By Harvinder S. Sandhu, MD, MBA
A 2022 Harris Poll found that more than 72 million Americans suffer from lower back pain which can often be debilitating and cause significant disruption to daily life.
Fortunately, new practices in treating spine conditions and the rise of new technologies are making access to safe and reliable treatments readily available. The spine treatments of the past that produced less reliable outcomes, less predictable results and more invasive surgical procedures are a distant memory. We can now deliver transformative spine care to improve patients’ chronic conditions safely and effectively. It’s a dynamic new era in spine treatment.
HSS is America’s leading provider of back and neck care. The treatments we provide often address degenerative conditions from wear and tear, a past injury, a history of spine vulnerability or an isolated event that has deteriorated the spine. We’re living longer and many people want to play tennis and golf later in life. The downside is that certain body parts break down over time, and the spine is one example.
Two Critical Phases
Our approach to spine care at HSS is based on two key phases. The first is to get the right diagnosis, which involves spending the time and effort to home in on the problem, and phase two is to pursue the least invasive treatment to improve a patient’s condition safely.
One of the key ingredients for making correct diagnoses and delivering optimal treatment — whether non-surgical or surgical — is having informative data. We are data-driven at HSS. As an academic center, we treat patients and educate specialists. We carefully examine patient data to understand what works and what doesn’t. We develop protocols built around what works best for our patients.
We’re also seeing improvements in the quality of MRI imaging which helps us pinpoint a patient’s problem more clearly and quickly. Our radiologists write textbooks on reading spine MRIs and teach the discipline to practitioners nationwide.
Injections for Pain Relief
One of the non-surgical treatments we use most to relieve back pain and improve mobility is injections, which include an anesthetic and a steroid to reduce inflammation around the nerve. The injection calms nerve irritation, allowing patients to exercise and pursue physical therapy.
Our surgical and non-surgical specialists work in partnership to test for potential issues and deliver targeted treatments. Many of our doctors are trained in neurosurgery and orthopedic surgery, which is especially useful in treating the range of spine challenges our patients face.
Advances in Spine Treatment
Today’s spine procedures are much less invasive than those in the past, and the less traumatic the surgery, the fewer complications for patients. They can get back on their feet and return to what they love doing more quickly, with a better long-term prognosis. We are committed to treating patients as safely as possible, which goes hand in hand with less invasive surgeries.
When I began practicing spine surgery 30-plus years ago, surgeries were so involved that many patients required three-week hospital stays. The precision surgeries we offer now drastically reduce recovery time. Same-day or next-day release from the hospital is normal, and patients are skeptical about how quickly they can return home and how much less pain they feel. This translates to less burden on family members and caretakers to assist in patient recoveries.
Navigation and Robotics
The availability of the latest high-tech equipment, including navigation tools and robotics, has been the biggest game changer in spine care. We use state-of-the-art navigation tools that only require small openings in the skin to insert devices, and it’s like having x-ray vision capabilities.
We also use robotics to assist during surgery. I work with the robotic device days ahead of surgery to develop a complete surgical plan. The patient’s spine is registered to the imagery we see on a computer screen. We can determine precisely where implants must be inserted into a patient’s spine. We make small needle-like holes in the patient’s skin, called percutaneous punctures. The robot gives us the trajectory for where the pins must be inserted. The screen lets us track the insertion of implants on the precise path we need.
Device Maker Relationships
Most device manufacturers come to HSS when seeking FDA approvals because of our reputation for using cutting-edge technology. HSS consults with device manufacturers, advises them when they are ready for market use, and conducts studies on our use of their equipment which we report to the FDA. HSS is one of just a handful of medical centers in the country that fill this role. We can offer state-of-the-art technology to patients and stay well-informed on the latest treatments.
As chief of the collaboration between HSS and Stamford Health, I am committed to increasing access to HSS-level care wherever our patients reside. Many of our surgeons split time between HSS locations in New York City and Stamford to share learnings and ensure the highest quality spine care in each location. Our spine care mantra is the same wherever we practice: use the least amount of surgery to deliver the most reliable and safest outcomes.
Harvinder S. Sandhu, MD, is Co-Chief Emeritus of HSS Spine and Chair of the HSS-Stamford Health collaborative.
