Dante Implicito, MD, an orthopedic spine surgeon and chief of spinal surgery at Hackensack University Medical Center, talked recently to The Star-Ledger about how technological advancements are transforming his field.
Q: How has spinal surgery advanced in the last few years?
A: Spinal surgery has evolved substantially. We are now utilizing a much more minimally invasive approach to surgery. This approach requires a significantly smaller incision to access damaged spinal discs or vertebrae. Many procedures can be carried out using an incision of about an inch, and patients often return home from surgery the same day.
Q: How does this minimally invasive approach benefit patients?
A: The biggest benefit to patients is the reduced recovery time. Historically, spinal surgery required the dissection of muscle and tissue to access the spine. This resulted in a longer recovery period, as not only did the incision need to heal, but also the damage to the muscles and tissue surrounding the spine. With the minimally invasive approach, we are placing small instruments between the muscle fibers, which spares the muscle from unnecessary damage.
Q: What technologies are being used during spinal surgery that allow them to be safer and more effective?
A: The two most advantageous technologies are spinal cord monitoring and image-guided surgical instruments. These allow surgeons to see in real time the placement of surgical instruments and implants, as well as the anatomy of the spine. Before these technologies, the only way to visualize instruments and anatomy was to create a larger incision and expose a large area of the spine. These technologies also reduce the incidence of nerve damage during surgery.
Q: What are some of the more common conditions for which patients seek treatment?
A: The most common conditions are herniated spinal discs, either in the cervical or lumbar spine. These disc herniations put pressure on the nerves that exit the spine and often cause pain and burning in the arms or down into the legs (sciatica). Another common issue is what is known as spinal stenosis, which is a narrowing of the spinal canal. This narrowing exerts pressure on the spinal nerves and can result in neck or back pain that radiates into the arms or legs.
Q: What preventative measures can patients take to avoid common spinal conditions?
A: In my practice, I always reinforce the importance of both stretching and core strengthening. The core (the muscles of the abdomen and back) plays an integral role in maintaining proper posture in the spine. When the core muscles are weak, it often causes patients to lean or hunch forward. This hunching causes unnatural pressure on the spinal column and can often lead to pain, soreness and other, more serious conditions. Maintaining adequate flexibility in the lower back and hamstrings, as well as a properly conditioned core, are our best defenses against future chronic, disabling spine pain.
Dr. Implicito’s practice, New Jersey Spinal Medicine and Surgery, is located in Glen Rock and Maywood and consists of various surgical treatments of cervical, thoracic and lumbar spine conditions. Known for his work in minimally invasive spinal surgery, he has been featured in several national publications. For more information, call (201) 251-7725 or visit NJspinalmedicine.com.