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The World Leader In Minimally Invasive Spinal Surgery tm
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This is a copy of our brochure from 2001
MicroSpine is dedicated to the treatment and research of spinal disorders. Through modern arthroscopic techniques, procedures that once could only be performed through large open incisions now can be performed through portals the size of one’s finger. These minimally invasive spinal surgeries allow for a reduction in post-operative pain, recovery time, rehabilitation needs, and intraspinal scarring. Using laser technology, fiber optic scopes and high definition cameras, regions of the spine which otherwise couldn’t be seen, now can be operated on with great precision and with exceptional results. Only a handful of physicians in the world are capable of performing similar procedures, and even fewer have performed the thousands that our surgeons have. MicroSpine truly is the world leader in minimally invasive spinal surgery.
Unlike conventional surgery where incisions are 3 to 12 inches, MicroSpine’s procedures are performed through portals that are ¼ to ½ of an inch. There is little room for error and the correct diagnosis is essential to proper treatment. Our physicians are more accurate than most physicians in diagnosing your problem. Why can MicroSpine make a better diagnosis? The answer lies in the feedback that patients give us before, during and after the surgical procedure and correlating this information with the preoperative MRI and X-ray images. A correct diagnosis is essential when a small incision is used, so the problem must be accurately identified preoperatively to ensure a good outcome.
The physicians working at MicroSpine are board certified M.D.’s, trained at accredited American medical schools and residency programs. These qualifications guarantee that the best-trained physicians are caring for you.
MicroSpine utilizes an algorithmic system developed by our physicians to define your treatment plan. This allows for the most expedient use of our treatment system and helps everyone to understand what treatment options are suitable and with what likelihood of success. MicroSpine’s goal is to demystify complicated spinal problems by breaking down each component of the pain. By identifying each component of the pain, it allows our physicians greater insight into correcting the overall pain syndrome. MicroSpine wants to eliminate confusion for the patient, the physician and the insurance company, so that aspects of the pain syndrome will not be missed. This special systematic approach to each patient, along with our minimally invasive techniques, often allows us to resolve even the most complicated pain syndromes.
Anthony R. Mork, M.D.
Dr.
Anthony R. Mork, a native of
Prior to co-founding MicroSpine,
Dr. Mork was in private practice from 1982 to 1988 in
Dr. Mork is a board certified physician as a member of the American Board of Orthopedic Surgery since 1984. He is also a member of the North American Spine Society, Southern Orthopedic Association, and a charter member of the American Association of Minimally Invasive Spinal Surgeons.
Dr.
Mork has written numerous articles relating to Orthopaedic Surgery published in
Leading Peer Review Professional Journals. In addition, Dr. Mork has an
extensive international education including training at institutions in
Our Procedures
MicroSpine utilizes minimally invasive arthroscopic laser spinal surgical techniques to rectify most types of back and extremity pain. One might ask what this exactly means. The term minimally invasive refers to the fact that our procedures are performed through small incisions ¼ to ½ of an inch in size. The term arthroscopic refers to our usage of fiber optics and high definition cameras to visualize the tissues of the spinal column. Our physicians utilize lasers to provide very precise tissue ablation and to aid in coagulation during the procedure. MicroSpine’s physicians also have the capability of bone removal when indicated.
Our procedures utilize a dilating portal system, which gradually create a small opening down to the spine. Through this opening all of our equipment, such as lasers, magnification optics, suction, and surgical instruments are inserted. These tools are very small and require highly skilled hands to accomplish these highly complex procedures.
Once the portal is in place, the surgeon can begin removing the tissue that is compressing the nerve or spinal cord. Due to our specialized portals, we can even remove bone and scar tissue compressing the nerve. Because our fiber optics and portal system allow our physicians to approach the spine at a multitude of angles, our techniques offer our surgeons a better view of the spinal problem than most open back surgeries. Our technique allows portals to pass through the muscle and ligaments directly to the problem with minimal damage to surrounding tissues.
Due to the limited size of the portal that our physicians work through, it is very important that the surgeons are exactly in the correct location. This is why the correct diagnosis of your pain is so important. During conventional open surgery there is room for error. The surgeon can always enlarge the incision, but with the proper diagnosis and the proper plan, we can avoid large incisions and the longer recovery times that follow them.
This
is a very precise surgery, but for MicroSpine’s surgeons it is just a daily
occurrence. MicroSpine offers the most advanced spinal care available today.
Scott M.W. Haufe, M.D.
Dr.
Scott M.W. Haufe is originally from
Dr. Haufe received
his M.D. degree from the
Dr. Haufe is Board Certified in Anesthesiology by the American Board of Anesthesiology. He is also Board Certified in Pain Management by The American Board of Pain Medicine. Dr. Haufe has extensive training and experience in all aspects of Pain Management including surgical implantation of spinal cord simulators and morphine pumps, radio-frequency thermocoagulation, epiduroscopy and cryotherapy.
Prior to co-founding
MicroSpine, Dr. Haufe was Chief of the Pain Management Department at
Dr. Haufe is a member of the American Society of Anesthesiologists, the Florida Society of Anesthesiologists, the Themis Honor Society, the Golden Key Honor Society as well as the Phi Kappa Phi Honor Society.
Anesthesia and Pain Management
During the MicroSpine procedures, physicians utilize conscious sedation techniques. What this means is that you are awake but comfortable. The reason you’re awake is multiple. First, mild sedation is much safer than general anesthesia, and the recovery time is less. Secondly, by being awake, you help guide us during the procedure. You can tell us when all your pain is resolved or when we are stimulating that “old pain” problem area. This helps us locate the exact region of the nerve that is being compressed and aids in telling us when the nerve is probably adequately decompressed. MicroSpine has performed thousands of these cases and over 95% of the patients claim that the procedure was “a piece of cake”. In fact, our physicians developed the anesthetic protocol for these procedures.
During your treatment at MicroSpine, you may need to utilize the pain management department. There you may receive diagnostic blocks to help in confirming the diagnosis prior to surgery. Also, our physicians may help your perioperative pain with nerve root or epidural injections. Not everyone will require these Pain Management services but MicroSpine provides them if you do.
Dr.
Chris Kunis is our Board Certified Director of the Medical Services Department
and is vital to the proper management our patient’s health issues during their
treatment at MicroSpine. Proper evaluation dictates what surgeries you need to
give you the best results. To avoid delays and complications, the Medical
Services Department oversees all patient health issues, from medications to
diagnostic tests. If you have any concerns about your health as it pertains to
our surgeries, these doctors and nurses are here to assist you in answering your
questions.
MicroSpine
is located in MicroSpine Center, a nearly 20,000 square foot surgery center, in
the city of DeFuniak Springs, Florida approximately 25 miles north of the sandy
white beaches of Destin, Florida. Our location was chosen for a multitude of
reasons. Our physicians enjoy the beautiful region of the Emerald Coast of
Florida with its gorgeous beaches. Our center allows the physicians to have
hospital privileges at the nearby hospital without having to take call and work
excessive hours at night. This assures you that your doctors will be fresh each
day to focus and work on you.
Flights
into the region will utilize Pensacola Regional, Fort Walton Regional, or Panama
City International airports. The facility is within one hour of all of these
airports. Thus, if you’re flying in, you'll have several choices of flights to
choose from. There are a multitude of accommodations in the area and everything
you need is easily accessible. Also, most of the local hotels offer our patients
significant discounts.
A compilation of the most commonly asked questions and our responses
1. How
can you help me when others cannot?
Since we use minimally
invasive techniques, we can solve problems that are more difficult to resolve
with conventional surgery. Scar tissue is less, trauma is less, and therefore we
can usually solve the problem without making things worse. Also, our techniques
are so advanced that we can resolve problems related to disc, bone or scar
tissue.
2. I
have spinal stenosis; can I be helped?
Yes, our techniques work very
well for spinal stenosis and other disorders. We can remove small amounts of
disk and bone that are impinging upon the spinal cord. The removal of this bone
and soft tissue is under direct observation to assure that the nerve impingement
is resolved.
3.
What are my costs for your procedures?
Currently, Doctors'
Haufe, Mork, and Kunis are Medicare providers, but some of the facility charges
are not covered by Medicare. None of the physicians are currently providers for
any other insurance plans. The surgery center is currently developing
relationships with insurance companies and thus it may or may not be a provider
for your insurance. We will work with you and your insurance provider to get
approval for your surgeries, but there may be extra costs beyond what your
insurance company charges. MicroSpine never wants to financially over burden
you, and what we charge for our services is usually less than that charged for
conventional surgery. We will be honest and upfront as much as we can. We don't
give false hope, we give real hope and real answers, and we want you to be happy
with our service. If there is a financial problem, we will try our best to
work with you. Talk with one of our billing personnel and they can help clarify
any issue you may have.
4.
I have "scar tissue" causing pain; can I be helped.
Yes, we actually attempt to
manually remove scar tissue via our minimally invasive techniques. We have
been able to resolve nerve entrapment pain due to scarring from infection, prior
surgery, etc.
5.
Why don't other physicians perform these procedures?
Other physicians actually do
perform these procedures, but because this is a relatively new field, their
numbers are very few (less than 5 in the world to be exact, and besides our
center there is only one other facility in
6.
It sounds too good to be true; can I really get the results you claim?
Often people say if it sounds
too good to be true, then it is. Well this is the exception to that rule. We're
not miracle workers, but by using modern science and new techniques we can
perform procedures that some would call a "miracle". We have performed
thousands of these procedures, with very good results and we are currently in
the process of performing research to validate our claims.
7. What
are your results?
Obviously it depends on your
problem, if you have had prior surgery, and the amount of nerve damage you have
had. But to give a ballpark percentage, about 70 to 90% of our patients get what
they term as "good to excellent" relief. This compares to conventional
surgery where most get 50 to 70% "good to excellent" results. Also, if
you have never had surgery, you could expect to be closer to 90% successful
results
8.
Why are you located in DeFuniak Springs?
Many people ask this question
and the honest truth is the following: When Doctors Mork and Haufe left their
previous group to venture out on their own they didn't have the resources
to open a large center. Both doctors also wanted to avoid taking
"call" and working late hours which occurs at most hospitals. They
also wanted to live in
9.
What type of anesthesia is used for these procedures?
The anesthetic medications
place the patient in a comfortable, yet awake state. This allows you to
communicate with the surgeon as the procedure is commencing. When your pain has
been resolved, then we can be sure we have taken care of the problem. Also,
having the patient awake makes the procedure safer. There are less risks from a
sedation-type anesthesia than will a general anesthetic, and there are less
risks of nerve injury. But don't worry about being awake! We have performed
thousands of these procedures, and over 95% of the patients say "it was a
piece of cake" being awake.
10.
Why don't more physicians learn this new technology?
First of all, this is very
sophisticated surgery. Many surgeons would have trouble learning how to perform
these procedures. It is almost like fixing a car through the muffler, the
surgeon has to rely on scopes and cameras to guide him. Secondly, less than 5
people in the world perform these types of procedures, and therefore, there
aren't many physicians to learn from. Thirdly, many doctors get fixed in
how they treat patients. It is easier for them to treat patients with techniques
that they learned in residency training, than to take the effort and risks of
learning new techniques. As MicroSpine expands, more physicians and centers will
appear, and gradually this will be more common of a surgical technique.
11.
What is "So Bad" about conventional or open surgery?
The biggest problem with
conventional surgery is that it is too much surgery for most problems that occur
in the spine. Large incisions mean more scar tissue and scar tissue can become a
problem 6-12 months later and your pain may return. Also, with conventional
surgery you are under general anesthesia and it is only after you awaken that
one can be assured that the pain had been properly treated. Thus, you may awaken
from surgery and still have pain. Sometimes, a surgeon will recommend a second
surgery. If he does, ask him what percentage of success he gives for second
procedures. Often, the success rate for second open or conventional procedures
is very low, under 50%. With our procedures you are awake and you will tell us
if the pain is gone at the end of the surgery.
12.
Why haven't I heard about these procedures on TV or radio?
To be perfectly honest, the
media is often years behind scientific advancement. The media often only hears
of new techniques and procedures after they have been thoroughly evaluated,
published and even somewhat advertised. This is unfortunate, but the media
really doesn't have access to cutting edge science. The reason for this lack of
access is often due to "competition protective measures". For
instance, if a company is developing a new medicine or procedure, they may not
want anyone to know about it until they are actually marketing the product or
have the patent. Often, the media hears of scientific advancements only
after the medical center sends them a press release.
13.
My doctor says he's performs this kind of surgery. Why should I go to you
First of all, we specialize
in minimally invasive spinal surgery and nothing else. Secondly, ask your
physician as to whether he truly does this kind of surgery. If he says that
he performs percutaneous discectomy, IDET (Intradiscal electro coagulation
therapy, ELF procedures, or hemi-laminectomies, then he is only bordering on the
fringes of doing what we perform. We also perform percutaneous diskectomies, but
we have found that this only solves the problem in a relatively small amount of
the population. Most individuals require some "bony" work. This means
that just removing part of the disk would not solve the problem, or may only
temporarily solve the problem. Bone, scar tissue and disk may be compressing the
nerve and causing pain, numbness or weakness. If you don't resolve the entire
problem, then, at best, you'll just band-aid the problem until a later date, or
you won't resolve anything at all. Very few physicians perform percutaneous
arthroscopic spinal surgery where they can perform bony work and solve the
entire problem. As for IDET, we don't perform that at this time. The reasons for
this are because with our arthroscopic techniques, we can remove the disk
protrusion, and attempt to laser the external nerves that innervate the disk.
IDET does not have a great track record. The company's own literature only says
it reduces pain 2 to 3 points on a scale of zero to ten. Thus if you're a 10
over 10, IDET will only give you about 25% relief. That is why we don't
perform IDET; we just don't think it works. As for hemi-laminectomies, this is
not really minimally invasive spinal surgery. This falls into the category of
minimal convention open surgery since these surgeries still require 2-3 inch
incisions. Our techniques are performed in holes the size of your finger (1/4 to
1/2 of an inch) that are measured in millimeters, not inches.
14.
What do I have to do to get an evaluation and do I need to go to your center?
Often we can give you an
"preliminary evaluation" without even seeing you! Just contact us and
we will be glad to evaluate your MRI films, Free of Charge! Just make sure it is
a fairly recent MRI (within one year, and after any other surgeries or
injuries). We can give you a reasonable idea of whether you are a surgical
candidate or not, but we cannot tell you what needs to be done to solve your
problem. Prior to any surgery we will need to evaluate you at our center,
but at least you can get some information about what options you have. Expect
about one month for your MRI's to be received, reviewed and then a response to
be made. You can also e-mail us your films (by
scanning them) and or reports and we can usually tell you whether or not you are
a candidate for these procedures or not.
15.
How many procedures will I require to solve my pain problem?
Since our work is so
minimally invasive, we can only focus on one area of the spine at a time. Many
individuals only have one nerve being compressed and therefore only require one
surgery. Others may have extensive hardware or scoliosis that may require more
work. Thus the answer to your problem is very specific to you. Nonetheless, half
of all our patients will only require one procedure.
16.
How long will I have to stay at your facility when I come for surgery?
We prefer that you remain for
around 3 days post operatively. This is so we can be available if there are any
problems that need to be addressed. Rarely, do problems occur, but if they do,
such as bleeding, they usually occur right away. Obviously, it is easier to
rectify the problem if you're nearby versus if you're 3000 miles away. Of
course, we do make exceptions for special cases, but this must be addressed
prior to your arrival.
17.
Can I have my initial evaluation and then surgery, without having to make an
extra trip?
Yes, we have many patients
from around the world, and this is a frequent concern. We will book your initial
evaluation and then two days later your surgery. This is a tentative surgical
date, assuming your health is optimized and insurance is approved. Nonetheless,
many patients utilize this scenario to avoid repeat travels to our facility.
18. I have hardware; can you
help me?
Possibly, depending on the
situation, we can arthroscopically work around the hardware to rectify your
problem or utilizing our new endoscopic hardware removal system, we can possibly
remove a piece of the hardware to open up the neural canal. It is truly
dependant on the situation and each case is evaluated independently.
19.
I have scoliosis; can I be helped?
Probably, we have had great
success with scoliosis through our arthroscopic techniques, and we don't
require a fusion. We simply decompress the area that is impinging upon the
nerve. We cannot straighten the spine, but we can relieve the pain associated
with the curvature.
20.
What are my limitations after surgery?
Generally, we don't want you
to perform any excessive bending or heavy lifting (greater than 10 lbs.) for
about two to four weeks after the surgery. We encourage a gradual return to
normal activities over this period of time. Often, many individuals who have
desk type jobs can return to work within a week.
21. My
doctor wants to perform IDET or Myeloscopy; is this the same type of procedure?
Absolutely not! First of all,
IDET has a very poor track record. According to the manufacturer's own data
(which is often the most positive data), IDET only improves pain by 2 to 3
points on a 0 to 10 pain scale. Thus, if your pain is a 10 over 10 (which many
patients are), you could only expect to decrease to an 8 over 10. This only
represents a 20% improvement and is barely significant. In fact, many of the
original researchers in IDET no longer perform IDET because of the overall poor
results. As for Myeloscopy (or Epiduroscopy), few physicians perform this
anymore. Results with Myeloscopy are not any better than just performing an
epidural steroid injection. Most insurance companies don't even pay for
Myeloscopy (Epiduroscopy). Therefore, in our opinion, both IDET and Myeloscopy
will gradually fall out of use by pain physicians as soon as patients and
insurance companies realize they are mostly ineffective.
22.
How long will I have to wait to have surgery?
Generally, MicroSpine is
"booked" ahead for both evaluations and surgeries. Thus, if you
are interested in MicroSpine's procedures, expect a delay of a couple of months.
Occasionally, openings do occur, but do not rely on this.
23.
Where are the other physicians who perform these procedures?
In
24.
What special needs should I arrange for prior to my surgery?
You need someone to drive you
to your hotel after surgery. Under no exceptions can you drive the day of
surgery. You should bring enough clothing and health supplies for up to a week.
Bring your medications with you. If you live further than 30 minutes from the
facility (which most of our patients do), we recommend that you stay in a local
hotel for 3 days after surgery.
25.
I belong to a HMO; will you become a provider of my plan?
Unfortunately, the answer is
no. We are not providers for any insurance plans, except Medicare, but we do
accept most insurance as a partial payment. That implies, we will accept the
insurance's payment toward the overall expense. Unfortunately we couldn't afford
to join any plans. Insurance companies keep dropping what they reimburse
doctors. Currently, Medicare and most insurance plans pay doctors less than they
did twenty years ago, not including inflation. Since we are Medicare providers
your costs are only 20% over what Medicare pays, except for the facility fees.
26.
My physician says he can "burn or destroy" my nerves to give me
relief?
This is commonly called Radio
Frequency Lesioning or Rhizotomy of the nerves. The effectiveness of this
procedure depends on who is performing it. If you have a physician who doesn't
have the experience then your results will probably be 50-50. But, no
matter who performs this procedure, it generally doesn't last longer than 6
months. It is not a permanent solution. The problem is that the nerves tend to
re-grow. What we offer is a permanent solution to back and neck pain due to
arthritis. It is permanent in 80% of the individuals who undergo the procedure.
27.
What is Nucleotomy?
This is a procedure which
some surgeons utilize to "decompress" the disc. It involves inserting
a tube into the disc and aspirating the contents of the disc. The problem with
this technique is that it doesn't decompress the disc significantly. Therefore,
most doctors utilize discectomy procedures which are more advanced and actually
remove the fragment and decompress the disc about 10%. People may get relief
with Nucleotomy or it may only be short lived, but it is a viable technique
especially for back pain when a simple discectomy cannot be done.
28. What
physical therapy requirements will I have?
MicroSpine's goals are not
only faster resolution of pain disorders but only reductions in costs. Thus, we
have noted that many patients require little to no physical therapy
postoperatively. Some people do require rehabilitation but most do not. We
suggest a gradual return to normal activities over a few weeks and then
progressing after that.
29. What
are the disadvantages of your procedures?
Obviously our website
stresses the advantages of our Microspinology techniques, but what about the
disadvantages. There is really only one disadvantage, since we are working
through such a small portal, we can only address one problem at a time.
Therefore, if you have spinal stenosis at two levels, we would have to perform
two procedures. People often ask why we cannot perform multiple levels at the
same time. This is impossible because each level takes about two hours and there
is a limit to how long people can tolerate being awake on an operating table.
Nonetheless, it is important to remember that you will be up and about the same
day. Most people say that the discomfort of having multiple procedures is far
less than one conventional procedure. Also, about half of our patients only
require one procedure.
30.
What does the term Microspinology, Microspinotomy or Microspinoscopy mean?
Microspinology is the science
of minimally invasive spinal surgery. It involves microdiskectomy, and
microspinotomy. Microdiskectomy involves removal of disk material, while
microspinotomy involves removal of bone material. Many (about 70) surgeons
perform Microdiskectomy of the lumbar spine. About 5 to 10 perform
microdiskectomy of the cervical spine. About 3 perform true microspinotomy, and
only we perform endoscopic hardware removal. Although we perform all these
techniques, it is microspinotomy and that is our claim to fame.
Microspinoscopy
involves any aspect of minimally invasive spine surgery that utilizes
arthroscopic (endoscopic) techniques. A Microspinologist or microspinoscopist is
someone who specializes in these techniques. A microspinotomist is a minimally
invasive surgery who performs arthroscopic bony work on the spine.
31.
I have had prior surgery, can you help me?
Yes, In fact about 50% of our
patients have had prior surgery. Our success rates with prior surgery range from
50% for hardware fusion to 80% for bone fusions or non-hardware surgeries.
We are among the very few who are capable of Microspinotomy which is necessary
to resolve these problems. Others want to use pumps and stimulators to mask the
pain, we want to solve the pain.
32.
Why do I have to wait so long for an appointment or surgery?
When you are one of only two
or three centers in
33.
What do success rates for surgery really mean?
For the patient this is often
very confusing. Success rates mean that the operation was successful with a good
to excellent result. Good to excellent results imply that the patients problem
was either resolved or significantly improved upon. Thus when a surgeon tells
you to expect a 70% success rate this means that 7 out of ten people end up with
a good to excellent result. Now for the downside. with every surgery there is
the possibility of NOT having a good to excellent result. This is the remaining
number and may imply that the pain is unchanged or that you are worse off than
before. Thus, if 70% of the patients get good to excellent results, 30% will get
poor to negative results. Thus, out of ten people, 7 will be improved or cured
and 3 will be unchanged or worse. Many physicians don't tell you that you may be
worse off after the surgery, but there is a significant amount of people who
suffer from failed spine surgery syndrome. Conventional spine surgery has a 60
to 70% success rate and our procedures have about a 90% success rate in patients
without prior spine surgeries and a 50 to 70% success rate in patients with
prior surgeries. (note: we are still working on documenting our actual success
rates. the numbers expressed are from patient satisfaction forms and thus there
may be some bias that we are unaware of). The big issue here is that our
procedures have a better success rate than conventional surgery and very rarely
do we have any patients actually worse off after surgery. This is due to the
small amount of tissues removed. No surgery is perfect, but there are
definite advantages to different surgeries and every patient needs to be aware
of them.
34.
I have been told I have arachnoiditis or scar tissue, can I be helped?
Yes, we can remove the scar
tissue piece by piece to free the nerve. Also excessive bone and disc may be
removed to give more flexibility to the nerves and thus reduce pain. Procedures
such as epiduralysis, Racz procedures and Epiduroscopy generally have not be
proven to be any more beneficial than an epidural steroid injection. The
solution is to free up the nerve and provide more flexibility to the surrounding
tissues by decompressing the remaining bone.
35.
What medications should I avoid prior to surgery?
We recommend that medications
such as aspirin and other anti-inflammatory drugs be stopped 10 days prior to
surgery. These medications result in increased bleeding. Coumadin, Warfarin,
etc. are blood thinners and should be stopped 3 days prior to surgery. Plavix
should be stopped 7 days prior to surgery. We also recommend that Vitamin A and
E be stopped as well. Other medication should be taken with a sip of water (a
sip, not a gulp or a whole glass!). If you have any questions, do not hesitate
to ask us.
36. Are
your procedures similar to the ELF procedure? (Endoscopic laser foraminoplasty)
The name sounds the same but
the procedure is different. ELF procedures utilize a bone cutting laser to make
very small chips in the bone of the foramen or opening for the nerves. This
sounds great but in reality it doesn't work. These lasers only remove small
amounts of bone and have the risk of burning the nerves. There haven't been any
good reports on the success of this procedure. We actually remove enough bone to
totally decompress the entire foramen from the spinal cord outward, not just
chip away a little bone. It may seem like a semantic lesson, but even though the
names sound similar, the procedures are quite different. Our concern with the
ELF procedure is that the amount of bone removed is negligible and thus the
problem will remain.
37. Who can treat spinal problems better? A neurosurgeon or an orthopedic
surgeon?
There really is no good
answer to this since both sides will say they are better at treating spinal
problems. The real answer is that the better individual is the surgeon who has
more experience in treating spinal disorders. Both orthopedic surgeons and
neurosurgeons regularly treat spine problems but many only treat them
occasionally. The neurosurgeon who mostly deals with brain problems and the
orthopedic surgeon who mostly deals with shoulders and knees are probably not
the best choice for your back related problem. Experience is the key. Ask them
how many similar surgeries they have performed and what their success rate is,
not the success rate listed in medical journals. Don't be afraid to ask
questions.
38. Are there any Board Certifications relating to minimally invasive spine
surgery?
The answer to this question
is: Currently No. There are several organizations that offer pseudo-board
status but they are not recognized and in their current state they probably
never will be recognized. A physician can only claim to be board certified when
they are a member of a board that is recognized by the government. There are
many organizations that call themselves "boards" but they are not
recognized and thus are not official.
39.
What is a laminoforaminoplasty?
A laminoforaminoplasty means
literally an alteration of the lamina and the foramen. This means that the
lamina and foraminal canal are altered so that as the nerve root leaves the
spinal cord there is no impingement of the nerve. The lamina is the bone on the
back of the spinal cord and the foraminal canal is the hole through which the
spinal nerves exit the spinal cord. Enough bone is removed to create a window
that will prevent any further impingement of the nerve.
40.
What is meant by endoscopic hardware removal?
When we remove hardware
endoscopically our main objective is to alleviate any pain that the hardware may
be causing by pinching nerves. Only part of the hardware is removed and this is
performed via a 1/2 inch portal. Special cutting tools are used to slice through
the hardware and to cut it to a size that will allow it to be removed through
the small portal.
41.
What is an endoscopic discectomy?
An endoscopic discectomy is a
relatively common and simple procedure that many physicians around the world
perform. It involves the removal of a portion of the disc to rectify both back
and leg pain. The amount of disc removed is approximately 10% of the total of
the disc itself and therefore it is really a partial discectomy. A discectomy is
substantially different from a Nucleotomy in that the latter only aspirates or
at the most removes a very small amount of material and thus a discectomy is
considered a more advanced technique.
42.
Is Microsurgery the same as minimally invasive surgery?
Although the names sound
similar they are in fact two totally different things. One of physicians was
very surprised when a surgeon that he was working with made a 3 inch incision in
the neck for what was termed "cervical spine microsurgery". When he
questioned the surgery about the description of the surgery, her response
was," it is microsurgery because I am using the big microscope." The
reality is that with microsurgery the size of the operation is unimportant, it
simply implies that at some point during the procedure a microscope was used and
thus the surgeon could bill for the use of the microscope. These are not little
microscopes; each microscope is about 6 feet high and weighs a ton. This is one
of the reasons we are pushing new terms such as microspinoscopy, microspinology,
and minimally invasive surgery which are more descriptive.
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