spine surgery

Airport Security and Metal Implants

“Will the metal in my device set off metal detectors at the airport?” Especially since September 11, 2001, when airport security measures increased significantly, it’s been a common question for spinal implant patients. They’re concerned they may set off detectors, be subjected to more screening than their fellow travelers, and, of course, delay their travel. Metal implants can include knee replacements, hip replacements, and other orthopedic implants. Implants are usually made of cobalt chrome, stainless steel, or titanium. The location of your implant, and what it’s made of, can both affect whether you set off a metal detector. While there are some reports of airport metal detection rates of orthopedic implants generally, there have been few data regarding spinal implants specifically. A recent study of pediatric spinal fusion patients found that cobalt chrome implants set off metal detectors 24% of the time, while stainless steel implants went undetected. Past studies have also found that implants with cannulated screws and implants with high iron content are more likely to be detected. A 2012 study showed that archway metal detectors do not detect modern spinal implants. Handheld metal detectors, on the other hand, detected all modern posterior spinal implants and anterior cervical

April 23, 2015

9+1: Derrek’s Patient Experience

Derrek is a patient of mine who has left a lasting impression – he recently ran his first half marathon after having a 2 level spinal fusion (see his xray to the left). He is a great example of patients who become more physically active after a spinal fusion than they were before, which is a common experience in our practice. Derrek’s back pain began eleven years before his surgery, when one day he woke up with terrible pain in his back. Over the course of the eleven years, after all else failed, his condition deteriorated to the point where he considered surgery. Failing to get the answers he was looking for after speaking to a doctor specializing in psychosomatic symptoms, Derrek came to my office. Here’s what he had to say about his experience: “Dr. McCance really did a great job explaining everything to me and my wife. He told us that surgery is what needs to happen now, or something much worse will happen later. “What I’m most impressed by is that Dr. McCance even explained the differences between psychosomatic therapy and surgery to my wife. He answered all of our questions and gave us two solid options.” Derrek’s options were

March 17, 2015

AARP’s Surgeries to Avoid

An AARP article that discusses common surgeries to avoid – including spinal fusion – has recently made its way back into the headlines. Specifically, it cites studies that show the frequency of this procedure has increased 1,400 percent between 2002 and 2007, and does not appear to be slowing down. The article suggests that the surgery is dangerous and is no more effective than physical therapy, which is inaccurate and misleading. Spinal fusion involves the joining of two or more vertebrae together, using screws and rods along with bone graft material, and sometimes cages (devices that support the vertebra). These techniques provide strong support for the spine, as well as correction of alignment and protection of the spinal canal and nerves. While spinal fusion has increased in frequency, in my experience it is a safe and highly effective treatment for patients when performed properly and for the right diagnosis. The key to success is careful selection of the patients who need a fusion (i.e., performing the procedure for the correct diagnosis), and also performing the surgery carefully to achieve maximal success (i.e., achieving a solid fusion). Where patients and doctors get into problems is when the procedure is performed for a

March 10, 2015

Regenerative Cell Therapy

Regenerative cell therapy is a major next step in medical research, with the potential to effectively treat the most complex diseases – including various forms of cancer. Researchers studying regenerative cell therapy look at both how stem cells may be used to replace, repair, reprogram or renew your diseased cells, and at how reprogrammed stem cells may be turned into specialized cells that can repair or regenerate cells. It has the potential to change the outcomes for patients who are left with little time and very few answers. In regenerative cell therapy, function is restored in damaged or destroyed tissues, rather than producing a new organ. This can be done either by intravenously injecting cells into damaged tissue or by inducing self-repair by recruiting from the patient’s own highly functioning tissues. There are a few different types of cells with various effects used in regenerative cell therapy, including: Induced pluripotent stem cells (iPSCs) – Cells that are taken from adult tissue and are genetically altered to behave like an embryonic cell. Embryonic stem cells (ESCs) – Cells that are taken from the inner mass of a blastocyst and have the potential to become any kind of tissue within the body.

February 17, 2015

Back on the Dance Floor: Kathryn’s Patient Experience

Kathryn is a former patient of mine who has left a lasting impression. Her back pain began when she hurt her L3/L4 disc after a spinning class, and she believes she aggravated the injury during a subsequent game of golf. Initially, Kathryn told me she didn’t think too much of it because she’s athletic and used to pushing herself outside her comfort zone. Kathryn thought this was something she could deal with – so she sought a massage treatment, iced her lower back area, and rested. Afterwards, she continued to play golf and attend spinning class. Unfortunately, what Kathryn didn’t do was listen to her body and get help when she needed it. I see this in a lot of patients; a good rule of thumb is if the pain persists, starts to travel down your arm or leg, and/or keeps you up at night, it’s time to see a physician. Unfortunately, the pain took a turn for the worse when Kathryn further exacerbated her injury lifting a mattress while vacuuming. Kathryn contacted my office and met with me to discuss different options that would work for her injury. Because she had severe nerve compression in her lower back due

February 3, 2015

Is Robotic Surgery Right For You?

What is Robotic Surgery? Robotic surgery is a term used for technological developments that use robotic systems to aid in surgical procedures. Robotically-assisted surgery has the potential to help overcome the limitations of minimally-invasive surgery, and to enhance the capabilities of surgeons performing some types of open surgery. To date, robotic surgery has had its biggest impact in Urological (Prostate) surgery, and general surgery. The applications in Spine surgery have been very limited to date, but we continue to monitor and research this technology. With robotically assisted surgery, the surgeon uses a remote manipulator to control the robotic arms that carry out the movements of the surgery. The advantage of this is to allow for very fine and controlled movements in a tight and inaccessible space, and for potentially improved visualization with the miniature camera systems that accompany the robotic arms, examples of such systems include the DaVinci Robot platform. Robotic surgery has been criticized for its expense, by one estimate costing $1,500 to $2000 more per patient. [1] However, this advanced technology allows surgeons to perform general exams as well as complex gynecological, cardiothoracic, and urological procedures with a minimally invasive approach. Potential benefits of robotic surgery In general,

January 20, 2015

Advancements in Robotic Spine Surgery: Weighing the Pros and Cons

There are incredible achievements happening in technology and science every day, especially in the world of spinal surgery. One of the most recent developments in spine surgery, using robotic technology in the operating room, has been up for debate among surgeons and spinal specialists, and I’ve been considering the pros and cons of these new treatment options myself. Robotic surgery is considered a minimally invasive procedure in which the surgeon controls the camera and instruments using a console. The surgeon operates the robot while looking through a monitor that allows him to see inside the patient. Every movement made by the surgeon is mimicked by the robot, allowing for unprecedented control, precision, and access to the human body. Numerous studies have shown the advantages of robotic technology and the implications it has for the future of medicine. Overall, the average length of hospital stay for patients undergoing robotic surgery was reduced by 27 percent, and complication rates were reduced by 48 percent. A recent study published in Head and Neck Oncology shows that a robotic arm can reduce unavoidable tremors in the human hand by filtering out hand movement. And finally, robotic technology is ergonomically desirable, allowing cosmetic benefits

February 19, 2014

The Misconceptions and Fears about Spine Surgery

The word “surgery” often causes anxiety and fear for patients. Many times, they specifically ask what treatment options are available aside from surgery because they want to avoid having an operation all together, due to common misconceptions. These misconceptions are about surgery, especially spinal surgery, and I’ve heard them all. More often than not, they get in the way of the best treatment that is available for the patient .The truth is, depending on what type of injury you have and the situation you are in, surgery may end up being your best and safest option for a full recovery. Although surgery is not always the answer, it is also not always the option of last resort. A few common misconceptions that I often hear at my practice are: I will never be able to be active again! Actually, the opposite is often true. Without spinal surgery, many patients continue to suffer from their symptoms, making any type of physical activity painful. After the problem is corrected, patients can very often get back to normal activities, including sports. Also, I usually recommend that my patients begin taking walks quickly after surgery in order to regain mobility, which also helps with the healing

May 28, 2013

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