Saturday, December 14, 2019

As mentioned in previous articles, the Center for Musculoskeletal Disorders has taken a leadership role in the Bergenfield Surgical Center, enabling greater patient care and efficiency.

Multiple pain management as well as podiatric and hand procedures have been done, as well as semi-complex spinal procedures such as removal of disc herniation as well as cervical fusion.

One such recent case occurred with Teaneck community member, L.M., a 48-year-old healthy female who was having four weeks of acute onset of back pain with severe radiation into the right thigh. The patient presented to the Center for Musculoskeletal Disorders office having utilized the group on previous encounters for various orthopedic and pain needs. She was evaluated by the spinal team, which requested an MRI. The films showed a moderate-sized disc herniation, which was pressing on the lateral (outside) aspect of her nerve. These particular disc herniations can be very, very painful!

After attempting several epidural steroid injections, the pain was still not relieved. It was decided to perform a spinal discectomy. The patient was very interested in getting it done quickly, having suffered for greater than four weeks. The question was where to schedule? Hospital versus ambulatory surgical center. Since the patient was very healthy as well as quite thin, it was decided to perform the procedure in the ambulatory surgery center to allow ease of scheduling as well as streamlining the process through our office.

On May 20, a microdiscectomy was done, using a microscope as well as tubular instrumentation through a 2-cm. incision. At surgery, the disc was isolated and removed without complication. The patient left the ambulatory surgery center after convalescing in less than three to four hours!

In an interview postoperatively with the patient, she noted that the entire process, from start to finish (although not something she would wish to repeat) was made much easier by the streamlining of the diagnosis to treatment to ultimate surgery with the use of an ambulatory surgery center. “I do not ever want to do this again, but if I had to do something like this, or had to advise someone, I would say that an outpatient surgery in the Bergenfield Surgical Center, even of a spinal nature, is something worthwhile to consider.”

The use of ambulatory surgery centers in the treatment of spinal disease is on the rise. Initially, when ambulatory surgeries were introduced, only simple gastrointestinal and/or injection procedures were performed, The benchmark has significantly widened.

As of 2019, the number of ambulatory center spinal surgeries done yearly is over 300,000! With cost-containment concerns and patient desire, that number is likely to increase. There have been no studies to date that show that the judicious use of ambulatory surgery centers in the treatment of spinal disease has led to any untoward impact.

In our own experience, we have found that the overall experience, both for patient and doctor, has led to both good to great results as well as reduced anxiety. If you, or anyone you know, is in need of spinal treatment, please do not hesitate to contact our office at (201) 510-3777 or reach out to Eliana Kranz, community liaison at [email protected]

Wishing you the best of health!

By Dr. Steven Horowitz and Dr. Jonathan Simhaee