a compassionate and supportive environment. Known for its quality of care, the team includes specially trained neurosurgeons, nurses, physical therapists, physician assistants, nursing assistants, rehabilitation specialists, case managers and the program coordinator.

We have a pre-operative patient education program and our program coordinator guides each patient from the time the surgery is booked until after the patient returns home from the hospital or short-term rehabilitation. Patient support services include making discharge arrangements and coordinating home care and rehabilitation services.

An option for surgical patients is autotransfusion, enabling a patient’s own blood to be transfused, if needed, during a surgical procedure. This may reduce the need for a transfusion from donated blood and risk of infections that can result from traditional blood transfusions.

Enhanced Recovery After Surgery Pathway

To optimize a patient’s recovery after spine surgery, our multidisciplinary team follows an enhanced recovery after surgery (ERAS) pathway. This pathway uses best practice elements before, during and after surgery, helping patients feel better, faster. Patients generally have a shorter hospital stay with less pain and fewer complications. The goal is for patients to be in their best health as possible before spine surgery. Other core ERAS elements include opioid-sparing pain management techniques, and within several hours after a patient’s surgery both walking and return to a normal diet. The ERAS pathway is used with many spine surgeries including cervical, lumbar and thoracic.

Minimally Invasive Surgical Techniques

Neurosurgeons at Lawrence + Memorial Hospital perform minimally invasive spinal fusion through two or three small one-inch incisions using a tiny scope to guide the surgery. Miniaturized instruments and innovative techniques help protect surrounding tissue. This causes less trauma to the body and offers significant advantages to patients including:

• Quicker recovery
• Less blood loss
• Less scarring
• Less pain
• Faster return to normal activity

Back and Neck Surgery

Hundreds of thousands of people annually suffer from chronic neck or back pain caused by a degenerative disc in the spine that is either compressing the spinal cord or pressing on a nerve root. At Lawrence + Memorial, all types of treatments are considered to help patients, including physical therapy, braces, injections and medications. For patients who need it, surgery is one of the most effective remedies for this kind of pain.

Cervical Discectomy and Fusion

With an anterior cervical discectomy and fusion, the diseased portion of a herniated spinal disc is removed, and the adjacent portions of the spine are then fused together. At L+M, our skilled neurosurgeons are performing both traditional fusions as well as using artificial disc devices. The artificial disc surgeries involve placement of a stainless steel “ball-in-trough” device that mimics the natural behavior of a spinal disc. Benefits can include more mobility after surgery and less stress on adjoining discs. Anterior cervical discectomies are usually performed under general anesthesia. Typically, the patient will remain in the hospital for one or two days. They will generally recover to most activities within 2 weeks, and generally fully recover within 6-8 weeks.

Lumbar Discectomy

A Lumbar discectomy is a surgical procedure to remove part of a problem disc in the lower back. Discs are essentially the pads that separate the vertebrae in the back, and a lumbar discectomy is surgery to relieve the pressure on a nerve root caused from either a herniated or ruptured disc. Most patients are in the hospital for one day after surgery. Recovery can take several weeks and physical therapy is recommended two to three weeks after surgery.

Lumbar Laminectomy

Degenerative changes in joints and ligaments, particularly in elderly patients, can cause what is known as spinal stenosis. This occurs when large joints place pressure on nerves in the back, often causing pains that can shoot down into the legs. A lumbar laminectomy is designed to remove a small portion of the bone around a nerve or group of nerves, giving the nerve root more space and therefore reducing the irritation and pain. Patients can be in the hospital for a day or two, depending on their recovery. Patients are encouraged to walk shortly after their surgery, but full recovery can take weeks, and it is recommended that patients avoid excessive bending or lifting during their recovery.

Lumbar Fusion

Degenerative changes in joints and ligaments, and in the discs themselves, can also cause mechanical back pain. This is typically pain that is present with movement, less so at rest. Removal of the degenerative disc, and possibly removal of the pressure on the nerve roots, followed by instrumentation designed to remove movement at the effected joints, may be recommended.

Non-surgical Spine Treatment

Depending on a patient’s spine condition, varied symptoms such as pain, weakness, and numbness may be successfully alleviated with nonsurgical treatments, including rest, activity modifications, anti-inflammatory medications, physical therapy and home-based exercise.

Nonsurgical therapeutic injections to treat inflammatory conditions in the spine include:

• Cortisone (steroid) injections to relieve inflammation.
• Interventional physiatry to treat pain using anti-inflammatory injections into the spine, guided by X-ray for precise placement.

Advanced imaging technology incorporated within our spine services includes:

• Globus ExcelsiusGPS^® robotic navigation system has proven to improve patient recovery time and reduce hospital length of stay.
  • ExcelsiusGPS^® is used in spine procedures such as posterior screw and rod fixation. On the day of surgery, medical images are taken and imported into ExcelsiusGPS^®. These images are used by your surgeon to determine the size and placement of screws and create a surgical plan based on your anatomy. The surgical plan guides the rigid robotic arm to a specific region of your spine, similar to a planned route or pathway on a GPS. The surgeon uses this pathway or route to accurately place screws using instruments.
    
    Throughout the procedure, the surgical instruments and implants are continuously displayed on the screen for the surgeon and staff to monitor. This display allows the surgeon to view live feedback during your procedure.
    
    (According to Globus Medical)