Spinal Medicine & Surgery Program

Overview

The treatment of spinal disorders is a challenging but also incredibly satisfying endeavor from the perspective of the physcian and surgeon; it requires an understanding of the connectivity and delicate nature of the nervous system and its interaction with the mechanics of spinal movement and weight bearing. Although an intimate knowledge of a broad spectrum of disease processes is required of spine specialists, symptoms referable to degenerative or arthritic conditions are by far the most common cause of complaints and are experienced by a great proportion of people to varying degrees in a lifetime. Caring for patients with the vast array of symptoms caused by spinal disorders requires insight, experience and the patience necessary to obtain an understanding of the patient's needs, limitations and expectations as identified by a throrough history and physical examination. With a careful analysis of this information together with an interpretation of diagnostic studies, a thoughtful treatment plan may be offered to improve quality of life. The physicians and surgeons at NJBSC have the rare experience and temperment to provide this level of care.

The Patient Experience - Initial Consultation

Referral to a spine specialist is requested in response to an array of symptoms including pain, weakness, numbness, tingling, clumsiness, difficulty walking, imbalance, urinary control issues, fatiguability or a change in posture. Often referrals to NJBSC are initiated after an evaluation by the patient's internist or general medical physician and preliminary diagnostic information has been drawn from the radiologist's interpretation of imaging studies (Magnetic Resonance Imaging-MRI or, Computerized Tomography-CT). A consultation by NJBSC neurosurgical spinal specialists, however, provide a more detailed analysis of the nature and origin of symptoms to design a universal treatment plan that may be based on medical, rehabilitative or surgical solutions.

Alternatively, the patient may have initiated their process of evaluation independent of their primary doctor. Given the largely unregulated business of spinal medicine and in particular back pain, it is often difficult for the lay person to select a knowlegable and reputable spine specialist. Information gathered from print media, television and the internet furthermore is often presented in a way to connote that conclusions have been drawn from scientific evidence. Sadly in many circumstances, the opposite is true. A face-to-face consultation with an NJBSC neurosurgical spine specialist clarifies confusion and doubt surrounding the origin of symptoms, the long term implications of a particular diagnosis and the relevence of findings on imaging. This reassurance is necessary to begin the process of healing.

During the initial visit, a detailed medical history, neurological examination and an analysis of laboratory tests and imaging will be performed. Patients will be best served by providing existing imaging studies, reports and relevant medical records. The attending neurosurgeon will personally review imaging studies with the patient and family and outline a treatment plan. The surgeon may recommend that additional more specialized imaging studies or laboratory testing be obtained to further characterize the patient's condition. Since there is great variability in diagnoses and the nature of symptoms, treatment plans vary according to the duration and severity of symptoms with a graded prescription emphasizing medical and rehabilitative treatments i.e. physical therapy and at times non-traditional forms of care i.e. acupuncture. Surgery is offered in circumstances where there is intractable pain, progressive deformity, weakness or loss of bladder function.

Collaboration, The Team Approach & Critical Self-Assessment

Patients with spinal conditions offer challenging clinical problems that often require the care and knowledge of a variety of specialists. Surgeons work closely with spinal orthopedists, pain management physicians, neurologists, rheumatologists and rehabilitation specialists to manage any problem that may arise. The neurosurgeons of NJBSC have created a network of the finest professionals and interact directly and regularly with them to ensure that communication is consistent, clear and uninterrupted. NJBSC is also one of the few neurosurgical centers in the nation participating in the National Neurosurgery and Outcome Database (N2QOD), a prospective national registry that seeks to quantify the success of surgical treatments thereby setting a benchmark and definition of quality (neuropoint.org).

Technical Excellence

Apart from the good judgement central to the practice of spinal surgery in particular and neurosurgery in general, surgeons at NJBSC are skilled technicians and are able to manage all aspects of spinal disease ranging from spinal tumors, vascular malformations, infection, deformity and scoliosis and degenerative conditions. They have advanced the quality of care in the region by developing technologies in minimally invasive and minimal access surgery. These techniques require shorter recovery times by limiting soft tissue manipulation. Members of the surgical team have been recognized by Castle Connelly, New York magazine and New Jersey Monthly as offering superior care when compared to their peers.

Physicians

Patrick A. Roth, MD, Roy D. Vingan, MD, Harshpal Singh, MD, Elizabeth Finale, PT.