News

Lumbar Spine Surgery is Becoming an Overnight Surgical Procedure for Most Patients

Lumbar Spine Fusion was developed decades ago as a method to stabilize the lumbar spine after tumor resection, traumatic injuries, degenerative disease, and scoliosis. Over the past 10 years, lumbar spinal fusion surgery (1-level & 2-level) has become an overnight procedure. Patients are now discharged the next day after surgery. Those patients with a long history of pain medication usage, chronic pain symptoms, or significant risk factors for complications may stay in the hospital longer.

Criteria that matter for early discharge include age, history of narcotics for pain, functional level prior to surgery, cardiac history, pre-operative symptoms such as weakness or excessive pain. Here are some of the reasons why lumbar fusion is heading towards an ambulatory procedure when you have surgery through the Lumbar Spine Center.

Positioning with the Jackson Table

Patients are positioned with the Jackson Table that allows the abdomen to fall away from the spine while prone (face down) reducing the pressure on the spinal venous plexus thereby reducing the amount of blood loss during surgery.

Cell Saver

Although we do not expect much blood loss, we use two cell saver suctions. The blood suctioned and lost during surgery is aspirated into canisters by the Cell Saver Machine and filtered to give back to the patients after surgery. In approximately 50% of the surgical procedures, we give the patients 100 ml – 150 ml of their own blood. It is our feeling that the blood helps with mobility after surgery and allows them to go home sooner.

Intraoperative CT Scan with Navigation

After the patient is asleep, we make the incision in the lower back and expose the posterior lumbar spine. Once exposed, we attach a Navigation Localizer and then bring in the CT Scanner or O-Arm to obtain an intraoperative CT Scan. After we perform a CT Scan, the images are sent to a Computer Workstation. The Workstation integrates the CT Scan Images to register with the space of the patient using the Navigation Localizer. When we use the pointer from the Workstation, it shows us exactly where we are pointing relative to the CT Scan images making pedicle screw placement much easier, more accurate and safer. The CT Scan is repeated after the placement of the pedicle screws and before the incision is closed to make sure they are in properly.

Intraoperative Monitoring

Once the patient is asleep, a Neuromonitoring Technician places electrodes into the muscle of the legs and arms to measure the signal conduction of the brain to the limbs during the surgical procedure. The technician monitors the impulses throughout the procedure reporting to an interpreting Physician from a remote location. During the surgery, if there is undue pressure on a nerve, the technician will alert the surgeons. Additionally, while we insert the pedicle screws, we are monitoring the screw as it is going into the pedicle bone to make sure it is not inadvertently placed too close to a nerve.

Power Tools

The majority of the pedicle screws placed are from Medtronic Spine. Medtronic provides a power drill (Powerease) that makes placing screws easier.

Bone Grafting Techniques

During your surgery, we collect bone graft (autograft) in removing the lumbar lamina through handheld instruments and bone shavings from using a high-speed drill. In particular, Dr. Abrahams uses the BDC-15, an FDA approved device that he developed to increase the volume of the patient’s bone thereby reducing the need for any cadaver bone (allograft). We use the BDC-15 Device with in-line suction.

Collected Bone Graft

During this surgical procedure, we collected 20 ml of autograft from the patient.



Excellent
Based on 74 reviews
Angelo Troiano
Angelo Troiano
November 14, 2022
Very professional and thorough with my surgery.
Faith Schwenker
Faith Schwenker
March 22, 2022
Dr. Abraham’s did my surgery and it was a great success. After nearly 8 years of pain, I finally found a doctor who could help me. My sciatica nerve was compressing my L4 and L5 which was giving me pain and a very poor quality of life. Not only does Dr. Abraham’s have a great bedside manner, but also he certainly knows the complexities of the spine. Thank you so much for giving me my life back!! P.S. I have referred his name to several of my friends and they too have had a successful outcome!!
Kathleen Cully
Kathleen Cully
May 28, 2021
Dr. Abrahams is an extremely compassionate and highly skilled neurosurgeon who, along with Dr. C. Shannon, saved my husband's life by removing a complicated malignant metastatic brain tumor during a very long surgery. In addition, Dr. Abrahams has been my surgeon for several spinal procedures and I trust him with my life.
Kathleen Darcy
Kathleen Darcy
February 22, 2021
My experience was great 😊. Dr Abraham was fabulous.
Xavier Masi
Xavier Masi
February 15, 2021
Dr. Abrahams is the best, very caring and takes time out to listen instead of rushing!!! thanks Doc.. I might have to come see you again. Anthony
Dale
Dale
February 15, 2021
😷 Dr Abrahams is THE BEST! He is the absolute best brain & spine surgeon by far! His group is beyond excellent! My back & neck had been fractured in an accident, and I made the mistake of seeing a "spine doctor on Tarrytown Road," who did not want to see me again unless I needed more surgery! I was outright denied an appointment, even after this "doctor" performed a lumbar laminectomy on me!!!😡 I was miserable and in excruciating pain. Then everything changed.... 🙏THANK GOD I FOUND DR ABRAHAMS! He took all the time he needed with me to come up with a new plan and thoroughly explained the correct surgery I needed. I had a fractured sacrum, lower back S1, right up to L5, needing spinal fusion. I also had cervical herniations. My life changed after Dr Abrahams took care of my surgery, his office still checks up on me to make sure I'm doing well. The office and entire staff is so helpful, friendly and caring. I recommend Dr Abrahams on a regular basis to people I meet that have brain or spine problems. Dr Abrahams is also BRILLIANT. He is the creator of many medical devices that he received patents for. When you go in his office your eyes won't know what to look at first he has so many awards & patents. He's a MUST GO TO doctor! He changed my life, and I am forever grateful to him, Lisa (his personal coordinator), and his entire staff, fellow doctors that are also in group with Dr Abrahams. I HIGHLY RECOMMEND HIM as well as the doctors in practice within his group. You will get the best care by far.😊
Helena Mattis
Helena Mattis
January 12, 2021
Dr. Abrahams literally saved my life. I went to him back in 2004 in horrible shape after being misdiagnosed by my Primary Care Physician. He went above and beyond in saving my life. I highly recommend him for his skills, ability, his humanity and love he demonstrates for both his patients and his work. Helena Edwards
Farah Rubeo
Farah Rubeo
September 13, 2020
Dr. Abrahams performed back surgery on me 6 years ago . I was 38 yrs old and in excruciating pain, not able to walk for longer longer than 5 minutes, sleeplessness nights and constantly being put on pain medication , including countless rounds of PT. Surgery was my only option to return to the quality of life I had before my injury and I am beyond grateful for Dr. Abrahams and his team. I have been playing softball, exercising , walking my dog and enjoying everything that I have missed for years! Dr. Abrahams to me Is a lifesaver! The best of the best !