Because Harborview is designated as the Level I trauma center for a four-state region (Washington, Alaska, Montana and Idaho) and is a regional referral center, many patients come to Harborview for treatment of their spine-related conditions.
Back and neck damage, no matter how slight, can drastically change a person’s life.
The spine is an essential and complex piece of the body’s framework,” says Dr. Jens Chapman, co-director of the University of Washington’s (UW) spine service, a spine surgeon at Harborview Medical Center and a UW assistant professor of orthopaedics and neurosurgery. “Pain, spinal cord damage or nerve damage can cause severe disability. These conditions can impair a person’s ability to move freely, walk and perform simple daily tasks.”
Injuries from motor-vehicle crashes and falls can cause severe damage to the spinal column. Spinal cord and nerve root damage can cause permanent weakness, numbness and even paralysis. Tumors, infections, disc problems and arthritis also may cause disabling pain and nerve damage. At Harborview, spine surgeons are using innovative and complex reconstruction techniques to improve the lives of patients who are suffering from these conditions.
"The spine injuries and problems treated at Harborview are among the most challenging and difficult problems spine surgeons encounter,” says Dr. Sohail Mirza, a spine surgeon at Harborview and a UW assistant professor of orthopaedics and neurosurgery. In fact, many of the procedures performed here are not performed at other area hospitals. Harborview’s program also has a national and international reputation for being one of the best centers for treatment of these difficult problems, he says.
The goal of our treatment is to preserve and restore the patient’s normal physical function,” says Mirza. “With trauma patients, our treatment focuses on restoring neurologic function and speeding up recovery. With chronic painful conditions, we work toward identifying the source of the pain and treating it through a comprehensive approach, which may include surgery.”
In some painful back and neck conditions, the source of pain can be difficult and sometimes impossible to localize. Extensive tests are frequently needed. However, only a few of the patients have problems that can be surgically corrected. Compressed nerves, painful disc degeneration or abnormal movement and alignment of the spinal column are examples of conditions that can be treated surgically.
New surgical techniques allow spinal reconstruction of problems previously considered untreatable. Harborview’s spine surgeons have developed techniques that allow patients better pain relief and earlier mobility. These techniques use graft materials and titanium implants to restore the strength and stability of the spinal column.
Graft materials, which include the patient’s own bone from a different part of the body, donor bone from a tissue bank or new calcium-based bone replacement compounds, provide a type of latticework for the patient’s body to make new bone and fuse together spinal vertebrae. Titanium implants such as cages, rods and screws hold the vertebrae together as bone healing takes place.
These newer minimally invasive surgical techniques allow procedures to be performed through small incisions. As a result, there is less surgical injury to tissues and a faster recovery time. Surgeons may use cameras and laproscopes to remove an abnormal disc and fuse the spine with graft material and titanium cages. Electrothermal disc surgery can offer an alternative to spinal fusion for some patients suffering from back pain. Some surgical procedures may take one to two hours, while others may take 12 to 14.
"Minimally invasive surgery avoids many of the problems associated with traditional approaches that required large incisions in the back, chest or abdomen,” says Chapman. “Spine surgeons at Harborview are doing research in these areas to determine which patients benefit the most from these procedures.”
The spinal surgeon’s approach involves the work of neurosurgeons, general surgeons, anesthesiologists, radiologists and rehabilitation medicine staff.
Many of the complex problems we treat with spine reconstruction require collaboration among different medical specialties,” says Mirza. “Fortunately, we’ve got the best from each medical field working together.”