1. 1. Suffering from Back or Leg Pain? Minimally Invasive Treatment Options for Degenerative Spine Conditions El Paso Spine Center Dean E. Smith MD
2. 2. Foundation Hospital
3. 3. Dean E. Smith MD Spine Center Board Certified Fellowship Trained Spine Surgeon Practicing in El Paso Texas Since 1992 Minimally Invasive Spinal Surgeries Major reconstructive Spinal Surgeries Cervical Spine Thoracic Spine Lumbar Spine
4. 4. Minimally Invasive Surgery Minimize Collateral Damage to normal tissue Typical Incision One level Lumbar Fusion
5. 5. About Back and Leg Pain An estimated 10 million adults suffer from chronic back pain annually. Back pain is the #1 cause of healthcare expenditures in the U.S. Direct cost of over $50 billion for diagnosis, treatment, and rehabilitation
6. 6. Back Pain Symptoms Acute pain Chronic pain Back pain can be felt constantly or intermittently and may be a dull ache or a sharp, piercing, or burning sensation. The pain can stay in one place or refer or radiate to other areas, such as the front, side, back, legs, and neck.
7. 7. Back Pain Causes Muscles Sudden, awkward movement, strained back muscles and ligaments, lifting heavy objects, or using improper form when lifting objects Nerves Pressure or impingement of nerve roots in the spinal canal can be caused by: Herniated discs Collapsed disc spaces Arthritic conditions Bone spurs Displacement of vertebrae
8. 8. Back Pain Prevention Body Position Lifting Sitting Sleeping Standing Exercise Aerobics Stretching Other Considerations Smoking Weight
9. 9. Non-Surgical Treatment Options Heat Medications Exercise Acupuncture
10. 10. Surgical Treatment Options Once all non-surgical treatments have been exhausted, surgery may be the next step. Symptoms and indications for back pain have not changed, but surgical treatment options have. Spinal surgery treatment options are defined by the approach, or the way in which the surgeon accesses the spine. Each option has its own set of risks and benefits.
11. 11. Traditional Surgical Approaches BackFront Back
12. 12. Surgical Approach XLif TLif ALif PLif eXtreme Lateral Interbody Fusion (XLIF) Advantages: Does not require entry through sensitive back muscles, bones, or ligaments or the retraction of major blood vessels anteriorly Made safe with the use of nerve monitoring technology Side
13. 13. Lateral Interbody Approach XLif Side
14. 14. A Minimally Disruptive Surgical Approach
15. 15. Surgical Incision
16. 16. Minimally Invasive Lumbar
17. 17. Minimally Invasive Lumbar
18. 18. Minimally Invasive Robot Lumbar
19. 19. Surgical Approaches
20. 20. NeuroVision JJB Advanced technology that provides intraoperative information about nerve safety Used successfully in over 100,000 spinal surgeries
21. 21. Laser Spinal Surgery * *
22. 22. Only FDA-approved mechanical guidance system for spinal surgery Over over 5,000 procedures performed Available in only 63 sites worldwide Reduce fluoroscopy/risk High confidence and Safety in difficult surgeries Mazor Robotics Renaissance
23. 23. Patient Benefits Minimally Invasive Surgery Source: *Wright N, XLIF the United States experience 2003-4, International Meeting on Advanced Spine Techniques, 2005, Banff, Canada. * * * *
24. 24. Benefits Reduced post-op pain Shorter hospital stays Faster recovery Rapid return to normal activity Minimally Invasive Procedure Less tissue disruption Minimal blood loss Nerve safety (NeuroVision )
25. 25. Lumbar Anatomy
26. 26. Indication Degenerative Disc Disease (DDD)
27. 27. Indication Degenerative Disc Disease (DDD) Symptoms Pain in the back, buttocks, or leg XLIF Correction Reduces motion between the vertebrae Corrects alignment Restores proper disc height Alleviates pain Disc Degeneration before XLIF Restoration of Height after XLIF
28. 28. Indication Degenerative Disc Disease (DDD) Symptoms Pain in the back, buttocks, or leg XLIF Correction Reduces motion between the vertebrae Corrects alignment Restores proper disc height Alleviates pain Disc Degeneration before XLIF Restoration of Height after XLIF
29. 29. Degenerative Disc Disease Case Study - x-rays (AP and lateral) - MRI if relevant
30. 30. Degenerative Disc Disease Case Study - x-rays (AP and lateral) - MRI if relevant
31. 31. Surgical Incision
32. 32. Indication Spondylolisthesis
33. 33. Indication Spondylolisthesis Symptoms Impingement of nerves and fatigue of back muscles XLIF Correction Reduces motion between vertebrae, corrects alignment, and restores disc height Spondylolisthesis (Malalignment) before XLIF Restoration of Alignment and Disc Height after XLIF
34. 34. Open Spinal Surgery
35. 35. Open Spinal Surgery
36. 36. Spondylolisthesis Case Study - Intra-op fluoro or photos, if available - keep to a minimum, fitting on this one slide only
37. 37. Indication Degenerative Scoliosis Symptoms Back and/or leg pain due to muscle fatigue and nerve impingement XLIF Correction Restores proper alignment and disc height Degenerative Scoliosis before XLIF Restoration of Alignment after XLIF
38. 38. Degenerative Scoliosis Case Study - x-rays (AP and lateral) - MRI if relevant
39. 39. Degenerative Scoliosis Case Study
40. 40. Case Study - Intra-op fluoro or photos, if available - keep to a minimum, fitting on this one slide only
41. 41. STEM CELLS Osteocel is an allograft cellular bone matrix retaining native mesenchymal stem cells (MSCs) and osteoprogenitor cells provides all 3 components for bone formation: 1. osteoconductivity: cancellous scaffold 2. osteoinductivity: MSC growth factor 3. osteogenicity: osteoprogenitor cells
42. 42. Nate Quarry, Ultimate Fighter & XLIF Surgical Patient, June 2006 Returns to Octagon 15 Months After Surgery
43. 43. Thank You ElPasoSpine.Center ElPasoSpineCenter.com FaceBook
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