Note from 9th annual Ortho conference in Chicago
Robert Nucci, MD, a surgeon at Citrus Park Surgery Center, gave a presentation titled "Minimally Invasive Outpatient Lumbar fusions and Multi-Level Outpatient Cervical Disc Replacements" at the 9th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 10, 2011. Dr. Nucci discussed the benefits associated with performing spine cases in ASCs and described the far lateral interbody fusion procedure he has performed on patients in ASCs.
The main concerns surgeons have with performing spine surgery in ASCs are:
• The infection rate is lower than in hospitals
• There is less overhead cost and increased efficiency in the OR
• Shorter anesthesia time
To perform single or multi-level FLIFs, Dr. Nucci removes the disc through a small incision, inserts a mesh cage and inflates it with allograft bone. The average OR time for the procedure is 129 minutes, surgeon time is 118 minutes and recovery time is 180 minutes. The average blood loss is 141 cc and there is minimal muscle tissue disruption.
Dr. Nucci also performs cervical disc replacement in ASCs using an artificial disc. The average OR time is 92.4 minutes, surgeon time is 77.5 minutes and recovery is 140.8 minutes. Patients are under anesthesia for approximately two hours and experience average blood loss of 95 cc. He hasn't experienced any complications with that procedure
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female age 45, height 5"6", 145 lbds, non smoker, conservative treatments failed, (7/2007) C4/5/6 peek disc replacements,plate & screws failed fusion,
(9/2008) revision with bone replace plate and screws, (10/2009) C3/4 stand alone peek cage, (12/2010) facet joint injections C3-7, (1/2011) rhizotomy C6/7 failed, Trouble swallowing
most recent mri (7/2011) shows ajacent level issues: right neural foraminal narrowing C2/3, posterior bulge indents thecal sac at C6/7/T1 no mass effect on cord.
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