In the recent D Magazine Medical Directory, the Center for Spine Care physicians were prominently interviewed for the “Ask The Experts” section on Spine Health.
Q: What does minimally-invasive spine surgery really entail?
A: Minimally invasive spine surgery is used loosely and means different things to different people. The major difference in minimally invasive spine surgery is that it does not interrupt the nerve or blood supply to normal tissue. Rather, it confines treatment to the pain source or pathology and is performed with small incisions with minimal blood loss so patients quickly recover. In addition, minimally invasive spine surgery needs to be safe, utilizing small, effective tools to enter the spine with anatomic visualization. True minimally-invasive spine surgery requires extensive surgical expertise, experience, training, and is accompanied by a steep learning curve. It requires constant diligence, training and updating of skills. It is the entire approach of accurate diagnosis, specific treatment options, precision surgery, and spine directed rehabilitation that make minimally invasive spine surgery work. Without all elements working complementary, it is not minimally invasive surgery.
“Beware of someone who has taken a weekend course on this,” says John Peloza, M.D. “Minimally invasive spine surgery requires years of extensive training and vigilant refining of techniques to perform this safely without complications. This is for dedicated spine specialists who train their entire careers to get to this point.”
Q: Is evidence-based medicine or clinical research important?
A: Evidence-based medicine is a systematic approach using the scientific method to determine which treatments work best for specific conditions. There is a specific methodology to not only prove the treatment works or does not work, but also to grade the quality of the studies. Evidence-based medicine is essential to clinical decisionmaking. One needs to understand the scientific method, statistical analysis, and significant clinical experience in order to make evidence-based medicine accurate and useful. In our practice, we have been involved in evidence-based medicine for years as part of FDA trials as well as research groups. We also contribute to large outcome databases and have tracked our own outcome data for all of our surgical procedures. Because we know our outcome data, we can help patients make informed decisions and understand the value (outcome and costs) of their care.
Because of the valuable clinical data that we have collected for years regarding our minimally invasive technologies, we are able to offer patients options and predictably successful outcomes.
“At CSC, we specialize in identifying the source of pain and treating it conservatively,” says Nathan Walters, M.D. “Usually, our patients get better with conservative care and need nothing else. Conservative therapy may include a variety of things, from physical therapy to injections or medications.”
The Center for Spine Care (CSC) has been on the true forefront of spine medicine since 1996 by being pioneers of true minimally invasive surgical technologies and by utilizing comparative effectiveness research. CSC collects clinical research data on all of its treatments and procedures, and therefore is able to diagnose and offer patients options based on this research.
“We use the latest, modern technologies such as Intraoperative 3-D Image scans and small instrumentation. The tools are in perfect position so we can perform minimally invasive surgery while looking at a screen,” says Michael J. Musacchio, Jr., M.D. “This enables us to perform spine surgery with incredibly small exposures and increased accuracy, making the surgery safer and the patient recovery minimal. In very rare instances do we have to open the spine anymore during surgery.”
Michael Musacchio, Jr., M.D., is a neurosurgeon specializing in minimally invasive spine surgery.
Nathan Walters, M.D., is director of pain management and specializes in conservative treatments..
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