UPMC’s Multidisciplinary Experts Offer Numerous Treatment Options for Back and Neck Pain
Jul 01, 2017 10:34PM
By North Hills Monthly magazine
Seated: Matt El-Kadi, MD, PhD, FACS Left: Mark Fye, MD Right: Scott Rainey, DO
As anyone who has ever had back or neck pain knows, it can be constant—and excruciating. Yet many people don’t go to a doctor for help because they are afraid that the only answer is surgery. At UPMC Passavant and the UPMC Outpatient Center in Wexford, there are numerous non-operative treatments that can provide relief without the need for surgery, as well as surgical options for when all other avenues have been exhausted.
“I tell my patients, ‘Just because you walk in the door doesn’t mean that you’re signing up for surgery,’” explains Scott Rainey, DO, an orthopaedic spine surgeon with Tri Rivers Musculoskeletal Centers, which is affiliated with UPMC Passavant. "We have many non-operative options that we try first, including physical therapy, anti-inflammatory medicines, and injections. Most are very effective, which is why the number of surgical candidates is so low.”
“Most people don’t need surgery; they need answers,” agrees neurosurgeon Vincent Miele, MD, of Tri-State Neurosurgical Associates-UPMC. “Our goal is to find a way for patients to avoid surgery unless it is their last resort.”
The Spine Program at UPMC Passavant
According to Matt El-Kadi, MD, PhD, FACS, vice chairman, Department of Neurological Surgery, director, UPMC Passavant Spine Center, and chief of neurosurgery, UPMC Passavant, he started building the spine program 15 years ago, which resulted in the establishment of the comprehensive UPMC Passavant Spine Center in 2015. This program includes services at the UPMC Outpatient Center in Wexford, where patients receive diagnoses and treatment from experts including neurosurgeons, orthopaedic spine surgeons, physiatrists, physical therapists, and specialists in sports medicine, pain management, and diagnostic imaging.
“Our program is convenient because it provides everything that spine patients need in one location; our multispecialty team works together to provide comprehensive care,” he explains. “More than 85 percent of patients with lower back pain can be treated here through a conservative approach without surgery.”
The UPMC Outpatient Center in Wexford is especially convenient for patients who may need to see more than one expert. Multiple appointments can be scheduled on the same day, saving them numerous trips to different doctors for the same problem.
Patients for whom surgery is recommended are treated in the state-of-the-art Patient Pavilion at UPMC Passavant, which features three dedicated neurosurgical and orthopaedic operating suites, as well as private patient rooms.
“Our patients are treated by extremely experienced neurosurgeons and orthopaedic surgeons who do nothing but spine, and receive care from specialized nurses in a specialized operating room on a specialized floor,” says Dr. El-Kadi.
Robert Del Greco, 63, came to see Dr. El-Kadi with symptoms that included paralysis in his left arm and excruciating neck pain. “I’d consulted first with a non-UPMC doctor who diagnosed a rotator cuff injury, and I began treatment for that,” Mr. Del Greco explains. “The pain persisted, so I went to see Dr. El-Kadi.
“After looking at my x-ray, MRI, and CT scan, Dr. El-Kadi diagnosed severe stenosis in my cervical spine,” he continues. “He said that the paralysis in my left arm was from nerve root compression and not the rotator cuff.”
Within 72 hours, Mr. Del Greco was undergoing a multi-level discectomy at UPMC Passavant. Upon waking the next day, he discovered that he already had more movement in his left arm. “I still have some deficiency in range of motion, but considering what condition it was in, I’m extremely pleased with the result,” he says.
Since his operation in April 2016, Mr. Del Greco has pursued yoga, swimming, and golf—and he could not be happier with his prognosis. “I cannot imagine a more positive and nurturing experience; the wing dedicated to spinal surgery at UPMC Passavant is truly remarkable,” he says. “The nursing staff, doctors, and surgeons are all concentrated in this one area, so I had great confidence that no matter which person I saw, I was dealing with someone who specialized in spine issues.
“When anyone asks me, I take the opportunity to recommend the amazing, dedicated group of surgeons at the UPMC Passavant Spine Center,” adds Mr. Del Greco. “I came here for treatment from where I live in the South Hills, but I would have driven anywhere for this result.”
From Diagnosis to Post-Op Care
Spinal issues can be complex, which is why it’s so important to find a surgeon who not only has years of specialty training, but who also takes the time to listen to patients’ needs.
“The art of taking a proper patient history is so important when you work with people with spine problems,” says orthopaedic spine surgeon Mark Fye, MD, of Orthopaedic Specialists-UPMC. “A lot of doctors simply look at an MRI scan and proceed with a surgical opinion, when what they need to do is really talk to the person and do a thorough physical exam.”
“I talk to each patient in detail: How long has the problem gone on? What aggravates it? What makes it feel better? Is there chronic or acute pain? Where does the pain begin, and does it travel elsewhere in the body?” continues Dr. Fye. “I value this interaction with patients because it helps me to truly understand the problem.”
Jean Schueler, 85, appreciates this caring and thorough approach. “Dr. Fye is exceptional. From day one in his office, he explained everything clearly to me,” she says.
Dr. Fye recommended that Mrs. Schueler undergo a laminectomy. “He sat down with me and a family friend, and took the time to show me what could be done and what the results would be,” she continues. “He made me so comfortable and relaxed.”
Since her surgery in May, Mrs. Schueler has continued to improve and no longer has pain in her right leg, as well as fewer symptoms in her left leg. “Dr. Fye told me exactly what he could do, and he did it,” she says. “Now I’m up and walking, and I can’t tell you how many laps I’ve done around the living room.
“I’ve dealt with numerous doctors through the years, and I’ve never been so impressed,” she adds. “He just goes above and beyond for his patients.”
According to Dr. Miele, one of the biggest advantages for patients who visit the UPMC Outpatient Center in Wexford is that all of its doctors work together to determine the best course of treatment for a patient. “The benefit of a system-based model versus a specialty model is that we are working together; not just neurosurgeons and orthopaedic spine surgeons, but pain doctors, physical therapists—anyone with expertise in spine,” he explains. “And patients don’t have to make an appointment two weeks later to see the next doctor; they can just go across the hall.
“There’s a real camaraderie between the neurosurgeons and orthopaedic surgeons; we discuss cases, which is a big positive for patients. Though each specialty is trained a little differently, we do a lot of the same things,” he adds. “The expertise of this group of surgeons is incredible, as a matter of pedigree—where they were trained, and their years of experience.”
In addition to this experience, UPMC Passavant spine specialists also stay up-to-date on the latest procedures. “One of the treatments that is becoming more common in western Pennsylvania is artificial disc replacement in the neck as an alternative to cervical fusion,” says Dr. Rainey, adding that the main benefit of this approach is that it helps to maintain range of motion in patients.
“While the vast majority of people who have disc herniations of the neck or lower back will heal without surgery, those who choose surgery now have another option,” adds Dr. Rainey. “Instead of having two vertebrae fused together with a plate, the disc that was removed can be replaced with a synthetic artificial disc that allows more movement and causes less stress to the discs above and below.”
Dominic Cercone, 60, recently underwent spinal surgery at UPMC Passavant. “I had symptoms for roughly 20 years, but I was just stubborn,” he says. “Then it got to the point where I could barely stand for more than five minutes. I couldn’t drive farther than short distances, and I couldn’t even go for a walk with my wife.”
Mr. Cercone tried conservative treatments including chiropractic, physical therapy, aquatic therapy, and steroid shots, but his condition kept getting worse.
“I’d heard stories about back surgery and it was frightening. It put me off from having anything done,” he says. “But when my chiropractor gave me Dr. El-Kadi’s name, I was desperate. When he looked at my MRI, he said he saw two problems that I needed to take care of immediately.”
Mr. Cercone had spinal surgery this past spring. "I was really uncomfortable for a few days, but the nurses and the people on the fifth floor were fantastic; they took unbelievable care of me,” he says. “If I had a problem, they found a solution. The physician assistants, the nurses, everyone in the office—they all treat you like gold.”
Two weeks after his surgery, Mr. Cercone was walking a mile each day and driving again. “I’m feeling wonderful. I’m probably back to 75 to 80 percent now, and I’m getting better every day,” he says. “I just went to the physical therapist and he couldn’t believe how much strength I’ve gained.”
A district judge in Bradford, Pennsylvania, Mr. Cercone was willing to drive 150 miles each way to receive this level of treatment. “I tell anybody who I know who is struggling with this kind of pain to go see Dr. El-Kadi,” he says. “I didn’t know Dr. El-Kadi from Adam when I started, but I feel like we’re more than just a patient and doctor now. I really feel that he and his staff care.”
Location and Convenience
While many patients, such as Mr. Cercone and Mr. Del Greco, are willing to travel miles to come to UPMC Passavant, those who live in the North Hills benefit from having access to these specialists and spine services right in their own backyard.
“It’s so convenient; people don’t have to fight traffic to get downtown or into Oakland, or have to pay for parking,” says Dr. Rainey. “And because we offer everything from non-operative treatments to surgery to postoperative care, they typically only need to come here to have their conditions managed.”
“I’ve worked at many different hospitals and clinics, and I can say that the patient experience at UPMC Passavant is as good as, or better than, I’ve seen anywhere,” adds Dr. Miele. “From the expertise of doctors to the care of the nurses, to the fifth-floor private rooms, it tops anything that I’ve seen.”
UPMC Department of Orthopaedic Surgery
UPMC Outpatient Center
Orthopaedic Specialists – UPMC
Tri Rivers Musculoskeletal Centers
Tri State Neurosurgical
Associates – UPMC
UPMC Department of Neurological Surgery – 1-877-986-9862
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