We integrate care from the leading professionals in all aspects of spine care before, during and after surgery.
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Having a spinal problem is a complex disease that requires more than just a skilled surgeon. It requires compassionate, evidence-based, streamlined care from the very beginning.
USA Health is the Gulf Coast’s only academic medical center. This means the doctors that train other doctors provide and supervise care. This also requires that practitioners and providers utilize the best and latest in academic research regarding all spine pathologies. Neurosurgeons are fellowship trained to specifically help with different aspects of complex spine problems and regularly attend and present at regional, national, and international neurosurgical academic conferences.
USA Health utilizes all the resources available at an academic medical center. To have the best possible outcomes we integrate care from the leading professionals in all aspects of spine care. This occurs before, during and after surgery. We partner with our colleagues in different medical specialties including physical therapy, occupational therapy, trauma surgery, orthopedic surgery, neuroradiology, interventional radiology, and critical care/internal medicine physicians.
Complex cases at USA Health are reviewed with different surgeons at our formal spine conference. This serves as a teaching modality for surgeons-in-training but also allows for a review of cases among professionals, integration of the latest scientific findings into the treatment plan and review with other experts in the field. This can improve outcomes and reduce complications.
Please feel free to reach out to begin your treatment with our spine team spine@health.southalabama.edu.
Spinal Deformity Service
The USA Health Complex Spine Center functions as a referral base for challenging and complex cases related to spinal deformity in both children and adults. This includes scoliosis, spinal deformity, and revision back surgery. The Complex Spine Center focuses on complex spinal disorders in both children and adults.
Team Approach
Spinal deformity, revision back surgery, and scoliosis are serious problems with complex solutions. From the beginning, the entire spine team is involved in your care. Patients undergoing spine reconstruction surgery will meet with a physical therapist before, immediate following surgery, and in the post-operative care sequence if indicated. Patients will meet the surgeon who will directly answer all questions, but the Complex Spine Clinical Nurse will also help coordinate multiple different aspects of your care. The goal is to have all of the patient’s questions answered before surgery and provide a constant line of communication with someone you know and trust.
This will continue in the hospital as well with a dedicated spine team protocol where patients will undergo the same standardized, evidence-based approach, with professionals who routinely treat complex spine patients.
Spine Fracture Service
USA Health University Hospital is the region’s only level 1 trauma center. Neurosurgeons at USA Health are experts in the evaluation, management, and treatment of operative and non-operative spine fractures in both children and adults.
Triage of Care
Patients presenting through the USA Health Fanny Meisler Trauma Center are first seen by a fellowship-trained trauma surgery specialist. These physicians treat and triage the patient’s entire trauma care and critically manage the patient during their initial presentation to the trauma emergency room and throughout their hospitalization. They will consult the neurosurgical team for brain and spinal cord injuries, including spine fractures.
Our Spine Fracture Service fully integrates the latest in standard of care from the Congress of Neurological Surgeons Guidelines regarding the operative and non-operative management of spine fractures.
Protocols
Treatment pathways include a conservative therapy approach whenever possible. Treatment of a spine fracture can involve observation, treatment with a brace or external orthosis, minimally invasive surgery, or traditional open surgery. Each care plan is individualized to the patient but the process of how the treatment is carried out is identical each time. This reduces uncertainty, improves patient satisfaction, and can reduce complications.
Minimally-Invasive Spine Surgery and Navigation
Leading technology, available at USA Health, allows for minimally invasive surgery whenever possible in appropriate cases. This minimally invasive technique can result in less post-operative pain, less blood loss, less chance of infection, and quicker recovery. Intra-operative navigation is a technological adjunct that can serve as a real-time GPS for the surgeon during select spine cases. This is just another tool available at our academic medical center.
Research
Academic centers, by definition, drive the field of complex surgery. Our team is at the forefront of research in spinal surgery related to outcomes, techniques and socioeconomic data. Neurosurgeons at the University of South Alabama conduct cutting-edge research that changes the way other surgeons take care of spine trauma patients.
Nursing
Erin Roberts, RN, Complex Spine Nurse
Erin handles all aspects of nursing in the clinic before and after surgery. Erin attended the University of Alabama in Birmingham where she received her Bachelors of Science in Nursing. She started in the operating room at USA Health University Hospital and has recently transitioned to the Strada Center to work with Dr. Menger and the USA neurosurgery department.
Carmen Morehead, RN, Inpatient Coordinator for the Spine Team
Carmen is the lead during the in-hospital portion of care. Carmen Morehead, RN is the Clinical Nurse Facilitator for the Neuroscience Intensive Care Unit at USA Health University Hospital and the inpatient coordinator for the Spine Team. She graduated from the University of South Alabama College of Nursing in 2013 and worked in the Surgical Trauma Intensive Care Unit at University Hospital for five years before transitioning to a leadership role.
Both orthopaedic surgeons and neurosurgeons perform spinal surgery. Being an academic center, USA Health is fortunate to have both types of surgeons within the same institution. USA Health has orthopaedic surgeons trained in pediatric spinal surgery as well as fellowship-trained neurosurgeons.
This is an umbrella term used to quantify and qualify any abnormal alignment of the bones of the spine. This can be from congenital problems (something you are born with) or from long-term wear and tear (arthritis) in the spine. This causes the body to have an abnormal posture either too far forward, too far to the side, or occasionally too far backwards. This can create a significant decrease in the quality of life. Overtime, the joints become stressed and the nerves can be pinched resulting in pain.
This is a type of spinal deformity that results from a lateral or sideways curvature of the spine. This can be cosmetically disfiguring but more importantly can cause a significant amount of pain when nerve roots get pinched due to the abnormal spinal architecture. In severe cases, with a curve greater than 70 degrees, the ability for the lungs and eventually the heart to work properly can be impacted.
Every spine has a normal amount of kyphosis or forward bend in the thoracic portion of the spine (or chest). Too much kyphosis can result in too much of a forward posture. This can be very painful for the patient as the body and other portions of it have to work “overtime” to keep the body straight. This etiology can be found in pediatric patients but also in the elderly patient who has difficulty standing up.
Every spine has a normal amount of lordosis or backwards saw in the lumbar or lower back part portion of the spine. Too much lordosis can result in a backwards leaning posture.
This is the slipping of one vertebra on top of another in the lower portion or lumbar spine. It can be caused by a variety of different pathologies in both children and adults. It can result in back pain as the joints move against one another; it can also result in leg pain as the nerves that go to the leg get pinched.
Physical Therapy
Encore Rehabilitation
Encore Rehab focuses on providing services in outpatient clinics, but also offers contract services for healthcare facilities, nursing facilities, schools, businesses, and many other settings.
The Mckenzie Method of Mechanical Diagnosis and Therapy (MDT)
Therapists associated with Encore rehabilitation and affiliated with the Complex Spine Center are some of the few in the area certified in the Mckenzie Method of Mechanical Diagnosis and Therapy. This is a very rigorous approach to acute, sub-acute, and chronic back pain. It can help patients achieve relief without surgery, but can also help patient’s before, immediately after, and following surgery. It’s backed by years of research, evidence, and clinical practice. It is a biopsychosocial system of musculoskeletal care emphasizing patient empowerment and self-treatment. This is assessment-driven plan focused on individualized treatment.
Physical Fitness
SouthFit
Keeping your body healthy is an essential part of good spine health. This includes are variety of core strengthening and cardiovascular fitness. For students, faculty members, staff, and affiliate members of the University of South Alabama, the campus recreation department offers a host of fitness programs. The SouthFit Program is comprised of group fitness classes, personal training, fitness certifications and workshops, and education.
General online resources:
We have a host of talented physician assistants and nurse practitioners who help in spine care. They help answer questions and evaluate the patients in clinic with the attending physician. They also help provide direct patient care in the hospital, evaluate patients in the Emergency Room, round with the attending physician, and coordinate care between different specialty teams. They can also serve as the first assist in the operating room. Complex Spine Clinical Nurse is Erin Roberts, BSN. Physical therapy provided by Encore.
In late August, Mandy McNatt was deployed to Cedar Rapids, Iowa, where winds of up to 100 mph from a storm known as a derecho damaged more than 800 buildings including 20 schools.
The initial plans for the site call for the development of a medical office building that will be home to primary and specialty care professionals. Additionally, a full array of imaging technologies are slated for the location.
Four USA Health practice locations – General Pediatrics, Pediatric Adolescent, Family Medicine and Stanton Road Clinic – recently were recognized as patient-centered medical homes.
