Ortho NorthEast’s commitment to the full range of care led to the establishment of PainONE. PainONE specializes in non-surgical treatments of musculoskeletal disorders through a comprehensive and multidisciplinary approach. Therapies may involve prescription drugs, spine injections, assistive devices, stress management and physical therapy. PainONE physical therapy programs emphasize stretching, strengthening and reconditioning exercises, as well as education about low back pain.
PainONE Medical Team
Injury, wear and tear and the normal aging process can all result in low back pain, keeping you from doing your work, participating in physical activities and enjoying life to the fullest. If low back pain does not respond to conservative methods of treatment, your physician may recommend surgery. A number of procedures can be performed alone or in combination depending on your specific condition.
Spinal surgery usually involves either a laminotomy or laminectomy. First, the surgeon will make an incision in the midline of the back. Next, a “window” is made in the lamina, the portion of the vertebrae that forms the roof of the spinal canal. Bone is removed to relieve pressure on the nerve and to allow the surgeon access to the spinal canal.
A laminotomy removes a portion of the lamina and is performed when the surgeon needs access to a small part of the spinal canal.
A laminectomy removes the entire lamina and is performed to create more room for the nerves and allows the surgeon greater access to the spinal canal. The bone removed does not grow back.
With access to the nerve and disc areas gained through the laminotomy or laminectomy, further corrections can be made. The surgeon uses small instruments to remove the damaged disc material that is pressing on a nerve root.
For patients with instability, a spinal fusion may be recommended. A spinal fusion involves placing bone grafts between vertebrae. Frequently only two lumbar vertebrae are fused. However, multiple vertebrae may be included. Bone grafts may be taken from the pelvic bone and placed in a hollow, porous implant that is placed between two vertebrae or the bone is placed along side the vertebrae on the transverse processes. As the body heals, the bone graft and the vertebrae grow into one unit or become fused. This stabilizes the vertebrae reducing pain caused by too much movement between vertebrae.
Before performing surgery, your physician will study your back by means of X-ray or other tests such as magnetic resonance imaging (MRI), myelography or a CT scan. Testing will help the physician determine what procedure will be best for you. Your doctor will discuss whether your procedure will be performed on an outpatient basis or if a hospital stay will be required; fully explain the procedure; and explain the risks and benefits of surgery.
To prepare yourself for surgery, you may be asked to do a number of things. You may be asked to lose weight if you are overweight. If you smoke, it is important for you to stop several weeks prior to surgery. If you are taking aspirin or certain anti-inflammatory medications, inform your surgeon; you may need to stop taking these two weeks before surgery.
What to Expect After Surgery
You will be monitored as you recover from your procedure and you will be given medication to relieve pain. As you prepare to go home, you will be given instructions about physical therapy and a prescription for pain medication. You will also be instructed about follow up visits to your physician.
Your active role in your recovery will continue once you are home by following your rehabilitation plan. Call your doctor if you have any of the following:
- new pain, weakness or numbness that begins after you return home
- fever, headache or extreme fatigue
- bladder or bowel problems
Recuperation will depend on the type of procedure performed and varies with each patient. Ask your doctor when it is safe to resume regular activities, including house work, returning to work, and athletic activities.
XLIF TURNS BACK SURGERY ON ITS SIDE.
Ortho NorthEast is first in our region to offer the advanced eXtreme Lateral Interbody Fusion (XLIF) back procedure. Because it approaches the spine from the side, XLIF involves less disruption of muscles and soft tissue. This means less pain and less recovery time for ONE patients. In fact, most people who have the XLIF procedure are walking within a few days and back to their daily activities in 4-6 weeks—as opposed to 6 months or more with traditional back surgeries.
The XLIF surgical procedure was developed by NuVasive, Inc. in San Diego, CA.
Dr. John Williams is the first surgeon in northeast Indiana to perform XLIF and has had outstanding results in dozens of patients. We encourage you to read about the experiences in the testimonials below and view a complete description of the procedure. If you suffer from chronic back pain, call ONE at (260) 408-2345 and schedule a consultation. Find out if XLIF is right for you.
Description of the Procedure
View a video describing the XLIF procedure.
NuVasive, Inc., the developers of the XLIF procedure, have created a web community for people who suffer from chronic back or leg pain and are interested in more XLIF information. Visit their external website, The Better Way Back to access additional resources from this company.
James Horton: “A Better Overall Experience”
As if teaching eighth grade English isn’t challenging enough, 48-year-old James Horton has been living with degenerative disc disease for many years now. He had already had three open back fusion surgeries when the pain began to worsen last year in a different vertebra. As he explained, “It hurt to stand up. It hurt to sit down. And it hurt to lie down. I couldn’t get comfortable to sleep, and bending was out of the question.”
A disc in the middle of his back had deteriorated to the point where pain medications were no longer effective, so he and his surgeon, Dr. John I. Williams at Ortho NorthEast, began to explore his options. “Dr. Williams studied my x-rays and determined that I was a good candidate for minimally invasive eXtreme Lateral Interbody Fusion, or XLIF,” said Horton. Developed by NuVasive, Inc. in San Diego, XLIF employs a surgical approach from the side of the body — reducing the disruption to soft tissue in the back that occurs during traditional back surgery.
Horton underwent the minimally invasive XLIF procedure at Parkview Orthopaedic Hospital in Fort Wayne at the end of April 2009. “I had surgery on a Monday and was released from the hospital that Wednesday. The nurses had me up and around the day after surgery to begin the rehab process.” Having had open back surgery, Horton was able to compare his experience with the XLIF minimally invasive procedure. “I know I healed up faster this time, and my wife even noticed a big difference,” he said. “In fact, I felt well enough to go back to teaching much sooner than I expected.”
Horton says he judges how well he’s doing by how it feels to wash dishes. “I’m 6’5″ so I have to bend over to reach the sink. Since the XLIF surgery, I’ve been able to stand there comfortably for the entire 10-15 minutes it takes.” Horton also reports that he no longer needs to take pain medication for his back. He wears a brace for support and has begun his rehabilitation therapy program at ONE.
James Horton is grateful to his doctors at ONE for making new procedures available close to home in northeast Indiana. “Procedures like minimally invasive XLIF offer new possibilities for people with back conditions like mine,” he said. “I would tell anyone who is a candidate that XLIF was a good overall experience.”
Ethel Weaver: “I Feel 20 Years Younger”
For Ethel Weaver, the pain in her leg was finally too much to bear. It had become so severe that she had to pick green beans from her garden on her hands and knees. Running the vacuum cleaner or doing the dishes was out of the question.
“I had so much pain in my left leg, and my doctor couldn’t figure out what was wrong” said Mrs. Weaver, a 77-year-old native of Syracuse, Indiana. “By the end of each day, I couldn’t stand up anymore. Eventually, I went for an MRI and was referred to Dr. John Williams at Ortho NorthEast. He said the pain in my leg was actually caused by degenerative disc disease in my back.”
Mrs. Weaver and Dr. Williams discussed her condition and treatment options. “He recommended a new procedure that had been very successful and would allow me to heal quicker,” she said. In fact, Dr. Williams is the first orthopaedic surgeon in Northeast Indiana to offer the minimally invasive eXtreme Lateral Interbody Fusion, or XLIF procedure. Developed by NuVasive, Inc. San Diego, XLIF employs a surgical approach from the side of the body — reducing the disruption to soft tissue in the back that occurs during traditional back surgery. It didn’t take Mrs. Weaver long to make her decision. “I was ready,” she said. “I was just tired of having so much pain.”
Dr. Williams performed Mrs. Weaver’s XLIF surgery on December 15, 2008. “I was in the hospital four days, and then I spent two and a half weeks in a rehabilitation facility until I was strong enough to go home,” she explained. “There, I underwent physical therapy—I was in very good hands.”
Looking back, Mrs. Weaver says her recovery seemed to go by very quickly. “When I went back to see Dr. Williams after one month, he was happy to see that I was walking on my own without a walker. By then, I only used it to make sure I didn’t lose my balance around the house.”
Six months later, Mrs. Weaver reports, she was back to her favorite activities. What a difference!” she said. “Last summer, I couldn’t bend over, and this summer, I was back to picking green beans just like old times.”
Mrs. Weaver’s advice to others in her situation? “Don’t suffer as long as I did.” She concludes, “Thanks to Dr. Williams and XLIF, I’m not only pain free—I feel 20 years younger!”