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John Abrahams, MD, FAANS
Q. Why is back pain so prevalent? And, what advancements are being made to better the surgical process if it’s needed?
A. Back pain is among the top five reasons that people visit their community Emergency Room each year. If you think about it, it makes sense. Your back and spine have held you in place your entire life. They’ve allowed you to dance, run and shovel your driveway each winter. After years of loyal service, things happen. Discs can bulge, an awkward movement or lift at the gym can happen and cause pain, or your genetic predisposition to arthritis may make itself known. The good news? Most people don’t need surgery. The better news? If you do need spine surgery – you can now go home the same day. Outpatient spine surgery is gaining popularity among both physicians and their patients.
Q. How have minimally invasive techniques made outpatient spine surgery possible?
A. According to the Society for Ambulatory Spine Surgery, only five percent of spine cases were performed on an outpatient basis in 2005. Today, almost half of spine cases are outpatient. Improvements in minimally invasive techniques that include smaller incisions with less dissection and decreased operative times have increased the number of surgical cases in the outpatient setting. In addition, these newer methods have allowed surgeons to correct and treat chronic spine and back pain and send their patients to heal where they’re comfortable, at home. Ninety five percent of my patients go home to same day and they can’t believe it when we tell them they can.
Q. Can anyone have outpatient spine surgery?
A. Right now, not all spinal surgery is ideal for outpatient healing. Lumbar fusions, for example, require a two day hospital stay. We’re working on lowering the amount of time spent in the hospital for this procedure by involving pain management education, social work and physical therapy even before the patient goes into surgery. By doing this, patients are in less pain, more mobile and overall, more equipped to care for themselves at home. Advanced age, certain pre-existing medical conditions and degree of functioning capacity are key factors I’ll consider when deciding if a patient is the right fit for outpatient spinal surgery. The ideal candidate for outpatient spinal surgery is someone who is independent at home, functional, and able to care for themselves. Those with sleep apnea used to be excluded from surgery in an outpatient setting, they’re not anymore. However, if you have a history of heart disease, stroke or a compromised immune system, you’ll likely stay overnight.
Q. What are the benefits of outpatient spine surgery?
A. Since its implementation at Northern Westchester Hospital, I’ve seen less pain after surgery, due to smaller incisions and less dissection; greater mobilization; a decrease in hospital acquired infections – the longer you’re in the hospital, where there are a lot of sick people – the more likely you are to get an infection, and finally patients who smile after surgery knowing they’ll be able to watch a movie with their family that night.
Northern Westchester Hospital
Co-Director, Orthopedic & Spine Institute, Spine Section
Learn More About Dr. Abrahams
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