Observing complex surgeries for continued education is one of the many ways Rockford Spine Center’s surgeons remain committed to providing the highest-quality, patient-centered care.
Rockford Spine Center’s Dr. Michael Roh recently attended the Scoliosis Research Society Meeting & Course 2017, which took place in Philadelphia.
Mike Maloney is flying high again, thanks to Rockford Spine Center.
To accommodate patients sooner, Rockford Spine Center has expanded hours in our MRI department.
Suzanne English has embraced exercise for as long as she can remember. She walked three miles a day for more than 20 years and biked outdoors.
Ten years ago, the retired speech pathologist from Ottawa was diagnosed with Parkinson’s disease, which she controls through medication. While that slowed her down some, it was the pain in her right leg that eventually led her to Rockford Spine Center.
Rockford Spine Center’s Cassie Alderks, PT, DPT, recently completed a specialized training course in Rosemont, Illinois, through the internationally acclaimed Gray Institute.
Surgeon Fred Sweet, M.D., will discuss Laser & Minimally-Invasive Spine Surgery
Rockford Spine Center Surgeon Michael Roh, M.D., recently spoke to employees at UTC Aerospace Systems in Rockford during the company’s monthly Employee Engagement Lunch and Learn Series.
He talked about his recent training at the Titleist Performance Institute. TPI trains physical therapists and other health care providers in techniques to help golfers prevent injuries and improve their games.
Rockford Spine Center Physical Therapist Kim Alexander, ATC, PT, MPT, recently completed training at the Titleist Performance Institute (TPI) in Philadelphia for additional training in golf-related injuries and treatments.
Rockford Spine Center Surgeon Michael Roh, M.D., recently spoke during Grand Rounds at OSF Saint Anthony Medical Center in Rockford.
Tim Gaumond still remembers the back surgery he had when he was a young teenager. During a five-hour procedure, surgeons placed rods in his spine to correct a congenital alignment condition. A long hospital stay was followed by weeks in a body cast and then time in a wheelchair and on crutches. He missed months of the school year. While the surgery was successful, the recovery was an ordeal.
Zach Gough is no ordinary athlete. A competitive bodybuilder for the last 10 years, he knows just how critical it is to keep your body functioning properly.
Rockford, Ill. (November 22, 2016) – Rockford Spine Center Surgeons Michael Roh, M.D., and Fred Sweet, M.D., recently attended the Scoliosis Research Society (SRS) Annual Meeting & Course in Prague, Czech Republic.
Tyler Pratt knows how to find people. An executive recruiter who runs his own firm in Rockford, he specializes in selecting executive candidates for health care clients. That knowledge served him well when it came time to find a solution to his pain.
Surgeons at Rockford Spine Center (RSC) are using a new technique to minimize the pain patients feel when recovering from spine surgery.
RSC surgeons Michael Roh, M.D. and Christopher Sliva, M.D., began using Exparel, a non-narcotic numbing medication, in 2015 during certain surgical procedures. Now, nearly 18 months later, a study by the OSF Saint Anthony Medical Center Pharmacy Department is showing the drug helping patients make a faster recovery and with less post-surgical pain.
The surgeons inject the medication at the surgical site toward the end of cervical, lumbar or thoracic fusion surgeries and other similar procedures. As the Exparel wears off, the other pain-reducing medications begin working, further reducing the pain the patient might feel.
“There’s typically a 36-hour window for post-surgical pain,” says Dr. Roh. “While each patient reacts differently, we’re finding that Exparel can typically reduce the immediate post-operative pain level from a 7 or 8 on a 0-10 scale to a 3 or 4, which most patients describe as quite tolerable.”
Less pain means a much shorter hospital stay following the procedure and a more pleasant surgical experience with higher patient satisfaction. Using the Exparel also has eliminated the need for patients to have a Foley catheter or a patient-controlled analgesia (PCA) pump.
“We’re in the business of reducing patients’ pain,” says Dr. Sliva. “We’re always looking for innovative ways to make our patients more comfortable following surgery and we’re excited at the results we’re seeing from this technique.”
Daniel Knolhoff, Pharm.D., is the Pharmacy Operations Manager at OSF Saint Anthony Medical Center. He and his team have been gathering data on more than 155 Roh and Sliva surgical patients that used Exparel since March 2015 in procedures at OSF. He says the data is very promising and shows the drug having a positive impact on length of stay, nearly one day less, and overall use of narcotic pain medication after surgery.
“That’s a good indicator that patients are feeling less pain,” says Knolhoff. “They can start physical therapy sooner, usually on the same day of surgery. And, by eliminating the need for a PCA or a Foley catheter, we increase mobility and reduce the risk of infection.”
Decreased length of stay also leads to increased patient satisfaction, decreased post-surgical complications and decreased costs to the overall health care system.
Suzy Erb is an elementary school music teacher in Lena, Ill., west of Freeport. She had spinal fusion surgery between the L-5 and S-1 vertebrae in 2010 with Dr. Roh and remembers the experience well.
“The surgery was great and worked wonderfully,” she recalls. “However, the hospital stay was very rough. I don’t tolerate pain medications well and my pain was pretty high.”
She says the relaxing and healing took place at home, after the more difficult time in the hospital. Earlier this year, she had a second fusion surgery with Dr. Roh, on the L-4 vertebrae, after developing cysts on either side of her spinal column. Dr. Roh used the Exparel protocol and the experience with her pain levels was completely different.
“Night and day,” she says. “The recovery was so much better this time. I was up walking around in the hospital and I barely felt like I had had surgery. I was able to transition to the pain killers and then got off them quickly. There was really very little pain at all.”
Mary Horvat tells a similar story. She’s a high school physical education teacher in Rockford who leads a very active lifestyle. She had spinal fusion surgery in 2007 on the L-5 and S-1 vertebrae and remembers the pain following the surgery.
“The surgery was a success but the pain was more than I expected,” she says. “The first few weeks were rough and I had to have several prescriptions and ended up adding stronger painkillers. Then, it was difficult getting off them, as I’d never had to wean myself from that type of drug.”
Earlier this year she had a second surgery on L-4 and L-5 and the procedure also repaired some compressed nerves. Dr. Roh explained to her that he’d be using a newer protocol to manage her post-surgical pain. The experience this time? Totally different.
“After the surgery, I was able to walk the halls later that day,” she says. “There was very little pain and I only ended up with one prescription for pain medicine and I didn’t even use the whole supply. I could have gone back to work even earlier if I didn’t have a job with a lot of physical activity.”
Rockford Spine Center and OSF are continuing to gather data on surgical patients that have used Exparel and hope to share their detailed findings with the medical community in the future.
Specialty Practice Adds to Its Team of Professionals
Rockford, Ill. (October 6, 2016) – Physical Therapist Cassie Alderks, P.T., D.P.T., recently joined the Physical Therapy Department at Rockford Spine Center (RSC). She will work with staff to provide a variety of services and care to patients.
Alderks earned a bachelor’s degree in exercise science and a doctorate in physical therapy from Carroll University in Waukesha, Wisconsin. She conducted research during her graduate training and presented at the national conference of the American Physical Therapy Association, of which she is a member.
Rockford, Ill. (October 11, 2016) – Rockford Spine Center Physical Therapist Assistant Dana Smitley recently completed a continuing education course on identifying and implementing appropriate treatments and interventions for patients with vestibular disorders and balance dysfunctions.
The course, “Evaluation and Treatment of Patients with Dizziness and Balance Disorders: A Comprehensive Approach Through Vestibular Rehabilitation Therapy,” was presented by Saravanan Chockalingam, P.T., D.P.T., C.L.T., C.Y.T. He is a physical therapist specializing in vestibular disorders and a member of the Vestibular Disorders Association (VDA).
According to the VDA, 30 percent of people over the age of 65 have dizziness as a common symptom. Often times, dizziness is treated with medications to address nausea and vertigo without addressing the source of the dizziness. Certain causes of dizziness can be resolved within one physical therapy session without medications.
Smitley joined RSC in 2015 and holds an associate’s degree in applied science for physical therapist assistants from Blackhawk Technical College. Her practice has centered on outpatient orthopedic rehabilitation.
Stephen Gabriel, M.D., remembers the shoulder discomfort coming “out of the blue” on a Wednesday back in February 2016. The pain gravitated to his neck and then escalated. By day three, he recalls, he couldn’t lift his arm.
When you’re an orthopedic surgeon, this is an especially troubling development. “I could probably gut it out through the pain, “says Dr. Gabriel, a general orthopedic surgeon at KSB Hospital in Dixon. “However, the loss of motor function was the biggest issue.”
A call to his friend and professional colleague, Rockford Spine Center Surgeon Fred Sweet, M.D., was the first step. They began with an MRI and knew immediately that surgery was the solution.
“Dr. Gabriel’s deltoid function had deteriorated quickly and he was unable to lift his arm to put on a surgical mask,” recalls Dr. Sweet. “I recommended a C4-C5 anterior cervical discectomy and fusion (ACDF).”
This procedure removes a herniated or degenerative disc in the neck. Surgeons typically make an incision in the throat area to reach the front of the spine and make the repair.
“It might have gotten better without doing the surgery but it might not have,” says Dr. Gabriel. “We needed to do it. I woke up from the surgery and the pain was gone.”
Today, six months later, his strength has returned to nearly 95 percent, he says, and he continues to do physical therapy.
“The progress was very quick and each day was a bit better,” says. Dr. Gabriel. “It was very surprising how quickly I was able to get back to work. I paced myself and was right back into it.”
Dr. Gabriel has been a colleague of Dr. Sweet’s for many years and guesses he’s referred more than 300 patients to him during that time. That relationship brought him peace of mind when he was facing surgery.
“Dr. Sweet is a professional and I really trust him,” says Dr. Gabriel. “I was very confident when I called him and did not hesitate to follow his recommendations.”
While some patients are often reluctant to visit a surgeon, Dr. Sweet says surgery is often the last thing he’s considering when working with a patient.
“I try first to understand who they are, how their condition or disease affects them and what the best way is to help them,” he says. “I explain their options and sometimes surgery is one of them. Careful selection is the key to good results.”
Dr. Sweet completed the surgery on a Tuesday and Dr. Gabriel was back at work that Thursday, seeing patients, and doing surgery on Friday.
“I was back at it very quickly and it was very fortunate that I didn’t need a more significant procedure,” he says. “I was also lucky to have the motor deficit affect my shoulder and not my hand. I saw patients three days later and was back in the OR as a surgeon, not a patient.”
Joe Altenhoff was no stranger to the pain. And, he’ll tell you, he’d even become used to it.
Active and in good physical shape, he’d altered his lifestyle in an effort to cope with the nagging irritation in his back that had lasted more than a decade. However, for the owner and principal at Arc Design, an engineering firm in Rockford, there finally came a time when he reached his limit.
“I lived with the pain for a long time,” says Altenhoff. “But when the pain escalated and my leg started to go numb, that’s when I knew I had to do something.”
That something turned into a lot of things. He’d tried chiropractic treatments, anti-inflammatories, along with a number of other therapies and exercises. Nothing worked.
A visit to spine surgeon Christopher Sliva, M.D., at Rockford Spine Center, led to the imposing-sounding diagnosis of isthmic spondylolisthesis, more commonly understood as a slipped vertebrae.
“Joe’s symptoms had progressively worsened,” says Dr. Sliva. “He was dealing with buttock, thigh and calf pain with numbness and paraesthesia, or a ‘pins and needles’ sensation.”
More importantly, Dr. Sliva understood the impact the pain was having on Altenhoff’s life.
“The pain was really disabling to Joe,” Dr. Sliva says. “He had to modify his lifestyle quite substantially and he wanted something more definitive to be done about it.”
After exhausting a number of non-surgical options, it was clear that surgery was the solution. He and Dr. Sliva discussed the procedure and worked together to develop a plan.
“We empower our patients so they can choose their course of treatment and surgery is typically our last resort,” emphasizes Dr. Sliva. “We look at conservative treatment options and how pain is affecting a patient’s quality of life. Only about 10 percent of our patients end up needing surgery.”
Altenhoff is an engineer, a problem-solver by nature, and he was very involved in the process. He and Dr. Sliva looked at the scans and the models of the spine to understand what was wrong.
“I was thinking about alternative ways to fix it,” he recalls. “However, I knew it was complicated and that it wasn’t going to go away and would most likely get worse. I had a lot of confidence in Dr. Sliva going into the surgery and I knew it had to get done.”
Working with Dr. Sliva and his team, Altenhoff was diligent in preparing for the procedure, known as a transforaminal lumbar fusion. The procedure involves removing a disc from between two vertebrae and then fusing the vertebrae to together. For the patient, the results can be remarkable.
“I woke up and instantly knew it was better,” remembers Altenhoff. “I could feel it right away and it was amazing. That was a start of a phenomenal recovery.”
A day after the procedure, he was doing occupational and physical therapy to jump start the recovery. Today, six months after the surgery, Altenhoff has resumed his active lifestyle. He’s made a few modifications but “nothing too radical,” as he puts it.
And, of course, the pain is no more.
“Having pain for so long, you take it for granted,” he says. “I’m grateful for Dr. Sliva and his team and so happy that the nuisance of having that daily pain is gone.”
Excruciating. That’s how Landi Miller describes the pain she was feeling on her right side, working down from her neck to her shoulder and into her right arm. This busy single mom with three kids and a job in the Winnebago County court system saw her life thrown into a tailspin when she was diagnosed with two herniated discs by her family practice physician.
“I was popping Advil non-stop and then had to switch to stronger medication,” she recalls. “That made me so tired I couldn’t do anything with my kids and it was affecting my job.”
Following the initial diagnosis in late 2014, her family physician referred her to Spine Surgeon Michael Roh, M.D., at Rockford Spine Center, who explained where the herniated discs were located and some treatment options, including surgery.
Patients have a very visceral reaction to their pain, says Dr. Roh. “When I meet with a patient, I pay close attention to both their non-verbal signs and the adjectives they use to describe their pain. What’s most telling is when a patient explains all the things that they can’t do because of their pain. It’s very emotional for them.”
In Landi’s case, the disc herniations were severe. Her first treatment was an epidural pain injection, followed by physical therapy. Neither brought her any relief.
“We tried the injection and then I did PT three times a week for a month but it didn’t help,” she says. “My right hand was going numb on a regular basis and when I dropped a cup of coffee because of that, I knew it was time to do something.”
She met with Dr. Roh again, who outlined the options for surgery. They chose a total disc replacement (TDR), which Dr. Roh has performed numerous times with very positive outcomes.
“A TDR can be very effective because it offers a shorter recovery time,” says Dr. Roh. “That’s important for all patients, obviously. However, for patients whose condition might be impacting their ability to work, it’s absolutely critical that they can return to their job in a timely manner.”
Landi remembers how “ready” she was to have the surgery and how excited she was to hear Dr. Roh tell her that when she awoke, the pain would be gone.
“It was just crazy how that worked,” she says. “He said I would have instant pain relief and it was immediately gone. I had the surgery on a Wednesday and was back to work on Monday.”
Landi followed her doctor’s orders and worked hard to keep her sutures and the incision clean, which led to a full and uneventful recovery. Today, about a year after the surgery, she tells people that if they have this kind of severe pain to get it checked out right away.
“It’s amazing how my life changed,” Landi says. “I’m back to being the mom I was before I was in so much pain. I can’t say enough about Dr. Roh and his team. They were just amazing.”
Rusty Hayes knows back pain. A former football player who has always lived a vigorous and active lifestyle, he’s had surgeries in the past to repair spine and disc issues. This time was different.
Working on his backyard deck last summer, he stood up and his back “seized up.” He couldn’t walk. For the Senior Pastor at First Free Rockford, this was a serious and unwelcome interruption to his ministry and his life that required immediate action.
A visit to his primary care physician, followed by consultations from both a pain management therapist and orthopedic surgeon, showed the severity of the injury. The diagnosis? Recurrent disc herniations with radiating pain, numbness and tingling, along with severe and intractable back and leg pain.
Unfortunately, physical therapy, pain medication and even electrical stimulation from a TENS unit brought no relief. A referral to Rockford Spine Center brought Hayes to spine surgeon Christopher Sliva, M.D.
“Seeing Rusty for the first time, it was clear he was suffering,” recalls Dr. Sliva. “He had difficulty even walking across the room before he had to stop and rest.”
The solution? Expedited surgery.
“From my first encounter with Dr. Sliva, I could tell that I was at a different place than what I’d experienced before,” Hayes recalls. “They have a tremendous team and it’s such an impressive facility. They spent time with my wife and me talking about the procedure and making a plan.”
A week later, Dr. Sliva and his team performed a transforaminal lumbar fusion on Hayes. The procedure removed two discs from between the vertebrae and then fused the vertebrae together, while “installing” two rods to stabilize the spine.
“Immediate relief,” was what Hayes felt when he woke up and he recalls being able to stand up on the same day following the surgery. For his surgeon, that brought immediate satisfaction as well.
“It’s gratifying to see how surgery can relieve the pain they were once experiencing,” says Dr. Sliva. “I see them right after the surgery and they have that initial relief. Then, I’ll see them again post-surgery and they’re progressing and back to doing the things they were unable to do because of the pain. That’s very rewarding.”
Hayes’ recovery has progressed quickly and he’s back in the gym and weight training again. If you were walking alongside him, he’ll point out, you couldn’t tell that anything is different. And, most importantly, he’s back preaching again.
“I’ve had procedures in Dallas and in Boulder, Colorado,” says Hayes. “This was by far the best I’ve ever experienced. It’s high quality and nationally elite. It’s such a blessing to be able to get that kind of care here.”
Dr. Roh Speaks on Cervical Spine Surgery