Surgical Treatment for Spine Disorders
Jamie Baisden, MD
Medical College of Wisconsin Neurosurgeon
“There’s no question that when it comes to spinal cord injury, outcomes are greatly improved when each discipline works together as we do here.”
Care for the spine, whether it’s to address degenerative spine disease or a spinal cord injury, can be challenging. Jamie Baisden, MD, discusses what is involved in treating patients with spine disorders.
Q: Degenerative spine disease is a common condition. How do you approach patient treatment of this disorder?
Most degenerative spine conditions should be treated non-operatively. Such management entails treatment of pain with anti-inflammatory medications, muscle relaxants, occasional narcotics, and an aggressive physical therapy and conditioning program. Those patients that fail to respond to non-operative treatment may be candidates for a minimally invasive surgical procedure or a more reconstructive procedure depending on the disorder. After surgery, an aggressive rehabilitation program is usually incorporated in the treatment and, hopefully, prevention of further spine injuries.
Q: Spinal cord injuries obviously have a different treatment approach. Can you describe that?
Three things are important in treating spinal cord injuries — timely diagnosis and treatment, and having all aspects of care under one roof. One of the things that sets Froedtert & Medical College apart is having an in-house trauma team. Patients are rapidly evaluated for cranial trauma as well as spinal trauma. There is 24-hour access to resources like CAT scans and MRIs. That immediate diagnosis is critical in determining the type of fracture causing the cord injury and helping us decide the best approach to decompress the spinal cord and stabilize the spine.
The Froedtert & Medical College Spinal Cord Injury Center is another important part of our care approach because it integrates every aspect of treatment. There’s no question that outcomes are greatly improved when each discipline works together as we do here. The minute a patient hits the trauma door until the time they are discharged from rehab, they’re receiving a continuity of care. As a neurosurgeon, I’m able to easily follow-up with my patients who are now in rehabilitation programs. I think the Spinal Cord Injury Center is a true resource in the community.
Q: What are some of the latest developments in neurosurgery to treat spine disorders?
There are multiple new innovations in spine surgery, but one of the most difficult aspects of spine surgery is the recovery period. However, for some surgeries, such as those to treat herniated discs, compression fractures, and certain degenerative conditions, we’re using refined imaging technology to assist us in performing minimally invasive surgery.
This new technology includes instruments and devices that allow us to operate accurately from a greater distance with minimal exposures compared to traditional open techniques. That means we can make smaller incisions that heal faster. In some cases, we can use devices that stretch rather than cut muscles, so we can reach the spine and accurately remove disc/bone which may be placing pressure on nerve tissue, or place fusion materials such as screws and bone graft. Not everyone is a candidate for minimally invasive procedures; but minimally invasive techniques will hopefully reduce postoperative pain, decrease hospital stays, and speed patient recovery.
In addition, we’re using image– guided technology to enhance surgical accuracy. We start with information from fluoroscopy, CAT scan, or MRI scans to create a three-dimensional model of the spine. Then we use special cameras to match that radiographic model to a patient’s anatomy during surgery. This “computer model” view helps us determine the exact location of our surgical instruments in relation to surrounding tissue or bone and reduces any risk to those critical structures.
Did You Know?
The Commission on Accreditation of Rehabilitation Facilities (CARF) recently reaccredited the Froedtert & Medical College General Rehabilitation Program, Brain Injury and Stroke Rehabilitation Program and Spinal Cord Injury Center. Froedtert is the only organization in Wisconsin currently holding CARF accreditation in all three areas. CARF endorsement means that these programs and centers meet strict requirements as hospital programs providing comprehensive rehabilitation services. Check out the spine care resources at Small Stones.