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Spine Pathways and Blogs
Spine Pathways and Blogs
Our mission is simple. Provide the best care, the best way possible for patients with spinal diseases. This is a means in which we can educate, empower, and engage our patients.
The site is not meant as a substitute for direct spinal care, for emergencies, and as a conduit for sensitive patient related information.
We want to share opportunities to educate yourself about your condition and also how to prepare yourself if you are scheduled for a procedure.
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Patient A was told that there was a significant compression on the spine, enough to need a surgical treatment.
Let's dissect what happened.
It started approximately four months ago, when a disc between the neck vertebra pushed back into the spinal canal. The disc often herniates back to to a side putting pressure on the nerve as it exists the spine.
Since much of the nerves in the neck support the arm it was somewhat predictable the outcome.
The neck or cranial nerves supply a host of muscles in the arm. The disc involved was between c5 and c6 which affected the wrist extension.
It was told that the c5 affected the biceps tendon, the c7 the wrist flexion and tricep, the c8 the ability to make a finger claw, and t1 the ability to move the fingers apart.
At last, the day of surgery came.
Anesthesia was given, and the neck was prepped with chlorhexidine alcohol scrub. Sterile drapes covered the neck, the small scalpel was used to cut in the skin crease. Small dissecting instruments were used to split the platysma and then the trachea and esophagus was moved towards the middle.
Self holding retractors held the tissues apart.
A microscope came in called the Pentero. It shows a clear picture on a screen and through the view finder.
The disc was cut and removed, a small curved curette was used to cut the back ligament to expose the white of the spinal cord. All of the herniation was plucked free.
A metal spacer with a plate was applied.
The skin was closed and a dermabond glue was applied. The tube then came out and the wrist extension came back.
What are things to do before Surgery?
1.Contact your Insurance Company.
2. Registration at the Hospital.
3. Medical and Anesthesia Clearance.
4. Laboratory Tests
What to expect?
Bills for Services
Patients will routinely get separate bills from the hospital, surgeon, hospitalist, anesthesiologist, internist, radiologist, and surgical assistant.
PreOperative Best Practices
NPO means "nothing by mouth," often at least eight hours for solid meals, four hours for very clear liquids like gatorade.
Bring loose fitting clothing, remove contact lenses, dentures prior to surgery.
Please make sure the doctor has the CDs of the imaging of CTs, MRIs, Xrays prior to surgery. Often reports are "sent" but the CDs are what shows the images of the pathology.
Discontinue one week prior:
Aspirin products, NSAIDs, Herbal supplements
Often patients can take Lyrica, Neurontin, blood pressure medications with a small sip of water.
Please bring a printed sheet with medications and doses, a CPAP machine if applicable, your necessary IDs, insurance information, an any monies for copayments.
Day Zero:
On the day of surgery, expect to check into registration and admission to the PreOperative Surgical Unit.
You will change into a hospital gown, get IV lines placed for medications, get interviewed by the nursing staff. Often you will be asked to put on white tight stockings.
The anesthesiologist will interview you and the surgeon can review your consent with you.
After Surgery:
You will go to what is called a PACU. Post Anesthesia Care Units have highly trained RNs and staff to ensure you are stable prior to transfer to the inpatient unit. In Medical Center of Plano, the main spinal unit is on the 6th floor.
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