Our Team Approach to Spine Care

by Oliver Tannous, MD, Spine Surgeon, MedStar Orthopaedic Institute
November 3, 2020

MedStar Orthopaedic Institute has a uniquely qualified team dedicated to spine surgery. The spine specialists here are specially trained and experienced in caring for the entire spine, from the base of the skull to the tail bone. 

We specialize in the entire gamut of spine care for disorders of the cervical, thoracic, and lumbar spine. We treat conditions like spinal stenosis and sciatica, where pinched nerves may cause pain, tingling, numbness, or weakness in the arms and legs. We have a specific focus on treating deformities, such as scoliosis, as well as infections, tumors and traumatic injuries of the spine.  

We treat these conditions using a tailored approach for each patient. Our procedures range from microscopic and endoscopic decompression to complex multi-level reconstructions. Our motion-preservation procedures are directed at avoiding fusions and enhancing motion; this includes cervical and lumbar disc replacements and minimally invasive decompressions. On the other hand, we have a focused multi-disciplinary approach for performing complex revision, reconstruction and deformity surgery.  

My colleagues and I are supported by a team of excellent specialists, including resident physicians from two of the most prestigious orthopedic programs in the region as well as highly specialized physician assistants and nurses who specialize in spine care.

Our imaging specialists, physical therapists, nutritionists, and other support staff all bring a unique and valuable skill set as well. Our team culture empowers each of us to be our best, every day. After all, each of our patients is a cherished family membersomebody’s mom, dad, sister, brother. 

The Challenge

The spine is complexcomposed of many joints, stacked one atop the otherIt’s one continuous and fluid unitand is classified into three sectionsthe cervical, or neck; the thoracic, or upper back; and the lumbar, or lower back.

Its main components are: 

  • Vertebraethe bones of the spine 
  • Discspads of cartilage between each vertebra that cushion and insulate them, keeping the vertebra separate and flexible 
  • Nerves that pass through the bones and cartilagevirtually every nerve in the body can be traced back to a branch of the spinal column, like branches on a tree trace back to its trunk 

This intricate and complicated system of moving parts can be affected by wear and tear, injury, disease, and deformities. When those kinds of problems affect the nerves, spine surgery can help.

Distinguishing Back Pain from Nerve Issues

It’s important to make the distinction between pain and nerve problems. Back and neck pain can have many causes. Most frequently, pain is a result of muscle strain and inflammation, often associated with arthritis. Surgery doesnt fix that kind of back and neck pain, and I recommend it for only a small portion of the patients I see.  

If there is no evidence of significant nerve involvement, non-surgical treatment is patient’s better option, including anti-inflammatory medications and physical therapy to improve conditioning, strength, and flexibility.  

We don’t dismiss pain, of course, since it can have such a negative impact on quality of life. So even if a patient is not a candidate for surgery, we connect them with the help they need, such as a physical therapy team and other non-surgical resources. 

For nerve problems, however, surgery can prove very effective in a variety of situations. For example, a patient’s arthritic spine can develop bone spurs that pinch nerves. Or when a patient’s disc slips out of place, it can put pressure on the nerve. When nerves become pinched by stenosis, the space they occupy shrinks and narrows, which can lead to painful arm and leg symptomsSurgery can relieve many of these issues 

Spine surgery can also successfully treat deformities such as scoliosis, tumors, infection, and traumatic injury. MedStar Washington Hospital Center is the region’s busiest Level I Trauma Center, so our team is routinely tasked with treating complex and challenging injuries, like those caused by motor vehicle accidents.  

Tracking the Source of Pain

When the spine is injured, the patient generally experiences the resulting nerve symptoms in other parts of the body; classic examples are pain, tingling, weakness or numbness in the legs and arms. Besides conducting a patient medical history and physical exam, we explore what’s happening via X-ray, CT scan, and MRI, and can order tests to gauge nerve function. 

The body is remarkably resilient. When we relieve pressure on the nerves, the system starts working again and we see real improvement. In many cases, we witness dramatic transformation after surgeryIt’s very gratifying to hear reports of patients dancing at a wedding who, previous to surgery, could barely stand or walk.

Nerve problems in the spine can cause pain, tingling, weakness or numbness in the arms and legs. Dr. Oliver Tannous explains when surgery can make a difference. https://bit.ly/3mHs61K via @MedStarWHC
Click to Tweet

Advanced Techniques

We can do more today than in years past, and much less invasivelywith less bone removal and fewer incisions. In some cases, we can preserve motion after surgery, with disc replacementan artificial implant replaces herniated disc and reduces strain on the joints above and below, potentially preventing future complications. 

Plates, braces, and other structural elements needed to strengthen and stabilize the spine are smaller and lighter than those used in the past. We operate under the microscope and use tiny cameras to better visualize the areas that need attention. 

Not every surgery can be done with minimally invasive techniques. But, for the right candidate, it can mean less postoperative pain, reduced infection riskand faster recovery.  

The team is also highly skilled in revisionor correctivesurgery for any new issues that develop after an initial surgical procedureMany spine problems spring from degenerative diseases like arthritisas that degeneration continues after surgery, it may cause additional problemsSometimes things don’t heal properly the first time around. Or an injury or break in one joint can weaken those above and below it, spurring issues five or ten years down the road. 

Revision procedures are challenging and put the team to the test. Because each case is unique, we take the time to consider all possible options and make the best possible decisionsThis careful consideration is important because the more successful the procedure, the more we can improve a patient’s quality of lifeand that is our primary goal. 

Engaging the Family

Everything before and after surgery matters. If your health is poor before surgery, you may have more difficulty healing after surgery. We work to get your nutrition right, or to get your diabetes under control orbecause nicotine slows bone healing, to help curb your smoking habit. 

Making these changes can seem daunting, and it can be a great help when the entire family is involved. Including the family engages the patient. When the family is “all in, they suddenly become critical members of the healthcare team, helping you make the required lifestyle changes 

The Road to Success

Nothing is left to chance. We get the patient in good health before surgery. We get both patient and family invested. We apply our best possible skills in the operating room. We follow up with appropriate and effective pain managementAnd whave the patient up and out of bed as soon as possible, which is proven to speed recovery.  

Then, after a period of healing, we provide access to rehabilitation and physical therapy experts with specialized experience in orthopedics. Our entire team pulls together to get the patient healthy and active. 

At MedStar Orthopaedic Institute, we are proud to be a true leader in spine surgeryOur large and complex volume of cases keeps our skills well-honed 

Restoring spine surgery patients to active living is exciting. And it’s what we strive for. 

Experiencing back pain?

Talk to a spine specialist.

Call 202-644-9526 or  Request an Appointment

Category: Healthy Living     Tags: or-2espine treatmentspine-surgery