Spine Surgery 101 eguide

Spine Surgery 101

What, When, and Why Spine surgery is not something to take lightly. Affecting 8 out of 10 Americans, back pain can be effectively treated with conservative methods 80% of the time. Yet, more than 600,000 undergo spine surgery each year. If you have been suffering from lumbar (lower) back pain and have not found relief with conservative treatments, you might be a candidate for spine surgery. By taking this first step to gather more information before you make a decision, you are already on the track to relief. Use this guide to better understand if spine surgery might be right for you.

For specific questions about spine surgery, please call South Denver Neurosurgery at 720-638-7500.

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Table of Contents Pages 1-2: Who Benefits From Spine Surgery?

Page 3: Before Choosing Spine Surgery

Page 4: Are You a Candidate?

Page 5: How to Select a Spine Surgeon – Neurosurgeon vs. Orthopedic Surgeon

Page 6: How to Select a Spine Surgeon – Spine Fellowships Pages 7-8: How to Select a Spine Surgeon – Experience Matters Pages 9-10: How to Select a Spine Surgeon – Interview Your Surgeon

Pages 11: About South Denver Neurosurgery

Pages 12-13: South Denver Neurosurgery Spine Team

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Pages 14: Notes

Who Benefits From Spine Surgery?

Chances are high that sometime in your lifetime you will suffer from back pain. While surgery is often the last line of treatment, spine surgery has been found to provide significant benefits over conservative treatments in the following cases: S pinal stenosis (narrowing of the spinal canal): Greater

improvements in pain reduction and function when compared to conservative treatments, according to findings in the Spine Patient Outcomes Research Trial (SPORT). P ersistent sciatica from lumbar disc herniation: Less pain and greater

long-term improvement with surgery, when compared to conservative treatments, according to the SPORT study. H erniated discs in the lower (lumbar) spine: Improved functioning

and reduced long-term pain and disability, when compared to nonsurgical treatment, according to an eight-year study published in Spine.

If you are experiencing any of these conditions and think spine surgery may be right for you after reviewing this guide, contact South Denver Neurosurgery online at sdnspine.org or call 720-638-7500.

SOONER IS BETTER Undergoing surgery for herniated discs sooner rather than later is more effective, according to a study published by the Journal of Bone and Joint Surgery. People who waited more than six months to undergo surgery after symptoms arose had worse results than those who had surgery within six months of the onset of symptoms.

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Who Benefits From Spine Surgery? CO N T I N U E D ď‚„T rauma: Medical emergencies that include broken bones or damage to the spinal

column typically require surgery. Patients with spinal cord injuries who undergo surgery within 24 hours are twice as likely not to suffer paralysis than those who wait, according to a study published in PLOS ONE. ď‚„L oss of motor or bladder control: Conditions that result in a loss of control and

function, such as cauda equina syndrome (a rare condition that affects the nerve roots in the lumbar area). The American Association of Neurological Surgeons recommends surgery within 48 hours of onset for conditions like cauda equina syndrome to provide the best benefits and reduce the likelihood of See how long-term issues. spine surgery Other conditions that may require surgery include scoliosis (curvature of the spine), kyphosis (humpback deformity), spondylolisthesis (vertebrae shifting out of place), radiculopathy (nerve inflammation/irritation caused by herniated disc), and degenerative disc disease.

can be effective for some patients.

For patients with severe, intractable lower back pain, surgery has been found, in many cases, to worsen back pain. A study published in Spine shows that spinal cord stimulation provides better outcomes for these patients.

If you are experiencing any of these conditions and think spine surgery may be right for you after reviewing this guide, contact South Denver Neurosurgery online at sdnspine.org or call 720-638-7500.

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Before Choosing Spine Surgery Before you decide on spine surgery, it’s important to consider all of your options. South Denver Neurosurgery recommends that all patients experiencing back or neck pain consult a family physician first to discuss nonsurgical options. In most cases, with the exceptions noted on the previous pages, patients should try six months of conservative treatment before considering surgery. South Denver Neurosurgery advocates the following steps before pursuing surgery: O btain a thorough health history and physical exam from your primary care

physician to help pinpoint the cause of the pain. Imaging tests (X-ray, CT, MRI) and diagnostic injections can help further identify the underlying issue.  I f possible, pursue conservative treatment, which includes:

• Physical therapy, acupuncture, and massage • Medications such as NSAIDs (e.g., ibuprofen), muscle relaxers and, in some cases, carefully controlled use of opioid pain medications • Steroid injections tailored to the origination point of the pain • Patient weight loss, smoking cessation, and control of diabetes and hypertension

Since nearly 80% of people will find relief with conservative treatments, it’s important to try conservative treatments before considering surgical options.

If you have tried these options and your pain has not diminished within six months or is negatively affecting your quality of life (preventing you from sleeping or exercising), spine surgery might be right for you.

Contact South Denver Neurosurgery online at sdnspine.org or call 720-638-7500 to schedule an appointment.

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Are You a Candidate?

View this video to see if you might be a candidate.

Using the most advanced surgical procedures, including minimally invasive surgery and robotic-guided procedures, spine surgery is now safer and more effective than ever before.

Are you a candidate for spine surgery?

If you answer “yes” to many of these questions, spine surgery might be right for you. H ave you tried physical therapy?  Have you tried medications?  Have you tried steroid injections? H ave you had imaging tests (X-ray, CT, MRI) of your spine and diagnostic injections?  Has a structural cause of your pain been identified?  I s your quality of life or activity level greatly diminished by your pain?

Spine surgery is only effective if a structural cause for pain can be identified.

If you answered “no” to two or more of these questions, South Denver Neurosurgery recommends you first consult with a primary care physician or pain specialist.

To learn more about South Denver Neurosurgery, visit sdnspine.org or call us today at 720-638-7500 to schedule an appointment.

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How to Select a Spine Surgeon— Neurosurgeon vs. Orthopedic Surgeon

While it’s true that an array of surgeons can perform spine surgery, choosing a neurosurgeon to perform your spine surgery offers unique expertise and benefits. Neurosurgeons, like those at South Denver Neurosurgery, undergo more extensive training than other surgeons and have specific expertise with nerves to ensure consideration is given to the central and peripheral nerves during surgery, maximizing your success and minimizing pain.

Why a neurosurgeon for spine surgery?  Six years more training than most orthopedic surgeons E xperience performing hundreds more spinal procedures during their residency and fellowships than orthopedic surgeons E xpertise in dealing with nerves and brain function, critical components of any surgery involving the spinal cord or spine area

South Denver Neurosurgery neurosurgeons were the first

to utilize the Mazor Robotics Renaissance™ Guidance System to perform complex open spine surgery at Littleton Adventist Hospital.

To learn more about South Denver Neurosurgery, visit sdnspine.org or call us today at 720-638-7500.

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How to Select a Spine Surgeon— Spine Fellowships

Both neurosurgeons and orthopedic surgeons can choose to participate in spine fellowship programs after completing their residency requirements and becoming board-eligible. Spine fellowships offer more specialized training and can focus on particular areas of spine surgery, such as anterior and posterior decompression, or specific categories of spinal issues, like adult spinal problems or pediatric deformities. Fellowships are typically one year in length and can require producing peer-reviewed publications. Introduced into the profession in the past 25 years, spine fellowships give surgeons more indepth, specialized training.

To learn more about South Denver Neurosurgery, visit sdnspine.org or call us today at 720-638-7500.

South Denver Neurosurgery’s Dr. Bernard Guiot has completed three specialty spine fellowships—one in pediatric spinal deformity and two in adult reconstructive surgery.

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How to Select a Spine Surgeon— Experience Matters

Experience matters when it comes to spine surgery. The experience of the surgeon and the outcomes of spine surgery are directly correlated.

Benefits of a more experienced surgeon: R educed complication rates: Complication rates are, on average,

lower among more experienced surgeons. In surgeries for spinal stenosis, complication rates were 38% higher among surgeons with minimal experience (less than 15 operations in four years) compared to those who had performed more than 80 procedures during the same time period, according to a study published in Neurosurgery. L ower infection rates: Less experienced surgeons often take longer to

perform surgery, which has been found to lead to increased infection rates, according to a study published by The University of Chicago Press.

HOW MUCH EXPERIENCE IS NEEDED? There is no magic number when it comes to experience. The general consensus judges “experience” by two marks: 1. Five years of performing the procedure; or 2. Conducting at least 30 surgeries of the given procedure (i.e., 30 disc fusions) All of South Denver Neurosurgery’s surgeons have extensive experience and meet these criteria.

To learn more about South Denver Neurosurgery, visit sdnspine.org or call us today at 720-638-7500.

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How to Select a Spine Surgeon— Experience Matters CO N T I N U E D Benefits of a more experienced surgeon: D ecreased length of hospital stays: In general, more

experienced surgeons are more accurate and efficient during surgery, resulting in less complications, anesthesia, and infections, all of which lead to shorter hospital stays.

View this video to see how Mazor benefits patients.

M ore careful patient screening: Highly experienced spine

surgeons (15 years or more in the field) are more likely to properly screen candidates for surgery, resulting in better outcomes, according to a survey published in the Journal of Spinal Disorders and Techniques. R educed reoperation rates: Many reports highlight infection

as a primary reason for reoperation, which a surgeon’s experience plays a significant role in reducing, according to 2014 research on reoperation within 30 days of fusion surgery.

South Denver Neurosurgery’s neurosurgeons have performed thousands of spine surgeries during the past 20 years, using evidence-based approaches.

To learn more about South Denver Neurosurgery, visit sdnspine.org or call us today at 720-638-7500.

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How to Select a Spine Surgeon— Interview Your Surgeon

Spine surgery is rarely an emergency. Before undergoing spine surgery, it’s important to select a surgeon right for you and your condition. Take your time to interview possible surgeons and their staff to ensure you find the right fit.

Ask your potential surgeon the following questions: D o you have extensive experience or fellowship training in spine surgery? H ave you completed this procedure before? If so, how many times? W hat is your complication rate when performing this procedure? W hat are the most common complications of this procedure? W hat is your infection rate? D o you have any statistics in regard to your surgery success? W hat does recovery from this procedure entail? W hat research have you conducted? W hat hospitals do you operate at?

To learn more about South Denver Neurosurgery, visit sdnspine.org or call us today at 720-638-7500.

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How to Select a Spine Surgeon— Interview Your Surgeon CO N T I N U E D

Additional things you should consider when choosing a spine surgeon: D o you have the surgeon’s full attention? D o you feel comfortable with the surgeon? D oes the surgeon’s appearance reflect the attention to detail you hope to see in the operating room?

And finally, pay close attention to the surgeon and his team: A re they friendly? D o they address your concerns? H ow helpful are they with paperwork, travel plans, scheduling, etc.?

HERE ARE additional tips for selecting a spine surgeon.

To learn more about South Denver Neurosurgery, visit sdnspine.org or call us today at 720-638-7500.

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About South Denver Neurosurgery The surgeons and staff of South Denver Neurosurgery take pride in providing patients with unbiased information that is supported by medical research. We are committed to offering patients information on all treatment options, whether those options are delivered by our practice or we need to make a referral to another specialist.

Why choose South Denver Neurosurgery?  Access to neurosurgeons who have completed thousands of spine surgeries  A highly experienced surgical team  Th e latest surgical advancements, including minimally invasive surgery and

robotic-guided procedures C omplication and infection rates equal or better than national averages U nbiased information that is supported by medical research, offering patients

information on treatment options regardless of whether they choose treatment at South Denver Neurosurgery

To learn more about South Denver Neurosurgery, visit sdnspine.org or call us today at 720-638-7500.

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South Denver Neurosurgery Team South Denver Neurosurgery is pleased to offer one of the top teams of spine surgeons in the nation.

Bernard Guiot, MD

J. Adair Prall, MD

Dr. Guiot is one of the most highly trained spine surgeons in the Rocky Mountain region, having completed three specialty spine fellowships — one in pediatric spinal deformity and two in adult reconstructive surgery — and performed thousands of spine surgeries over the past 20 years. Read Dr. Guiot’s complete bio here.

Board certified by the American Board of Neurological Surgery, Dr. Prall is a leader in his field with more than 20 years of neurosurgical experience, specializing in all types of cranial and spinal surgery as well as minimally invasive and motion-preserving spine surgery.

Meet Dr. Prall and understand his expertise in spine surgery. Read Dr. Prall’s complete bio here.

South Denver Neurosurgery is an affiliation of South Denver Neurosurgery.

Our main Denver location is: Littleton Adventist Hospital • Arapahoe Medical Plaza III 7780 S. Broadway, Suite 350 • Littleton, CO 80122 sdnspine.org • 720-638-7500

To learn more about South Denver Neurosurgery, visit sdnspine.org or call us today at 720-638-7500 to schedule an appointment.

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South Denver Neurosurgery Team

CO N T I N U E D

South Denver Neurosurgery is pleased to offer one of the top teams of spine surgeons in the nation.

David P. VanSickle, MD, PhD Dr. VanSickle is board certified by the American Board of Neurological Surgery and specializes in minimally invasive and motion-preserving spine surgery, spinal disorders, and spinal cord stimulator implantation for pain. Dr. VanSickle also is a leading surgeon in deep brain stimulation. See Dr. VanSickle’s impact on patients’ lives here.

Our main Denver location is: Littleton Adventist Hospital • Arapahoe Medical Plaza III 7780 S. Broadway, Suite 350 • Littleton, CO 80122 sdnspine.org • 720-638-7500

To learn more about South Denver Neurosurgery, visit sdnspine.org or call us today at 720-638-7500 to schedule an appointment.

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Notes Use this space to gather more information from your primary care physician to better understand if spine surgery is for you.

Can my back or neck pain be pinpointed to a structural issue? ____________________________________________ ______________________________________________________________________________________________ What reservations might you have about recommending spine surgery for my condition? ______________________ _______________________________________________________________________________________________ How can I better prepare my body for spine surgery? ____________________________________________________ _______________________________________________________________________________________________ What surgeons in the area would you recommend? _____________________________________________________ _______________________________________________________________________________________________ I have additional questions about ‌ _________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________ My biggest concerns are ‌ _________________________________________________________________________ _______________________________________________________________________________________________ _______________________________________________________________________________________________

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