A Muldisciplinary Approach – The Backbone of UPMC Passavant's Spine Program

Each  year, people suffering from spine and musculoskeletal disorders account for more than 70 million physician visits nationwide. And lost wages and productivity from these disorders total about $50 billion dollars. UPMC Passavant’s spine program is fast becoming the area’s busiest spine program — with more than 1,000 spine surgeries performed in the past year — because of the hospital’s innovative approach to the diagnosis and treatment of spinal problems. Back patients at UPMC Passavant have access to numerous specialists on the hospital’s McCandless and Cranberry campuses, depending on what their conditions require. These include neurosurgeons, neurologists, physiatrists, psychologists, internists, physical and occupational therapists, dietitians, social workers, orthopaedic surgeons, behavioral medicine specialists, and pain management specialists.

In addition to the expertise of its medical staff, patients come to UPMC Passavant to take advantage of the breadth and complexity of the spinal procedures performed. “We have earned a reputation for being able to perform very complicated surgeries using the most advanced technology available,” says Matt El-Kadi, MD, chief of Neurosurgery, UPMC Passavant, and clinical professor, University of Pittsburgh School of Medicine. “As a result of patient outcomes, we have seen a significant increase in the number of patients we treat in Allegheny County and western Pennsylvania, as well as those from outside our service area including New York, New Jersey, Virginia, West Virginia, and Ohio.”

Patients at UPMC Passavant have access to state-of-the-art operative and non-operative modalities, including diagnostic testing such as x-ray, CT, MRI, bone scan and bone density tests, therapeutic and diagnostic interventional injections, and implantable devices. Patients also can undergo functional capacity evaluations and participate in work-hardening and conditioning programs. In the future, patients will have access to education programs for sports, spine, and disease-related musculoskeletal injuries.

“By having all of these experts available, we save patients a lot of time, confusion, and frustration,” says Dr. El-Kadi.

“One of our goals is to help patients understand their diagnoses and to become more proactive in management of their condition,” says John Bookwalter, MD, UPMC Department of Neurosurgery, and assistant professor, University of Pittsburgh School of Medicine. “Because people are sometimes suspicious about the types of spinal treatments available, they may hesitate to get involved in different therapies. They may need rehab and not surgery; or they might need to see a rheumatologist for an underlying inflammatory disorder. It is our job to see that they are properly diagnosed and educated about the different avenues of therapy available to them. ”

Patients who do require back surgery can rest assured that they are receiving the most advanced care available. “There have been many advances made in spinal surgery, particularly in regard to minimally invasive alternatives,” says Dr. Bookwalter. “Through this approach, we can minimize the amount of tissue disturbed while maximizing the preservation of motion.”

Minimally invasive procedures performed at UPMC Passavant include lumbar microdiscectomy and minimally invasive decompressions. “Instead of accessing both sides of the spine, we can take the pressure off the spinal sac through a relatively small exposure on only one side,” says Dr. Bookwalter. “This procedure can also be used to treat tumors in the spinal cord.”

Neurosurgeons and orthopedic surgeons at UPMC Passavant use a microscope during these minimally invasive procedures to give them a more intricate view of the patient’s body. “With the aid of a microscope, we can see the nerves and spinal cord five times larger to help prevent any injury to these areas,” says Dr. El-Kadi. “Though this technology is crucial to spinal surgery, not many surgeons are experienced in its use.”

Future State

“While traditional treatment usually involves many specialists and requires the patient to travel from physician to physician, we are developing a one-stop-shop approach where patients can see all of the specialists they need in one location,” says Donna Jasko, vice president, Ancillary Services, UPMC Passavant.

In addition to being convenient for patients, this approach allows for improved communication between all of the specialists involved in the patient’s care. “When patients travel from place to place and see different doctors, they may end up having duplicate tests performed because one doctor may not have certain patient records,” says Dr. El-Kadi. “Through our spine program, a patient’s diagnostic, pre-operative, and post-operative testing all can be done at UPMC Passavant, which is a major advantage.”

“This multidisciplinary approach to back  problems is a big reason why UPMC Passavant is at the forefront of spine and musculoskeletal care and will continue to provide patients with advanced treatments in all aspects of spine care,” says Ms. Jasko.

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