Orthopedics, Pediatric Services, Spine

Norton Children’s first in the world to perform scoliosis surgery that allows free spine growth

Norton Children’s Orthopedics of Louisville surgeons recently performed the world’s first implantation of a novel device for correcting scoliosis in young children. The device is an advancement from traditional growing rods and harnesses the body’s natural growth to straighten the patient’s spine. Surgeons with Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of…

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Adult Services, Case Study, Spine

Case Study: Ankylosing spondylitis and trauma- Complex management with posterior instrumentation

The patient A man in his forties with a history of epilepsy and ankylosing spondylitis presented with acute onset neck pain after he was found down on the ground next to his bed by his father. The patient is amnesic to the event. The challenge The care team The solution The patient was placed in…

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Adult Services, Spine

Assessing neck injuries in athletes

Neck injuries are common among athletes. When assessing the nature of a neck injury, valuable diagnostic tools include considering any neurologic component and comparing the initial symptoms with the current symptoms, according to Jeffrey L. Gum, M.D., a spine and orthopedic surgeon with Norton Leatherman Spine. A video of the event or an eyewitness account…

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Adult Services, Spine

Minimally invasive techniques have limitations in spinal deformity correction

As health care providers, it’s essential to stay aware of the evolving surgical techniques and technologies in spine surgery. In a presentation by John R. Dimar II, M.D., spine surgeon with Norton Leatherman Spine, several questions were raised regarding the widespread promotion of minimally invasive techniques and their applicability in complex cases. Dr. Dimar cautioned…

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Adult Services, Research, Spine

Reducing risk of robot-assisted sacroiliac joint fusion complications

Robot-assisted sacroiliac joint (SIJ) fusion surgery can, in about 1% of cases, injure the superior gluteal artery (SGA), but preoperative imaging, precise robot-assisted screw insertion and soft tissue protection can mitigate risks, according to a recently published study in the Journal of Neurosurgery: Case Lessons. The study describes the case of an 80-year-old man who…

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Adult Services, Spine

Optimizing general health and well-being through ‘prehab’ can improve surgical outcomes

Prehabilitation, or “prehab,” refers to optimizing general health and well-being before surgery to improve surgical outcomes. Prehab takes a multidisciplinary approach, focusing on strength and aerobic exercises, nutrition, smoking cessation, alcohol reduction, and psychological factors such as mitigating stress, anxiety and depression. The approach is primarily designed for patients who are at the highest risk…

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Adult Services, Case Study, Spine

Sciatic neuropathy case study: 4-centimeter tumor discovered on sciatic nerve

The patient A 64-year-old woman tripped after “missing a step,” fracturing her left tibial plateau and resulting in deformity of the joint. This was managed conservatively, with a leg brace removing weight from the extremity. She developed persistent numbness and tingling in her left leg, as well as weakness. She was evaluated in the Norton…

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Adult Services, Spine

Advantages of minimally invasive spine surgery

Spine surgeries have come a long way from the large open procedures that were the standard of care for many years. A wide range of minimally invasive surgeries are now possible for patients, with excellent results and faster recovery. Our goal with minimally invasive surgery is to decrease soft-tissue disruption yet accomplish the same results…

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Adult Services, Spine

Reducing opioid use before and after spine surgery

Until recently, opioids have been the analgesic of choice for managing back pain before and after surgery. Now we are in the midst of an opioid crisis and know all too well the many drawbacks of opioids. At Norton Leatherman Spine, we take seriously our role in reducing this public health catastrophe. We are working…

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Adult Services, Spine

Managing osteoporosis and spine surgery

Osteoporosis in the aging population is now estimated to affect over 10 million people and significantly affects postmenopausal women, although the condition can occur in other groups. There are many predisposing factors, including a family history (genetics), race, smoking, alcohol abuse, chronic illness, cancer, deficient vitamin D3 levels and living a sedentary lifestyle. The condition…

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Adult Services, Spine

Improving surgical decision-making for cervical spine patients

Difficulty with standing balance is a frequent clinical issue with multiple possible etiologies. It may be seen with normal aging or common pathologies such as diabetic neuropathy. In patients with cervical degenerative disease, progressive standing and gait imbalance can be an indication of cervical spinal cord dysfunction, termed cervical spondylotic myelopathy (CSM). As opposed to…

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Adult Services, Diabetes, Spine

Putting patients on the fast track to better blood sugar control before surgery

Studies have shown patients with diabetes who have poorly controlled blood sugar are more likely to have more adverse outcomes after elective surgery. At the same time, patients do not want to wait for spine surgery. Waiting means prolonging their pain, disability and immobility — and results in significant patient dissatisfaction. To improve surgical outcomes…

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