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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Returning to the Field After a Soccer Injury

Returning to the Field After a Soccer Injury

Kelly Sawyers is passionate about her job as a soccer
coach. Thanks to Dr. Shah and the staff at Saint Joseph London hospital, she didn’t let a torn meniscus and ACL keep her off the field.

Kelly Sawyers, Soccer CoachKelly was coaching high school girls’ soccer for Whitley County when a scrimmage resulted in her injury. Having seen other athletes experience this before, Kelly said she knew almost immediately what had happened.

Treatment at Saint Joseph London

Kelly visited Saint Joseph London where Dr. Shah treated her torn meniscus and ACL.

“Dr. Shah was so professional and patient,” said Kelly. “He walked me through my X-rays and explained everything. He showed me what was torn and told me what it would look like after surgery.”

Dr. Shah provided Kelly with a list of at-home exercises that would prepare her for surgery, including walking and stretching to loosen the muscles that needed surgery. Kelly followed the exercise plan and received surgery within a month of getting injured.

“Dr. Shah fixed everything quickly and always made me feel comfortable,” said Kelly. “You could tell he really cared about me. He offered his phone number and said to call anytime with any questions. He explained every step of the process so that I was never blindsided.”

Recovering from Surgery

Kelly’s procedure was outpatient and she noted how Dr. Shah used small, precise incisions to minimize scarring.

“Before surgery, I was so nervous and emotional. I said to Dr. Shah, ‘Small cuts, small scars,’” said Kelly. “He kind of laughed and said ‘OK,’ but he didn’t let me down. My scars are smaller
than my pinky nail. And it made me feel good that he listened to what I had to say.”

Kelly is now working hard in physical therapy toward her goal of coaching soccer again in June. Dr. Shah is overseeing her therapy and providing protocol for her therapists to ensure she heals correctly. She is engaging in agility training and can already run more than a mile.

“The recovery process has been very encouraging,” said Kelly. “Dr. Shah pushes me toward my goals, but never pushes too hard. Best of all, he understands my passion for soccer and tells me that I will play again. He never says ‘no,’ he just says ‘in time,’ which keeps me going.”

Dr. Jay Shah is an orthopedic surgeon at KentuckyOne Health Orthopedic Associates at Saint Joseph London