September 1, 2022

DISC Sports & Spine Center announces plans for its most advanced outpatient facility yet.

Patients looking for the latest technology and top-caliber spine care will soon have another option in the Los Angeles area. DISC Sports & Spine Center, a longtime provider of outpatient spine surgery, is currently constructing a brand-new 11,000-square-foot ASC in Marina del Ray, Calif., with an anticipated opening in early 2023.

The facility will be DISC's most technologically advanced center yet, and capable of hosting 1,000 complex spine cases per year. Amenities will include two state-of-the-art ORs outfitted with Zeiss microscopes, a PACU bay, four private patient rooms including a luxury suite, an inviting family lounge, a private consult room, a modernly designed waiting room, 2,000 square feet of administrative space, digitally integrated OR feeds, collaborative workstations and conference space for teaching purposes.

To be located in a space adjacent to DISC's existing musculoskeletal clinic in Steelwave's Marina Park, DISC plans to combine "the latest advances in minimally invasive technology and medical infrastructure with a world-class surgical team to elevate the patient experience in a safe, modern setting," according to a press release.

DISC is no stranger to cutting-edge ASCs constructed in aesthetically appealing ways that make patients feel as if they're checking into a hotel instead of undergoing an operation. Its 12,000-square-foot, two-OR DISC Surgery Center at Newport Beach, a destination for spine patients from across the country, has the look and feel of a five-star hotel, says DISC Chief Operating Officer Karen Reiter. "Behind the beautiful facade lies the framework of a technologically advanced facility designed to deliver state-of-the-art spinal care," she says. Take, for example, the facility's HVAC unit, a sealed system that covers the entire ASC. "Every air exchange goes through pre- and post-HEPA filters and is treated with ultraviolet light," says Ms. Reiter. "The advanced system was a significant expense that goes unseen, but it has contributed to our zero infection rate."

DISC launched its first ASC in Marina del Rey 16 years ago. "Over these past 16 years, we have embraced a fierce commitment to constantly evaluate, learn, innovate and fine-tune every part of the patient experience, whether the cases are simple or complex," says founding director Robert S. Bray, MD, a neurological spine surgeon. "Our new facility is the product of all of this — an ASC upholding DISC's superior quality while creating a model that is truly the future of high-acuity outpatient spine for the U.S."

Technology enhances its effort to provide maximum accuracy and efficiency in spinal surgery.

University Health's (UH) St. John Medical Center and Cleveland Medical Center has become the first health system in greater Cleveland to acquire the Mazor X Stealth Edition Surgical Robotic Guidance Platform. The platform will first be used at UH St. John Medical Center by neurosurgeon Dustin Donnelly, MD, PhD, who specializes in spine surgery.

The Mazor X's robotic arm enables precise placement of surgical tools while providing 3D visualization of the surgical area of the spine. The idea behind the purchase is to help the surgeon operate with greater precision, efficiency and confidence, with the goal of improving subsequent outcomes. "Robotics is an enabling technology that allows us to maximize accuracy and efficiency across the spectrum of spinal surgery, from percutaneous and other minimally invasive approaches to complex deformity correction," says Dr. Donnelly.

The platform enables the health system's surgeons to plot an optimal surgery in a 3D simulation using the patient's own CT imaging. Computer analytics provide the surgeon with data for the preoperative planning, as well as guidance during the procedure.

Nicholas Bambakidis, MD, chairman of the Department of Neurosurgery and director of the UH Neurological Institute, says that although minimally invasive procedures are becoming more common for spine, they can also present a challenge to surgeons due to limited views of the patient's anatomy. "The Mazor X helps to overcome this challenge with a 3D comprehensive surgical plan, giving the surgeon more complete information and visualization before the surgery begins," he says.

Balloon kyphoplasty produces better pain relief and quality of life for patients with acute VCF compared to patients treated with non-surgical management.

Joshua Hare
Joshua Hare, MD

Optimizing treatment of patients with painful vertebral compression fractures depends on promptly identifying which patients could benefit from an interventional procedure. That's according to Dr. Joshua Hare, an anesthesia and pain management physician practicing with Elite Pain Consultants in Dalton, Ga., and Cleveland, Tenn. Hare sees patients with painful VCFs from a variety of sources, from primary and urgent care to emergency department follow-ups. What the patients all have in common is what Hare calls intense, severe back pain.

In an outpatient setting, Hare said patient care begins with conservative measures including anti-inflammatory medications, muscle relaxers or over-the-counter pain relievers.

"If the pain kind of persists, ultimately, they end up getting an X-ray, and. a lot of times, we'll pick up the initial deformity on an X-ray," Hare said. "And then we'll kind of accelerate our treatment. We realize we're not just treating a run-of-the-mill lower-back pain or mid-back pain — we actually have a more serious issue. So, at that point, we'll move on to things like bracing, potentially some physical therapy, and, again, continuance of conservative medicines. If those things don't get them better and they're continuing to have severe pain — greater than 5 out of 10, inhibiting their daily activities, and not able to complete a course in physical therapy or just having chronic, persistent severe pain — we think about proceeding with some sort of vertebral augmentation like balloon kyphoplasty."

Balloon Kyphoplasty is a minimally invasive surgical procedure for the treatment of spinal fractures due to osteoporosis, cancer or non-cancerous tumors. These spinal fractures, also called VCFs, occur 800,000 times a year in the United States.¹ Over the years, studies comparing balloon kyphoplasty to non-surgical management have shown balloon kyphoplasty produced better pain relief and quality of life for patients with acute VCF compared to patients treated with non-surgical management.^2-4

Although the complication rate for Balloon Kyphoplasty is low, as with most surgical procedures serious adverse events, some of which can be fatal, can occur including heart attack, cardiac arrest (heart stops beating), stroke and embolism (blood, fat or cement that migrates to the lungs or heart). Other risks include infection; leakage of bone cement into the muscle and tissue surrounding the spinal cord and nerve injury that can, in rare instances, cause paralysis; and leakage of bone cement into the blood vessels resulting in damage to the blood vessels, lungs and/or heart.

Hare said he educates referral sources about how his team is prepared to treat patients with painful VCFs. "If a referring physician gets an X-ray to our office, send the patient over. We'll get them in quickly and we'll manage the entire situation."

A vertebral augmentation procedure doesn't mark the end of the care pathway, Hare said. Patients with painful VCFs are referred for post-fracture care to the hospital's Healthy Bones Clinic. "It does the entire gamut of osteoporosis treatment from basically from soup to nuts," Hare said, "so we put those folks into that immediately. Because we really want them to avoid having this kind of continual process of fractures. Once a patient has an osteoporotic compression fracture, their risk of getting a second one goes up dramatically.⁵"

References:

1. Medtronic Data on File - Business Insights & Analytics Sept 2019

2. Berenson J, Pflugmacher R, Jarzem P, et al. Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: a multicentre, randomised controlled trial. Lancet Oncol. 2011 Mar;12(3):225-35.

3. Boonen S, Van Meirhaeghe J, Bastian L, et al. Balloon kyphoplasty for the treatment of acute vertebral compression fractures: 2-year results from a randomized trial. J Bone Miner Res. 2011;26(7):1627-1637.

4. Van Meirhaeghe J, Bastian L, Boonen S, et al. A randomized trial of balloon kyphoplasty and nonsurgical management for treating acute vertebral compression fractures: vertebral body kyphosis correction and surgical parameters. Spine. 2013;38(12),971-983.

5. Lindsay R, Silverman S, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001;285(3):320-323