Archive for category minimally invasive surgery
Spine-related Ambulatory Surgery, Minimally Invasive Spine Surgery, Less Invasive Spine Surgery review by KBNI Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Port Arthur, Galveston, Dallas, Fort Worth, San Antonio, Austin
Posted by admin in ACA, Affordable Care Act, ALIF TLIF PLIF DLIF XLIF AXIALIF, ambulatory surgery center, ASC, baytown, beaumont, herniated disc surgery, houston, infection, katy, less invasive spine surgery, lumbar fusion, minimally invasive surgery, neurosurgeon, neurosurgery, PPACA, spinal fusion, spine surgeon, spine surgery, sugarland, woodlands on March 30, 2015
Spine-related Ambulatory Surgery, Minimally Invasive Spine Surgery, Less Invasive Spine Surgery
Historically, back surgery had a reputation for damaging muscles along the spinal column and requiring a long post-operative period of physical therapy to restore mobility. This is because traditional back surgery involves long, deep incisions that lacerate muscle and retract upon muscle so that the incision may be pulled open, giving the surgeon a full view of the incision site as well as the damage to be repaired in the spinal column. While this method is effective, it also poses a few serious risks to the patient’s health: the aforementioned lengthy recovery time (and compromised mobility during physical therapy) as well as the increased risk for surgical site infection (SSI) from keeping the patient’s internal workings exposed to open air (and thus possible contamination). There can also be additional spine pain during the recovery process of large open spine procedures.
Fortunately, recent advancements in both hospital technology and neurosurgery / spine surgery skills has made it easier for spine surgeons to perform spine surgery with less interruption of normal tissues surrounding the spine. Many spine procedures now use a device called a tubular retractor, which is a small metal tube that is inserted through a small incision near the patient’s spine. The tubular retractor grants the surgeon access to the damaged spinal column or herniated disc within the spinal canal. Any material threatening the patient, such as a fragmented spinal disc or piece of vertebral bone tissue, is extracted through the tubular retractor, while any equipment necessary for the back surgery (such as plates or screws to stabilize a damaged spinal column) is inserted through the retractor. Some procedures may require surgeons to use multiple retractors, but the small incisions damage the muscles along the spinal column far less than traditional deep incisions. This minimizes recovery time, reduces the risk of surgical site infection, and helps patients preserve their mobility during recovery.
Minimally-invasive surgery procedures on the spine also occasionally transform the classification of certain kinds of surgery. Whereas traditional back surgery requires a hospital visit, minimally-invasive techniques allow many kinds of surgery to be possible in an ambulatory care setting. In other words, instead of a hospital visit compounding the expense of certain kinds of surgery, patients (and insurance companies) are finding the benefit of performing spine surgery procedures in an outpatient setting. The Affordable Care Act (ACA, PPACA) of 2010 (also known as the ACA or Obamacare or PPACA) became famous for the mandate that required all US small business owners with 50 or more full-time employees to purchase health insurance coverage benefits for their full-time staff. As of 2015, the long-term effects of the Affordable Care Act (PPACA) remain to be seen. Sweeping re-classification of major surgical procedures has yet to emerge under the ACA / PPACA, as there are still very real practical concerns: how to prevent surgical site infection effectively, for example. New methods of pay for performance and bundled care payments may also change the way healthcare is evaluated and reimbursed, and will encourage decreased hospital stays and improved outcomes. New minimally invasive spine surgery techniques are emerging, however, so additional ambulatory care surgery may be increasingly employed in the future. Ambulatory surgery centers (ASC) are ideal for spine surgery procedures in which patients are expected to return home the same day, or within 23 hours of the surgery. There are also many conveniences to a patient, when having a surgery performed in an ambulatory surgery center (ASC). The ambulatory surgery centers (ASC) are very well prepared to quickly and efficiently move patients through the preop evaluation process. The patient stays briefly in the preop holding area while the nurse evaluates the patient, the anesthesiologist or nurse anesthetist speaks with the patient, and the neurosurgeon or orthopedic spine surgeon identifies the patient (to prevent any wrong patient surgery from occurring). The patient is then taken back to the operating room, and put to sleep, and the neurosurgeon or orthopedic spine surgeon performs the procedure. The patient is then taken to the post op recovery room, and usually held there until the patient is awake enough, and the pain is well controlled enough, to allow discharge of the patient home.
Minimally invasive spine surgery employs less invasive spine surgery techniques to approach the spine. These minimally invasive surgery on the spine techniques can be used to perform lumbar discectomy for removal of a herniated disc, as well as for a lumbar fusion ( ALIF, TLIF, PLIF, DLIF, XLIF).
Physicians at the Kraus Back and Neck Institute have significant experience treating patients with diseases of the spine in an ambulatory outpatient setting. They are well versed in the full spectrum of treatments, and know when to advise conservative measures, and when to recommend surgical intervention upon the spine.
The Kraus Back and Neck Institute (KBNI) in Houston TX cares for patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.
Patients suffering from neck pain or lower back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at
……. Or visit www.SpineHealth.com to SCHEDULE AN APPOINTMENT ONLINE
Keywords: ambulatory care, back surgery, minimally invasive surgery, minimally invasive spine surgery, ACA, Affordable Care Act, PPACA, ASC, ambulatory surgery centers, Houston, Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center (TMC), Dallas, Fort Worth, San Antonio, Austin
Magnetic Resonance Imaging MRI and Herniated Disc by KBNI Houston, Katy, Woodlands, Spring, Sugarland, Memorial City, Texas
Magnetic Resonance Imaging MRI and Herniated Disc by KBNI Houston, Katy, Woodlands, Spring, Sugarland, Memorial City, Texas
Patients often wonder what the best test is to determine whether they have a herniated disc in the spine. Without a doubt, magnetic resonance imaging MRI has revolutionized the imaging field of medicine, and allowed immense clarity and accuracy when trying to diagnose a herniated disc. There are several different primary imaging exams that physicians use to aid in making an accurate diagnosis. When it comes to the spinal column anatomy, an incredibly complex system of powerful load-bearing bones and facet joints all working in conjunction with spinal discs and nerves, making an accurate diagnosis can be difficult. Typically, physicians will begin with a series of physical exams that test a patient’s mobility and back pain levels. Based on these findings, physicians will have a much better approximation of the possible causes for the patient’s back pain. Consequently, a series of spinal imaging exams may be recommended to confirm the diagnostics. X-rays are normally used when spinal fracture is suspected, but if soft tissue damage (such as spinal nerve compression) is the main cause of a patient’s back pain, magnetic resonance imaging MRI is used to gain an accurate estimate of the damage.
Magnetic resonance imaging MRI uses powerful magnetic fields and radio wave energy to map the body’s soft tissue systems. This information is then relayed to a computer so that different systems can be studied in more detail. Magnetic resonance imaging MRI also has the advantage of remote viewing, where clinics that have access to other physicians’ MRI recordings can make recommendations based on samples that have been relayed electronically. MRI scans can be done on what is known as a closed machine or magnet, or an open machine or magnet. Typically, for patients who have difficulty with claustrophobia, an open magnet or machine may be easier to tolerate. For patients with claustrophobia, a mild oral sedative or an intravenous ( IV ) sedative may help them to tolerate the machine. Most patients are able to have their MRI scan done on a closed machine, with accommodations made, even if they have mild claustrophobia.
Different MRI sequences on the MRI scan can help the radiologist and spine surgeon (neurosurgeon or orthopedic spine surgeon) to help determine whether the herniated disc is more acute or chronic in nature. In addition, MRI images can be taken in different planes. This means that the orientation of the images of the spine can be seen in sagittal (as if looking from the side), coronal (as if looking from the front of the body) or axial (as if looking from the feet with the patient lying on their back) views. With a high quality MRI scan, individual nerve roots can be seen in cross section, and a herniated disc which compresses the nerves can usually be easily visualized. Typically, an MRI scan of the cervical spine shows the spine from the skull base to the top of the thoracic spine. A cervical herniated disc can be easily seen in cross section or sagittal views on a cervical MRI. A thoracic spine MRI scan typically shows the spine from the bottom of the cervical spine to the top of the lumbar spine. A thoracic herniated disc can be seen on axial and sagittal MRI views. A lumbar MRI scan usually shows the spine from the bottom of the thoracic spine to the sacrum, which lies below the lumbar spine. An axial or sagittal MRI scan will usually show a lumbar herniated disc. A spine surgeon finds that an MRI scan provides critical information for a herniated disc surgery.
Within the spinal column, magnetic resource imaging MRI allows for complete renditions of the spinal discs (herniated disc) , which help in determining conditions like advanced disc degeneration, herniated disc, cartilage degeneration between the facet joints, and integrity of the spinal canal that houses the central nervous system’s spinal nerves. MRI scans can also be used as a secondary imaging exam if the results of an X-ray or CT scan (computerized tomography) are inconclusive. MRI scans are not always able to pinpoint the origin of a patient’s back pain, however, due to the fact that some patients may exhibit extreme pain while showing relatively few signs of soft tissue degeneration. Other patients may show much more degeneration in the spinal column, facet joints, or spinal disks, but have much lower levels of back pain during routine movement. As with other imaging exams, MRIs are used in conjunction with other imaging exams to ascertain whether more serious methods of treatment (such as back surgery) are necessary.
When a patient is not able to undergo an MRI scan, possibly due to an implanted pacemaker or spinal cord stimulator, they can undergo a myelogram. A myelogram is a study in which a spinal tap is performed, usually in the lumbar spine, and a water soluble iodine dye is placed into the spinal canal. This iodine dye shows up on x ray and CT scans of the spine. After the myelogram is performed, with iodine dye in the spinal canal, a CT scan of the spine is performed to show an outline of the spinal nerves, and determine whether there is pressure upon the nerves. In this manner, a herniated disc in the lumbar, thoracic or cervical spine can be seen. The CT scan will also who any hard bone spurs or calcium within the herniated disc.
Neurosurgeon spine experts at the Kraus Back and Neck Institute (KBNI) in Houston, TX, have expertise in using MRI scans to evaluate the cervical, thoracic and lumbar spine, and diagnose a herniated disc, among other spinal disorders. With accurate scanning and imaging techniques, KBNI physician experts can help to diagnose the cause of pain or weakness in the neck, back, arms and legs, and to find a treatment strategy which will help the patient recover. In the majority of cases, patients will achieve good relief of pain without the need of a spine surgery. When surgery on the spine is needed, neurosurgeons at the KBNI utilize the latest techniques in minimally invasive spine surgery techniques, when appropriate.
The Kraus Back and Neck Institute (KBNI) in Houston TX takes care of patients in Houston and the surrounding areas, including Sugarland, Woodlands, Katy, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Memorial City, Texas Medical Center (TMC) and other Texas TX cities including Dallas, Fort Worth, San Antonio and Austin.
Patients suffering from neck pain or back pain, or who have been told they may require a spine surgery, can contact the Kraus Back and Neck Institute at
……. Or visit www.SpineHealth.com to schedule an appointment online
Keywords: MRI, herniated disc, Houston, Woodlands, Katy, Memorial City, Sugarland, Texas Medical Center, Spring, Sealy, Baytown, Pearland, Beaumont, Galleria, Tomball, Conroe, Humble, Kingwood, Port Arthur, Galveston, Texas, TX, Dallas, Fort Worth, San Antonio, Austin
Minimally Invasive Surgery: Houston, Kingwood, Spring, Woodlands, Katy, Memorial City, Humble: 281-713-6296
Minimally Invasive Spine Surgery
Until relatively recently back surgery required large incisions accompanied by long periods of physical rehabilitation in post-operative care. With recent surgical advancements, however, new procedures have resulted in much shorter periods of physical rehabilitation. These surgical procedures—termed minimally invasive surgery or laporoscopic surgery—have revolutionized the way physicians approach not only back surgery, but several other varieties of major surgery as well.
Neurosurgeons specializing in spine surgery, Dr. Gary Kraus MD and Dr. Masaki Oishi MD PhD, at the Kraus Back and Neck Institute in Houston TX, have a vast experience in performing minimally invasive surgery of the spine. The procedures can be used to treat low back pain, neck pain, herniated discs of the spine, as well as sciatica. In some cases, spinal stenosis and spondylolosthesis can also be treated with minimally invasive techniques. Patients throughout the Houston and surrounding areas, including Katy, Spring, Woodlands, Sugar Land, Memorial City and the Texas Medical Center have trusted the neurosurgeons at the Kraus Back and Neck Institute for treating their spine with minimally invasive surgery. Call 281-713-6296 for an appointment.
Minimally invasive surgeries typically involve one or more small incisions into which physicians insert thin plastic tubes. The tubes then provide the means for small observation cameras to be inserted. Using these cameras, surgeons can continuously adjust their technique during the operation, minimizing scarring and ultimately decreasing the patient’s post-operative pain levels and length of recovery. New robotic surgical assistants further contribute to the process by plotting optimal routes of incision and minimizing the number of physical adjustments a surgeon makes.
Many types of back surgery, however, do not have minimally invasive equivalents. Thorough medical consultation should be a top priority for patients considering minimally invasive surgery, as a misdiagnosis could result in a less effective procedure. Should the patient be a good candidate, a shorter, less expensive hospital stay and a faster recovery is the norm. This makes physical therapy all the more necessary—patients may feel that they can skip the process entirely given that their pain levels during post-operative care are much lower. Patients are advised to follow up on their physical therapy sessions as well as any subsequent visits to their spinal specialist. This will minimize the possibility of additional back surgery as well as maximize the chances for an effective recovery.
Physical rehabilitation for minimally invasive surgery is often similar to other kinds of surgery. In the case of most back surgery, core strengthening is often emphasized to assist in load-bearing activities (lifting, sitting, and standing) as well as to pressure from the spinal discs. Patients will also receive information on how to change their daily lifestyles to minimize the chances of re-injury and subsequent surgery.
Neurosurgeons Dr. Kraus and Dr. Oishi, at the Kraus Back and Neck Institute, would be available for consultation to any patients suffering from low back pain, neck pain, sciatica, herniated discs, or any other spinal disorders. Even though they offer minimally invasive surgical approaches to the spine, they are able to treat many of their patients without the need for surgery. Patients from the Houston and surrounding areas including Katy, Spring, Woodlands, Sugar Land, Memorial City and the Texas Medical Center, can be seen without any prior testing or imaging studies.
Keywords: physical rehabilitation, minimally invasive surgery, spine surgery, back pain, back surgery, sciatica, Houston, katy, spring, texas medical center, Woodlands, Sugar Land