1. Suffering from Back or Leg Pain? Minimally Invasive
Treatment Options for Degenerative Spine Conditions El Paso Spine
Center Dean E. Smith MD
2. Foundation Hospital
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. Minimally Invasive Surgery Minimize Collateral Damage to
normal tissue Typical Incision One level Lumbar Fusion
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. 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. 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. Back Pain Prevention Body Position Lifting Sitting Sleeping
Standing Exercise Aerobics Stretching Other Considerations Smoking
Weight
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. Traditional Surgical Approaches BackFront Back
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. Lateral Interbody Approach XLif Side
14. A Minimally Disruptive Surgical Approach
15. Surgical Incision
16. Minimally Invasive Lumbar
17. Minimally Invasive Lumbar
18. Minimally Invasive Robot Lumbar
19. Surgical Approaches
20. NeuroVision JJB Advanced technology that provides
intraoperative information about nerve safety Used successfully in
over 100,000 spinal surgeries
21. Laser Spinal Surgery * *
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. 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. 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. Lumbar Anatomy
26. Indication Degenerative Disc Disease (DDD)
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. 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. Degenerative Disc Disease Case Study - x-rays (AP and
lateral) - MRI if relevant
30. Degenerative Disc Disease Case Study - x-rays (AP and
lateral) - MRI if relevant
31. Surgical Incision
32. Indication Spondylolisthesis
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. Open Spinal Surgery
35. Open Spinal Surgery
36. Spondylolisthesis Case Study - Intra-op fluoro or photos,
if available - keep to a minimum, fitting on this one slide
only
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. Degenerative Scoliosis Case Study - x-rays (AP and lateral)
- MRI if relevant
39. Degenerative Scoliosis Case Study
40. Case Study - Intra-op fluoro or photos, if available - keep
to a minimum, fitting on this one slide only
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. Nate Quarry, Ultimate Fighter & XLIF Surgical Patient,
June 2006 Returns to Octagon 15 Months After Surgery
43. Thank You ElPasoSpine.Center ElPasoSpineCenter.com
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Tumbir @ElPasoSpineCenter