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Did you know that back pain is the second leading cause of hospital admissions
in the United States? Think of all the time these people needed to take away
from work and home while they were hospitalized. While there will always be
some spinal conditions for which lengthy hospital stays are necessary, the explosive
growth in the development of minimally invasive spinal procedures is revolutionizing
the way many spinal conditions are being treated. The best part is, many of
these procedures can be done on an outpatient basis - and more and more of them
are being done in Spine Centers.
But what is minimally invasive spine surgery and what are Spine Centers? To
find out more, SpineUniverse interviewed Dr. Mick J. Perez-Cruet, Director of
Minimally Invasive Spine Surgery at Rush- Presbyterian St. Luke's Medical Center
in Chicago, Director of the Institute for Spine Care in Joliet, Illinois, and
Editor of the textbook "Outpatient Spinal Surgery" by Quality Medical Publishing,
Inc.
SpineUniverse: Dr. Perez-Cruet, can you explain what minimally invasive
spine surgery is?
Dr. Perez-Cruet: Minimally invasive spine surgery is a type of surgery
with the primary goal of returning patients to their normal activities of daily
living quickly, with minimal pain and discomfort.
It is called minimally invasive because the surgical procedures do not
cause as much operative trauma to the body. The technology now available to
spine surgeons allows us easier access to the spinal column while minimizing
surrounding muscle and tissue trauma. The incisions are smaller, operative time
and blood loss is less and the procedures do not cause as much post-operative
pain and discomfort for the patient. As a result, we can perform these surgical
procedures on an outpatient basis and patients can go home the same day!
SpineUniverse: What exactly is a Spine Center?
Dr. Perez-Cruet: A Spine Center is a freestanding surgical center designed
specifically for outpatient spine surgery. It's a "one stop shop" for people
with certain spinal conditions because all of their medical needs can be met
under one roof.
Most Spine Centers are affiliated with 8-10 neurosurgeons and/or orthopaedic
surgeons as well as several anesthesiologists, plus allied health professionals
such as Physical Therapists, and perhaps chiropractors. Most Spine Centers also
include:
1 - Surgeons' offices so patients do not need to go to one place for an office
visit and another place for their procedure.
2 - Experienced nursing staff with specialized training in caring for spinal
patients.
3 - Two to four fully equipped operating rooms with the latest fluoroscopic and endoscopic
equipment.
4 - Experienced administrative staff experienced in dealing with insurance claims,
workman's comp and managed care.
5 - Pleasant and comfortable waiting areas for patients and families.
6 - Many Spine Centers also utilize electronic record keeping to coordinate
and consolidate patients' appointments, medical history, etc.
SpineUniverse: What services are provided at Spine Centers?
Dr. Perez-Cruet: As I mentioned earlier, Spine Centers are designed
to be a one-stop shop for patients with certain spinal conditions. Since everything
is right there, patients no longer need to go to one end of town to see their
surgeon, the other end of town to have their procedure, and a totally different
town to receive other services such as pain management and physical therapy.
Specifically, Spine Centers can provide the following services:
Surgery
o Anterior cervical microdiscectomy
o Posterior cervical microdiscectomy, and
or foraminotomy
o Endoscopic cervical, thoracic, and lumbar spine techniques
o Lumbar microdiscectomy
o Lumbar laminectomy
o Minimally invasive spinal fusions
o Percutaneous pedicle screw instrumentation and fusion
o Vertebroplasty
Interventional Pain Management
o Pain management consultation and treatment
o Fluoroscopic guided epidural steroid injections (cervical, thoracic, lumbar,
or caudal) for radicular pain
o Sympathetic blocks (sphenopalatine, stellate, celiac, and lumbar)
o Fluoroscopic guided facet joints (zygapophyseal) and selective nerve root
injections
o Diagnostic dorsal root ganglion and median branch blocks
o Radio-frequency lesioning (ablation treatment of dorsal root ganglion and
median branch blocks)
o Cancer pain management
o Neuromodulation techniques (spinal cord stimulation implantation and management)
o Surgical implantation of intrathecal and epidural programmable fusion pumps
(opiods or baclofen)
Chiropractic Manipulation
Rehabilitation and Physical Therapy
o Rehabilitation specialist and therapy
o Exercise programs
o Fitness center
o Trigger point injections
o Botox injections
o Work strengthening programs
o Massage therapy
Imaging and Diagnostic Studies
o Plain films
o MRI/CT
o Myelogram
o EMG
o Nerve conduction studies
o Selective nerve root blocks
o Discography
o Lab tests
SpineUniverse: You have recently opened a Spine Center in your area,
how is it doing and what do your patients think of it?
Dr. Perez-Cruet: We are doing very well! We routinely ask our patients,
before and after their procedures, about their experience here and our responses
have been nothing but positive. They seem to really appreciate the fact that
everything they need is right here and that the staff and how the facility operates
is familiar to them. The fact that they are up and moving around again so quickly,
and can go home the same day, does wonders for their recovery.
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