Working Alongside the LESS Institute: an Intern’s Gratitude

By Abagail Sullivan

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The LESS Institute is so proud to have hosted Sema Santana, a high school junior from Arizona, for one week during an internship at our Florida offices. During her time, Sema was able to experience the fields of orthopedic surgery, sports medicine and chiropractic medicine by spending time with some world class providers. Big thank you to Bommarito Performance Systems and the office of Dr. Zev Mellman for taking the time to allow her into your top notch facilities! Below are kind words from Sema herself, of her experience with the LESS Institute and beyond.

Hello Mr. and Mrs. Chin,

I would first like to say how thankful I am to have gotten the chance to work with the both of you, your team, the people at the Bommarito Performance Center, and Dr. Mellman himself. Not only was this internship a great experience for me, but it was also very interesting and I was able to learn a lot. This internship allowed me an inside look of what some of the medical field entails. It was very impressive to see how well both you, Vanessa, and Dr. Chin run your practices, in the sense that you guys work in an organized, yet efficient way. Many would think that the medical field is hectic, though it can be in some cases, but you all work as a team, which was very refreshing to see and experience. Although, spinal orthopedics isn’t the field I personally want to pursue, it was very interesting to see what Dr. Chin does on the daily, and it was amazing to have had the chance to observe surgeries this early in life. It was truly amazing to see a surgeon be able to fix something as complex as the human body. It was also very interesting to see athletes work at a professional level. This experience also gave me an inside look at athletic training at a professional level, which only made me more excited for the future. Even though I only got to work with Dr. Mellman for a couple of hours, it was very interesting to see a different side of spinal care. Although, it was amazing to see how to fix the spine, it was very interesting to see how doctors work to prevent the spine from getting injured. Learning the true meaning of Chiropractic Medicine was very eye opening for me, and was truly a great learning experience. All in all, I would again like to say thank you to all of you for this amazing experience I had and that I will never forget. But, I would like to especially thank Dr. Chin for letting me learn under him, and teaching me that a big part of being successful is to keep working at your goal, and that you need to work as a team. Also, thank you Vanessa for all that you have done, it was a great experience for me because of you and all your hard work. Thank you for letting me into your home and your lives, it’s something I will never forget.

Hopefully, I can visit again. I honestly cannot say thank you enough!

Sincerely,

Irasema Santana

Sema with Vanessa Chin of the LESS Institute

Sema with Vanessa Chin of the LESS Institute

With interest in working alongside our team, contact the LESS Institute at 1 855 411 LESS.

With interest in working alongside our team, contact the LESS Institute at 1 855 411 LESS.


Clinical Outcomes With Midline Cortical Bone Trajectory Pedicle Screws Versus Traditional Pedicle Screws in Moving Lumbar Fusions From Hospitals to Outpatient Surgery Centers

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Scientific Paper

Chin KR1, Pencle FJRCoombs AVElsharkawy MPacker CFHothem EASeale JA.

Interested medical professionals can read through the full paper, also published in Clinical Spine Surgery, here.

Study Design

Level III.

Objective

To report on the outcomes of midline cortical bone trajectory (CBT) pedicle screw surgical technique for posterior lumbar fixation in the outpatient surgery center (OSC) compared with traditional pedicle screws in the hospital.

Summary of Background Data

Traditional pedicle screws have been the gold standard for posterior lumbar fusion. Advances in spine surgery, including less invasive procedures have propelled the design of instruments and implants to achieve greater posterior spinal fixation, with decreased tissue destruction and higher safety margins. Biomechanical studies have validated the superior pullout strength of cortical screws versus the traditional pedicle screws and represent an opportunity to perform safe lumbar fusions in OSCs with same day discharge.

Materials & Methods

The medical records of 60 patients with prospectively collected data were reviewed. Two matched cohort groups consisting of 30 patients each, CBT pedicle screws performed in OSC patients (group 1) was compared with traditional pedicle screws performed in hospital patients (group 2). Outcomes were assessed with self-reported Visual Analog Scale (VAS) scores, Oswestry Disability Index scores, and radiologic fusion rate.

Results

Totally, 33 males and 27 females, age range (28-75), average 58±3 years. Average body mass index was 29±1.15 kg/m. A total of 65% of surgeries were at L5-S1 level. Significant improvement noted in VAS back pain scores in the OSC group from 7.8±0.5 to 2.5±0.7, P=0.001. Comparing intergroup VAS back pain scores and Oswestry Disability Index scores, OSC group demonstrated significant improvement, P=0.004 and 0.027, respectively. Fusion rate at 2 years was similar, P=0.855 between groups.

Conclusions

We successfully transitioned our lumbar fusions from hospitals to OSCs using a midline CBT pedicle screw technique. Although traditional pedicle screw placement is effective and may be viable in an OSC, we see more advantages to use midline cortical screws over traditional pedicle screws.

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About Author Dr. Kingsley R. Chin

Dr. Kingsley R. Chin is a board-certified Harvard-trained Orthopedic Spine Surgeon and Professor with copious business and information technology exposure. He sees a niche opportunity where medicine, business and info. tech meet – and is uniquely educated at the intersection of these three professions. He has experience as Professor of Clinical Biomedical Sciences & Admissions Committee Member at the Charles E. Schmidt College of Medicine at Florida Atlantic University, Professor of Clinical Orthopedic Surgery at the Herbert Wertheim College of Medicine at Florida International University, Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School, Visiting Spine Surgeon & Professor at the University of the West Indies, Mona, and Adjunct Professor of Clinical Biomedical Sciences at the University of Technology, Jamaica.

Learn more about Dr. Chin here and connect via LinkedIn.

About Less Exposure Surgery

Less Exposure Surgery (LES) is based on a new philosophy of performing surgery, leading the charge to prove through bench and clinical outcomes research that LES treatment options are the best solutions – to lowering the cost of healthcare, improving outcomes and increasing patient satisfaction. Learn more at LESSociety.org.

The LES Society philosophy: “Tailor treatment to the individual aiding in the quickest recovery and return to a pain-free lifestyle, using LES® techniques that lessen exposure, preserve unoffending anatomy and utilize new technologies which are safe, easy to adopt and reproducible. These LES®techniques lessen blood loss, surgical time and exposure to radiation and can be safely performed in an outpatient center. Less is more.” – Kingsley R. Chin, MD

About The LESS Institute

The LESS Institute is the world leader center of excellence in Less Exposure Surgery. Our safe, effective outpatient treatments help patients recover quickly, avoid expensive hospital stays and return home to their family the same day. Watch our patient stories, follow us on Facebook and visit TheLESSInstitute.com to learn more.

About SpineFrontier

The above study utilized LES Technology from SpineFrontier – leading provider of LES Technologies and instruments – offering surgeons and patients superior technology and services.

Scientific Paper Author and Citation Details

Authors

Chin KR1, Pencle FJRCoombs AVElsharkawy MPacker CFHothem EASeale JA.

Author information

  1. *Herbert Wertheim College of Medicine at Florida International University †Charles E. Schmidt College of Medicine at Florida Atlantic University, Miami ‡Less Exposure Surgery Specialists Institute (LESS Institute) §Less Exposure Surgery (LES) Society, Fort Lauderdale, FL.

15-Year-Old Jamaican Girl Appreciates Life Changing Scoliosis Surgery in Jamaica by Dr. Kingsley R. Chin

By Caitlin Lubinski

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On a late Saturday night in May, an unlikely group of people’s paths crossed in a small operating room in the University Hospital of the West Indies. It was hot, and beads of sweat formed on the doctors’ foreheads above their surgical masks. Outside the O.R., the windows in the hallways were open to catch the breeze that filtered through the open slats. The hallway was quiet, filled only with an empty gurney with a canvas stretcher and wood handles. A clock on the wall covered in a metal casing methodically tracked the passing moments.

Inside the O.R., Dr. Kingsley R. Chin, an orthopaedic surgeon and founder of Less Exposure Surgery Specialists (LESS) Institute in Florida, and Dr. Carl A. Bruce, a consultant neurosurgeon at the University of the West Indies at Mona Jamaica, operated on a fifteen year old young woman. Around them stood Kevin Chappuis, a medical technology engineer from SpineFrontier, Inc, Harisha Buggam, a medical device distributor in the West Indies, and the University’s Chief of Anesthesiology, Dr. Harding. The operation, a high level, scoliosis case, required that surgeons correct a deformity in the patient’s spine.

Shinel Binns, the patient lying on the operating table, was fit and healthy -a normal young woman in every way, except for the severe curve in her spine. Standing up, Shinel’s legs were perpendicular to the ground, but at her waist, her torso and head angled sharply to the left, as if she had to fight gravity from pulling her left shoulder and head to the ground. A lifetime of trying to hold her head and torso upright to counterbalance her lumbar spine’s deformity had begun to create a curve in her thoracic spine.

Shinel lived in Saint Elizabeth Parish –a two hour journey from the hospital she was now being treated at in Kingston, Jamaica. She and her family had waited a long time for this moment. She would never have been able to afford an operation, but the donated time from the doctors, and over $500,000 in donated technology and personnel from SpineFrontier, as well as her community’s donation of $5,000, was making her operation possible.

Dr. Kingsley R. Chin had flown in earlier that day from the United States. Born and raised in Jamaica, he often returned to perform surgeries for people in need. As a pioneer in the Less Exposure Surgery (LES®) approach, Chin has devoted his life to refining and training others in a revolutionary approach to back surgery. The LES Philosophy of surgery pinpoints the problem, fixes it without collateral damage to surrounding tissues, and lets patients go home the same day.

A patient examination and X-Rays had confirmed to the doctors that Shinel’s original spinal deformity was in the lumbar spine. Because the thoracic curve was compensatory to keep her upright, Dr. Chin and Dr. Bruce operated on the most pronounced section of the curve (L1-L4). Dr. Chin used a Less Exposure Surgery (LES) approach, addressing the most pronounced section of the spinal curve (L1-L4) by inserting SpineFrontier’s S-LIFT® Lateral Interbody through a single, three inch incision at those levels to straighten out the spine. The surgeons then placed unilateral MISquito® Percutaneous Pedicle Screws to hold the straightened position.

The LES approach through the small incision on the side of the abdomen was low impact and saved Shinel the trauma of an incision through her stabilizing back muscles that could disrupt her strength. It also minimized the surgical trauma and maximized its effectiveness for a rapid and less painful recovery. This approach was especially important because it would allow a teenage girl to resume her daily activities more quickly. The surgeons expected that the thoracic curve would straighten itself over time. After the operation, Shinel already felt straighter and only had minimal superficial pain.

Harisha Buggum, the medical device distributor, had observed several other scoliosis corrections before through the Scotiabank Scoliosis Programme that provided implants at a greatly reduced cost to teenagers with scoliosis. But she had a renewed sense of excitement when talking about Shinel’s operation.

In this surgery, you could see the technology changing the deformity and you could see the spine literally straightening up through the fluoro imaging. It’s good to know technology has turned in the direction so that someone with scoliosis can actually get a correction from Less Exposure Surgery.”

“I’ve never seen that kind of procedure done,” Harisha said, leaning forward and talking energetically, “This was different for us than our day-to-day [procedures]. In this surgery, you could see the technology changing the deformity and you could see the spine literally straightening up through the fluoro imaging. It’s good to know technology has turned in the direction so that someone with scoliosis can actually get a correction from Less Exposure Surgery.”     

Harisha’s excitement over what she observed in the O.R. was just a small window into the many cases that Dr. Chin and his colleagues at the LESS Institute perform on a daily basis in the United States.

“This case is a perfect example of how Less Exposure Surgery can transform a patient’s life,” Chin commented.

Learn More About Less Exposure Surgery and connect with Dr. Kingsley R. Chin.

Wellness Wednesdays: Rest Up! May is “Better Sleep Month”

By Abagail Sullivan

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Rest up! May is Better Sleep Month and we’re here to remind you of the major benefits of prioritizing your sleep – giving you even more reason to hit that snooze button.

Benefits of Sleep that Might Just Surprise You

Strengthen Your Memory Skills

Sleep can help strengthen memories and your brain can even practice previously learned skills while you’re at rest.

Get That Inflammation Under Control

People who get less than six hours of sleep a night have seen higher blood levels of inflammatory proteins; one study found that C-reactive protein – which is associated with heart attack risk – was higher in people of the same category.

Get Your Creative Juices Flowing

Sleep helps reset your mind and restructure your memories, fostering potential for a creative-revamp. Researchers at Harvard University and Boston College found that people seem to strengthen the emotional components of a memory during sleep – so maybe “sleeping on it” is a good idea after all.

Relieve That Nagging Pain

Getting just the right amount of rest is believed to help with chronic pain, as many studies have given evidence that lack of sleep can lower your pain threshold.

Change Your Mindset

The pure power of rejuvenation (and waking up on the right side of the bed) can improve your mood and set the tone for the rest of your day. Just don’t over-do it on the R&R, or you could have health effects to the other end of the spectrum!

For those who (attempt to) sleep with back pain…

Listen up, restless sleepers! Back pain can become a big pain when trying to achieve your best night’s sleep. Here are some tips to get you through the night.

Back sleepers: place a pillow under your knees to maintain the normal curve of your back.

Stomach sleepers: sleeping on your stomach can be detrimental in this realm, but if you can’t shake your go-to position, try placing a pillow under your pelvis and lower abs to reduce some of the strain on your lower back.

Side sleepers: place a pillow between your knees as you rest. Try a body pillow for full coverage!

We spend about ONE THIRD of our lives sleeping – so let’s enjoy it! Let us know what YOU do to snooze deeper, longer and all-around better. Share your tips and tricks to your best night’s rest yet.


The LESS Institute Gives Back: Jamaica’s First A-CIFT SoloFuse-P Case

By Abagail Sullivan

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On July 3, 2015 Dr. Kingsley R. Chin of the LESS Institute in Florida and Jamaican Neurosurgeon Dr. Franz Pencle performed a Less Exposure Surgery procedure on a middle age, male patient who suffered from severe myelopathy (spinal cord compression) due to a progressive degenerative disorder. The procedure took place at Cornwall Regional Hospital in Montego Bay, Jamaica. Before surgery, the patient was incapacitated. “He was basically quadriplegic,” Dr. Fabio Pencle, a LESS Institute Research Fellow who supported the case says. “On his strength test, he scored a 1/5 throughout all limbs –which means he could barely flicker his digits.” Dr. Fabio Pencle believes that the patient survived because of treatment. “Patients with similar symptoms demised because they didn’t receive timely treatment,” says Dr. Fabio Pencle.

Dr. Chin, Dr. Franz Pencle and Dr. Fabio Pencle donated their time for the case and SpineFrontier donated the SoloFuse hardware. The Less Exposure Surgery (LES) procedure was performed through a midline cervical incision, dissection to expose the affected level and a discectomy using rongeurs and burr. A DBM packed A-CIFT SoloFuse was placed and fixed with screws. This was the first case a standalone implant in Jamaica. It was also the first outpatient spine surgery done at Cornwall Hospital. The patient could sit upright twelve hours after surgery, and he tested 5/5 on a strength test in the upper limbs and 4/5 in the lower limbs –indicating that he had significant improvement in less than 24 hours.

About SpineFrontier’s A-CIFT™ SoloFuse-P™

The A-CIFT SoloFuse-P standalone Less Exposure Surgery system features a simple dual screw construct, a large graft window, large diameter screws, and slim, agile instrumentation. Its zero-profile and all PEEK-OPTIMA Natural design minimizes tissue disruption.


Clinical Outcomes of Outpatient Cervical Total Disc Replacement Compared With Outpatient Anterior Cervical Discectomy and Fusion

By Dr. Kingsley Chin

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Scientific Paper

Chin KR1, Pencle FJRSeale JAPencle FK.

Interested medical professionals can read through the full paper, as published in Spine, here.

Study Design

A single-center, retrospective study.

Objective

The aim of this study was to determine the safety and outcomes of total disc replacement (TDR) as an outpatient procedure in the ambulatory surgery center (ASC).

Summary of Background Data

Anterior cervical discectomy and fusion (ACDF) has been demonstrated to be safe in the outpatient setting, as the awareness of same-day surgery procedures is on the rise due to better outcome and shorter recovery time. There is a need for motion preservation in a subset of patients TDR provides a solution. Transitioning spine surgery to the outpatient setting including cervical TDR is the next logical step.

Methods

The medical records of 55 consecutive patients undergoing single level TDR (Group 1) were compared with our control group of 55 patients who had single-level ACDF (Group 2). Outcomes assessed included Visual Analogue Scale (VAS) neck, arm, neck disability index (NDI) scores, and complication rate.

Results

Fifty-five patients in Group 1 (TDR, 60%) were male with the group’s mean age being 42.6 ± 1.4 years and body mass index (BMI) 24.8 ± 1.2 kg/m. Fifty-five patients in Group 2 (ACDF), 57%, were male with the group’s mean age being 53 ± 1.0 years and mean BMI 27.9 ± 0.8 kg/m. There was no statistically significant intergroup difference in 2-year VAS neck, arm and NDI scores. Dysphagia was the most common postoperative compliant in both groups (six patients), with no intergroup significance, P = 0.4.

Conclusion

In the ambulatory setting, TDR has shown statistical significant intragroup improvement in VAS neck, arm pain scores, and NDI scores (P < 0.001). In this study, no patients reported serious complications, no incidence of hematoma formation, or worsening postop pain. We conclude that single-level TDR can be safely done in an ASC with satisfactory clinical and patient-reported outcomes. This is comparable to single-level ACDF in the outpatient setting and previous 2-year TDR studies.

Level of Evidence

3.

About Author Dr. Kingsley R. Chin

Dr. Kingsley R. Chin, Founder of philosophy and practice of The LES Society and The LESS Institute

Dr. Kingsley R. Chin, Founder of philosophy and practice of The LES Society and The LESS Institute

Dr. Kingsley R. Chin is a board-certified Harvard-trained Orthopedic Spine Surgeon and Professor with copious business and information technology exposure. He sees a niche opportunity where medicine, business and info. tech meet – and is uniquely educated at the intersection of these three professions. He has experience as Professor of Clinical Biomedical Sciences & Admissions Committee Member at the Charles E. Schmidt College of Medicine at Florida Atlantic University, Professor of Clinical Orthopedic Surgery at the Herbert Wertheim College of Medicine at Florida International University, Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School, Visiting Spine Surgeon & Professor at the University of the West Indies, Mona, and Adjunct Professor of Clinical Biomedical Sciences at the University of Technology, Jamaica.

Learn more about Dr. Chin here and connect via LinkedIn.

About Less Exposure Surgery

Less Exposure Surgery (LES) is based on a new philosophy of performing surgery, leading the charge to prove through bench and clinical outcomes research that LES treatment options are the best solutions – to lowering the cost of healthcare, improving outcomes and increasing patient satisfaction. Learn more at LESSociety.org.

The LES Society philosophy: “Tailor treatment to the individual aiding in the quickest recovery and return to a pain-free lifestyle, using LES® techniques that lessen exposure, preserve unoffending anatomy and utilize new technologies which are safe, easy to adopt and reproducible. These LES®techniques lessen blood loss, surgical time and exposure to radiation and can be safely performed in an outpatient center. Less is more.” – Kingsley R. Chin, MD

About The LESS Institute

The LESS Institute is the world leader center of excellence in Less Exposure Surgery. Our safe, effective outpatient treatments help patients recover quickly, avoid expensive hospital stays and return home to their family the same day. Watch our patient stories, follow us on Facebook and visit TheLESSInstitute.com to learn more.

About SpineFrontier

The above study utilized LES Technology from SpineFrontier – leading provider of LES Technologies and instruments – offering surgeons and patients superior technology and services.

Scientific Paper Author and Citation Details

Authors

Chin KR1, Pencle FJRSeale JAPencle FK.

Author information

  1. *Herbert Wertheim College of Medicine at Florida International University and Charles E. Schmidt College of Medicine at Florida Atlantic University, Fort Lauderdale, FL †Less Exposure Surgical Specialists Institute (LESS Institute), Fort Lauderdale, FL ‡Less Exposure Surgery (LES) Society, Fort Lauderdale, FL §Department of Neurosurgery, Cornwall Regional Hospital, Montego Bay, Jamaica.


A Successful Day of Giving with Food for the Poor

By Abagail Sullivan

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It was the LESS Institute’s pleasure to be a small part of the wonderful Food for the Poor/Join the Pack event to help feed hungry families in Haiti!

Our LESS Institute team showed up excited to help volunteer at Boca Advent Lutheran Church with Food for the Poor and became recognized for our fundraising efforts to aid.

Nearly 125,000 meals were packed by more than 500 volunteers at the Second Annual Join the Pack Event. The meals were prepared with boiling water and each bag contains six generous servings. The LESS Institute team personally packed 36 MannaPacks in each box with nearly 25 total boxes packed.

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Because of our group’s efforts, a whopping 91 children will be fed every day for a WHOLE YEAR, with a total of 340 children fed from combined teamwork in this one single session. Thank you to Food for the Poor, our LESS Institute team members, our fellow Manna-packers, donators and everyone who spread the word of this noteworthy cause!

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To view a video recap of our experience at the event, click here! Or visit us on Facebook to check out our team’s photo album.


Here’s Why You Should Start Practicing Yoga to Promote a Healthy Spine

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From improving flexibility and posture to making you an overall happier person, there’s no secret yoga has its share of benefits. But when back pain and spinal spasms get in the way of your daily activities, practicing something like yoga might seem far fetched. To the contrary, yoga can be a notably beneficial activity for those struggling with back issues. Here’s why YOU should release your inner yogi and see what the buzz is all about.

Benefits

Protect Your Spine

Spinal discs get nutrients through movement. So it’s no surprise back bending, forward bending and twisting helps promote supple and healthy spine discs.

Perfect That Posture

Even those without back pain should be looking for ways to improve their posture, to avoid pain and degenerative arthritis of the spine. When your head and neck are balanced directly above your spine, it gives your body a break from straining the muscles to support it.

Relieve Lower Back Pain

Many yoga moves stretch and strengthen the lower back muscles and increase blood circulation. This, in turn, brings healing nutrients to injured tissues, easing pain from lower back muscles.

Learn Your Limits

learning your limits with yoga is crucial in preventing further back pains and injuries or worsening your condition. Practicing various positions (and re-positions) helps individuals understand their unique limitations.

Relaxation Nation

Relaxation is perhaps the most appealing aspect of yoga, and can actually be quite beneficial in promoting back health as well. Yoga practices incorporate relaxation among stretching, which reduces tension in muscles carrying stress.

Check out the Yoga Journal for moves to alleviate back pain. If you’re short on time, use this 10-minute yoga sequence as your go-to guide. Comment below to your fellow yogis, sharing what’s helped you in promoting a healthy spine and back.


Soft Tissue Swelling Incidence Using Demineralized Bone Matrix in the Outpatient Setting

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Scientific Paper

Chin KR1, Pencle FJR2, Seale JA3, Valdivia JM3.

Interested medical professionals can read through the full paper, published in the Journal of the AAOS, here.

Aim

To assess use of demineralized bone matrix (DBM) use in anterior cervical discectomy and fusion (ACDF) in outpatient setting.

Methods

One hundred and forty-five patients with prospectively collected data undergoing single and two level ACDF with DBM packed within and anterior to polyetheretherketone (PEEK) cages. Two groups created, Group 1 (75) outpatients and control Group 2 (70) hospital patients. Prevertebral soft tissue swelling (PVSTS) was measured anterior to C2 and C6 on plain lateral cervical radiographs preoperatively and one week postoperatively and fusion assessed at two years.

Results

There was no intergroup significance between preoperative and postoperative visual analogue scales (VAS) and neck disability index (NDI) scores between Group 1 and 2. Mean preoperative PVSTS in Group 1 was 4.7 ± 0.2 mm at C2 level and 11.1 ± 0.5 at C6 level compared to Group 2 mean PVSTS of 4.5 ± 0.5 mm and 12.8 ± 0.5, P = 0.172 and 0.127 respectively. There was no radiographic or clinical evidence of adverse reaction noted. In Group 1 mean postoperative PVSTS was 5.5 ± 0.4 mm at C2 and 14.9 ± 0.6 mm at C6 compared Group 2 mean PVSTS was 4.9 ± 0.3 mm at C2 and 14.8 ± 0.5 mm at C6, P = 0.212 and 0.946 respectively. No significant increase in prevertebral soft tissue space at C2 and C6 level demonstrated.

Preoperative radiograph showing retropharyngeal/prevertebral soft tissue at the level of C2 vertebral body and at the level of C6 vertebral body.

Preoperative radiograph showing retropharyngeal/prevertebral soft tissue at the level of C2 vertebral body and at the level of C6 vertebral body.

Conclusion 

ACDF with adjunct DBM packed PEEK cages showed a statistical significant intragroup improvement in VAS neck pain scores and NDI scores (P = 0.001). There were no reported serious patient complications; post-operative radiographs demonstrated no significant difference in prevertebral space. We conclude that ACDF with DBM-packed PEEK cages can be safely done in an ASC with satisfactory outcomes.

About Author Dr. Kingsley R. Chin

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Dr. Kingsley R. Chin is a board-certified Harvard-trained Orthopedic Spine Surgeon and Professor with copious business and information technology exposure. He sees a niche opportunity where medicine, business and info. tech meet – and is uniquely educated at the intersection of these three professions. He has experience as Professor of Clinical Biomedical Sciences & Admissions Committee Member at the Charles E. Schmidt College of Medicine at Florida Atlantic University, Professor of Clinical Orthopedic Surgery at the Herbert Wertheim College of Medicine at Florida International University, Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School, Visiting Spine Surgeon & Professor at the University of the West Indies, Mona, and Adjunct Professor of Clinical Biomedical Sciences at the University of Technology, Jamaica.

Learn more about Dr. Chin here and connect via LinkedIn.

About Less Exposure Surgery

Less Exposure Surgery (LES) is based on a new philosophy of performing surgery, leading the charge to prove through bench and clinical outcomes research that LES treatment options are the best solutions – to lowering the cost of healthcare, improving outcomes and increasing patient satisfaction. Learn more at LESSociety.org.

The LES Society philosophy: “Tailor treatment to the individual aiding in the quickest recovery and return to a pain-free lifestyle, using LES® techniques that lessen exposure, preserve unoffending anatomy and utilize new technologies which are safe, easy to adopt and reproducible. These LES®techniques lessen blood loss, surgical time and exposure to radiation and can be safely performed in an outpatient center. Less is more.” – Kingsley R. Chin, MD

About The LESS Institute

The LESS Institute is the world leader center of excellence in Less Exposure Surgery. Our safe, effective outpatient treatments help patients recover quickly, avoid expensive hospital stays and return home to their family the same day. Watch our patient stories, follow us on Facebook and visit TheLESSInstitute.com to learn more.

About SpineFrontier

The above study utilized LES Technology from SpineFrontier – leading provider of LES Technologies and instruments – offering surgeons and patients superior technology and services.

Scientific Paper Author and Citation Details

Authors

Chin KR1, Pencle FJR2, Seale JA3, Valdivia JM3.

Author information

  • Charles E. Schmidt College of Medicine at Florida Atlantic University, Boca Raton, FL 33431, United States.

  • Less Exposure Surgery Society, Malden, MA 02148, United States. fabiopencle@thelessinstitute.com.

  • Less Exposure Surgery Specialists Institute, Fort Lauderdale, FL 33311, United States.

Misaligned Versus Straight Placement of Anterior Cervical Plates: A Clinical and Radiologic Outcomes Study, JAAOS

By Dr. Kingsley Chin

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Scientific Paper

Chin KR1, Pencle FJFrancis SDFrancis CASeale JAHothem EA.

Interested medical professionals can read through the full paper, published in the Journal of the AAOS, here.

Background

In anterior cervical diskectomy and fusion (ACDF), misaligned plates are concerning because of the risk of screw-and-plate failure; however, these plates also hypothetically have the potential for asymmetric micromotion on the facet and uncovertebral joint. The aim of this study was to determine whether misaligned plate placement during ACDF had clinical benefits compared with straight plate placement.

Methods

Postoperative AP radiographs of 128 consecutive patients who underwent ACDF with anterior cervical plate (ACP) fixation were reviewed, and plate alignment was assessed. Patients were separated into control group 1 (straight plates) or group 2 (misaligned plates).

Results

The mean age of patients was 51.5 ± 0.9 years, and women represented 51% of the total population. There was no significant difference between groups with regard to the preoperative visual analog scale (VAS) and Neck Disability Index (NDI) scores (P = 0.744 and P = 0.943, respectively). At 6 weeks postoperatively, the VAS scores for group 1 decreased from 7.6 ± 0.2 to 4.0 ± 0.2 compared with the scores in group 2, which decreased from 7.7 ± 0.2 to 2.1 ± 0.1, which demonstrated statistical significance (P = 0.019). At 2-year follow-up, no significant difference was demonstrated between the groups’ VAS and NDI scores (P = 0.670 and P = 0.266).

Straight placement

Straight placement

Misaligned placement

Misaligned placement

Conclusion 

Misaligned plates have increased torsional strength and are associated with better clinical outcomes compared with those of straight plates in the early postoperative period. After fusion, no significant difference in clinical outcomes between the groups was noted, which may reduce the concerns regarding misaligned plates.

Level of Evidence

Retrospective comparative study.

About Author Dr. Kingsley R. Chin

Dr. Kingsley R. Chin, Founder of philosophy and practice of The LES Society and The LESS Institute

Dr. Kingsley R. Chin, Founder of philosophy and practice of The LES Society and The LESS Institute

Dr. Kingsley R. Chin is a board-certified Harvard-trained Orthopedic Spine Surgeon and Professor with copious business and information technology exposure. He sees a niche opportunity where medicine, business and info. tech meet – and is uniquely educated at the intersection of these three professions. He has experience as Professor of Clinical Biomedical Sciences & Admissions Committee Member at the Charles E. Schmidt College of Medicine at Florida Atlantic University, Professor of Clinical Orthopedic Surgery at the Herbert Wertheim College of Medicine at Florida International University, Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School, Visiting Spine Surgeon & Professor at the University of the West Indies, Mona, and Adjunct Professor of Clinical Biomedical Sciences at the University of Technology, Jamaica.

Learn more about Dr. Chin here and connect via LinkedIn.

About Less Exposure Surgery

Less Exposure Surgery (LES) is based on a new philosophy of performing surgery, leading the charge to prove through bench and clinical outcomes research that LES treatment options are the best solutions – to lowering the cost of healthcare, improving outcomes and increasing patient satisfaction. Learn more at LESSociety.org.

The LES Society philosophy: “Tailor treatment to the individual aiding in the quickest recovery and return to a pain-free lifestyle, using LES® techniques that lessen exposure, preserve unoffending anatomy and utilize new technologies which are safe, easy to adopt and reproducible. These LES®techniques lessen blood loss, surgical time and exposure to radiation and can be safely performed in an outpatient center. Less is more.” – Kingsley R. Chin, MD

About The LESS Institute

The LESS Institute is the world leader center of excellence in Less Exposure Surgery. Our safe, effective outpatient treatments help patients recover quickly, avoid expensive hospital stays and return home to their family the same day. Watch our patient stories, follow us on Facebook and visit TheLESSInstitute.com to learn more.

About SpineFrontier

The above study utilized Inset® LES Technology from SpineFrontier – leading provider of LES Technologies and instruments – offering surgeons and patients superior technology and services.

Scientific Paper Author & Citation Details

Authors

Chin KR1, Pencle FJFrancis SDFrancis CASeale JAHothem EA.

Author information

  1. From the Department of Clinical and Biomedical Sciences, Florida Atlantic University, Boca Raton, FL, the Department of Orthopedics, Florida International University, Miami, FL (Dr. Chin), and the LESS Institute, Miami (Dr. Chin, Dr. Pencle, Ms. S. Francis, Ms. C. Francis, Dr. Seale, and Dr. Hothem).