Game-changing procedures show spine center expertise

Steve Dye is a new man, and he wants people suffering like he was to hear his story.

Last year, the retired Myrtle Beach businessman thought he might lose the ability to walk after a thoracic disk ruptured, putting extreme pressure on his spinal cord. Dye was using a cane to get around when a doctor told him he needed to go to either Duke University or the MUSC Health Spine Center for specialized surgery. Dye chose MUSC. 

Five months later, he was able to rejoin his softball team for a game that had an ending that could have come straight from a movie. “I find myself abandoned and standing in the softball field all by myself,” Dye wrote in a testimonial to the doctors at the MUSC Health Spine Center. “My team was with me seconds ago, but they have all run off the field.”

Then he heard clapping. It was his fellow softball players. They knew he’d gone from being afraid he’d end up paralyzed to being able to walk normally again.

“As I fight back tears, I realize the applause is for me,” Dye wrote. “I must pass it on to the doctors, nurses, friends and family who made it possible for me to be standing on that field.”

Dye’s surgeon, Stephen Kalhorn, M.D., said that’s the kind of story that makes him love coming to work each morning. “It reaffirms our cause,” the complex spine neurosurgeon said. “We take on the most challenging of cases, the most advanced spinal issues that come from across South Carolina and the Southeast United States. The reward for this is seeing your patients doing well.”

Charles Reitman, M.D., the orthopedic surgeon who co-directs the MUSC Health Spine Center, said it also reminds his team of the difference it can make in patients’ lives. “Spine is critically important for function, so it can have a huge positive or negative impact a person’s quality of life.”

The spine, which supports the body while letting it move freely, has three natural curves supported by muscles that keep the curves properly aligned. Disks cushion the bones of the spine.

But for some people, through an injury, aging or another factor, that system gets out of whack. They need to see a spine expert. Choosing one with the experience and ability to make the right decision for each patient instead of doing the same procedures over and over again is crucial, Reitman said. “What sets apart successful spine surgeons is their judgment.” 

And what sets apart successful spine centers is a strong team of experts, including neurosurgeons such as Sunil Patel, M.D., and orthopedic surgeons such as John Glaser, M.D. 

“We have people who specialize in rehabilitation, injections, psychology, weight loss, medical treatment and pain management,” Reitman said. “We approach the patient from a comprehensive point of view and give them what they need in the most efficient, cost-effective way and achieve high quality results.”

The team members keep an eye on each other’s work. Since the MUSC Health Spine Center is part of the Medical University of South Carolina, treatments and results are scrutinized. “It’s an academic center, we have the resources to look at problems in a comprehensive way. This provides a nice check and balance system to do the right thing,” Reitman said.

Reitman’s fellow co-director, neurosurgeon Bruce Frankel, M.D., said the center also stays on the cutting edge. “We’re not just using technology or procedures. We’re creating them here.”

Reitman said four of the newer spine treatment options stand out these days: cervical disc arthroplasty, SI fusion, endoscopic discectomy and stereotactic spinal radiosurgery.

Cervical Disc Arthroplasty

Cervical disc arthroplasty is joint replacement surgery that can help the neck work normally again in somebody with a damaged or worn-out intervertebral disc. The doctor removes the natural disc and replaces it with an artificial one. Reitman says this procedure is best for active people with mild degenerative disease. 

“The advantage to arthroplasty is a fast return to activity,” Reitman says. “If I have a parent with a bunch of kids or somebody who has to get back to work quickly, this is a phenomenal operation. It’s really a game changer.”

SI Fusion

Sacroiliac joint fusion, also known as SI fusion, can stabilize the sacroiliac joint and ease lower back and leg pain. There are two SI joints, both in the lower back, one on each side of the pelvis. They’re held in place by ligaments and work the spine and femur to help people bend and walk.

Usually age, trauma, or prior adjacent surgery can cause problems with the SI joints. SI fusion stabilizes the joint with implanted devices. MUSC Health Spine Center contributed to a recent study published in the Journal of Neurosurgery which found people with sacroiliac joint dysfunction who had SI surgery wound up feeling less pain than people who were treated with nonsurgical methods.

Kalhorn is currently recruiting patients for an SI study to explore the effects of the SImmetry Sacroiliac Joint Fusion device.

Endoscopic Discectomy

The MUSC Health Spine Center leads the way for South Carolina in endoscopic discectomy, becoming the first center to offer it in 2013, Reitman said. It’s a minimally invasive procedure that eases pain triggered by herniated discs pressing on the roots of nerves. “Very few doctors in this area are doing this,” Reitman said. 

Stereotactic Spinal Radiosurgery

"Stereotactic radiosurgery is used for spinal tumors at MUSC Health. It beams radiation right on the tumor with great precision, protecting the surrounding healthy tissue and in particular the spinal cord,” Reitman said. As a result, this can be used in combination with or instead of surgery to offer cancer patients more effective treatment with less invasive procedures.

Non-Surgical Options

The center’s surgeons are also involved in developing new devices to help both doctors and their patients, with a goal of boosting the number of ways they can treat spine problems without having to resort to surgery. Their work in this area is done through the Zucker Institute of Applied Neurosciences in the MUSC Department of Neurosurgery.

Dye’s Recovery

Dye, whose thoracic spine surgery turned him into a “walking medical miracle,” as his friends call him, wants other people with spine problems to know that there is hope. And there are a lot of people in that condition. Back problems plague an estimated eight out of ten people at some point in their lives. Most don’t need surgery, but those who do need expert care.

It’s often not a one-stop fix. Dye struggled with back problems for years and is still not able to do everything he’d like to do. “Although I have now ‘mastered’ walking, I still have a goal to be able to run again,” he writes. “Would somebody please tell me I can't do it! It will motivate me to make it happen. I will run again!”

Kalhorn said he should be able to. “I think Mr. Dye is doing great.”