We’ve all heard the saying “When you have a hammer, everything looks like a nail.” So if you were referred to a spine surgeon, it would be natural to think you would end up with a long scar down your neck or back. But surgeons like Dr. Alfred Ogden here at The Spine Hospital at the Neurological Institute of New York know that not every spine problem is a nail.
Dr. Ogden specializes in a type of surgery called “minimally invasive spine surgery.” This means that when surgery is necessary, it can be performed through small openings with less pain and shorter recovery times.
Does that sound almost too good to be true? “Minimally invasive surgery” is just what it sounds like: surgery, but done in a way that minimizes disruption to the body’s tissues. Minimally invasive spine surgery uses smaller incisions, through which surgeons can insert tiny surgical instruments. Because it results in easier, shorter recovery times and fewer hospital expenses, minimally invasive surgery has been more and more popular for all kinds of conditions, from gallbladder surgery to angioplasty, and now spine surgery.
Dr. Ogden’s neurosurgical training was largely focused on these minimally invasive techniques. In fact, he’s one of a small number of surgeons in the nation with in-depth training in this specialty. After his neurosurgical residency here at Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, he did an additional year of fellowship training specifically focused on techniques that would allow him to do spine surgery with as little trauma to the patient as possible.
One of these techniques is called the “tubular approach.” Surgeons use tools called tubular retractors to insert a tube through a small incision and gently spread the muscles apart to get at the spine, rather than cutting through them. Dr. Ogden says this procedure is one of the biggest technological advances that makes minimally invasive spine surgery possible.
Using the tubular approach Dr. Ogden can perform delicate procedures such as discectomy (removing all or part of a spinal disc), laminectomy (removing part of a vertebra) or even spinal fusion, in which he connects two or more vertebrae with bone grafts—all through a small incision. Dr. Ogden’s extensive experience with this technique puts him in demand at surgical conferences. He was recently asked to speak about the tubular approach at a meeting of the International Society for Minimal Intervention in Spinal Surgery (ISMISS).
For spinal tumors Dr. Ogden has yet another tool he can turn to: stereotactic spinal radiosurgery. Instead of using even small incisions, this kind of surgery uses no incisions at all. Dr. Ogden uses X-rays to target and treat spinal tumors without having to cut into the patient and without harming healthy tissue around the tumor. Radiosurgery is usually used to treat metastases, which is when cancer has spread from one part of the body to another. Spinal radiosurgery can stop the tumor from growing in the spine and may even be able to reduce its size. You can read more about how Dr. Ogden uses spinal radiosurgery here.
But even with all of these tools at their fingertips, Dr. Ogden and his colleagues prefer to treat spine problems conservatively. They will often begin with nonsurgical therapies, progressing to surgery only if these fail to bring relief. In many cases nonsurgical treatments such as physical therapy will be all that is needed to get the patient up and running. Dr. Ogden works hand in hand with the Spine Hospital’s nationally recognized physical therapy team, led by Evan Johnson, D.P.T., and Rami Said, D.P.T., to come up with individualized treatment for each patient, with the goal of restoring spine health without surgery.
Drs. Johnson and Said have a wealth of experience in both correcting and preventing spinal injuries and disorders. They also have a strong focus on education for good spine health. Even if you’re not a patient, visit the Physical Therapy Department’s page to find exercises and workstation tips you can use right now to keep your spine in excellent shape. There’s no need to wait until you have a spine injury to benefit from our physical therapy resources. In fact, learning about good spinal health and proper exercise form can help you prevent a spine injury in the first place.
So if you’re referred to a spine surgeon here at the Spine Hospital, you can rest assured that you may not necessarily be in for a major operation. Dr. Ogden, like all the spine surgeons here, will carefully evaluate your unique situation and use whatever tool is best to get you the best possible outcome, whether that’s open surgery, physical therapy or a minimally invasive procedure that will have you up again in no time.
Read more about Dr. Ogden’s experience with minimally invasive surgery here.