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Complex Spine Center

We integrate care from the leading professionals in all aspects of spine care before, during and after surgery.

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About the USA Health Complex Spine Center

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.

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.

  • Drs. Rusyniak and Martino published the outcomes for a different approach to complex thoracolumbar trauma.
  • Dr. Menger and colleagues published a new technique for the treatment of complex upper cervical fractures.
  • Along with residents and trainees numerous book chapters, like this one, have been authored.
  • Multiple studies are actively ongoing.

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. 

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Orthopaedics and Neurosurgery

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.

Types of Spine Conditions

Spinal Deformity

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.

Scoliosis

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.

Kyphosis

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.

Lordosis

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.

Spondylolisthesis

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.

Specific Conditions Treated

  • Adolescent idiopathic scoliosis
  • Early onset scoliosis
  • Infantile/juvenile scoliosis
  • Degenerative scoliosis
  • Congenital scoliosis
  • Hemivertebra

  • Kyphosis
  • Neuromuscular scoliosis
  • Spondylolisthesis/spondylosis
  • Herniated disc/disc bulge
  • Pinched nerve/sciatica
  • Myelopathy

  • Radiculopathy
  • Flat back syndrome
  • Lumbar spinal disease
  • Cervical spinal disease
  • Chin-on-chest deformity
  • Sagittal imbalance
  • Spinal stenosis

Types of Surgical Services Offered

  • Minimally invasive spine surgery (MIS)
  • Spinal decompression
  • Cervical spinal fusion (ACDF and posterior)
  • Thoracic and lumbar spinal fusion (PSIF, TLIF, ALIF, LLIF)
  • Scoliosis bracing

  • Mehta casting
  • Growing rods
  • Magnetically controlled spinal
  • Growing rods (MAGEC) vertical expandable prosthetic

  • Titanium Rib (VEPTR)
  • Revision spine surgery
  • Complex spine reconstructions
  • Spinal osteotomies (PCO, PSO, VCR)

Conservative Treatment

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.

Resources

General online resources: 

Complex Spine Center Providers

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.

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Upcoming Events

Jul102020

Nationally certified car seat technicians from USA Health will inspect car seats to ensure they are properly installed. First Friday of the month excluding holidays.

Aug72020

Nationally certified car seat technicians from USA Health will inspect car seats to ensure they are properly installed. First Friday of the month excluding holidays.

Sep112020

Nationally certified car seat technicians from USA Health will inspect car seats to ensure they are properly installed. First Friday of the month excluding holidays.

Sep132020

USA Health Children's & Women's Hospital is the "Leader in Births," so expectant parents will have peace of mind when they deliver at our hospital.

Sep172020

It's the 13th year for the USA Health Mitchell Cancer Institute GO Run presented by the Catranis Family Charitable Foundation, and we are going virtual! That means you have the freedom to run wherever you'd like, whether it's on a treadmill, indoor track, or the great outdoors. In addition to our traditional 1 mile fun run/walk and 5K, we've added 10K and half-marathon distances this year. All proceeds will benefit the amazing gynecologic cancer research taking place at the USA Health Mitchell Cancer Institute.

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