Centered on Health 2-20-25 - Indications that you need spine surgery with Dr, John Serak

Centered on Health 2-20-25 - Indications that you need spine surgery with Dr, John Serak

Episode Transcript

Speaker 1 (00:01):
It's now time for Centered on Health with Baptists Help.

Speaker 2 (00:04):
On use Radio.

Speaker 1 (00:05):
Wait forty WJS Now, here's doctor Jeff Tumbler.

Speaker 3 (00:11):
Good evening, and welcome to this week's episode of Centered
on Health with Baptist Health here on news radio eight
forty WHS. I'm your host, doctor Jeff Tublin, and tonight
we are talking about neurosurgery and when it's time to
consider having spine surgery. And spine surgeries are one of
the most common types of surgeries that are performed in

(00:33):
the United States, and there's up to five hundred thousand
spine surgeries done in the United States alone, let alone worldwide.
And the impact and the quality of life and the
impact on our function and our daily lives are so significant.
And we have doctor John Saruk back with us again
tonight to talk to us about surgery and when it's

(00:55):
time to have neurosurgery. So Doctors Rock has been on
our show for He is a neurosurgeon with the Baptist
Hospital Medical Group with practices in Louisville and New Albany.
He went to Indiana University School of Medicine and Residency
and fellowship at the University of Miami Jackson Memorial Hospital.
He does robot assisted neurosurgery of the spine, minimally invasive surgery,

(01:17):
and complex surgery.

Speaker 2 (01:20):
Welcome back, Thanks for having me.

Speaker 3 (01:25):
Well, we always love having you. And this is just
a topic that you know, so many people want to
know about because obviously problems with the back and the
spine can have such a major impact. But you have
been here a few times and I'd love to just
get a little bit more background about you and things
about how you chose this. So University of Miami, that

(01:47):
is a hospital I remember looking at when I was
touring and I did a lot of my training at Grady.
What was your training like at a place like University
of Miami.

Speaker 2 (01:58):
Well, it was interesting. So you know, Miami, Florida is
a lot different than the Midwest. I'm a Midwest kid.
I grew up the suburbs of Indianapolis, and so I'll
tell you when I wanted to get out of the
Midwest and do my training somewhere somewhere different, and I
guess I couldn't have picked something more different than Miami.

(02:20):
So it was it was a bit of a culture
shock going there, But you know, I kind of fell
in love with the program. The residents there when I
was interviewing were fantastic, and the program was was very
kind of clinically oriented and in other words, really concentrated
on training you to be a surgeon and really provided

(02:44):
residents with the opportunity to do a whole lot of
surgeries and a whole variety of surgery. And so that's
kind of what drew me there. But you know, working there,
they have i think at the time was the biggest
spine center in the nation, so you know, a lot
a lot of great surgeons to learn from in terms
of spine surgery, and also one of the biggest busiest

(03:07):
trauma centers in the nation as well, So so that
also made things very interesting. In fact, the Army would
train there and so, uh, you know, I'd be in
the trauma bay taking care of a patient as a resident,
and I've got you know, Army personnel watching me learning.
So it was it was certainly an interesting experience, and
I feel like I got fantastic training as well.

Speaker 3 (03:31):
Is this what you always thought you would do or
did you go into medical school thinking you might do
something else or was this sort of always your path?

Speaker 2 (03:41):
No, you know, when when I went to medical school,
I you know, I thought I wanted to be a surgeon.
In fact, that I wanted to be a plastic surgeon.
You know, I was interested not so much on the
cosmetic side, but I'd shattered some uh, pediatric plastic surgeons
as a high school student and college student, and I
thought I wanted to go into craniofacial reconstructive sort of surgery.

(04:05):
You know, I thought it was very interesting in rewarding
surgery and sort of an art form in and of itself.
But I did some research in neuroscience, kind of lab
research during my first and second year of medical school,
and then I spent about a month working with the

(04:26):
neurosurgeons at IU where I went to medical school, and
I found myself in a conundrum, and you know, couldn't
sleep at night, you know, torn between well do I
pursue this plastic surgery dream or do I do neurosurgery.
And ultimately, you know, I settled on neurosurgery, and you know,
I'm happy about that decision.

Speaker 3 (04:48):
Well we are happy about it as well. So tell
us what what's an average day like for you when
you're in the office. How many patients do you typically
see and what is the most common surgery that you do?

Speaker 2 (05:02):
So, you know, days are variable, you know, but typically
I'm in the office once or twice a week seeing
you know, in the area of twenty five to thirty patients.
You know, these could be you know, patients that are
that are new to me, or they could be follow
up patients or patients that have had already had surgery.

(05:23):
And then the other days, you know, I spend in
the o R working and you know, there's a number
of surgeries I do frequently. So you know, the most
common complaint that I see our patients that are having
issues basically due to arthritis, wear and tear of the spine,
what we call degenerative changes or problems. And some of

(05:44):
the most common you know, surgeries I do things like
dyskectomies or decompression surgeries on the lumbar spine. In other words,
there's compression of nerves and just going in and taking
pressure off of those nerves and other commonsury as people
have abnormal alignment or what we call spond a little
thesthesis in their low back and in addition to taking

(06:07):
pressure off the nerves, you know, those those patients frequently
need a fusion surgery where you know, we put in
screws and rods and the goal is to kind of
pull things back into better alignment, take pressure off the nerves,
and then over the course of time that the body
will actually fuse the two bones that we're we've held together, uh,

(06:28):
you know, together permanently. So that's another common surgery. And
then do a fair amount of surgery on the neck,
similar sort of issues where there's a you know, herniated
disk or narrowing what we call stenosis. In the neck,
it's a little different, there's the spinal cord there, so
you know, oftentimes we're working to make sure we take

(06:50):
pressure off of the spinal cord, not just the nerves,
but similar sort of surgeries, uh where where we can
go in and oftentimes have to remove a disc and
do a fusion surgery or or potentially place an artificial
disc as well. So you know, those surgeries on the
neck and the low back to take pressure off of
the nerves or the spinal cord are certainly the most

(07:13):
common surgeries that I do.

Speaker 3 (07:16):
And in the intro and we've talked about this a
little bit before. With your training, you are trained in
complex surgery. So tell us a little bit about was
that extra training on top of the neurosurgical training that
most people do, and what kind of indicates a surgery

(07:36):
is complex?

Speaker 2 (07:40):
Sure, Yeah, So I did a fellowship in spine surgery,
specifically minimally invasive and complex spine surgery. So a fellowship
is additional time spent, you know, concentrating on those subjects.
So I spent a year just doing spine surgery. And
I did this at the University of Miami. Again, they have,

(08:02):
at least at the time, had that I think, the
largest spine surgery in the nation and a number of
great surgeons to learn from, So you know, I did
concentrate on that area. And some of the things that
make things more complex are what we call deformity problems

(08:23):
of the spine, in other words, abnormal alignment of the spine.
So the kind of thing we think about first is scoliosis.
And when we think about scoliosis usually think about kids,
and that's an abnormal curvature of the spine. So if
you're looking from the front of somebody kind of at

(08:43):
their head and their chest kind of instead of the
spine being straight up and down, there's curvature. And then
also we think about spinal deformity looking from the side.
So if we're looking at the spine from the side,
generally speaking, the spine holds a head up directly above
the pelvis. But with scooliosis and other what we call

(09:05):
spinal deformity problems, the head will actually sit in front
of the pelvis, and so that becomes a major problem
in terms of standing, walking, that sort of thing. So
these these spinal deformities kind of constitute the majority of
the complex surgeries that I'm doing at this time. But

(09:31):
the double surgery, Oh go ahead.

Speaker 3 (09:34):
No, No, I was just going to say that, you know,
it's great. I mean I feel like, you know, we've
got a great taste of kind of your training and
what you do, and we're going to talk about some
of these surgeries when we come back. We're going to
take a quick break. And I want to tell everybody
that you are listening to Center on Health with Baptis
Health here on news radio eight forty w h as.

(09:55):
I'm your host, doctor Jeff Toblin. We're talking tonight to
doctor John Starak about neurosurgery and when it's time to
think about surgery we'll be right back. Welcome back to
send it on Help with Baptist Help here on news

(10:16):
radio eight forty w h as. I'm your host, doctor
Jeff Tublin, and we're talking tonight with doctor John Siroc,
who's a neurosurgeon and is talking to us about spine
issues and especially when is it time to consider having
spine surgery. So welcome back, doctor Sirac. And for those
of you who are just joining us, Doctor Strock is
a neurosurgeon with the Baptist Hospital Medical Group. So one

(10:40):
of the things I think it's really great for our
listeners to hear is sort of you know, why why
is the spine so important? I mean, I know that
sounds sort of obvious, but you know, in terms of
our function and our daily living, how do you how
do you see that and approach that?

Speaker 2 (11:00):
Know, you know that the spine is important for multiple reasons.
Kind of the two most important reasons, So one is
keeping you up right, so allowing you to stand up
and walk. The spine has three separate curves, a curve
in the in the neck, a curve in the mid back,
and a curve and the low back. And those three

(11:20):
curves are designed to allow you to stand up with
your head sitting directly above your pelvis, and that allows
you to walk normally. So you know, when when the
spine gets what we call out of balance in other words,
that your head is no longer sitting kind of directly
above your culvis, you know, we run into major issues

(11:42):
in terms of your ability to walk and walk efficiently
in other words, walk without pain, walk without you know,
severe stress on your muscles. And then the other extremely
important part about the spine is that these spinal cord
of nerves run through the spine, and the spinal cord
of nerves carry impulses back and forth from your brain

(12:03):
to your arms and your legs and your body as well.
So that's extremely important for providing sensation and also what
we call motor innervation in other words, nerves that go
to the muscles and tell the muscles to move. So
you know, if you have a problem with spinal cord
or nerves, you can lose function, lose sensations, cause pain,

(12:29):
or even lose function of the muscles in your arms
and your legs.

Speaker 3 (12:35):
And do you tend to deal more with acute injuries
or chronic problems of the spine and is one easier
to manage than the other or not necessarily.

Speaker 2 (12:49):
So generally I'm dealing with stuff that's more chronic, so
in other words, that it's probably been going on for
months or years rather than rather than days or or
happened immediately, you know, things like spinal trauma is something
that I dealt with a lot more UH previously during

(13:11):
residency and the previous time I spent practicing UH in
in Colorado where I was working at trauma center. So
fortunately I don't see as much sor spinal trauma here
UH with Baptist as we're not a trauma center, but
certainly fell my fair share of very acute problems. But

(13:33):
the majority of problems I see are people that I
that I see in the office that have issues, you know,
things do not need to be taken care of kind
of as an emergency, but something that you know, if
we identify a problem and we identify that it needs surgery,
something that can usually happen in the future, you know,
usually weeks or even even months in the future. So

(13:56):
typically more more chronic stuff or what we call some
acute in other words, it's been going on you know,
for at least several weeks.

Speaker 3 (14:07):
And you know, our topic tonight is focused a little
bit on considering kind of when is it time to
kind of think about having that surgery. So let's think
about somebody in your office and what are the typical
kinds of symptoms that people present to you with that
indicate a problem of the spine. And what would someone

(14:28):
tell you that might indicate that it's time to have
surgery on that. And as a secondary question sort of
in the office, when you're doing a physical exam, are
there things that tell you that something is more urgent
than not.

Speaker 2 (14:44):
Yeah, So in terms of how how people present or
the symptoms that they have, you know, it's very common
for someone to have either neck or low back pain,
sometimes mid back pain, and that can indicate that there's
something going on with the spine. You know, it's possible

(15:06):
with pain of the neck and the low back. This
can be caused by a number of different things, including muscles, tendons,
et cetera. But you know, by the time you make
it to me, chances are that there's been something identified
and there's a problem with with the spine that that
can be causing that that pain. So certainly pain in
the in the neck or the low back are very

(15:27):
very common and in addition, we often have issues with
the arms of the legs, and the pain that can
happen in the arms and the legs is what we'd
call referred pain. So within the within the spine, nerves
are transmitted to the arms and legs. In other words,
the nerves travel from the brain and then they go

(15:49):
out to the arms and the legs. And if these
nerves are being pushed on, you know, due to a
herniated disk or bone spur or whatever it may be,
that can cause pain, but not but not pain in
the in the spine itself, but rather pain going into
a very specific location in the arm or the leg
depending on which which nerve is being compressed. So those

(16:12):
are very common issues. And then more severe issues we
see is when people start developing weakness. So in terms
of the low back, if you have severe compression of
a nerve, you may notice weakness in a specific location.
Many people have probably heard the term foot drop before,
in other words, not being able to lift the foot,

(16:34):
and that that can can can occur due to compression
of a specific nerve in the in the low back,
so they you have a discarnation and it's pushing on
that nerve, you know, you can lose function of lifting
the foot. In addition to having pain radiating down the leg,
this can also be associated with numbness. In other words,

(16:55):
the nerve is also carrying the fibers that allow you
to feel or sense when someone touches you in a
specific area on your leg, and so you know, compression
of the nerve can cause that numbness, it can cause
that pain, and it can cause that weakness potentially. And
then in terms of the neck or the mid back,

(17:16):
because I think I mentioned before and the low back,
you just have have the nerves, and you know, nerves
can can be compressed and can cause serious problems. But
generally speaking, nerves are pretty resilient in the neck primarily,
and then also can occur on the mid back as well.
You can actually have compression of the spinal cord. So

(17:37):
in addition to potentially having problems with pain, numbness, or
or you know, weakness in a specific area within the arms,
you can also have symptoms that are due to compression
of the spinal cord. And typically those those symptoms or
you'll have trouble using your hands, dropping things kind of
numbness potentially over your entire hand or evening up your arms.

Speaker 1 (18:01):
Uh.

Speaker 2 (18:01):
These are very common issues. And spinal cord compression can
also cause you to feel off balance, so maybe you're
having frequent falls, you know that sort of thing. All
the all those things are possible with compression of the
spinal cord and the in the neck or the mid back.
In addition to you know, the symptoms that you may
have from from pressing on the on the nerves.

Speaker 3 (18:26):
And so in your evaluation, you know, obviously we're all
familiar with T scans and MRIs and you know, I
know a lot of times there are things all over
these imaging tests that may or may not actually be
related to two symptoms. So how do you use imaging
in your assessment for patients?

Speaker 2 (18:50):
Well, imaging is extremely important, So at least for me,
I'm a surgeon. You know, I'm looking for something I
can go in and cut and sticks. So so I'm
looking for compression of nerves or the spinal cord that
would correlate with the symptoms that a patient is having,
specifically usually in their in their arms and their legs.

Speaker 1 (19:12):
Uh.

Speaker 2 (19:13):
And we can usually correlate that pretty well, and that
that really takes kind of the guesswork out of out
of what's going on and really helps to ensure that
we're making the right diagnosis that the symptoms you're having
uh fit with what we're seeing on the MRI. And
then MRIs can also and CT scans and other imaging

(19:33):
can show wear and tear changes of discs and joints
in the spine, which we can also we can connect
that with you know, neck pain or or back pain
that may be occurring as well, because not all patients
have pain in their arms or legs or issues with
their arms and the legs. They may just have you know,
pain in the neck or pain in the back. So

(19:57):
so that's how we use imaging and again extremely important
that we we've matched the findings that we're seeing on
the imaging to what the patient is experiencing perfect.

Speaker 3 (20:09):
We are talking tonight with doctor John Sarac Neurosurgery about
neurosurgery and when it's time to consider going to the
operating room. We're going to take a short break. I
want to remind everybody that you're listening to send it
on Health with Baptist Health here on News Radio eight
forty whas. I'm your host, doctor Jeff Tublin, and we'll
be right back after this. Welcome back to Senate on

(20:37):
Health with Baptist Help here on News Radio eight forty whas.
I'm your host, doctor Jeff Tublin, and tonight we are
talking with doctor John Sarac, neurosurgeon with the Baptist Hospital
Medical Group, who is talking to us tonight about not
just understanding the spine and why we need surgery, but
we're focusing a little bit tonight on probably know when

(20:58):
it's time to have surgery, because that's always kind of
a big question. So we're going to continue that conversation
and doctor Strock, I'm going to ask you, when a
patient is having problems with their back and you're seeing them,
what's the thought process and approach about, well, when is
it time to go to.

Speaker 2 (21:18):
The o R. So, again, most of the patients that
I'm seeing clinic are patients that have those degenerative issues
and other words stuff that's where and tear are right?
Is that sort of thing? You know, we can talk
about trauma or accidents injuries to the spine that that
occur that oftentimes it may require surgery, and there's no

(21:42):
good option. And then also people can develop tumors in
the spine, and that's also kind of a different consideration.
But again, the vast majority of people with those degenerative changes,
you know, we can kind of group them into kind
of two groups of people. One group of people, well,
would be people that have uh, you know, severe compression

(22:04):
or pushing on the spinal cord or the nerves, and
they're symptomatic in other words, they're they're having that weakness
or or or numbness. And we look on the m
R and we see, well, the spinal cords being compressed
or the nerves being severely compressed, and in those cases,
you know that that's when it's it's more black and white.

(22:25):
So in other words, we really need to do surgery
because we know if we don't, things will get worse
because of pressure on that spinal cord or pressure on
that nerve, and the person could potentially lose more function
in the future. And that's that's a good portion of
the of the people I see. It is kind of
that cut and dry, But there also is a very

(22:46):
large group of people where you have the again those
wear and tear features, arthritis, and you know, maybe you
have some leg pain and you also have the back
pain going on, and we're able to you know, look
on the MRI and point and say, okay, well, you
know we we can we can correlate your your symptoms
with what we're seeing on the MRI, and you know

(23:07):
there's something we could do surgically to help you. But uh,
you know, there's nothing dangerous going on. You're not gonna
most likely lose function of your arms or your legs
or anything like that if we don't do surgery. And
so in those cases, it really comes down to, you know,
the degree of pain or discomfort someone is in and

(23:29):
is this something that's really affecting their daily life? And
and you know, if it is really causing problems of
their daily life, that's that's when we kind of can
push more towards surgery. Uh. The other important consideration and
people that fall into that camp of you know, surgery
for improvement of quality of life or improvement of pain,

(23:49):
or we'll have you have you tried everything else to
try to fix this? In other words, have you done
in physical therapy? Have you gone and had spinal injections
like epidural injections that sort of thing have you kind
of tried everything and nothing else has worked, And if
you have done that, well, you know surgery is on
the table. And again, assuming we can correlate your symptoms

(24:11):
with what we're seeing on the imaging, you know, very
good possibility that will improve your symptoms quite a bit
with surgery.

Speaker 3 (24:20):
That is very helpful. And when you're having your conversations
with patients about surgery, I know every surgery is different
and obviously, but in general, how do you talk to
patients about what the potential risks of surgery are?

Speaker 2 (24:36):
Well, yeah, it is highly dependent on the specific surgery itself,
and you know, really all of medicine and certainly and
making decisions in surgery, it's all a risk benefit sort
of ratio that you're looking at. So you know, if
there's a surgery that I feel is particularly high risk

(24:57):
and maybe the patient falls in that camp of you know,
very elective, you know, kind of just for improvement of
quality of life, then you know we may be pushed, well,
the risks are too high and the benefits aren't that great.
So it's it's always kind of that relationship. But generally speaking,

(25:18):
you know, these surgeries that we do for the wear
and tear changes are are pretty safe and and we
do have very good outcomes. But again it comes down
to a person, the person looking at the risks individually
and and kind of going from there.

Speaker 3 (25:41):
Well said, and you mentioned when you were talking about
the you know, have you tried everything kind of discussion
you mentioned physical therapy. Do you work with physical therapists
in terms of free having before surgery like neurosurgery or
is that not kind of standard yet?

Speaker 2 (26:01):
Well, most most people have seen physical therapists, you know,
before surgery and have worked with them, and they get
an idea of uh kind of activity or ways to
kind of preserve their spine or kind of take pressure
off their spine. And I guess specifically what I'm talking
about is is after a surgery on your spine, you

(26:23):
usually have limitations, and those limitations are often being careful
with bending, twisting, listing, that sort of thing. And so
if you've been seeing a physical therapist prior to surgery,
hopefully they've really ingrained proper bending and lifting techniques and
then you can kind of carry those on to your
to your post operator recovery. Uh. And then of course

(26:45):
I believe physical therapy is extremely important after surgery and
encourage all of my patients to see physical therapy, uh,
you know, for for several weeks to several months following surgery.

Speaker 3 (26:57):
Now you may have you may have already answered and
what you just said, But in general, are there things
that we as a population should be doing throughout our
lives to prevent some of these back issues.

Speaker 2 (27:16):
That's that's a very good question. So I think generally speaking, again,
proper bending and lifting techniques are extremely important, you know,
especially if you have a job that requires you to
do a lot of that a very physical job, it's
important to always be thinking about your spine. I can

(27:37):
tell you that that I'm extremely careful with you know,
proper bending and lifting techniques, uh you know, And I
don't have spine problems, and I hope to not have
spine problems as a result. Another thing that people can
do generally to try to reduce the risk of spine
problems is to exercise, and specifically to work on muscles

(27:58):
of the of the core, so muscles of the abdomen
and back, and doing exercises to make sure that those
muscles are stronger. If you're able to have strong muscles
around your spine, you can engage those muscles or use
those muscles when you're doing things like bending or lifting,
and that can take pressure off your spine and put

(28:20):
it on your muscles. And so that that's another important
habit that people can pick up and do.

Speaker 3 (28:28):
Fantastic. And I do want to just ask you about
a couple of different kind of terms that maybe we
hear in the general population and what they mean. So
when somebody says they have ridiculopathy, what does that mean.

Speaker 2 (28:44):
So ridiculopathy is a term that refers to pressure on
a nerve. And as I kind of referred to before,
that ridiculopathy is when you get pain shooting down the
arm or the leg. It can be associated with numbness
and beer cases, even weakness. And again that pain, that numbness,
and that weakness affecting a very specific area that that

(29:08):
nerve is responsible for. So that's again ridiculopathy is compression
of the nerve, you know, in the spine or as
the nerve is exiting the spine.

Speaker 3 (29:18):
And that's that's something that you can you fix with
kind of opening the disk space or how do you
fix that.

Speaker 2 (29:29):
Yeah, So to fix that basically just taking pressure off
the nerve. So depending on where that compression is, you
can go in you can remove bone, ligament and disk
in order to open up that space and take pressure
off the nerve.

Speaker 3 (29:44):
Fantastic. Well, we have a lot more. We're going to
have to try and and get to you in the
next section because we're going to take our final break
here and you are listening to Send It on Health
with Baptist Health here on news Radio eight forty whas
our guests this evening, doctor neurosurgeon. We're talking about when
it's time to have neurosurgery. And if you miss any

(30:04):
part of tonight's show or want to hear all of
this information in its entirety, download the iHeartRadio app. It's free,
it's easy to use and gives you access to tonight's show.
We'll be right back. Welcome back to center It on
Hew with Baptist Help here on news radio eight forty whas.

(30:29):
I'm your host, Doctor Jeff Tublin, and tonight we're talking
with doctor John Sarach, neurosurgeon with the Baptist Hospital Medical
Group about neurosurgery and when it's time to have surgery.
I want to remind everybody to download the iHeartRadio app.
It's free, it's easy to use, and you can use
the app for all the features that it has to offer. So,
Doctor Sirok, right before we went to this break, we

(30:50):
were talking a little bit about some terms, and I
want to ask you a little bit about some of
the surgeries you probably do and if you could kind
of explain to us what they are and what type
of surgery they are. And the first one is a
lamin ectomy and then the other one is a fusion.
I think those are terms we hear all the time
and what's the difference and what do they mean.

Speaker 2 (31:14):
So lambinecomy and fusion are two terms and refer to
specific surgeries that we perform on the spine. So a
lambinectomy refers to removal of bone and ligament that's overlying
the nerves, and that can happen anywhere in the spine.
It's probably most commonly performed in the low back in

(31:36):
the lumbar spine. And so if there's compression of the nerves,
typically what we call spinal stenosis or narrowing around the nerves,
lambinectomy can be performed to open up that space and
take pressure off of the nerves. A number of different
ways that that can be performed. You know, the typical

(31:57):
sort of traditional way to make an incision and kind
of pull down the muscles and then remove the bone
and ligament. In your back. You can actually feel in
your low back the kind of hills and valleys, and
the hills or the bones and the valleys are the
ligaments that sit between the bones. And so with the

(32:17):
lambin ectomy, kind of the traditional styles to go in
and remove the hill and the valley that's pushing on
the nerves. So remove that bone and ligament entirely in
order to take pressure off the nerves. And then there's
other techniques I typically do this and what we call
the minimally invasive ways. So the goal with minimally invasive

(32:38):
surgery is to be minimally disruptive, so try to preserve
the muscle and normal normal structures of the spine as
well as we can. So we can in that case
use a small tube and pass the tube down it
splits between the muscles and we can look down with

(32:58):
the microscope and see the bone and ligament that's directly
pushing on the nerves and just remove that stuff that's
overgrown rather than removing the other portions of the bone
and ligament in the back, and so that's another option
for lamin ectomy. So in terms of fusion, fusion surgery

(33:20):
refers to basically fusing two bones together. So the spine
is made up of bones stacked on top of each
other called vertebra, and between the bones are discs and
the discs are joints, and so your spine is made
up of a series of joints stacked on top of
each other. And if one of those joints is severely

(33:44):
degenerated again wear and tear that sort of thing, or
maybe have abnormal alignment or movement, that can be a
reason why we'd want to do a fusion surgery. And
so the goal of fusion surgery is basically to get
those two bones with the disk in between those bones
to fuse together. And nowadays that the most common way

(34:06):
to do that is to go in and remove the
disc and put a spacer where the disc used to be.
And that you know, there's multiple ways to do that.
You can come from the front of the spine, from
the side of the spine, from the back of the spine,
but that's the typical way that most people are doing
fusions these days, and that may or may not require

(34:28):
things like screws and rods in the back to hold
things in place. But overall the goal of the surgery
is to basically set the patient up so that over
the course of time, they will form bone where that
disc used to be, and those two bones will be
then fused together. In other words, they'll no longer move,
there won't be a joint there anymore, and that is

(34:49):
what a fusion surgery is interesting.

Speaker 3 (34:52):
So I'm glad you mentioned the term minimally invasive, because
I think people hear that term a lot, and so
I really loved your explanation about you avoiding cutting through
that muscle and we can sort of picture why that
is less invasive. But where else are we headed in
terms of neurosurgery. Are there things on the horizon that

(35:13):
are new and new techniques coming out? I know at
one point I had heard about some artificial discs being
put in. And where are we in terms of advancements
in neurosurgery.

Speaker 2 (35:27):
Yeah, So, I mean I think we're poised for very
big advancements in neurosurgery and spine surgery as well, in
terms of things like artificial discs. Artificial discs have been
around for quite a while now, and by quite a while,
I mean, you know, fifteen to twenty years and have
advanced over the course of time, and artificial discs can

(35:49):
be performed instead of doing a fusion surgery. Say that
disc is severely degenerated, wear and tear and causing all
the pain or pushing on a nerve, you know, it's
possible to go in and remove the disc and put
in an artificial disc or basically a device that will
work like a disc and move like a disc, so
you're not fusing the bones together, You're you're putting in

(36:11):
prosthetic just like you might, you know, replace a knee
or replace a hip. The same idea behind that. And
the issue with artificial discs is they only work for
some people, and they tend to work for people who
are younger that that don't have as much arthritis or
wear and tear going on. But but they can be
a very good solution for those people of other areas

(36:35):
of neurosurgery there and spine surgery that are advancing or
use of robotics, and so I use a robot to
do a lot of my fusion surgeries. Especially in the
low back, especially the more complex surgeries, the uh, scoliosis corrections,
that sort of thing. And the robot doesn't do all

(36:59):
the work for me, at least not yet, but.

Speaker 3 (37:02):
They want you.

Speaker 2 (37:04):
Yeah, allows me to place place screws into the spine
very precisely and very efficiently. It also allows me to
use minimally invasive retractor systems that that that the robot
can hold in place while I remove discs, and you know,

(37:24):
place spacers where where the where the discs used to
be doing fusion surgeries. And another interesting area in spine
surgery now is is kind of personalization or customization of
things like the robs that we're putting in or the
spacers that we're putting in where where the discs used
to be. So currently, if I'm doing a complicated surgery,

(37:49):
a fusion surgery on somebody with we talked about deformity
problem in their spine, where where I've got to look
at their spine before surgery and say, okay, we've got
to take you from here uh to here uh, you know,
after surgery, so that we pull your your your head
back above your pulvis. You know, that requires a lot
of planning and I'm able to actually plan that out

(38:12):
and uh and then I'm able to have a company
build a rod that that will work precisely for for
the patient. So it's a custom rod that will when
I put it in, it will ensure that I'm pulling
the patient back into the proper alignment. So that's very interesting,

(38:33):
and more and more companies are getting into kind of
this customization of of these implants or the uh, you know,
the spacers that we're putting in the rods, et cetera.
So that's that's a very interesting area, very cool area
of technology. And uh you in addition to that, we
talk about artificial intelligence AI that sort of thing, and

(38:56):
and we're using that more and more in spine surgery.
We're we're collecting more and more data so looking at
you know, patients X rays or imaging before surgery and
after surgery, kind of looking at what was done and
kind of what the outcome was and and using all
that information to help us kind of make decisions before surgery.

(39:18):
So you know, say somebody has a problem and you know,
you could look at this and they could use a
database and compare what the problem is, uh, you know,
before surgery what the plan is for surgery and kind
of tell you what the outcome is going to be.
In other words, how's the spine going to look after
you do surgery and taking a number of factors into accounts. So,

(39:41):
you know, kind of very very complicated stuff, but something
that I think, uh, over the course of time will
probably make my decision making not only easier but also
much much better for the patient.

Speaker 3 (39:55):
So well, doctor Throck, once again, I mean, I know
you've been on our show before, but every time we
learn something new and we just appreciate having you out there,
we appreciate when you come and join us on the show.
So that's going to do it. For this week's segment
of Centered on Health with Baptist Health, I'm your host,
doctor Jeff Tavlin. I want to thank our guest doctor

(40:16):
John Sarah over and over again because you are always
so helpful in us understanding this. I want to thank
our producer mister Jim Fenn, and of course the listeners
and join us every Thursday night for another segment. Have
a great rest of your week and a great weekend.

Speaker 1 (40:33):
This program is for informational purposes only and should not
be relied upon as medical advice. The content of this
program is not intended to be a substitute for professional
medical advice, diagnosis, or treatment. This show is not designed
to replace a physician's medical assessment and medical judgment. Always
seek the advice of your physician with any questions or
concerns you may have related to your personal health or

(40:56):
regarding specific medical conditions. To find a Baptist health provider,
please visit Baptistealth dot com.