State-of-the-art Spinal Surgery at Valley Health

Back on Track

“I am so happy I have my life back,” says Angie Clower. Thanks to a remarkable spine surgery at Winchester Medical Center in September, she is cooking breakfast again most mornings at the popular diner she owns. In the afternoons, she plays with her six grandchildren.

Those daily activities had become nearly impossible. Clower, 51, owner of the Romney Diner in Romney, West Virginia, developed scoliosis (a side-to-side curving of the spine) and flat back (loss of the natural curve of the lower back) as an adult, leaving her with severe pain in her back, hips and legs. “My legs would go numb, and I would trip,” she says. “I had trouble sleeping. I couldn’t stay in one position for more than 20 minutes. Now I sleep great.”

Clower’s successful procedure illustrates Valley Health’s comprehensive approach to spine care for a broad range of back and neck conditions.

“The depth and breadth of what we offer is on par with any large university medical center,” says Charbel Fawaz, MD, a neurosurgeon at Valley Health Virginia Brain & Spine who performed Clower’s surgery. He specializes in minimally invasive spine surgery and complex spine procedures. “Our team of surgeons and support staff have a high level of expertise. Plus, Valley Health offers advanced technology, so patients experience optimal recovery and results,” says Dr. Fawaz. “What makes us really happy is that our patients see real improvements in their quality of life. And they refer their family and friends to us.”

THE SPINE TEAM

At some point in our lives, 80 percent of us will have back or neck pain. Spine conditions can cause discomfort, numbness and difficulty moving the neck, torso, arms or legs, as well as other symptoms.

At Valley Health, the diagnosis, management and treatment of back, neck and other spine-related conditions is the work of a team of neurologists, neurosurgeons, pain specialists, rehabilitation specialists and more. Each patient receives individualized care, says Lee Selznick, MD, chairman of the Neurosciences department and chief of neurosurgery.

“We provide both surgical and nonsurgical care for anyone with back or neck problems,” says Dr. Selznick. “As our community grows, we grow with it, adding exceptional providers to neurosurgery, pain management and physical medicine/rehabilitation. We are also developing clinical pathways to get patients to the right provider and service to optimize their treatment with us and with other providers in the community, including those in primary care, physical therapy and chiropractic care.”

In other words, it’s a “one-stop spine shop,” says David Salvetti, MD, a general neurosurgeon at Valley Health Virginia Brain & Spine with expertise in complex multilevel spine surgery, spinal deformity correction and minimally invasive spine surgery.

“The collaborative structure between neurosurgery, pain management and neurology allows for comprehensive care for each patient,” says Rehan Waheed, DO, medical director of interventional pain management at Valley Health and a physician with Valley Health Interventional Pain Specialists. “The neurosurgical team led by Dr. Selznick and Dr. Patrick Ireland, has been instrumental in our effort to build a full-service spine program. We are committed to this goal as a team and continue to see improved outcomes for the community.”

PAINFUL CONDITIONS, EFFECTIVE SOLUTIONS

Up to 90 percent of people with back and neck pain do not require surgery. Nonsurgical, conservative options include physical therapy, chiropractic care, medication, hot and cold compresses, and advanced pain management techniques. For about one in 10 adults with back and neck pain, surgery may be the best option. “We consider surgery when we have exhausted all other options,” Dr. Fawaz says.

The range of spine conditions treated at Valley Health includes cervical and lumbar stenosis (narrowing of the spinal canal), herniated discs (slipped or bulging discs), spine injuries and fractures, tumors, scoliosis, arthritis, osteoporosis and more. Valley Health’s spine team also provides revision surgery—procedures to repair or update previous spine surgery if symptoms return or other areas of the spine degenerate or move out of alignment.

Many common spine conditions can be treated with minimally invasive spinal surgery (MISS). “We work through small incisions instead of opening up an incision four, five or six inches long,” Dr. Fawaz explains. “MISS is the least disruptive way to get to the spine. Instead of cutting through muscle, we can spread apart the muscle fibers, do our work, then remove the ports we work through and close the incision. We don’t cut blood flow. Muscles stay vitalized and healthy for a faster, easier recovery. There’s less pain and it’s less mentally draining.”

Patients may go home the same day or the next day in many cases. They may return to an office job in as little as two weeks and to a more active job and/or more strenuous physical activity in four to six weeks. Others may require open surgery, including complex procedures, says Dr. Salvetti.

“Complex surgeries are for more severe conditions,” he says. This may include fusion procedures, placing screws and rods to keep the spine in alignment, removing tumors, correcting deformities, fixing a spinal fracture, or revising a prior surgery. “In general, someone with a spine problem that results in back pain and possibly leg pain but who also has an alignment problem could benefit from complex surgery. If your daily life is consumed by your back issues and the disability they cause, it may be beneficial.”

For some people, the results are dramatic, Dr. Salvetti notes. “People who were incapacitated are back to an active lifestyle,” he says. “It is the improvement in quality of life that we’re after. A good outcome is to see pain reduced by at least 50 percent.”

BACK TO NORMAL

Clower’s procedure took place over two days and included a fusion of vertebrae in her neck and decompression of vertebrae in her lower back.

“I used minimally invasive techniques and deformity correction techniques,” Dr. Fawaz says. “I used robotics for the hardware implantation as well as the intraoperative CT scan and navigation station to confirm everything was in optimal position.”

In late December, Clower returned to the Romney Diner. “My customers were so excited to see me,” she says. But another fan club closer to home may be even more thrilled. “Now I can get down on the floor to play with my grandchildren and pick them up,” Clower says. “I had missed that.”

To learn more, visit vabrainandspine.com or call 540-450-0072.