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Hard-charging attorney Michael Basile revels in work and loves a good game of golf and his daily runs. But persistent pain and numbness in the right side of his right leg put a halt to those pleasures. The diagnosis: sciatica; the result of a herniated spinal disc and spinal instability compressing a nerve in his back.
“I tried a bit of everything from a chiropractic physician, physical therapy, massage, and even a series of epidural shots in my spine. But the pain continued,” he says. “It got to the point that standing became difficult.”
Minimally invasive procedure is option of choice.
Then Michael was referred to Seyed Babak (Bobby) Kalantar, MD, co-director of the MedStar Spine Center.
Dr. Kalantar always first advises patients to take the least invasive treatment approach. For Michael, he recommended moderating his activities. But when that proved unsuccessful, both Dr. Kalantar and his patient thought surgery was his best option.
“I was hesitant because I had heard people talk about poor outcomes and long recovery times from spinal surgery,” Michael recalls. “But it was a revelation to learn about minimally invasive surgery from Dr. Kalantar.”
“This minimally invasive spinal surgery is performed with a simple one-inch incision on the side and one or two half-inch incisions on the back, with none of the repositioning of the patient during the procedure that occurs when you perform spinal surgery from the back and front,” Dr. Kalantar says.
The procedure, called XLIF (eXtreme Lateral Interbody Fusion), means less muscle cut, less bleeding, in and often out of the hospital the same day, faster recovery, and back to work in half the time, explains Fred Mo, MD, spinal surgeon. He and Dr. Kalantar perform hundreds of XLIF procedures a year. “The technology and instrumentation have gotten better and better in just the last five years,” he notes.
In addition to all these benefits, Michael had one more advantage—an innovation called LessRay that enables less radiation exposure to the patient.
Innovative software means less radiation exposure.
During the XLIF procedure, computer navigation directs placement of instruments. Multiple x-rays are taken in real time and loaded into the computer to produce images that help the surgeon avoid critical vessels and reach the correct location in the spine. Instruments are moved through a retractor that is placed in the small incision.
An array of procedures is performed using this technique—everything from the removal of herniated discs and placement of implants to correction of scoliosis by realigning the spine and restoring height.
“This is a very effective procedure, but it requires a good deal of exposure to x-ray radiation to the patient and the surgical team,” explains Dr. Kalantar. “LessRay is a new computer software program that decreases radiation exposure by 90 percent. We are the first major medical center in the country to test LessRay and in the last year have found it extremely valuable.”
For Michael, this bonus meant Dr. Kalantar could view enhanced images, with low dose radiation. The x-ray machine is hooked up to a computer that uses LessRay software, which can stitch images together, correct poor images and create a high-quality 3-D image of the spine that would normally require higher dose radiation.
Dramatic results improve quality of life.
“I went into MedStar Georgetown University Hospital in the morning and was home by lunch time the next day,” says Michael. “I walked out that day and felt none of the symptoms that I had had—no pain.”
“We are often the choice for patients who have had unsuccessful spinal surgery,” says Dr. Mo. “They are really suffering with life-limiting nerve pain and we are able to give them their lives back. I’m proud of our team of experts and the patient-centered care we provide.”
This patient-centered care delivered dramatic results for Michael. “Dr. Kalantar told me to listen to my body during recovery, and in theory I shouldn’t have begun to run as soon as I did,” he says laughing. “But today, I jog three to four miles a few times a week—and play golf, too.
“Now when people ask me about back pain and surgery, I tell them when they are ready, go see Dr. Kalantar!”
Doctors Kalantar and Mo perform hundreds of XLIF (eXtreme Lateral Interbody Fusion) procedures a year now using a new computer software that greatly decreases radiation exposure during the surgery.