Spine Surgery’s New Side

Spine Surgery's New Side

Spine Surgery's New Side

By approaching spine surgery from a different angle, surgeons help patients recover faster.

The disks that give the spine its flexibility are remarkable structures, but they’re not immune to change. Over time, they can weaken and break. These changes may lead to conditions that cause pain or make the spine curve abnormally, such as spondylolisthesis or degenerative scoliosis.

Physical therapy, medication and steroid injections help many patients find relief from disk-related back and leg pain, but others run the gamut of conservative treatments without success. For them, spinal fusion surgery to remove the deteriorated disk and shore up the spinal column is an option — and now, a minimally invasive one.

Splitting the Difference


Saint Joseph East, part of KentuckyOne Health, now offers eXtreme Lateral Interbody Fusion (XLIF®), a procedure that uses a 2-inch incision in patients’ left side rather than a larger one in the back.

James Rice, MD“Entering through the side allows us to split muscles instead of cutting them, as is usually done in a traditional fusion performed from the back, so patients experience less pain,” said James Rice, MD, a fellowship-trained spine surgeon at Kentucky Orthopedic Associates and Saint Joseph East. “Once we get to the spine, we remove the damaged disk and replace it with an implant containing bone substitute. The implant will support the spine while bone grows over the area to join the vertebrae. We may use screws or plates to hold the implant in place while fusion occurs.”

Patients typically spend at least one night in the hospital after XLIF, a shorter stay than with traditional spinal fusion. XLIF leaves patients with a smaller scar and allows them to regain mobility and recover faster. Patients can walk and drive short distances soon after surgery but should avoid heavy lifting and repetitive motion short term, according to Dr. Rice.

“When it comes to lower back fusions, individuals who opt to have XLIF are some of my happiest patients,” Dr. Rice said. “They have outstanding results compared with patients who have traditional fusions.”

Part of what makes eXtreme Lateral Interbody Fusion a safe, precise procedure is NVM5®, an electronic intraoperative monitoring system. NVM5 is like a high-tech road map for the surgeon. The system updates the surgeon in real time about the location and function of nerves — important information that helps reduce injury.

This article originally appeared in the 2017 Fall edition of One Health Magazine. Sign up for your free subscription.

If you are suffering from a bone or joint disorder or a sports related injury, an orthopedic specialist can help you get back on your feet. Find a provider near you today

Customizing Knee Replacements, One Patient at a Time

Customizing Knee Replacements, One Patient at a Time

Customizing Knee Replacements, One Patient at a Time

Thanks to robot-assisted technology, knee replacement procedures are tailored even more closely to each individual patient.

Is the idea of a knee replacement procedure daunting, despite living with severe daily joint pain? New technology available at Jewish Hospital, part of KentuckyOne Health, may help soothe those nerves. Stryker robot-assisted knee replacements get you home and back to daily life quicker and with less pain and scarring.

“Robot-assisted technology tells me the size of the total knee implant and exactly where it needs to be placed on the patient before I begin the procedure,” said Arthur Malkani, MD, orthopedic surgeon with KentuckyOne Health Orthopedic Associates. “We try to match the patient’s own bone anatomy using precise robot-assisted technology. This leads to better results for patients in both the short- and long-term.”


A Better Fit


Every patient and knee is different. The Stryker robot-assisted knee replacement system allows the knee replacement to truly be the best fit for each specific patient.

“I see real-time, 3-D information on a computer screen that helps me place the implants more accurately. It helps us do a better job for each patient,” Dr. Malkani said. “Suppose you are driving from Louisville to Little Rock, Arkansas. Think of what GPS does for you while driving in terms of information and peace of mind — with robot-assisted technology, it’s as if I have a GPS telling me what size I need and the best way to position the parts.”

Any patient who needs a partial or total knee replacement is eligible for the robot-assisted procedure.

“If a patient’s new knee is balanced and the implants are aligned optimally for them, they’ll be happier,” Dr. Malkani said. “Who wouldn’t enjoy faster recovery and less pain?”


Do I Need a knee replacement?


Almost 5 million individuals in the U.S. have undergone a total knee replacement surgery. Should you join them?

Knee replacement, a procedure that involves replacing damaged parts of your natural knee with artificial pieces, is one of the most commonly performed joint replacement procedure. Most people have it to ease pain associated with arthritis and to regain mobility. If you’ve reached the point where conservative methods are no longer enough to manage your pain, it may be time to consider knee replacement surgery.

Knee replacements aren’t for everyone, however. If you’re obese, live with any kind of nerve, lung or heart disorder, or have an infection in your knee, you may not be a candidate for the procedure. Have a conversation with your doctor to find out if a knee replacement is right for you.

Learn more about robot-assisted knee replacements, or call 844.318.4459. 

This article originally appeared in the 2017 Summer edition of One Health Magazine. Sign up for your free subscription.

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Taking a Swing at Elbow and Shoulder Pain

Taking a Swing at Elbow and Shoulder Pain

Taking a Swing at Elbow and Shoulder Pain

You don’t have to live with long-term problems related to your elbow and shoulder.

When your elbow or shoulder hurts, it can be hard to make it through the day, much less pursue activities you love. Arthritis, or the wearing down of the joint, can cause discomfort when the bones rub together. Sometimes arthritis results because of a prior traumatic injury, but the condition can also develop for no apparent cause.

Although it is not always possible to prevent arthritis from affecting shoulders and elbows, you can take steps to address your arthritis-related pain.

Addressing Arthritis-related Pain

“Many patients believe they will just have to live with consistent pain and disability associated with their shoulder or elbow,” said Ryan Donegan, MD, MS, divisional chief of orthopedics at Saint Joseph East, part of KentuckyOne Health, and orthopedic surgeon and shoulder/elbow specialist with Bluegrass Orthopaedics and Hand Care. “If you have consistent shoulder and elbow pain, see a provider with extensive training in these conditions — there are more options available for treatment than you might think. Shoulder and elbow reconstruction allow us to replace damaged anatomy in the joint with other materials, including the patient’s own tissue.”

The most common surgical procedure for elbow and shoulder pain due to arthritis is total joint replacement. Just like a replaced hip or knee, doctors remove the damaged elbow or shoulder and replace it with an artificial joint that allows for greater mobility and less pain.

Individual Care to Help and Heal

“Each patient’s case is different and requires significant time spent understanding the unique anatomy of the problem and how arthritis has affected the joint,” Dr. Donegan said. “An intensive review of X-rays, MRIs or CT scans prior to every surgery is necessary to deliver the best possible result.”

Most major shoulder and elbow reconstructive procedures require up to six months for complete recovery. However, the majority of patients feel significant improvement to their arthritis pain within days of surgery.

Though shoulder and elbow replacement surgery are less common than knee or hip replacement surgery, these procedures can have an extremely positive impact on patients’ lives. Each year, approximately 53,000 shoulder replacements and 3,000 elbow replacements are performed nationwide.

This article originally appeared in the Spring 2017 issue of One Health magazine. Receive more health and wellness news and information by signing up for your free subscription to One Health.

Download our joint pain guides to learn more about the symptoms and causes of hip and knee pain, treatment options available and when you should contact your health care provider.

From Couch to 5K

5K Training Tips

Tips for Couch to 5K Training

A guide to help you get from the sofa to the starting line.

Setting a clear, achievable goal for yourself — like participating in a 5K race, for example — can be the first step toward creating a healthier life.

A 5K is a 5 kilometer, or 3.1 mile, road race. Though a 5K is considerably easier to run than a half marathon or marathon, it still requires training and preparation for you to make it across the finish line.

Follow these tips from Neil M. Patil, MD, sports medicine doctor with Shea Orthopedic Group, part of KentuckyOne Health, and James Rollins, MD, orthopedic surgeon with KentuckyOne Health Orthopedic Associates, to help you on your way to conquering a 5K.

Sign Up

For some people, the hardest part is getting started. Signing up for an event like a 5K, even if it’s several months down the road, will help get you motivated.

Get the gear

Don’t skimp on good running shoes. They may be more expensive, but high-quality running shoes can help prevent joint problems sometimes caused by running.

Start slow

If you haven’t run before, it will probably take some time to get used to the activity. Give your body time to adjust. Start with what you can do, even if it’s just walking, and gradually increase your activity 10 percent each week. This will help you avoid overuse injuries.

“It’s never too late to become active. Even if you have chronic pain or other issues holding you back, a trainer or physician can help find activities suited to your needs and abilities,” said Dr. Patil. “Don’t let fear hold you back.”

Work Together

Tell others about the 5K you’ll be running. Better yet, ask someone to run it with you. This will give you a training buddy to help keep you accountable.

Go at Your Own Pace

It may be called a “race,” but that doesn’t mean you fail if you don’t finish near the top. Run, jog or walk if you need to. The goal is to finish.

“Tight hamstrings can cause lower back pain, meaning it is very important to stretch prior to and after finishing a run,” said Dr. Rollins. “You don’t have to run faster than everyone. Pick your own pace, and walk if your body is telling you to stop,” said Dr. Rollins.

Receive more health and wellness news and information by signing up for your free subscription to One Health magazine

Join KentuckyOne Health Sports Medicine Care Wednesday, July 26 at Medical Center Jewish Northeast for the free Training Program Kickoff for this year’s Urban Bourbon Half Marathon. Learn more and register to attend today.