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Suffering from Back or Leg Pain?
Minimally Invasive
Treatment Options for Degenerative Spine Conditions
El Paso Spine CenterDean E. Smith MD
Dean E. Smith MDSpine 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
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
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.
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
Back Pain Prevention
• Body Position– Lifting– Sitting– Sleeping– Standing
• Exercise– Aerobics– Stretching
• Other Considerations– Smoking– Weight
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.
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
NeuroVision® JJB
• Advanced technology that provides intraoperative information about nerve safety
• Used successfully in over 100,000 spinal surgeries
• 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™
Patient BenefitsMinimally Invasive Surgery
Source:
*Wright N, XLIF – the United States experience 2003-4, International Meeting on Advanced Spine Techniques, 2005, Banff, Canada.
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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®)
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 Degenerationbefore XLIF
Restoration of Heightafter XLIF
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 Degenerationbefore XLIF
Restoration of Heightafter XLIF
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 Alignmentand Disc Height after XLIF
Spondylolisthesis Case Study
- Intra-op fluoro or photos, if available
- keep to a minimum, fitting on this one slide only
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 Alignmentafter XLIF
Case Study
- Intra-op fluoro or photos, if available
- keep to a minimum, fitting on this one slide only
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 scaffold2. osteoinductivity: MSC growth factor3. osteogenicity: osteoprogenitor cells
Nate Quarry, Ultimate Fighter & XLIF® Surgical Patient, June 2006 – Returns to Octagon 15 Months After Surgery