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Note from 9th annual Ortho conference in Chicago
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| iSpine Discuss Note from 9th annual Ortho conference in Chicago in the Main forums forums; Robert Nucci, MD, a surgeon at Citrus Park Surgery Center, gave a presentation titled "Minimally Invasive Outpatient Lumbar fusions ... |
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06-23-2011, 11:35 PM
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Note from 9th annual Ortho conference in Chicago
Robert Nucci, MD, a surgeon at Citrus Park Surgery Center, gave a presentation titled "Minimally Invasive Outpatient Lumbar fusions and Multi-Level Outpatient Cervical Disc Replacements" at the 9th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 10, 2011. Dr. Nucci discussed the benefits associated with performing spine cases in ASCs and described the far lateral interbody fusion procedure he has performed on patients in ASCs.
The main concerns surgeons have with performing spine surgery in ASCs are: • The infection rate is lower than in hospitals • There is less overhead cost and increased efficiency in the OR • Shorter anesthesia time To perform single or multi-level FLIFs, Dr. Nucci removes the disc through a small incision, inserts a mesh cage and inflates it with allograft bone. The average OR time for the procedure is 129 minutes, surgeon time is 118 minutes and recovery time is 180 minutes. The average blood loss is 141 cc and there is minimal muscle tissue disruption. Dr. Nucci also performs cervical disc replacement in ASCs using an artificial disc. The average OR time is 92.4 minutes, surgeon time is 77.5 minutes and recovery is 140.8 minutes. Patients are under anesthesia for approximately two hours and experience average blood loss of 95 cc. He hasn't experienced any complications with that procedure
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female age 45, height 5"6", 145 lbds, non smoker, conservative treatments failed, (7/2007) C4/5/6 peek disc replacements,plate & screws failed fusion, (9/2008) revision with bone replace plate and screws, (10/2009) C3/4 stand alone peek cage, (12/2010) facet joint injections C3-7, (1/2011) rhizotomy C6/7 failed, Trouble swallowing most recent mri (7/2011) shows ajacent level issues: right neural foraminal narrowing C2/3, posterior bulge indents thecal sac at C6/7/T1 no mass effect on cord. 
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06-24-2011, 04:10 PM
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Thanks Maria, I was going to ask about that. Around here they are called Outpatient Surgery Centers
judy
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2007 ACDF 4-7 2008 hip , knee scope, hip replacement 2009 thoracic T-5 thru T-11fusion 2009 VATS T7-8, posterior only T11-12. removal of thoracic hard wear 2010 lung surgery 2010 T2-L2 kyphosis correction 2010 Kyphoplasty T-3, T-4 2011 Cervical osteotomy ,revision C4-T5 2011 Foot surgery 2011 Revision fusion T7 thru L4/laminectomy 2012 Hammertoe correction left foot 2012 Revision fusion T-12 thru L5 2012 Revision fusion L4-L5
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06-25-2011, 12:31 PM
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yes
they are called that i guess in most places.
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female age 45, height 5"6", 145 lbds, non smoker, conservative treatments failed, (7/2007) C4/5/6 peek disc replacements,plate & screws failed fusion, (9/2008) revision with bone replace plate and screws, (10/2009) C3/4 stand alone peek cage, (12/2010) facet joint injections C3-7, (1/2011) rhizotomy C6/7 failed, Trouble swallowing most recent mri (7/2011) shows ajacent level issues: right neural foraminal narrowing C2/3, posterior bulge indents thecal sac at C6/7/T1 no mass effect on cord.
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06-25-2011, 01:31 PM
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Ambulatory Care
I used to work in an ambulatory care center which was a clinic outside the main hospital that saw an outpatient population. Not that one had to be walking in because we had a fair share of patients that came in w/motorized wheelchair.
I don't know whether in most cities unattached surgery centers are called ambulatory care surgery centers or outpatient surgery centers.. I still call the Emergency Dept. the Emergency Room as in go to the ER now vs. go to the ED now. No matter how many times I see ED in print I just can't get into calling it that.
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06-25-2011, 03:59 PM
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This fusion technique sounds like the Optimesh fusions I saw many years ago at IITS meeting in San Diego. (International Intradiscal Therapy Society) They had a cadaver lab in which this technique was taught.
The mesh sac can be inserted endoscopically. It is then packed (inflated) by packing morselized bone. As I remember, the problem with this device is that the fusion rate is not that great. The implant may then function like an artificial disc. However, it is not very nicely controlled and can move, breakdown, etc...  Mark
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1997 MVA 2000 L4-5 Microdiscectomy/laminotomy 2001 L5-S1 Micro-d/lami 2002 L4-S1 Charite' ADR - SUCCESS! 2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova Summer 2009, more bad thoracic discs! Life After Surgery Website President: Global Patient Network, Inc. Founder: www.iSpine.org
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