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Euby J. Kerr, III, M.D.
Fellowship trained Neck and Spine Surgeon Center
for Orthopaedic Surgery & Sports Medicine
Many spine procedures needed to treat patients with common
spine problems encountered in our working bipedal world required the
following: a 3-5 day stay in the hospital, large painful
muscle-stripping incisions, the harvesting of bone graft, with a 30%-40%
chance of continued pain up to 2 years after surgery at the graft site,
and rehabilitation in the hospital before a patient could be discharged
to home. Mercifully,
these same procedures germane to cervical and lumbar surgery have
evolved to our advantage.
Innovative advances in the technology of spinal fixation
and instrumentation, clinical use of bone morphogenic proteins (BMP) and
bone substitutes have allowed spine surgeons to develop minimally
invasive spinal (MISS) procedures.
The goal of these procedures is less operative trauma to the
normal anatomic soft tissues while correcting spinal pathology.
Patients, therefore, can return to their activities of daily
living quickly with minimal pain and discomfort.
This translates into less cost, disability, and time lost from
work associated with the treatment of spinal pathology.
A facility that can provide efficient and timely diagnosis,
treatment and management of a largely industrial population will
contribute directly to a company’s bottom line - prompt return of
their employee’s to gainful employment.
Straightforward spine procedures such as single level
anterior cervical fusion and microlumbar discectomy are being done
frequently in surgery centers on an outpatient basis.
The impetus to do more advanced cases employing the above
technology is now available. Soon
single level laminectomy’s, posterior cervical foraminotomies,
PLIF’s and ALIF’s will join the list. Thus, with proper patient
selection and education, liberal use of pre-emptive and post-operative
analgesia many MISS procedures can be done on an outpatient or 23 hour
short-stay basis. And, as
more spine surgeons become comfortable doing these types of procedures
in this environment, outpatient spinal surgery could rapidly become the
standard of care.
The future of spine surgery remains bright and exciting.
The correct use of the above technology will take the field of
spine surgery into a new era. Our
patients will have better results, less pain and morbidity with return
to a productive life with minimal delay.
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