Back and Spine - Physician Q&A

In this Q&A, Terence Doorly, MD, chief of neurosurgery, along with other members of the spine team, discuss the conditions treated at the Salem Hospital Spine Center, the decision-making process for choosing surgical or non-surgical treatments, and the advanced technology used by the team, including the area's only robotic surgery system.

What spine conditions are treated at the Salem Hospital Spine Center?
At the Spine Center, we treat a wide variety of spine and nerve issues. These range from long-term conditions like spinal stenosis to sudden problems such as fractures in the spine or slipped disks (disc herniations). Common conditions we treat include back pain, peripheral nerve pain (like carpal tunnel syndrome), trouble with balance and walking, and difficulties with other fine motor skills issues (like writing or buttoning a shirt).

Our approach goes beyond traditional spinal care - we specialize in both treating conditions affecting the spine and peripheral nerves and managing the symptoms. Our team will work with you to create a treatment plan that fits your needs.

What are some common conditions or injuries that might need surgery?
The decision for surgery is based on how much your condition affects your safety and everyday life, not just on the condition itself. For example, if you often fall, can't grip things, or have severe pain that makes it hard to enjoy life, we might consider surgery as a potential treatment option.

All spine surgeries at Salem Hospital are performed using small (microsurgical) tools and minimally invasive techniques. This method is very precise and accurate, which helps avoid injuries to the areas around where the surgery happens. Most patients can go home on the same day as their surgery, as long as there are no complications.

We've also started using robotic surgery at Salem Hospital. This type of surgery is less invasive (minimally invasive) and uses smaller cuts. It has fewer risks and complications than traditional surgeries that need larger cuts. We have three surgeons who are trained to use this robotic system for these minimally invasive procedures.

What are some non-surgical ways to treat spine conditions?
At Salem Hospital, we always consider non-surgical treatments first. Our team includes different specialists like physiatrists, physical and occupational therapists, podiatrists, and pain management doctors. Together, we create personalized treatment plans for spine conditions that don't involve surgery. We also explain how likely it is that your condition will get better with these treatments, so you can make informed decisions about your care.

If your condition affects your daily life, like causing severe pain that stops you from walking, then we might recommend considering surgery.

What sets spine care at Salem Hospital apart?
We take the time to talk with each patient, answer all their questions, and fully explain their treatment options. We make sure to understand their goals and expectations so that we can help them make the best decisions for themselves without feeling rushed or pressured. Our providers are skilled in a wide range of spine and nerve care, from simple to complex procedures.

We also use advanced tools and technology. We are the only hospital on the North Shore with a robotic system for spine surgery. We use a 3D microscope to get a very clear and detailed view of delicate nerve structures during surgery, which helps us work more safely and precisely. These tools allow us to do surgeries that are less invasive.

We also have an orthopedic and spine navigator, who is an important member of our team. They help patients get care quickly and smoothly. They:

• coordinate visits
• connect with the surgical coordinator to schedule surgeries
• handle referrals to specialists outside Salem Hospital, such as consultations with neurologists
• help patients choose the best therapy options

This approach ensures our patients and their families are well-supported throughout their care.

What can patients expect during a consultation at the Salem Hospital Spine Center?
We begin with a physical examination and review of their medical history, current symptoms, and any past issues. We'll also look at any relevant imaging tests. Using this information, we'll create a personalized treatment plan, which might include physical therapy, medication, or a meeting with our surgical team. It's important to note that meeting with the surgical team doesn't necessarily mean a patient will have surgery. We believe in making decisions together with our patients by discussing all available options. If another doctor has recommended surgery, we will review the information together and decide if surgery is the best choice.

During the consultation, we'll also educate patients about the recommended treatment, what to expect during recovery, and any steps they can take to help with healing. Our goal is to help patients regain their function and live life as comfortably as possible.

How does physical therapy help with spine care, whether or not you have surgery?
Physical therapy is very important for spine care. If patients need surgery, physical therapy helps get patients in the best possible physical condition for the operation. After surgery, physical therapy can help a patient recover faster by improving posture, movement, and core strength - all of which contribute to a healthy spine. Patients who had physical therapy before surgery often do not need as much of it after surgery.

Physiatrists and occupational therapists also play important roles in rehabilitation. They work with patients to figure out what kind of therapy they need based on their individual needs. Whether we're working with our trusted network of providers or a patient's preferred therapist, we make sure every patient gets personalized care that meets their specific needs.

To learn more about spine treatment, talk to your doctor or request an appointment with one of our orthopedics and spine specialists.