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Leading-Edge Scoliosis and Spine Care, Locally
Texas Health Presbyterian Hospital Plano and Texas Back Institute have collaborated to offer the Scoliosis & Spine Tumor Center to provide advanced care for adolescent and adult patients suffering from scoliosis, spinal deformities and spine tumors.
The Scoliosis & Spine Tumor Center, which opened last April, is led by Isador Lieberman, M.D., M.B.A., FRCSC, Medical Director of the center and an internationally recognized spine surgeon. Through his research efforts and clinical expertise, Dr. Lieberman has codeveloped advanced technology, such as the SpineAssist surgical robot, and has made it available to patients throughout the region.
“Since the 1990s, Texas Health Presbyterian Hospital Plano and Texas Back Institute have worked together to deliver advanced clinical care and technology for patients in need of spinal care,” says Jeffrey Canose, M.D., President of Texas Health Presbyterian Hospital Plano. “We wanted to create a destination for orthopedic excellence, so we began examining our services to determine what we needed to add to our portfolio, which turned out to be scoliosis and spine tumor surgery. By recruiting Dr. Lieberman — who is recognized as one of the top spine surgeons in the country — we have been able to make this a world-class center.”
Applying the Least-Invasive Treatment Option
The Scoliosis & Spine Tumor Center maintains a philosophy of providing patients with relief from symptoms while using the least-invasive methods possible. Exercise, weight loss and smoking cessation are always encouraged when it applies, and depending on the patient’s specific diagnosis, conservative care such as physical therapy, bracing and the use of anti-inflammatory medications may be employed prior to surgery.
If conservative methods fail to yield results and surgery is indicated, minimally invasive surgeries are available to shorten recovery times and help patients return to daily activities more quickly.
Leading-Edge Technology and Services
Dr. Lieberman is one of the developers of the SpineAssist surgical robot, which was recently introduced to the Plano area. The surgical system — one of only three in the United States — is indicated for use in many procedures, including minimally invasive surgery where cage implants are necessary, restructuring of the spine for treatment of degenerative disease, disc replacement surgery, kyphosis, scoliosis treatment and spinal tumor removal.
The SpineAssist surgical robot consists of two main components: a software and computer graphics interface and a robotic arm. Using SpineAssist software, surgeons can utilize a patient’s preprocedure CT scan to determine exactly how the surgery should be performed.
“Surgeons preplanning a procedure using the SpineAssist surgical robot are very much like pilots preparing a flight plan prior to takeoff,” says Dr. Lieberman. “The robot allows us to determine exactly where to cut the bone, where to place the implants and how much correction should be used.”
Referencing and registration software allows for easier planning prior to surgery. The software uses two X-rays taken in the operating room before surgery to allow surgeons to create a reference frame for the patient. The software then matches the spinal column point for point so that the robotic arm can reference the spine in 3-D space.
“Once the referencing is completed, surgery can begin, and the robot will execute the preoperative plan,” says Dr. Lieberman. “For example, if the surgeon needs to place a screw in the L-2 vertebral body, the robot will go there and guide us directly to where the screw needs to be placed. The robot is not actually performing the surgery, but it helps facilitate a more precise and efficient surgical procedure by guiding the surgeon’s hand according to the preoperative plan we have crafted. Whenever we manipulate the spine or place an implant, the robot is a very useful tool.”
Some surgeries performed using the SpineAssist surgical robot are minimally invasive procedures. Patients benefit from shorter recovery times, less pain and a reduced risk of infection and less scarring. Additionally, Dr. Lieberman utilizes advanced resources during surgical cases such as cell-saving technology and neuro monitoring.
Minimally invasive vertebral augmentation of spinal tumors combined with percutaneous fixation for tumors that have spread to the spine is also available at the Scoliosis & Spine Tumor Center.
After surgery has been completed, therapists provide state-of- the-art rehabilitation services to help patients return to their daily lives as soon as possible. One-on-one therapy appointments are available, and for adolescent patients, specially trained nurses and therapists are available to listen to concerns and provide support.
“We care for patients from start to finish,” says Sara Misuraca, Program Director of the Scoliosis & Spine Tumor Center. “From the first clinic appointment through postsurgical hospital discharge, we offer a multisdisciplinary team to care for our patients. We are able to care for patients who range in age from adolescence through geriatrics. We also follow up with referring physicians so they can remain a part of their patients’ care.”
An Emphasis on Research
Aside from continuing work on the SpineAssist technology, Dr. Lieberman also participates in a number of clinical trials at the Texas Back Institute. Clinical trials are currently underway to examine several disc replacement devices, and clinical studies in spine tumor work and scoliosis are being carried out to examine patient outcomes and success rates.
Dr. Lieberman is also working on the development of several new surgical instruments and implants.
“As we continue to establish better ways to fix the spine, we are developing technology that I believe will introduce a new standard of care,” says Dr. Lieberman. “We are consistently finding so much more we can do with this technology, and I believe that it is going to set a new standard in the treatment paradigms for spinal surgery.”
For more information about the Scoliosis & Spine Tumor Center at Texas Health Presbyterian Hospital Plano, call 1-877-500-5454 or visit the website at www.TexasHealth.org/PlanoSpine.
MD News October/November 2010, Dallas/Fort Worth