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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, and in 1982 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.

In 1992, surgeons at the Spine Center were 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 has just completed multicenter FDA clinical trials for the treatment of spinal stenosis. This minimally invasive outpatient procedure performed under local anesthesia eliminates 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. We look forward to FDA release in late 2004.

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.

Innovations in Spine Surgery

Over the past few years, excitement has invigorated the field of spine care. Ingenious, high-tech medical devices like the X-STOP implant and the Pro-Disc and FlexiCore artificial discs have entered the surgical scene, promising to help more people recover from neck and back pain with greater success. And back pain sufferers in the Bay Area have been among the first in the country to benefit from these advances. Why? Because they come to St. Mary's Spine Center, where renowned spine surgeons James Zucherman, M.D., Ken Hsu, M.D., and Matthew Hannibal, M.D., aren't just employing these devices, they're inventing and perfecting them.

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, and Hannibal'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), is on the threshold of approval by the Food and Drug Administration. The FDA also relies on the three 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 6 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.