Category: Neurosurgery

The Myth of Laser Spine Surgery

Posted on April 24, 2018

Many people are under the impression that a laser is the main surgical tool used in the procedure advertised as laser spine surgery. That couldn’t be farther from the truth, according to back painneurosurgeon Dr. Scott Simon of Orthopaedic and Neurosurgery Specialists (ONS).

What’s more, Dr. Simon believes that use of a laser in spine surgery is more of a marketing gimmick than surgical innovation. “The laser is only used to remove the soft tissue over the spine after an incision has been made and the surgeon performs whatever minimally invasive procedure is called for,” Dr. Simon explained. “Using a laser actually creates an unnecessary step to the surgery.” If soft tissue needs to be removed from the spine, electrocautery, in which a heated needle is used, is a more effective technique, he added

Lasers are certainly not new technology. Lasers have been available for use in medicine since 1973. However, they have not been widely adopted as a tool to be used in spinal surgery. “Most neurosurgeons do not use or recommend the use of lasers for spine surgery because there are no clear benefits and there are other well-established and documented studies proving the effectiveness of more modern and established spine surgery techniques,” Dr. Simon said, adding that ONS neurosurgeons do not use or recommend laser spine surgery.

The laser is in fact just a light that burns soft tissues and is unable to remove ligaments, discs, bone or bone spurs. It is actually much less precise than the more modern surgical tools. Bone spurs that press on nerves or the spinal cord, for instance, are easily taken care of through minimally invasive spine surgery. “The outcomes are excellent and patients often go home the same day as their procedure,” Dr. Simon said.

The majority of spine conditions can be effectively treated without surgery, noted Dr. Simon. When surgery is recommended, he advises patients to carefully research the qualifications of the neurosurgeon and surgical facility. “Minimally invasive spine surgery, fusionless spine surgery and outpatient spine surgery are often advertised as the latest advances in spine care, when in fact the specialists at ONS and elsewhere have been performing and improving these procedures for nearly 20 years,” he said.

Schedule a consultation with an ONS spine specialist at our offices in Greenwich or Stamford, CT or in Harrison, NY by calling 203-869-1145 or submit this online form.

 

Is Your Back and Leg Pain from Sciatica?

Posted on August 25, 2016

PAIN FROM SCIATICA CAN RADIATE FROM THE SPINE TO THE TOES, SAYS NEUROSURGEON MARK CAMEL, MD.

While most back pain is confined to a specific region of the spine, those suffering from sciatica can experience pain from their back down to their toes.Herniated Disk According to neurosurgeon Dr. Mark Camel of Orthopaedic and Neurosurgery Specialists, “There are many causes of back pain. Making a correct diagnosis is the important first step before prescribing treatment.“

Sciatica is a condition in which pain travels along the sciatic nerve. It runs from the lower back through the hips and buttocks and down each leg. The pain from sciatica is usually limited to one side of the body. It also tends to affect people between the ages of 30 to 50.

The most common causes of sciatica is a herniated disk, spinal bone spur or a narrowing of the spine called spinal stenosis. These injuries put pressure on the nerve roots in the lower back and cause inflammation and pain. Sudden pressure on the the lower spine vertebrae from an acute injury can also trigger the condition creating a sharp, leg cramp that can last for weeks.

In most cases, sciatica can be resolved with such non-surgical treatments as rest, anti-inflammatory medications, heat and cold application as well as physical therapy. However, if the pain persists or worsens, doctors may administer a cortisone injection into the spine. If those measures fail to relieve the pain, surgery may be recommended. “Sciatica is a manageable condition with the appropriate treatment,” said Dr. Camel.

Patients experiencing lower back, hip, and leg pain or develop numbness, burning, and weakening in the leg or foot should consult with a physician.

Make an appointment with an ONS spine specialist to learn if sciatica is the root of your back and leg pain.

Finishing First Following Spine Surgery

Posted on June 2, 2016

SPINE SURGERY PATIENT FINISHES FIRST IN FAVORITE 5-MILE RACE ONE YEAR AFTER PROCEDURE.

Amanda Miller has been running the 5-mile Jim Fixx Memorial Day Run in downtown Greenwich for as long as she can remember.  “That race is my annual barometer. It tells me where I am with Amanda Miller Race 3 webmy running and it kicks off my summer running season,” explained the 50 year old real estate agent and mother of three.  This year’s run was particularly triumphant.  Amanda ranked first in her age group with a 39:46 minute finish and 11th among women runners of all ages.  Her triumph, though, was the fact that she could run the race at all.  A herniated disc and subsequent back surgery in 2015 could have kept her on the sidelines indefinitely.

Amanda is married to ONS orthopedist and shoulder surgeon, Seth Miller, MD, so she didn’t have to look very far to find one of the top spine surgeons in the state.  “I give all the credit to my doctor, Paul Apostolides.  He gave me confidence that I’d be able to run again,” she said. Six months after surgery, Amanda was back on the road.

Amanda has had a lifelong passion for running distances, competing with herself to run faster or further with each race. In the fall of 2014, she achieved a personal goal by running in the New York City Marathon.  However, in many ways this year’s Memorial Day race was a sweeter accomplishment.  “By finishing the race in less than 40 minutes, I am running at nearly the same pace I was before the surgery,” she said. “I’ve always known that ONS is among the best practices in the tri-state area because of how consistently high the doctors are in the rankings, but now I’ve lived through it myself. I’m so grateful.”

ONS Physicians Open State-of-the-Art Ambulatory Surgery Center

Posted on April 7, 2016

STAMFORD ASC IS A NEW ULTRA-MODERN AMBULATORY SURGERY CENTER DESIGNED SPECIFICALLY FOR ORTHOPEDIC SURGERY AND NEUROSURGERY. Clain ASC_edited-1

The Stamford ASC has recently received Connecticut State Department of Health approval for license and is now open for physicians to treat patients. Stamford ASC specializes in musculoskeletal surgeries and interventional pain management. The center includes two surgical suites built specifically for orthopedic and neurosurgical procedures, equipped with the latest arthroscopic and computer-assisted technology. The facility also has a procedure room for interventional pain management, a comfortable waiting room, and pre-operative and post-operative areas designed for utmost safety, comfort and efficiency. The technologically advanced surgery center offers patients access to the same arthroscopic and open surgery options found in a hospital setting but in a smaller, more comfortable environment.
Entrance 2 (2)

The warm surroundings of the center and emphasis on caring, individualized attention minimizes the stress often associated with surgery. Patients are released within hours of their procedure so they may complete their recovery in the comfort of home. Covered parking and a ground level entrance help make the patient experience as easy and convenient as possible.
“The Stamford ASC is the result of several years of research and planning, which began when ONS partners with a shared mission set out to build an industry-leading surgical care facility,” said Mark Camel, M.D., one of the Stamford ASC partners.

Formed by 14 experienced and respected orthopedic surgeons and neurosurgeons affiliated with Orthopaedic and Neurosurgery Specialists (ONS) in Greenwich and Stamford CT, the Stamford ASC reflects the standard of excellence that patients have come to expect from surgeons at ONS. “In the current healthcare environment, patients are looking for a more personalized surgery experience that is first and foremost, safe and efficient,” said Dr. James Cunningham, Medical Director of Stamford ASC. “This center will provide service that meets, if not exceeds, the most stringent Government safety requirements and infection controls.” The center was surveyed and approved by the Connecticut State Department of Health earlier this month.

“High quality outpatient facilities such as Stamford ASC best position physicians for healthcare industry challenges by combining cost efficiency with cutting edge technology and a new kind of patient experience,” said Dr. Cunningham. “I fully expect that the Stamford ASC will set the standard for efficient, cost-effective and patient-focused care in the region.”

Read the local press coverage in Greenwich Time and on the Daily Voice

ONS Featured in Greenwich Sentinel

Posted on January 25, 2016

sentinel_logo_transparentYou can learn about the early days of ONS and the philosophy that made us the most comprehensive and advanced practice the region. The writer, Sara Poirier Correa, did an excellent job explaining that with 22 top sub-specialty trained physicians, ONS is able to provide personalized services to patients. The article also highlights the Women’s Sports Medicine Center and the ONS Foundation for Clinical Research and Education, which has published internationally and competes among researchers at larger universities such as Harvard, Yale, and Johns Hopkins. http://bit.ly/1PNTkfh

 

15 ONS Physicians Rated Among Top Doctors in Connecticut

Posted on January 11, 2016

 

ApostolidesWhite  CamelWhite
 ClainWhite CunninghamWhite EnnisWhite
FioreWhite  HeftlerWhite  HindmanWhite  KavanaghWhit3  Miller
 NocekWhite  Sethi_White  SimonWhite  VadasdiWhite  CroweWhite

Fifteen orthopedic surgeons with Orthopaedic & Neurosurgery Specialists (ONS) were named among Connecticut’s Top Doctors in a report published this month by Moffly Media. The doctors were selected by Castle Connolly Medical, Ltd, a well-respected national healthcare research and information company.

Among the physicians recognized for medical expertise and excellence were ONS’s entire neurosurgery team — Paul J. Apostolides, MD, Mark H. Camel, MD, Amory J. Fiore, MD and Scott Simon, MD. Orthopedic surgeons, Michael R. Clain, MD, James G. Cunningham, MD, Francis A. Ennis, MD, Steven E. Hindman, MD, Brian P. Kavanagh, MD, Seth R. Miller, MD, David P. Nocek, MD, Paul M. Sethi, MD, and Katherine B. Vadasdi, MD, were ranked among the top in their category as was Jeffrey M. Heftler, MD, for Physical Medicine and Rehabilitation. John F. Crowe, MD, who retired from ONS at the end of 2015 after 30 years of practice, was one of the leading physicians in his area of specialty, Hand Surgery.

 

ONS is Expanding!

Posted on April 23, 2015

Stamford announcment art.smWe are excited to announce that ONS will open an expanded, state-of-the-art office and physical therapy facility at 5 High Ridge Park in North Stamford in June. Construction began in January and is expected to be completed by the end of May.

The Stamford location will offer a team of physicians and clinical staff dedicated to that office. Some of our other surgeons from Greenwich will also maintain a schedule to see patients in Stamford on a weekly basis. In addition to the doctors’ office, the site will feature a state-of-the-art physical therapy facility outfitted with the latest equipment in an aesthetically comfortable and healing environment.

The new facility is being added in order to accommodate ONS’s growing patient population in the Stamford, New Canaan, Darien and surrounding communities. “Many of our patients come from the Stamford area. Now they can receive the excellent level of orthopedic and neurosurgical care they count on without having to drive to Greenwich,” explained Dr. Seth Miller. In house x-ray and a fully integrated electronic medical records system will make the ONS Stamford office a convenient choice for patients in that area.

Greenwich Hospital Announces New Chief of Staff, ONS Neurosurgeon Paul Apostolides, MD

Posted on March 28, 2015
Paul Apostolides, MD Neurosurgeon
Paul Apostolides, MD
Neurosurgeon

Dr. Paul Apostolides, Section Head of the division of Neurosurgery at Greenwich Hospital, has been appointed hospital Chief of Staff as of January 1. Dr. Apostolides joined Greenwich Hospital’s medical staff in 1998 and has served on many committees including the credentialing committee, executive committee and peer review committee. For three years prior to his current appointment, he was Assistant Chief of Staff. He has served on the Greenwich Hospital Board since 2012.

A graduate of Stanford University and University of Massachusetts Medical School, Dr. Apostolides completed his residency and fellowship training at the Barrow Neurological Institute. He is board certified by the American Board of Neurological Surgery, and is in practice with Orthopaedic & Neurosurgery Specialists (ONS) in Greenwich. He specializes in minimally invasive as well as complex reconstructive spinal surgeries.

ONS is an advanced multi-specialty orthopedic and neurosurgery practice serving patients throughout Fairfield and Westchester Counties and the New York Metropolitan area. ONS physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. For more information, visit www.onsmd.com, or call (203) 869-1145.

14 Doctors from ONS included in Greenwich Magazine’s Top Doctors list

Posted on January 2, 2014

When you need the name of a good doctor, ask another doctor.  As a means to that end, each year Moffly Media asks Castle Connolly, the physician-led medical research team that vets doctors nationwide, to provide a list of top physicians in Fairfield County for their annual Top Doctors list. The January 2013 Top Doctors issue of Greenwich, Stamford, New Canaan/ Darien and Westport Magazines contains information on over 323 doctors in 48 medical specialties.  This year’s list includes 14 doctors from Orthopaedic and Neurosurgery Specialists, PC (ONS) in Greenwich Office Park:  neurosurgeons – Paul Apostolides, MD, Mark Camel, MD, Amory Fiore, MD and Scott Simon, MD; orthopedic surgeons – Michael Clain, MD; James Cunningham, MD; John F. Crowe, MD; Frank Ennis, MD;  Steven Hindman, MD; Brian Kavanagh, MD; Seth Miller, MD; David Nocek, MD; and Paul Sethi, MD; physiatrist – Jeffrey Heftler, MD.

“Once again, we are proud to have so many of our skilled physicians recognized in this year’s Top Doctors lists,” said Dr. Seth Miller.  “Our doctors are among the very best in the country. Each has been hand-picked for their superior credentials and experience”

Each year Castle Connolly’s experts ask medical leaders across the country to identify physicians they believe to be the best in their respective fields. The nominees’ credentials, including educational and professional experience, are then carefully screened and the list compiled.

Orthopaedic and Neurosurgery Specialists PC (ONS) physicians provide expertise in the full spectrum of musculoskeletal conditions and injuries, sports medicine, minimally invasive orthopedic, spine and brain surgery, joint replacement and trauma. The main office is located at 6 Greenwich Office Park on Valley Road, Greenwich, CT. For more information, visit www.onsmd.com or call (203) 869-1145.

ONS Foundation Along With NFL Alumni Chapter Held Concussion Talk at Greenwich Library

Posted on November 18, 2013

Concussions are the hot topic in the NFL and on high school and college campuses across the country with ongoing concern about the brain health of players of contact sports.

The ONS Foundation wants to raise awareness about the risk of concussion and help educate high school athletes about concussion signs and symptoms. According to neurosurgeon Dr. Scott Simon of the ONS Foundation, concussions are the most common type of brain injury sustained in sports and most concussions do NOT involve loss of consciousness.

Where: Cole Auditorium at Greenwich Library
When: Tuesday, November 19th, 2013 @ 7:00 pm

For more information, click the link below:
http://www.onsfoundation.org/home/concussions/

 

International Trigeminal Neuralgia Awareness Day

Posted on October 7, 2013

Today is International Trigeminal Neuralgia Awareness Day!

Trigeminal Neuralgia, also called tic douloureux, is a disorder of the trigeminal nerves that carry sensation to the face. Patients afflicted with this disorder experience debilitating pain on one side of the face. This pain is often described as sudden, stabbing, electric shock-like pain in the forehead, nose, lips, and/or jaw. Because the second and third divisions of the trigeminal nerve are most commonly affected, the pain is usually felt in the lower half of the face, causing some people to first seek treatment from their dentist.

ONS neurosurgeon Dr. Scott Simon specializes in the diagnosis and
treatment of Trigeminal Neuralgia.

Learn more from this CNN story!

 

 

Wide variety of spinal disorders treated at the ONS Spine Center

Posted on June 12, 2012

The large majority of people in the United States will have some type of spinal disorder but most will recover completely with nonsurgical treatments. The first line of treatment after a full evaluation should be conservative measures like physical therapy, medications, injections or even acupuncture. If a patient does not improve using conservative treatments, spinal surgery may be an option.

The ONS Spine Center is made up of a team of highly-skilled and experienced neurosurgeons who specialize in the full spectrum of non-operative spine treatments and operative spine treatments. From diagnostic imaging to physical therapy to therapeutic spinal injections to the most advanced surgical techniques including Minimally Invasive Spine Surgery, our Spine Center offers premier and comprehensive spine care.

Seminar on Spinal Fusion: Treatment for Spinal Instability -May 8th

Posted on May 3, 2012


Considering a Spinal Fusion? Attend this informative seminar on Tuesday, May 8, 2012, 9:00 a.m. at Greenwich Hospital, 5 Perryridge Road, Greenwich.

Spinal fusion is used to treat spinal instability and alleviate chronic mechanical back pain. The procedure restores stability to the spine by securing vertebrae together so they permanently “fuse.” By eliminating abnormal movement between vertebrae, pain is alleviated. Once only performed as open surgery, spinal fusion at Greenwich Hospital is now often done minimally invasively through small incisions. Neurosurgeon Paul Apostolides, MD will explain how and why spinal fusion is performed and will take questions about the procedure and its recovery.  Registration is required. To register, call 203-863-4277 or 888-305-9253.

The Spine Institute at Greenwich Hospital is certified for cervical (neck) and lumbar (lower back) spinal fusion for adhering to national standards for excellence, quality and safety.

“Does Laser Spine Surgery Work?”

Posted on February 7, 2012

 

…a question often asked by our patients.

Here’s the answer:

Spine surgery is typically done to relieve pain and other symptoms by decreasing pressure on a compressed nerve or by stabilizing the spine.  In the case of a herniated or ruptured disc, a discectomy may be done to remove the damaged portion of a disc in the spine; or a laminectomy may be done to remove bone spurs or other spinal growths. In cases where the spine is unstable, a spinal fusion can be performed to secure together two or more of the vertebral bones so that they “fuse” together.  These surgeries are now often performed using minimally invasive techniques that minimize damage to the surrounding tissue and allow for a faster recovery with much less blood loss. Laser spine surgery is often promoted as being minimally or even noninvasive and risk-free.  However, these laser spine procedures do require incisions and the laser itself can result in serious complications.

Laser spine surgery has never been studied in a controlled clinical trial to determine its effectiveness. Marketing pitches for spine surgery performed with a laser often make bold promises of pain relief for chronic neck and back pain and a quick return to normal life; sometimes in a matter of days. What is often not clear from marketing hype, is that laser spine surgery does actually involve surgery.  An incision is required to allow access to the spine.  A focused beam of light (laser) is then used only to remove the soft tissues over the spine.   Bone and ligament are then removed in order to free the nerve from compression using small instruments.  The laser in laser spine surgery actually plays a very minor role.

Lasers are certainly not new technology.  Lasers have been available for use in medicine since 1973.  However, they have not been widely adopted as a tool to be used in spinal surgery.  The fact is that most neurosurgeons do not use or recommend the use of lasers for spine surgery because there are no clear benefits and there are other well-established and documented studies proving the effectiveness of more modern and established spine surgery techniques.

The Importance of a Proper Diagnosis

It is important to have a proper diagnosis of your problem before deciding to undergo spine surgery.  Most cases of back and neck pain are muscular in origin and do not require or benefit from surgery. Unless severe pain or muscle weakness is making walking or performing daily activities extremely difficult, surgery is rarely the first line of treatment. Anti-inflammatory medication, physical therapy and exercise, lifestyle changes and other noninvasive treatment modalities such as therapeutic massage are often successful at resolving back and neck pain.

If conservative treatments fail to reduce back pain, then surgery may be necessary, depending on your diagnosis. For example, if you have a herniated disk with leg or arm pain as a major symptom that hasn’t been relieved with other treatments, discectomy may be appropriate. If surgery is recommended, get a clear explanation of your diagnosis and how the surgery will help relieve your symptoms.

Traditional spine surgery has been tested in numerous clinical trials.  The vast majority of patient who undergo discectomy for treatment of a herniated disc experienced relief from pain and other symptoms.  In elderly patients diagnosed with spinal stenosis, laminectomy is also a highly effectively procedure. Very few neurosurgeons regard laser spine surgery as a viable alternative to conventional spine surgery techniques. ONS neurosurgeons do not use or recommend laser spine surgery.

Mayo Clinic Opinion on Laser Spine Surgery

 

Greenwich Docs Included in Castle Connolly New York Top Doctors Guide, 14th edition

Posted on May 11, 2011

10 Specialists from ONS included in New York Area Medical Guide Book

ONS on Valley Drive in Greenwich, CT.

Ten physicians from ONS are included in the latest edition of Castle Connolly Top Doctors, New York Metro Area guidebook. The 2011 resource directory, which is in its fourteenth edition, is a guide to finding the top primary care and specialty care doctors in the tri-state metropolitan New York area. It details information on over 6000 physicians in 65 specialties. Physicians profiled in the guide were nominated by their peers and screened by a research team at Castle Connolly.

ONS physicians included in the guide are neurosurgeons Paul Apostolides, MD and Amory Fiore, MD; orthopedic surgeons Michael Clain, MD; John Crowe, MD; James Cunningham, MD; Steven Hindman, MD; Brian Kavanagh, MD; Seth Miller, MD; and Paul Sethi, MD; and physiatrist Jeffrey Heftler, MD.

“We are honored to be part of this distinguished group of physicians and to be recognized by our peers as among the region’s most trusted physicians,” said hand and wrist specialist Dr. Crowe. “Our practice takes pride in working as a team to offer patients the highest standard of care. The multidisciplinary nature of ONS makes it possible to provide patients with access to the most advanced techniques and treatments available in orthopedics, neurosurgery and physiatry.”

Castle Connolly sends 12,000 nomination forms to medical professionals in throughout the New York metropolitan region including physicians and hospital executives. Survey recipients are asked to nominate those doctors who, in their judgment, are the best in their field and related fields– especially those to whom they would refer their own patients and family members.
Castle Connolly Medical Ltd. provides researched and screened information through consumer guides including America’s Top Doctors® and Top Doctors New York Metro Area and partnerships with leading regional and national magazines, such as New York, Connecticut and Greenwich Magazines.