Here's Dr. Prada's take on minimally invasive spine and what's at the forefront for the Laser Spine Institute.
Q: What are the most pressing issues in spine surgery?
Dr. Stefan Prada: There are several factors on the forefront of spine surgery. Generally, in any aspect of surgery, staying advanced with technology is at the forefront, especially with spine surgery in this day and age. The key is performing minimally invasive procedures. What you take away from meetings [of industry professionals] is that if you aren't in minimally invasive, you are falling behind.
Another point everyone is looking at in medicine is trying to maintain the cost of medicine in the United States, making it readily accessible to patients. [The Laser Spine Institute] is trying to make sure you put the patient as the number one priority and make sure they don't get lost in the shuffle.
Q: What technologies are being implemented at the Laser Spine Institute?
SP: On the forefront of spine especially is staying technologically advanced with minimally invasive surgery. Here at the Laser Spine Institute, our main premise is to always be on the forefront of unique surgeries with neck and back. We do our surgery in an ASC, so we have same-day surgery with quick recovery times. Our latest endeavor is minimally invasive fusion, which used to involve a long incision and destruction to the soft tissue. Now we put small screws and rods, if necessary, into small poke holes and preserve the muscles. This limits low back pain, and studies show if you preserve the soft tissue around the spine, you will have better outcomes. Doing it in a minimally invasive setting allows for outpatient surgery to be done, maintaining lower costs and a quicker recovery. Patients can go home or go to a hotel the same day. This eliminates the expense of hospital admission and overnight stays.
We also have a variety of cutting-edge endoscopic surgeries. In endoscopic surgery we operate through small tubes in the neck and low back. We have 16 and 18 millimeter tubes to look through. The cameras we look through are 5 mm. The camera goes down to the source of the spinal nerve compression, and we see everything magnified on a screen. It makes for very crystal clear image of the pathology
Q: How do you make patients your top priority?
SP: As a physician, I want to do what's right for the patient and advocate for them. You don't want to tell them you can help them and have them come in for surgeries that aren't going to benefit them. So we are having a third-party venue access and log our outcomes, that way there is no bias in the outcome studies. In streamlining our healthcare process, we have developed a way to treat patients in a personalized manner.
Each patient is assigned a patient coordinator from day one, from when they call our office to sending them to the MRIs to getting them here and helping them get accommodations. Their patient coordinator makes sure everything is working for them, including transportation to and from the facility. Many of our patients form a bond with their coordinators and call them first after the surgical process if they have any questions. It's a personal touch every patient gets when they come through our system, and we get very positive feedback from patients.
Q: What do you see on forefront spine surgery?
SP: Minimally invasive spine surgery is going to catch on in ASCs once people see you can do it in an outpatient setting safely with outstanding results, still maintaining lower costs than the old-fashioned way with big incisions. Everyone is trying to cut costs.
There are always advances. We are starting a RegenaDISC program, which is the process of rejuvenating discs in patients with early wear of a disc that is not yet herniated. Those can be quite painful. Most are ignored or are given therapy or pain management. We are looking to rejuvenating these discs. We use a combination of a laser treatment to the disc and inject healthy cells into discs with a combination of stem cells. By combining these technologies we are leaving patients with rejuvenated discs and preventing fusion or artificial disc replacement in the future. The patient can get an improved quality of life.
Studies have shown low level laser treatments of discs can stimulate cell growth in the disc and stimulate channels to allow nutrients to flow through the disc to stay healthy.
Q: What are the biggest challenges you are facing in the spine surgery industry?
SP: The biggest challenge for us is when we have patients come in with more than one issue. In an outpatient setting that would involve more than one surgery. Often people come in from out of town hoping for one procedure or one cure. We do testing to make sure they are candidates and discover if the source of pain truly is the source of their pain. It's not until we've truly proven that source do we proceed. Unfortunately, to maintain as outpatient, we have to do more than one procedure, which can slow their recovery process.
Our population is aging and living longer. We see the older generation coming in with more than one issue. But the younger generation frequently has one issue and we can treat them and help in providing a productive lifestyle. We have 93 percent of patients report satisfaction. Ninety-seven percent would recommend Laser Spine Institute to a family member or friend and report a better quality of life.
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Performing Minimally Invasive Spine in the Outpatient Setting: Q&A With Laser Spine Institute's Dr. Stefan Prada FeaturedWritten by Heather Linder | September 28, 2012
Stefan Prada, MD, is a board-certified orthopedic surgeon with Laser Spine Institute's Tampa, Fla., facility. Dr. Prada is a fellow of the American Academy of Orthopaedic Surgeons, and he has an interest in treating with minimally invasive, endoscopic procedures.
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