Spine Surgery

During the early part of December, I had the privilege of being a visiting professor at NYU. I lectured for the New York University Hospital Joint Division of Spine Surgery on the following topics: “Intraoperative Spinal Navigation” and “Upper Cervical Spine Trauma.”

Intraoperative Spinal Navigation is basically the GPS system in the operating room that allows us to see anatomical structures in 3 dimension on a computer screen and navigate or see our instruments in relation to anatomical structures.

The information given during the Upper Cervical Spine Trauma presentation included the diagnostic evaluation and treatment of upper cervical injuries for the occiput to C2.

In a prior blog entry, I highlighted a meeting the IMAST continuing education meeting that I participated in late this summer. (link to prior blog entry). At this meeting, a few talks/topics that I presented or facilitated discussion on included:

·         A paper that I co-authored on Cervical Spondylotic Myelopathy Study: Perioperative Complication Rates Associated with Surgical Treatment Based on a Prospective Multicenter Study of 302 Patients

·         At a debate on Multilevel Cervical Stenosis in the Straight Spine: Optimal Treatment, I presented the viewpoint of Anterior Decompression, Instrumentation and Fusion as the optimum spine surgical treatment.

·         I also moderated an instructional lecture on Options in Cervical Motion.

This November, a few chapters that I co-authored on spinal navigation were included in the Handbook of Spine Surgery published by Thieme Publishers. This book is a continuing medical education resource for spine surgeons. One chapter was on Spinal Navigation, which was included in the “Clinical Spine Surgery” section of the book. The other chapter in the “Surgical Techniques” section was on Facet Screw Fixation/Fusion.

This spine surgery educational book provides principles and techniques of spine surgery. Included in the book are sections on clinical spine anatomy, clinical spine surgery, spinal pathology and surgical techniques.

For more information or to order this spine surgical educational resource, visit this link.

I recently co-authored a chapter on Cervical Arthroplasty. This chapter was included in the book Advanced Reconstruction: Spine edited by Jeffrey Wang and published by the American Academy of Orthopaedic Surgeons and North American Spine Society.

This continuing medical education book highlights the way that spine surgeons handle complicated spine surgical cases. Chapters provide detailed step-by-step guidelines on spine surgical procedures. In addition to surgical guidelines for each procedure – this medical education resource also provides indications, contraindications, alternate treatment, results, surgical techniques and post operative information for the procedures.

In addition to the chapter on cervical arthroplasty, there are over 60 spine surgical procedures addressed. A few other spine surgical procedures in the book include Anterior Cervical Discectomy and Fusion, Cervical Laminectomy and Fusion and Posterior Lumbar Interbody Fusion. To review the complete table of contents, visit this link.

For more information or to purchase this book, visit this link.

This blog entry is part of a series of interview responses provided by Kevin Macadaeg, MD, a minimally invasive spine specialist with Indiana Spine Group. Dr. Macadaeg was recently interview about back pain and spinal treatments.

What are some of the different causes or reasons for chronic neck or back pain? What would you say is the most common cause of back or neck pain?

The most common causes of chronic neck or back pain are degenerative disc disease and degenerative spondylosis (degeneration of the spinal joints, development of bony spurs, disc degeneration and calcification of spinal ligaments).

Other causes include herniated disc, spinal stenosis (narrowing of the spinal canal) and spondylolisthesis (slipping of a vertebra).

What are the different options available to treat this type of pain?

Please join us, as we celebrate the grand opening of Indiana Spine Group's
new Carmel facility. Thiscelebration will include tours, health information,
refreshments and giveaways.

November 19, Saturday | 2 - 5 p.m. | 13225 N. Meridian Street, Carmel, IN 46032

(located east of Meridian at W. Main and Pennsylvania Avenue)

Our new Carmel facility provides comprehensive spine care in one centralized location. This includes:

• Patient diagnostics and treatment,
• Physical Therapy,
• Imaging Center,
• North Meridian Surgery Center,
• Medical Academic Center,
• Cafe, and more.

For more information, call (317) 228-7000 or send an email to info@indianaspinegroup.com.

Earlier this year, I was asked to present at the fourth annual meeting of the Lumbar Spine Research Society.

At this meeting, held in Chicago, I facilitated the discussions on the following papers: 

• the “Functional Outcomes and Height Restoration For Patients With Multiple Myeloma–Related Osteolytic Vertebral Compression Fractures Treated With Kyphoplasty”
• “The  The Effect of the Alpha‐2 Agonist Brimonidine on Intraocular Pressure During Prone Spine Surgery”

A recent reader submitted a billing question about spine surgery.To have specific insurance, self pay and billing questions answered to please call (317) 228 -7000 and ask to speak to the billing specialist.

In May, I had the honor of being an invited faculty member at the 4^th Annual Dubai Spine Masters continuing medical education program. This “Spine Trauma Masters Update” was held in Dubai, and included  spine surgeons from 70 different countries who are leaders in spinal trauma.

At this meeting, I lectured on the Rationale and Overview of Minimally Invasive Spine Surgery in Spinal Trauma, and Balloon Assisted Endplate Reconstruction (BAER) for TL Burst Fractures. I also moderated a case discussion on thoracolumbar spine trauma.

In this blog, I included a picture of the Health Minister of the United Arab Emirates. At this meeting, he gave the opening address and welcomed the attendees.

Congratulations to Rick Sasso, MD, a spine surgeon with Indiana Spine Group, on his recent patent assignment. This patent, filed in 2007 was approved in September 2011. US Patent number 8.016,831 is for” instruments and techniques for guiding instruments to a spinal column.”

This patent is related to spine surgery instrumentation and  techniques for anterior cervical discectomy and spinal fusion, as well as safely and accurately placing cervical artificial discs replacements into the intradiscal space. For more detail about this patent, visit this link.

Congratulations to Rick Sasso, M.D., Indiana Spine Group spine surgeon, for his recent publication of a chapter in Rothman Simeone The Spine – 6^th edition. Dr. Sasso co-authored a book chapter on “Cervical Disc Replacement”.

The Spine provides spine surgeons a continuing medical education resource to help them achieve optimal outcomes in the clinical practice of spine surgery for adults and pediatric patients. This resource includes chapters contributed by international experts on spine surgery, and highlights state-of the-art treatments and surgical techniques.

For more information about this resource, visit .

This past spring I had the honor of presenting at the annual continuing medical education meeting of the American Association of Neurological Surgeons / CNS Section on Disorders of the Spine and Peripheral Nerves. The focus of this medical education meeting, held in Phoenix, was Evidence-Based Spine Surgery in the Real World.

At this medical education program I was a faculty member for a section on cervical myelopathy, and presented on Myelopathy at the CVJ. This course reviewed and discussed the evaluation and treatment algorithms of cervical myelopathy and discussed surgical approaches. Additionally, etiology, pathogenesis and diagnosis of cervical myelopathy were reviewed. A few of the continuing medical education objectives of this session are outlined below.


Participants will be able to:

•  Synthesize appropriate anatomy and biomechanics of the cervical spine.
•  Differentiate the methods for diagnosis of neck disorders.
•  Apply operative and non-operative treatment options for cervical spine       disorders. 
• Recognize and respond to complications of surgical treatment, and more.

I co-authored a book chapter on “Cervical Disc Replacement”, that has been recently published in Rothman Simeone The Spine – 6^th Edition.

The Spine is a continuing medical educational resource for spine surgeons and highlights state-of-the-art spine treatments and spine surgery techniques. In addition to the text, there is also a video resource for physicians highlighting different surgical techniques and procedures.

Some sections of this book include: Basic Science, Spinal Diagnosis, Surgical Anatomy and Approaches, Thoracic and Lumbar Disc Disease, Minimally Invasive Surgery, Spinal Stenosis, Spinal Fusion and Instrumentation and more. For more information about The Spine and a table of contents, visit this link.

·         Sixteen patient exam/treatment rooms.

·         Imaging suite that will include MRI and CT scanning.

·         Physical therapy suite, that includes equipment selected specifically for treating spinal conditions. In addition to physical therapy treatment, services will also include therapeutic exercise and other spinal-focused physical therapy programs.

·         Outpatient surgery center with three surgical suites specifically designed for spinal surgery, two minimally invasive procedure rooms, and associated support and recovery areas.

·         Medical Academic Center (MAC) that will include a dedicated, state-of-the-art, bio-skills lab with ten fully-equipped work stations. This lab will provide both a local and national resource to physicians and health care professionals for hands-on medical procedure training. Additionally, the MAC will include a 65-seat auditorium, multi-purpose area for receptions/meetings and conference/board rooms.

·          Multiple patient waiting areas, which will include a library / video room, children’s area, and a café.

·         Administrative support areas that will include corporate administration and staff offices, physician offices, medical records, medical research and more.


Other Indiana Spine Group Office Locations
When this new Carmel facility opens, the Harcourt Road office will be closed.
 
In addition to the Carmel office, patients can be seen at their Indianapolis (8040 Clearvista Pkwy, Suite 400, Indpls 46256) , Kokomo (307 S. Berkley Rd, Kokomo, 46901) and Anderson (2101 Jackson St, #203, Anderson, 46016)locations.

For more information about this new facility, visit this link.

For more information about Back Talk, call (317) 228-7000, or visit this link.

Back Talk | A Comprehensive Review and Practical

Approach to Spinal Diagnosis and Treatment

During this current session Paul Kraemer, MD, a spine surgeon with Indiana Spine Group, will address the many myths and insights of spine surgery. This includes the what, when and why. A few topics that will be reviewed include evidence-based research documenting the indicators for spine surgery. Dr. Kraemer will also review the criteria for patient selection for spine surgery. A few of the common misconceptions of spine surgery that will be discussed include age appropriateness, rest requirements, postoperative pain and bracing.

Back Talk | A Comprehensive Review and Practical

Approach to Spinal Diagnosis and Treatment

One challenge to physicians is ongoing back pain following spine surgery. This session will provide attendees a better understanding of failed back syndrome / post-laminectomy syndrome.

During this continuing medical education session during the Back Talk spine symposium, speakers will discuss the contributing factors and causes of failed back syndrome. Additionally, the medical and interventional treatments for failed back syndrome will be reviewed – their indications and expected outcomes. One treatment that will be discussed is spinal cord stimulators. Indications for salvageable spine surgery and the outcome predictors will be reviewed.

Faculty for this continuing medical education session includes minimally invasive spine specialist Jonathan Gentile, MD, and spine surgeon Thomas Reilly, MD, FACS.