Laser Spine Institute Blog

Laser Spine Institute Celebrates 5th Anniversary

2010-03-15T17:22:15Z

On March 14, 2005, Laser Spine Institute opened for business with just three physicians and nine employees. Working in a 2,500-square-foot space, the small team averaged about 15 procedures per month. Five years later, Laser Spine Institute has grown into the leader in minimally invasive spine procedures. In fact, no surgical provider in the world can match the 400 spine procedures that LSI performs on average each month.

Why has the company experienced such phenomenal growth? Certainly there has proven to be a tremendous demand for a gentle alternative to traditional open back and neck surgery ... one that allows patients to be back on their feet in about an hour, and back to normal activities in just a couple of days.

Today, Laser Spine Institute boasts 18 physicians and nearly 300 employees who are committed to "Above and Beyond" patient care. Stacy Danahy, LSI's director of medical operations, explains, "As I look back on the past five years, I truly love the difference we make in people's lives, whether it is surgical, educational, medical or personal. I believe in our leaders and surgeons, assisting people who have often tried so many alternatives find real relief and get their lives back."

The company now performs endoscopic procedures in surgical centers in Tampa, FL; Scottsdale, AZ; and Philadelphia, PA. In addition, patient consultations are also provided in convenient medical facilities in Beverly Hills, CA; San Diego, CA; Ft. Lauderdale, FL; and The Villages, FL.

To keep up with the unprecedented interest in its outpatient procedures, Laser Spine Institute hosts free educational seminars in cities throughout the United States and Canada. In 2009, more than 16,000 people took advantage of the comprehensive presentations, which are highlighted by the opportunity for attendees to have their MRI films or CT scans reviewed by board-certified physicians.

Laser Spine Institute is proud to celebrate its 5th anniversary of helping people find relief from debilitating pain.

Published in Laser Spine Institute's monthly newsletter, The Spinal Column, March 2010, Volume 2, Issue 3.

Loving the California Lifestyle: LSI Beverly Hills Medical Center

2010-03-11T13:00:42Z

A few weeks ago, I blogged about our San Diego medical consultation center - LSI's first of four medical offices in the U.S. During the first year of the San Diego office, we noticed many patients were traveling from the Los Angeles area to meet with Dr. Richley and learn about LSI's endoscopic approach to spine surgery. In fall of 2009, we opened a Los Angeles medical consultation facility in Beverly Hills.

What I have learned over the last year about the west coast from traveling to our medical offices and attending many seminars throughout the great state of California is that California residents truly enjoy life and won't let anything affect their lifestyle. I completely understand because there are so many things to enjoy in California; hiking, biking, skiing, surfing, driving along the coast, dining at many fine restaurants and traveling to various parts of the state from San Francisco and Napa Valley to the desert of Palm Springs. I have traveled throughout California and loved every region. If you are a California resident, I don't blame you for enjoying every minute!

If you live an active lifestyle, but are faced with chronic back or neck pain, don't suffer any longer. Let me know what conservative treatments you have tried and how they have worked for you.

Fear of Back Surgery; Fear No More

2010-03-09T12:52:06Z

In 2009, 4-million people in the U.S. reported that they were candidates for spine surgery or exhausted all other alternatives, but only 1.2-million people actually elected to do surgery! People always ask me why people are hesitant about spine surgery. My answer is always "fear." Fear of the pain of the procedure; fear of the unknown potential complications from surgery and fear of the length of time to recuperate. I am certain if more people knew about minimally invasive spine surgery that more people would elect to take the plunge and get on with their lives.

I avoided a three-level cervical spine fusion that would have required a plate and six screws. In one surgery that lasted 50 minutes, the LSI foramintomy and laminotomy procedures treated my spinal stenosis, degenerative disc disease and facet arthritis. I returned home one hour after my cervical surgery. Later that afternoon, I walked a mile and a half. I went back to work in two days and played golf in eight days (of course that was not recommended by Dr. St. Louis. LOL)

If the 2.8 million people living with pain and afraid of spine surgery knew about the caring medical staff at LSI; they would feel better about treating their spinal conditions sooner rather than later. If you are living with pain, please don't wait because of fear. Take the next step toward getting your life back.

Guest Blogger - Gretchen Dezelick, Director of Nursing at Laser Spine Institute Tampa: Infection Control Statement

2010-03-04T14:38:50Z

The infection preventionists at Laser Spine Institute have designed a coordinated infection prevention and control program to protect everyone who comes into the facility, including patients, healthcare workers and the public. Here are the steps we have taken at Laser Spine Institute to reduce the risk of infection.

Our program incorporates evidence-based practices from leading authorities in infection prevention including the Centers for Disease Control and Prevention (CDC) and the Association for Professionals in Infection Control and Epidemiology (APIC). In addition, we comply with regulations from government agencies such as the state and local health departments, the Occupational Safety and Health Administration (OHSHA) and the Centers for Medicare and Medicaid Services (CMS), as well as accrediting bodies, such as the American Association of Ambulatory Healthcare.

The essential elements of an infection prevention and control program to prevent healthcare-associated infections include:

• Rigorous hand hygiene practices that ensure healthcare providers clean their hands before and after providing patient care and after having contact with the patient's environment.
• Patients as well as visitors need to practice good hand hygiene. We encourage our patients to be partners in their care and talk with their healthcare providers about hand hygiene.
• Use of barrier precautions, such as gloves, gowns, masks, caps, etc. by healthcare workers and visitors.
• Separating patients with serious infections from other patients to prevent the transmission of infection.
• Proper disinfection of the patient's skin prior to surgical procedures.
• Environmental cleaning and decontamination of equipment, especially items that are frequently touched or are close to patients, such as bedrails and bedside equipment.
• Monitoring the cleaning, disinfection and sterilization of instruments and equipment used for patient care.
• Staff education on best practices to prevent infections including the spread of resistant organisms such as MRSA (Methacillin Resistant Staph Aureous) and VRE (Vancomycin Resistant Enterococci).
• Sharing information with patients and families so they understand the importance of infection prevention practices in all healthcare settings and at home.

In order to ensure patient safety, the medical team is trained to identify any breaks in infection prevention and control practices and prepared to intervene, if such breaks are identified.

Ocean Breeze and Sunshine: LSI San Diego Medical Center

2010-02-23T15:30:45Z

I am pleased to hear that our patients have truly benefited from a visit to one of our medical consultation centers. Since 2005, we have offered several different ways for patients to discuss their diagnosis and symptoms whether over the phone or at a seminar. Our new medical offices offer a different dynamic to the Laser Spine Institute consultation for chronic back and neck pain sufferers. In July 2008, we entered our first consultation market in beautiful San Diego, which is truly one of my favorite places to visit. Please allow me to share the LSI San Diego story with you.

Dr. Richard C. Richley, our managing physician in California, has been practicing in San Diego as a board-certified orthopedic surgeon and pioneer of minimally invasive spine surgery for over 34 years. After his service in the U.S. Army Security Agency and four years of playing football for The Ohio State University, where he graduated from medical school, Dr. Richley came to San Diego for his residency at the University of California San Diego.

In 1976, Dr. Richley started his practice before opening his Point Loma office in 1991. Nestled in the historical seaside community of San Diego, Dr. Richley grew his orthopedic practice through community involvement, love for local sports teams and philanthropic work on the Arthritis Foundation Board of Directors. He also served as a doctor with the Chargers and team physician for the Padres and U.S. Olympics. In the early 90's, Dr. Richley focused on new laser technology used in orthopedic medicine. He invited surgeons to learn new laser procedures and traveled the world to help apply the techniques within their practice.

In 2008, we were fortunate to add Dr. Richley to our medical team and adapt his practice to our first medical center. He now heads the LSI San Diego and Beverly Hills medical offices as well as travels the western U.S. and Canada to educate back pain sufferers on the anatomy of the spine, treatment options and Laser Spine Institute advanced procedures.

When you meet Dr. Richley, he will conduct a thorough medical examination and orthopedic assessment to understand the pain you're experiencing. Then, he will review your MRI films or CT scans to pinpoint the causes of your suffering, and explain how our advanced approach will get you relief. As he often reminds me about San Diego, "there's a little bit of ocean breeze and a lot of sunshine, not to mention the caring staff that has been with me for years offering patients a comfortable and engaging environment." And I have to agree it is one of the best places on Earth.

Healthcare Service: Taking Care of Our Patients

2010-02-17T13:07:45Z

I think it is safe to say we expect the healthcare industry to provide the best care available. With higher insurance coverage, out-of-pocket expenses and prescription drug costs, why shouldn't we also expect the best service by our chosen healthcare providers?

Taking into consideration my personal medical and surgical experiences, I have made a commitment to deliver the best service and exceed expectations of our patients here at Laser Spine Institute. Not only do we treat our patients and their loved ones like family during their journey with us but we remain in constant contact after they return home.

Our patient services team is devoted to each patient keeping an eye and ear open throughout their recovery for weeks to years after their procedure. This dedicated team provides support to patients who have post-operative questions about anything from caring for their incision area to returning to the activities that they love. Their goal is to help each and every patient achieve a successful recovery and get their lives back. We are proud to share in each patient's experience every step of the way.

A Night of Champions

2010-02-11T12:59:49Z

It is amazing how fast a year goes by. This time last year, Laser Spine Institute made a medical donation to the Gridiron Greats Assistance Fund to assist NFL legends without disability coverage, pension benefits or financial means to afford individualized care. Supported by more than 150 retired NFL players and coaches, Gridiron Greats is a non-profit organization that provides financial assistance and social services to retired NFL players with dire needs.

Last Friday before the Super Bowl in Miami, Gridiron Greats held a Night of Champions dinner and recognized many organizations involved with the fund. Dr. Michael Perry and I were pleased to receive the honor of Medical Partner of the Year on behalf of Laser Spine Institute. As a young boy, I dreamt of being an NFL football star like Johnny Unitas, Raymond Barry or Bart Starr. We were grateful for the award but the best part of the night was being surrounded by the retired players and coaches like Mike Ditka, Mark Clayton, Tony Dorsett, Eric Dickerson and Carl Eller, all of whom I admire.

It is no surprise that these former players, coaches and organizations support the fund because no one ever thought NFL legends would suffer as they have from the game they love. It is unbelievable that former professional athletes don't have the medical support they need after long successful careers in the NFL. Many of us at LSI share the love of the game and decided to donate our time, talents and resources to get these heroes their lives back.

Over the past year, we have helped retired players such as Jim Marshall from the Minnesota Vikings and Edwin Beckman from the Kansas City Chiefs. Mr. Marshall told us, "I feel better than I have the past 20 years" after his procedure. When speaking with Ed Beckman, he said, "When I was younger I could deal better with the pain, but as you age the body deteriorates. The pain worsened each year after I retired from the NFL. It got to where my legs would get numb and I would start falling down." After attending one of our seminars, we pointed him to the Gridiron Greats. Ed underwent a cervical and lumbar procedure at LSI and feels great. Thanks to our surgeons who help others get their lives back every day.

Stay Heart-Healthy For Your Valentine

2010-02-09T13:44:52Z

Hallmark Card and Kay Jewelers commercials on TV are a reminder that Valentine's Day is quickly approaching. It is so important to tell your loved ones how much you care about them, however, it is equally important to take care of yourself.

I would like to remind everyone that this month has another important focus - February is American Heart Month. Laser Spine Institute is known for relieving chronic back and neck pain. But we're big fans of heart health too.

The American Heart Association has developed this simple, seven-step list to help you live a long, productive healthy life:

1.    Get active
2.    Eat better
3.    Control cholesterol
4.    Manage blood pressure
5.    Reduce blood sugar
6.    Lose weight
7.    Stop smoking

This is a great list to live by and I am making strides on many of these steps every day. Show your family you love them this month not just for Valentine's Day but every day by taking care of yourself and staying heart-healthy.

Separating Fact from Misinformation: The Patient's Guide

2010-01-28T19:53:45Z

Many patients want to be vigilant and proactive in choosing a healthcare provider, but are uncertain of where or how they can access credible information. Filtering through the cloud of information is often both tedious and confusing for patients. So, what is the alternative? Whenever patients ask me this question, the best advice I can provide is to verify the provider's practice history and credentials through independent and reliable sources, such as local departments of health websites or hotlines. Examples of questions you should ask or factors you should consider are as follows:

•   Has the provider's medical license been suspended or revoked due to negligence or
   medical malpractice?
•   Has any disciplinary action been taken against the facility or its providers?
•   Does the provider practice transparency, i.e., do they provide a forum through which
   patients can publicly voice their concerns, opinions, and experience, and interact with
   existing and former patients?
•   Does the provider have a referral list with a reasonable number of patients? For example, if
   the facility claims to perform 30,000 procedures, but can only offer a list with 10 patients,
   then you should probably be skeptical and do further research.
•   Does the provider focus on criticizing other providers, rather than justifying their value on
   the basis of merit and success? If so, this is a propagandistic technique known as
   diversion and you should exercise caution when this approach is taken.

Please note that the list I have provided is by no means exhaustive, but it can be used as a starting point or guide. Remember, there are inherent risks involved with any surgery, but these risks can often be mitigated, or in some cases eliminated. As such, you should always exercise due diligence when selecting a provider.

Guest Blogger: Consumer Finance Specialist - Clay Grossman

2010-01-22T01:47:34Z

At Laser Spine Institute, we can determine a patient's total upfront cost after we verify their current insurance coverage. We strive to make our surgical procedures as affordable as possible with hopes of alleviating as much back and neck pain as possible. Through this effort, LSI has partnered with a few new insurance carriers, including United Health Care & affiliates, and also has the opportunity to lower our Medicare pricing. With these new agreements in place, moving forward in 2010 - LSI patients will experience the same state of the art, highest level of medical treatment available, with lower cost and commitments.

With regard to payment plans for those patients with upfront cost, LSI has established relationships with a few national healthcare finance companies that offer affordable monthly payments. And, while most financial lenders are currently restricting available credit, LSI has actually seen an increase in the average credit line approval.

This type of financing is a great option, but not necessarily the best for everyone. I recommend first looking into your personal resources, for instance:

1) Retirement/savings accounts (i.e. 401(K), IRA...)
2) FSA (Flexible Spending Account) - medical payment plan offered by your employer
3) The equity built in your home (i.e. Home Equity Loan, Reverse Mortgage, and Refinance & Consolidate Debt)

Even though the economy has tightened, these are viable options offering the lowest interest rates. For example, it is realistic to find a Home Equity Loan for 4 to 6 percent because the current Prime Rate is at all-time lows. If equity is not available, you may want to take advantage of your 401(K) or IRA funds. A majority of finance companies are offering loans penalty-free from a retirement account. This type of loan provides a greater return than the current average retirement plan.

It is my goal to help patients gain a better understanding of the programs, specifically created to offset any additional healthcare expenses after insurance reimbursement and tailor the right solution for each patient.

Endoscopic Spine Surgery Featuring Dr. John Spallino, MD

2010-01-15T01:30:51Z

Many patients suffering from back and neck pain may not be fully aware of all available options. Reflecting on my own experience, I did not know much about minimally invasive spine surgery until I was introduced to Dr. St. Louis. So, I thought it would be a good idea to share an article that was featured in this month's issue of our monthly newsletter, The Spinal Column. In this article, Dr. John Spallino discusses how endoscopic spine surgery has evolved, much like arthroscopic knee and shoulder surgery. I hope you will find this article helpful.

Endoscopic surgery refers to the use of specialized video cameras and instruments, which are passed through small incisions into the chest, abdominal or joint cavities to perform surgery. There is a threefold benefit of endoscopic spine surgery. The actual sizes of the surgical incisions are smaller, which leads to less pain and less damage to the surrounding tissues, so the recovery from surgery is much quicker.

Endoscopic techniques have been used for several decades, but these were exclusively for diagnostic purposes. In the late 1970s and early 1980s, endoscopic techniques were advanced, so that both a diagnosis could be made and the condition could be treated. These techniques have now been advanced to the treatment of spinal conditions including: herniated or bulging discs, bone spurs, spinal stenosis, foraminal stenosis, and facet disease.

By using special scopes, instruments and even a laser, LSI's surgeons have been able to successfully treat spinal conditions with minimal injury to surrounding healthy tissue and muscle. Therefore, what once required 3 to 6 months of recovery now requires 3 to 6 weeks. As with the surgical treatment of other medical conditions affecting gallbladder, knee, or shoulder, operations performed traditionally through large incisions are being performed less frequently, while the endoscopic approach is becoming the standard of care due to its overwhelming benefits.

Dr. John Spallino is a Medical Information Specialist at Laser Spine Institute. In this capacity, he facilitates patient education by conducting nationwide informational seminars, in addition to interpreting and analyzing radiographic imaging. To learn more about Dr. Spallino, click here.

Identifying the Source of Back and Neck Pain: Diagnostic Testing, Part 3

2009-12-31T18:21:44Z

Diagnostic Facet Injections

A common diagnostic procedure in these cases is the diagnostic facet injection. Targeted placement of anesthetic in the small "knuckle like joints of the spine" may reveal them to be the primary source of pain in many patients. Alternatively, some patients may require a test of the intervertebral disc space, which involves stimulating the disc with fluid designed to reproduce the pain and reveal microscopic injury or disease of the disc that is frequently invisible on MRI and x-rays.

What Happens During the Procedure?

Spinal diagnostic tests are performed in a specialized x-ray suite, using state of the art fluoroscopic equipment. This allows the physician to precisely steer a spinal needle toward the anatomic abnormality in question, such as a bone spur or disc. Once accurate placement is achieved, a small amount of lidocaine is injected to temporarily remove the pain caused by that bone spur or disc. This is the best predictor of the ultimate effect of removing the spur or disc.

The procedure is usually not painful and immediately after, the patient is typically able to move about freely. In all cases, except the discogram, it is desired that the patient presents for the block while experiencing some of their typical pain, in order for the block to have effect upon. Skipping a pain tablet and provoking the pain with mild activity is helpful at times.

Identifying the Source of Back and Neck Pain: Diagnostic Testing, Part 2

2009-12-29T19:15:40Z

Minimally invasive spine surgery succeeds in large part due to the skill and experience of our surgeons in identifying the primary target in the spine responsible for the pain and selectively decompressing the nerve in that spot. Once the patient is evaluated and examined and the MRI is reviewed, the need for a diagnostic test will be considered.

Spine Treatment: More Than Meets the Eye

Conventional imaging studies such as an MRI, provide the foundation of the surgical order, however, often, the MRI shows abnormalities that are in fact asymptomatic. Careful assessment of patients' symptoms and comparing them to the imaging study usually allow the surgeon to plan the operation only on necessary areas. However, in some patients, the MRI is inconclusive in appearance. In those cases, selective pre-operative diagnostic injections are ordered.

For patients with primarily neck or lower back pain, the MRI may not fully identify the exact area causing pain, as some spine conditions result from microscopic injury or disease. In those cases, diagnostic injections can locate the areas of pain and allow surgery to be performed on the correct area based upon knowledge of those unseen, but now understood abnormalities.

Selective Nerve Root Block (SNRB)

For patients with the appearance of more than one area of nerve root compression, there may be a role for a selective nerve root injection. In this test, the suspected nerve root is identified and then "blocked" using x-ray guided placement of an anesthetic agent (lidocaine) to determine what symptoms are resulting from that area of compression. The immediate relief is reported in a percentage of reduction in pain and those results are then used to develop the final surgical order. In cases, the results are negative or no relief and a second area may need testing. In other cases, it may be determined that more than one area is involved and so may require additional surgery at a later date.

In part three, we will discuss additional diagnostic tests and explain what happens during these procedures.

Dr. Robert Gruber is the Director of Spinal Diagnostics and Therapeutics at Laser Spine Institute. Click here to learn more.

Helpful Holiday Tips from Laser Spine Institute, Part 2

2009-12-24T20:31:09Z

As promised, below are additional tips to help you enjoy your holiday activities, while protecting your spine. The Center for Disease Control (CDC) also has excellent tips on general holiday safety, so I encourage you to visit their website. Happy Holidays!

Tip 3: Holiday Travel

Are you taking a long trip by car or plane? Consider a travel pillow to support your back or neck. An ice or heat pack can also be a helpful aid. When traveling with luggage, use suitcases with wheels to avoid the strain on muscles and joints from carrying on your shoulders.

Tip 4: Online Shopping

Many spend time at the computer shopping for holiday gifts online. To avoid lower back strain, sit back in a chair so your spine is fully supported. Thighs should be parallel with the floor with hips higher than your knees. The top of the monitor should be at eye level.

Helpful Holiday Tips from Laser Spine Institute

2009-12-22T19:52:12Z

Holidays are generally filled with activities and chores. Whether you are stringing lights on the roof, wrapping Zhu Zhu pets or Tickle Me Elmos for your children or grandchildren, or affixing ornaments throughout the house, it is important to protect your spine. Many times, we tend to become wrapped up in the festivities and forget to exercise care. As such, I am reminding everyone to take care while you have fun. To help you, we will be providing tips throughout the holiday season on how to avoid injury.

Tip 1: Home Decorating

When putting up lights or other holiday decorations, be sure to secure yourself on a stable ladder or stepstool. Try not to reach too far to avoid injury and straining back and neck muscles. Ask a friend or relative for help with heavy boxes or bulky objects.

Tip 2: Gift Wrapping

When wrapping gifts, rotate between sitting at a table and standing at a counter as needed, in order to avoid stress on your neck and lower back. Wrapping while kneeling or sitting on the floor causes you to bend and stretch your muscles causing unnecessary stiffness and pain.