Spine surgery is becoming less painful with shortened recovery, thanks to advances in the field. Many area hospitals, such as the Mayfield Clinic and University Hospital have adopted these advanced procedures.

The Mayfield Clinic, with 15 locations in the Tristate, is one of the largest neurosurgical practices in the world and has been helping people with spine problems since 1937.

University Hospital's Spine Surgery program also features some of the country's most experienced groups of spine surgeons in treating Level 1 spine injuries.

Dr. William Tobler, a neurosurgeon at the Mayfield Clinic and the director of neurosurgery at The Christ Hospital, uses the latest advances in spine surgery to change the way spine care is delivered in Cincinnati.

"We have begun to do a lot of spine surgery in the outpatient setting," Tobler says.

At the Christ Hospital Spine Surgery Center on Smith-Edwards Road just off I-71, patients are able to come in, have the surgery and go home to sleep in their own bed that same night.

"It's almost like going to a spa. It's a very relaxing place; it's less anxiety-provoking," Tobler says. "That's a more efficient way of delivering spine care and that's been enabled by many advances, including the broad category of doing surgery in a way that we call minimally invasive."

Less Invasive, Less Painful

Minimally-invasive surgery uses technology to operate through microscopic incisions in the body. Even a more difficult surgery like a spinal fusion can now be done as an outpatient surgery because of new procedures.

In the past, spine surgery would require doctors to make big incisions and dissect the muscles to get to the spine. Now, Tobler says, they make a one and a half to two-inch incision and work through special dilating tubes using a microscope to see everything. As a result, the damage to the spine is reduced and the pain afterward is not as agonizing.

"A lateral fusion, or XLIF, is where we actually make an incision in the side of the back, not the back of the back," Tobler says. "The TLIF is when we can do a fusion in the back through two small incisions and can avoid going through the abdomen."

The AxiaLIF is a similar procedure in which surgeons make incisions into the body from the top of the buttocks.

Another type of minimally invasive surgery is artificial disc replacement. Instead of fusing the spine together, it replaces the disc and preserves the motion of the normal physiology of the replaced disc.

"We do the artificial disc in the neck and in the low back, and can do them with the same fairly minimally-invasive approaches," Tobler says. "By introducing these smaller incisions and shorter operations, we're reducing the cost of health care and making people feel a little more comfortable than if they had to have a major surgery..."

University Hospital's Spine Division, which is headed by world-class physicians who have years of extensive surgical experience, also offers minimally invasive and complex revision surgeries.

With years of focus on the treatment of adult traumatic spine injuries and complex spinal instabilities, including disorders of the cervical, thoracic and lumbar spine, University's physicians are able to make patients feel more comfortable with a quicker, less painful surgery.

Image Guidance Surgery

Doctors can now more accurately diagnose the problem, plan the surgery and confirm that what they've done is accurate with more advanced imaging.

"We actually can take images in the operating room to confirm that what we've done is accurate," Tobler says. "It's called image guidance in surgery. It's like navigation during surgery. It's the same as driving around with your navigation in your car. So you're seeing a map of what you're doing."

Tobler and other doctors at the Mayfield Clinic also use non-surgical treatments for patients who have spine problems, but might not require surgery.

They do injection therapy, which involves injecting steroids into the spine in order to relieve pain.

"Sometimes a series of those injections are enough to make the patient better and be able to avoid surgery," Tobler says.

"The Spine Athlete"

These doctors also created a concept called the spine athlete.

"I think a lot of people live until they're 40 and 50 and never have done much exercise and then they get into trouble with their spine," Tobler says. "We want them to think like an athlete thinks."

This means exercising every day of the week for a couple of hours each day, just like a high-performing athlete does when training.

He says that the best way to maintain a healthy spine is to participate in low-impact sports like swimming, biking and Pilates exercises, especially if a person is having spine problems.

"High-impact exercise, like running, is not good for a problem spine," he says. "Anything with lots of jumping and jarring is also high-impact and not good for a problem spine."

He also recommends that people focus on core-strengthening exercises to maintain everyday spine health. Doing exercises that strengthen a person's core — muscles in the abdomen and back — are the best way to do this. Some specific exercises include beginner, mid-level and advanced level bicycle crunches, medicine ball rotation and plank exercises.