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As a physician, Nahed El Kassar, MD, has been trained to cast a critical eye on all things related to medicine. As a patient, she understands the experience of entrusting one’s health to someone else’s hands. For both these reasons, she chose the spinal surgery team at MedStar Georgetown University Hospital—not once, but twice.
In 2010, Nahed was a patient at MedStar Georgetown due to pain she was having after a car accident. Neurosurgeon Jean Marc Voyadzis MD, co-director of the Center for Minimally Invasive Spine Surgery at MedStar Georgetown, performed a successful cervical fusion in her neck. Years later, after pain related to an L4-L5 spondylolisthesis afflicted her lower back and left leg, she knew right away that she wanted Dr. Voyadzis to treat her again.
This time, not only did her minimally invasive, robotic spine surgery lead to a successful outcome, the entire experience compelled Nahed to write to the hospital and share, “What made my experience positive was mainly the high level of care, professionalism, and compassion of Georgetown personnel. I had zero anxiety. I felt like I was home.”
According to Dr. Voyadzis, Nahed’s underlying condition was “one of the most common degenerative conditions that we see as neurosurgeons specializing in the treatment of spinal conditions. She developed a shifting of one of the bony vertebrae on top of the other called a ‘spondylolisthesis.’” What was uncommon was the method chosen to treat it: a minimally invasive laminectomy and fusion, performed with robotic assistance.
“The traditional way of doing this operation is essentially an open surgery,” explains Dr. Voyadzis. This requires “making a sizable scar along the middle of the back; detaching the muscles to expose all the bony elements; then fusing the bony vertebra by inserting screws and titanium rods; and then repairing the damaged disc. At MedStar Georgetown, we have the capability to do that same surgery in a far less invasive way and with greater accuracy. This offers patients a much easier recovery,” he says.
MedStar Georgetown was the first hospital in the city to perform minimally invasive robotic spine surgery. Today, its highly experienced team of neurosurgeons does the highest volume of robotic spine surgery in the area.
Nahed’s entire surgery was done with just two one-inch incisions. “We create a little working portal through the muscle fibers, without detaching the muscles or making a long scar,” explains Dr. Voyadzis. A robotic arm helps to guide the placement of screws with a very high level of precision. Plus, the robotic arm’s built-in imaging capability virtually eliminates the need for x-rays during surgery—saving the patient and the team from unnecessary radiation exposure.
Most important, minimally invasive spine surgery has a faster recovery time, with less pain, and lower rates of post-operative bleeding and infection. “Immediately after I awoke in the recovery room, I knew the surgery was a success,” says Nahed. “I had no pain in my left leg. I was smiling!” She was discharged home after less than 48 hours.
Nahed is thrilled her surgery was a success, but adds she appreciated that Dr. Voyadzis tried more conservative approaches first, including physical therapy, medications, and steroid injections. “Dr. Voyadzis listens carefully, explains all the pros and cons of each option, and makes sure that the decision is always shared with the patient,” says Nahed.
Now pain free, Nahed has resumed her normal activities, including her work as a medical researcher at the National Institutes of Health. Looking back, she said that “Usually, pain is a solitary experience. During the entire experience, I didn't feel alone. This helped me recover fast and I was pain-free three weeks after my surgery.”
After two positive experiences she says, “I will not hesitate to return to MedStar Georgetown”. But if she does, she may find even more reasons to feel confident. “We already have top physicians and outstanding nurses,” says Dr. Voyadzis. “And soon we’ll have the new surgical pavilion with large private patient rooms, and state-of-the-art operating facilities with intraoperative MRI capabilities.” Whether you are a doctor, a patient, or both (like Nahed), that’s good news for all.
By Karen Hansen