North American Spine

[cp7959]

Is anyone familiar with North American Spine and their AccuraScope procedure?

From what I read they use the scope to go up the spinal canal and use a laser to remove herniation's. These are anesthesiologist that perform the surgery.

My gut tells me it sounds to simple to be reliable.

I have a central Herniation at L3/L4 and was hoping to get advice on surgical options. A couple of surgeons told me that discectomy's are really not an option because of the central location. Which means fusion or ADR.

Not sure how far down the surgical route I'll go. I've had this for 13 months and the sciatica can be difficult. I haven't sat for extended periods for over a year. If I felt time would help I would still wait it out. All opinions are appreciated.

[Keano16]

Fraud.... Google it.

I wrote a lot about NAS and I was never denied, so that means I was right.

Laser application with their technique is dangerous.

[mmglobal]

Minimally invasive spine surgery is a compromise. Smaller access typically lowers the ability of the surgeon to visualize the field. It is more restrictive on the tools they can use. Their animation demonstrates the approach, but other than that it is quite amusing. I'd be curious how they safely vapor a calcified disc herniation that is adhered to the nerve root? It's great on the animation how it shrinks uniformly down to zero.

I have not experience with that center, so I'm not prepared to say anything as strong as what Keano said, but I'm quite skeptical.

One thing you seem to understand correctly is that all endoscopic surgery is not the same. There are so many different twists on the procedure. Some twists are better than others and may also be better or worse in specific types of cases. Sadly, the operators tend to do the procedure they like, and in MISS, they seem to think that they won't hurt you, so you might as well try. That is great if you can afford the second surgery. But, if they take a low percentage case without telling you that you are not really a good candidate, then you can't take the next step because you are broke, they have done a great deal of harm!

I have a client who underwent a microdiscectomy on a very large central herniation on Monday. Unfortunately, he went to a NY clinic that does PLDD. This procedure had no chance of working on such a herniation... what a shame.

Be skeptical.

Mark

[Keano16]

There are many lawsuits against them. Check spineuniverse forum and Google.

Regards

[cp7959]

Thanks for the responses. I wonder how they stay in business or more info. isn't out on them. According to their rep. they do 70 procedures a month. That's a pretty large number if their a "smoke and mirrors" shop, with out more bad press out on them.

Thru anyone's experience is ADR or Fusion the only option for central herniation's?

Is there still hope of a herniation resolving itself without surgery after a year?

[Keano16]

Endoscopic surgery is possible for all types of herniations, as well as micro-endoscopic (a.k.a. METRx) surgery if herniation is too big.

Some of my patients live with extrusions with NO pain.....

[mmglobal]

I don't know why anyone would suggest that ADR or fusion is the only option for large, central herniations??? If your disc is so severely degenerated that a discectomy is not likely to succeed, that may be closer to the truth.

Time heals many spine problems. After a year, if it's going in the right direction, I'd wait. However, if your life is bad enough to consider surgery and it's not getting better, I'd look long and hard at your options.

I don't think they are 'smoke and mirrors'. In some cases it seems that they are willing to perform surgery on a poor candidate because they believe that they will not make them worse. That does not mean that on prime candidates, their surgery is not likely to be a success.

Mark

[cp7959]

With a central herniation, how does the surgeon access/approach the protrusion to perform a "microdiscectomy?

It's obvious if it's a lateral, but central?

[mmglobal]

Tony Yeung works from inside the disc, so central herniations are not a problem to reach. Very centrally located herniations are more difficult to get to with more traditional endoscopic techniques. With open microdiscectomies, the can more easily move things around to get there.

How severely degenerated is your disc? If it's too severely degenerated, then discectomy may not be your best option.

Mark

[Keano16]

For central herniations there is a great alternative to open surgery. Its called micro-endoscopic or somewhere METRx surgery (tubular retractor).

[cp7959]

Degeneration isn't that bad on MRI views. There is good disk height and the "herniation" is 3-4mm directly in the center. It rears it's head mostly when i sit.
When I stand up or lay down there isn't much discomfort. periodically I only have minimal back pain, usually it's not a problem. Most problem is sciatica.

I'm sure if I become more aggressive with my activity the symptoms will worsen. So I stay as active and "controlled" as I can hoping it will resolve. But this is getting old.

Always looking for advice or opinions.

[ADR seeker]

North American Spine:

Theoretically that they do can work. I called them and I got a sales pitch like the DXR 9000. I think that NAS helps some people and that the technology is valid but from what I read their surgeons are hacks and there are no peer reviewed studies.

A laser fired in the disk can make it better but the surgeon needs skill and training. I don't think the NAS jokers like most American surgeons are well trained. Just my opinion. You may want to roll the dice but before you do read this.

http://radiology.rsna.org/content/225/3/895.full.pdf

http://radiology.rsna.org/content/225/3/895.full.pdf

Traction works. Learn how to do it. I am too far gone for the disk to recede but some of you may find it helpful. I still try it. I don't exceed 30 lbs for cervical.