Spine Surgery
St. Mary's Spine Center surgeons have long been among the nation's pioneers in the latest surgical techniques. Numerous new surgical techniques, including minimally invasive surgery developed by Spine Center surgeons, result in less postoperative discomfort, a shorter hospital stay, and a quicker return to normal activity.
The Spine Center surgeons pioneered the use of stabilization instrumentation for lumbar degenerative disease. By the late 1970s, St. Mary's surgeons began using metallic fixation for difficult spinal problems, they were the first surgeons on the West Coast to introduce the pedicle screw systems that have become the general standard of care for fusions, instability, and fracture treatment.
The first in the United States to perform percutaneous cervical discectomies, an outpatient procedure that results in minimal scarring and a quicker recovery time than standard discectomies. Our surgeons also developed the laparoscopic approach to the lumbar spine, and were the first in the world to perform the minimally invasive instrumented laparascopic lumbar fusions that are now performed worldwide.
More recently, surgeons at the Spine Center invented the X-STOP implant, which was approved by the FDA in 2005 for the treatment of spinal stenosis. This minimally invasive outpatient procedure performed under local anesthesia reduces the need for painful and risky laminectomy and/or fusion and reduces the recovery time to one week, compared to 6 to 20 weeks for the traditional surgery.
Total disc replacement surgery is ongoing. Single and double level cases are currently being done. Cervical cases will be added later this year.
This spirit of innovation and the quest for even better surgical techniques continues with efforts such as clinical trials of the "Pro-Disc" artificial disc replacement procedure, which is expected to replace the need for spinal fusion in many cases. Spine Center surgeons adhere to the ideal of using the least invasive approach to correcting a spine problem surgically.
Always at the Forefront
"Our passion is inventions and innovations," says Dr. Hsu. "The goal is to be able to treat any kind of spine problem, even difficult problems, using the least invasive approach for the greatest effect." This spirit of innovation has fueled Drs. Hsu, Zucherman's partnership. Their most recent invention, the X STOP, a small implant used to treat spinal stenosis (a painful condition in which enlarged spine joints pinch nearby nerves), was approved by the FDA in 2005. The FDA also relies on these surgeons as principal investigators for clinical trials of many other devices, such as artificial discs.
The X-STOP implant and the Pro-Disc and the FlexiCore artificial discs may soon replace more complicated surgeries. Before the X STOP implant - which is inserted between vertebrae to take pressure off the nerves - spinal stenosis was treated through laminectomy, a surgery that required weeks of recovery, with a success rate between 50 to 70 percent. Patients who receive the X STOP implant can go home the same day and typically recover within 10 days. Likewise, people with degenerative disc disease - worn out, painful discs - seem to fare better with artificial discs, instead of the traditional fusion surgery that requires extensive rehabilitation. "We've had patients with disc disease who have been on the strongest painkillers for many years," says Dr. Zucherman. "But with their artificial disc, they have returned to fairly rigorous work. I have one patient who, following his artificial disc implant, is now unloading 4,000 pounds a day at his job."
Success With Conservative Care
While these surgical breakthroughs are exciting, Dr. Zucherman is quick to point out that most people won't need them. "Ninety percent of all spine problems get better within six weeks," he says. For those who are seen at St. Mary's, typically only six percent ever require surgery. That’s because the Spine Center emphasizes a full spectrum of noninvasive treatments that are proven to work. Many St. Mary's patients relieve their pain and heal injury through effective physical therapy and education. Others improve with osteopathic treatment - manually stretching muscles and mobilizing joints. Still others respond to advanced pain-management techniques, such as spinal injections.
A team of expert physicians at St. Mary's - three physiatrists (rehabilitation specialists), two osteopaths, one neurologist/chronic pain specialist, and three surgeons - work together to diagnose problems accurately and decide the best course of treatment for a given patient. "Our team has been together so long that we confer with each other constantly," adds Dr. Zucherman.
The Personal Touch
"We have skill and experience, but we also provide personal care," says Dr. Hsu. "Each patient’s problem is different, so we don't generalize anything. We're willing to spend time with patients and do whatever it takes to give them the best treatment possible."
If you have back or neck pain that hasn't improved within six weeks, or if you have pain radiating down your legs or arms, St. Mary's Spine Center can help. You can make an appointment with us directly, or get a referral from your personal physician. To reach us, call (415) 750-5849.
