Answers about Controversial Trends in Spine Care

I found an excellent link where a group of spine surgeons answered questions about controversial trends.
https://www.beckersspine.com/biologics/item/50488-stem-cells-in-spine-orthopedics-6-notes-for-surgeons.html
This is a good resource for patients to understand issues if they run into a medical opinion about a procedure that could be unusual or risky. This also gives the patient a basis to ask questions of their medical providers and gauge the answers they get against current accepted medical thinking and of course keeping in mind that every patient case is different. By understanding some of the "solutions" being offered, the patient can ask more detailed investigative questions before they consent to a procedure. It is too easy to be a patient who just says yes without understanding possible risks or consequences as well as financial burdens of treatments that may not be effective.

The surgeons expressed opinions about marketing of new technologies as a solution looking for a problem to solve, rather than focusing on the patient's needs and what is best; in other words, letting marketing of hardware and implants influence choices in surgeries, or when a procedure carries risks because the providers are not spine surgeons, or the surgical procedure can be compromised because a minimally invasive procedure doesn't allow enough access to completely fix the problem. Should artificial disc replacements be used next to or combined with fusions? While stem cells are being studied for spine repairs, at this time, stem cell studies have not come far enough for treatment to be able to just inject a damaged spinal disc and expect a miracle.

These are some of the topics they covered. As a patient, always ask questions about benefits and risks of surgical procedures. Get multiple opinions if you can before a decision about major surgery, and you may find different procedures offered. Some surgeries can make a patient worse, so do your best to understand how and why a procedure can help, and why and what happens if it fails, and their success rates specifically for the provider you are choosing in relation to your health status. These are the topics surgeons talk about at conferences where spine surgery leaders present their cases and discuss the results. They also present cases where they have to try to fix something that wasn't done well in a prior surgery. Knowing this kind of information may help a patient recognize when they have found a good surgeon in whom they can place their trust. I was an advocate for myself for cervical spine surgery and looked for information like this to help inform my decision.

I was watching some Youtube videos, and saw several touting ultrasonic techniques for cervical stenosis. I was surprised to not find any threads about this here (at least searching for 'ultrasonic' did not return anything).

Has anyone had experience with this technique? It appears to be claiming far less intrusive, less chance of damage to the spinal cord, quicker recovery etc.
It claims to be a newer technique, and I know from experience that many doctors only recommend what they were trained on, no matter how long ago.

Thanks,

Mitch

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@birdman518

I was watching some Youtube videos, and saw several touting ultrasonic techniques for cervical stenosis. I was surprised to not find any threads about this here (at least searching for 'ultrasonic' did not return anything).

Has anyone had experience with this technique? It appears to be claiming far less intrusive, less chance of damage to the spinal cord, quicker recovery etc.
It claims to be a newer technique, and I know from experience that many doctors only recommend what they were trained on, no matter how long ago.

Thanks,

Mitch

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Hi @birdman518, Thanks so much for your post. I added it to @jenniferhunter post so you guys could connect. Just different concepts for spine surgery.

Can you share what your doctor recommended or what you know about the doctors you have seen?

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@amandaburnett

Hi @birdman518, Thanks so much for your post. I added it to @jenniferhunter post so you guys could connect. Just different concepts for spine surgery.

Can you share what your doctor recommended or what you know about the doctors you have seen?

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@birdman518 I looked up ultrasonic bone scalpel on Beckersspine.com and found you are correct. There is an article where surgeons weigh in about this tool. Beckers Spine Review does require you to sign up to access the information and they ask why you want to look at it. It used to be accessible without signing up, and I signed up because of what I do here. The company that makes this tool is Misonix and here is a link to their product information relating to use in spine surgery.
https://misonix.com/products/bone-scalpel/
The surgeons who reviewed this tool on Beckers Spine were Kai Ming Gregory Fu, MD, PhD, neurosurgeon with Weill Cornell Medicine Brain and Spine Center in New York City, and Nicholas Theodore, MD, director of the Neurosurgical Spine Center and a professor of neurosurgery at Johns Hopkins Medicine in Baltimore. Both spoke favorably of the precision of the tool and the degree of safety it provided and spoke of it as a game changer in their field. They spoke of the future of spine surgery with the pairing of an ultrasonic scalpel with a robotic assist.

Another surgeon who spoke of the Misonix ultrasonic scalpel is Isador Lieberman, MD, Spine Surgeon, Texas Back Institute, Plano. He called it a game changer that allows cuts to be made with precision and in a less invasive manner.

Here is a link to testimonials by surgeons who use the Misonix ultrasonic scalpel.
https://misonix.com/testimonials-bonescalpel/
This was an interesting question, and this new technology is making spine surgery better and safer according to the opinions of surgeons who use this device. If you are seeking a surgeon using this technology, the testimonials will provide a list.

Mitch, are you just curious or are you in need of surgery that might utilize this device? Thanks for asking; it was a great question.

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Is this a possible alternative to the stimulation implant?

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@stantallusa

Is this a possible alternative to the stimulation implant?

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@stantallusa The Misonix is a surgical tool that allows surgeons to cut through bone with precise accuracy. It makes spine surgery more efficient. It is not an implant.

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@jenniferhunter

@stantallusa The Misonix is a surgical tool that allows surgeons to cut through bone with precise accuracy. It makes spine surgery more efficient. It is not an implant.

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I understand that. I was wondering if this allowed the paths the nerves go through to be opened up and relieve the pain.

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@stantallusa

I understand that. I was wondering if this allowed the paths the nerves go through to be opened up and relieve the pain.

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@stantallusa OK, thanks for clarifying. What comes to my mind is the foramen which are the spaces between each vertebrae where the spinal nerves exit the spine. These can get closed down with arthritic bone growth compressing the nerves. The Misonex ultrasonic scalpel can be used for this and they describe this on their website because the tool is flat and can slice thin slices of bone with accuracy to open up the foramen and free the trapped nerves and avoid hitting the nerves. It is specifically for cutting bone. In other places in the body nerves can get trapped in small spaces where they travel around and through muscle bundles, tendons and ligaments and past joints.

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Thanks Jennifer… sorry for the delay as I was on the road. I have my appt with my neurosurgeon Oct. 6, so I will ask about this.

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@jenniferhunter

@birdman518 I looked up ultrasonic bone scalpel on Beckersspine.com and found you are correct. There is an article where surgeons weigh in about this tool. Beckers Spine Review does require you to sign up to access the information and they ask why you want to look at it. It used to be accessible without signing up, and I signed up because of what I do here. The company that makes this tool is Misonix and here is a link to their product information relating to use in spine surgery.
https://misonix.com/products/bone-scalpel/
The surgeons who reviewed this tool on Beckers Spine were Kai Ming Gregory Fu, MD, PhD, neurosurgeon with Weill Cornell Medicine Brain and Spine Center in New York City, and Nicholas Theodore, MD, director of the Neurosurgical Spine Center and a professor of neurosurgery at Johns Hopkins Medicine in Baltimore. Both spoke favorably of the precision of the tool and the degree of safety it provided and spoke of it as a game changer in their field. They spoke of the future of spine surgery with the pairing of an ultrasonic scalpel with a robotic assist.

Another surgeon who spoke of the Misonix ultrasonic scalpel is Isador Lieberman, MD, Spine Surgeon, Texas Back Institute, Plano. He called it a game changer that allows cuts to be made with precision and in a less invasive manner.

Here is a link to testimonials by surgeons who use the Misonix ultrasonic scalpel.
https://misonix.com/testimonials-bonescalpel/
This was an interesting question, and this new technology is making spine surgery better and safer according to the opinions of surgeons who use this device. If you are seeking a surgeon using this technology, the testimonials will provide a list.

Mitch, are you just curious or are you in need of surgery that might utilize this device? Thanks for asking; it was a great question.

Jump to this post

I am 99.9% sure I have cervical radiculopathy as well as lumber issues due to "severe stenosis" in both places. I have severe numbness and pain in right shoulder and arm, and my right hand is pretty numb, with the thumb and index finger the worst.

REPLY
@jenniferhunter

@stantallusa OK, thanks for clarifying. What comes to my mind is the foramen which are the spaces between each vertebrae where the spinal nerves exit the spine. These can get closed down with arthritic bone growth compressing the nerves. The Misonex ultrasonic scalpel can be used for this and they describe this on their website because the tool is flat and can slice thin slices of bone with accuracy to open up the foramen and free the trapped nerves and avoid hitting the nerves. It is specifically for cutting bone. In other places in the body nerves can get trapped in small spaces where they travel around and through muscle bundles, tendons and ligaments and past joints.

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Wow. Now I need to find someone to look at my MRIs and tell me if this may be an option for me. I have seen ads over the last few years advertising “cyber knife”. Is that what this is?

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@stantallusa

Wow. Now I need to find someone to look at my MRIs and tell me if this may be an option for me. I have seen ads over the last few years advertising “cyber knife”. Is that what this is?

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@stantallusa Only a surgeon can clarify what the tools are that they use and how they use them, so we can't assume anything about an advertisement. Calling something a "cyber knife" instead of the actual product name sounds like a term to make it less worrisome and more attractive to patients. I know that isn't an answer to your question, but it is so important to ask questions so you fully understand everything about surgery you are considering. I have not sought out surgeons who are advertising for patients, and personally, I would have a hard time trusting a surgeon who needs to advertise to get patients. Some have educational online videos for patient education which would not be considered advertising. Their reputation and skills should be recognized by respected medical institutions and the ratings by the insurance companies who are funding the procedures. I look for medical literature by any surgeon I am considering and read it. I look for participation in spine surgical societies and conferences and for a surgeon who is teaching surgical procedures at the conferences. There you will find the leaders in the field. Choosing the best surgeon you can find who's interests match with what you need can make a lot of difference in the results and recovery from a procedure, and also being the best patient you can be by making wise health choices that will improve your ability to heal. Often it helps to get multiple opinions because there can be different ways to solve a problem, and the risks may be a bit different with different procedures or implants. The patient needs to make an educated choice about what is best for them with the advice of a physician that they trust.

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@jenniferhunter

@stantallusa Only a surgeon can clarify what the tools are that they use and how they use them, so we can't assume anything about an advertisement. Calling something a "cyber knife" instead of the actual product name sounds like a term to make it less worrisome and more attractive to patients. I know that isn't an answer to your question, but it is so important to ask questions so you fully understand everything about surgery you are considering. I have not sought out surgeons who are advertising for patients, and personally, I would have a hard time trusting a surgeon who needs to advertise to get patients. Some have educational online videos for patient education which would not be considered advertising. Their reputation and skills should be recognized by respected medical institutions and the ratings by the insurance companies who are funding the procedures. I look for medical literature by any surgeon I am considering and read it. I look for participation in spine surgical societies and conferences and for a surgeon who is teaching surgical procedures at the conferences. There you will find the leaders in the field. Choosing the best surgeon you can find who's interests match with what you need can make a lot of difference in the results and recovery from a procedure, and also being the best patient you can be by making wise health choices that will improve your ability to heal. Often it helps to get multiple opinions because there can be different ways to solve a problem, and the risks may be a bit different with different procedures or implants. The patient needs to make an educated choice about what is best for them with the advice of a physician that they trust.

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These are great strategies for finding the best in other fields as well……and it is essential in medicine. I look with disdain at those who must advertise and create stories without substance. Thank you Jennifer.

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