laser spine institute guide to miss
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Guide to EndoscopicSpine Surgery
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Table of contents
Message from the CEO 02
About endoscopic spine surgery 03
Why choose Laser Spine Institute? 06
Is endoscopic spine surgery right for you? 07
Streamlined patient experience 08
Meet our surgeons 09
State-of-the-art facilities 12
Patient stories 13
Frequently asked questions 15
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Message from Chief Executive Officer
Bill Horne
Like many of you, I have lived with chronic pain. Being an active and athletic
person, a neck injury was taking a toll on my daily activities. It was affecting
my work as well as my personal life.
I had neck and shoulder pain that radiated down my arm causing a feeling of an
electric charge as well as a loss of feeling in my fingers, which progressively
worsened over a nine-month period. I did everything I could to alleviate my pain
short of a surgical procedure including physical therapy, electrical stimulation,
ultrasound, traction, and epidural steroid injections, but they were only
temporary fixes.
I received the same diagnosis and treatment after meeting with four different surgeons. They wanted to takea bone out of my hip, cut the front of my neck 6 inches, fuse the bone to the vertebrae, and place a steel
plate and six screws to hold everything in place. Although this major procedure seemed terrifying, I felt that it
was my only hope and I needed to book the surgery.
Luckily, about one week before my surgery date, I met a friend for lunch and he told me about a spine procedure
that his wife had just gone through and had significant improvement. I found out that it was Dr. James St. Louis
who performed the procedure, and I cancelled my previous surgical date immediately. I met with Dr. St. Louis
who diagnosed my three herniated discs that were impinging the nerve and causing most of my pain. When the
surgery was complete, I could feel relief in the operating room. I walked one mile that evening, returned to work
the next day, started working out with weights five days later, and played a round of golf 10 days after surgery!
Three years later, I am able to enjoy traveling, spending time with my wife and children, and playing many rounds
of golf. I was so impressed with this minimally invasive spine procedure that I became a managing partner
for Laser Spine Institute. As the CEO and walking testimonial for Laser Spine Institute, I want to spread the word
about endoscopic spine surgery and share my story with potential patients all over the world.
Whether you choose our location in Tampa, FL; Scottsdale, AZ; Philadelphia, PA; or Oklahoma City, OK;
Laser Spine Institute offers a state-of-the-art medical destination with five-star amenities for those who suffer
from back and neck pain.
Congratulations on taking the next step toward becoming free of the pain!
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About endoscopic spine surgery
Laser Spine Institutes minimally invasive procedures are the safe and effective alternative to open back or
neck surgery. Each month, more people come to Laser Spine Institute to relieve their neck and back pain than
to any other spine surgery center in the nation.
Advantages of our endoscopic spine surgery:
Outpatient procedure
No lengthy recovery
Less than 1-inch incision
No fusions or hardware
93.8% patient satisfaction
Providing relief for these conditions:
Spinal stenosis
Bulging/herniated discs
Pinched nerves
Degenerative disc disease
Bone spurs
Sciatica
Arthritis of the spine
Facet disease
Foraminal stenosis
Laser Spine Institute specializes in four types of endoscopic surgeries.
Foraminotomy
To relieve pressure on nerves compressed by the intervertebral foramen.
Laminotomy
To relieve pressure on the spinal cord compressed by spinal stenosis.
Endoscopic Discectomy
To remove the portion of a herniated or bulging disc that is pressing on a nerve root or the spinal cord.
Surgeons utilize X-ray monitoring and fiber-optics devices in order to see precisely what is compressing the
nerve and to remove it without causing any destabilization of the spine.
Facet Thermal Ablation
To debride the facet joint and deaden the nerve utilizing a laser and irrigation inside a 2mm tube.
Nearly all surgical procedures are performed at Laser Spine Institute with local anesthetic and intravenous
sedation. In the operating room, a small incision is made, and a series of tubes, increasing in size, are placed
over the first tube, one at a time, to slowly create an opening to the spine. This practice allows the surgeons
to perform spinal procedures with minimal damage to the surrounding muscles. Through the last translucent
working tube (18mm in diameter), a laser, camera, suction, irrigation and other small surgical instruments
can be inserted. The procedure is conducted under X-ray guidance and the patient is comfortable throughout
the procedure.
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Once the procedures are complete, the tube is slowly removed allowing the muscles to move back into
place. Only a stitch or two is used to close the incision. Approximately an hour after recovery, the patient with
their companion is free to return home or to their hotel room.
Following a day of rest and recovery, the patient will meet with the surgeons nurse and medical assistant
who will evaluate the incision, change the bandage, and provide wound care instructions and dressing
material. The patient is also given detailed instructions on postoperative care recommendations and follow-up
protocol. It is imperative that these guidelines are adhered in order to ensure patient safety and prevent
postsurgical complications.
Finally, the patient is provided with individualized activity instructions to reintegrate normal activities
once they return home.
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Condition treated
Spinal Stenosis
Herniated/Bulging Discs
Pinched Nerves
Bone Spurs
Degenerative Facet Joints
Sciatica
Arthritis of the Spine
Facet Arthritis
Facet Disease
Facet Hypertrophy
Facet Joint Syndrome
Foraminal Stenosis
Foraminotomylaser-assisted
Laminotomylaser-assisted
Facet ThermalAblationlaser-based
EndoscopicDiscectomylaser-assisted
Laser Spine Institute specializes in four types of endoscopic surgeries.
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Relief without the complications of open back surgery or fusion
Minimally invasiveendoscopic procedures Open back/fusion
Hospital stay
Infection rate
Complication rate
None
0.1%
4%
25 days
27%
31%
Why choose Laser Spine Institute?
Laser Spine Institute successfully performs more endoscopic spine surgeries each month than any other
spine surgery center in the nation, setting us apart as the leader in endoscopic spine surgery.
Below you will find a few distinguishing facts and figures about Laser Spine Institute:
1. Our dedication to minimally invasive procedures has made Laser Spine Institute the largest spine surgery
center in the nation. This advantage grows every week, leading to a higher level of expertise, as Laser
Spine Institute helps thousands of families get their lives back.
2. Laser Spine Institute has built its comprehensive medical facilities to provide an integrated service within
the walls of each surgical center, or by trusted service providers nearby. Provided services include:
complete clinical evaluation, state-of-the-art imaging, diagnostic testing, pain management, surgery and
postoperative assessment.*
3. Laser Spine Institute patients report industry-leading results for patient experience that are almost 30
points higher than the national hospital average.
4. All surgeons complete Laser Spine Institutes proprietary fellowship training, led by Chairman of Surgery
Emeritus, Founder Dr. James St. Louis, two-time recipient of the Physician of the Year award in 2005 and
2008 by the American Association of Physician Specialists in the field of Orthopedic Surgery.
5. Over 87% of patients report improvement in their quality of life within three months of having their surgery
and some patients report improvement at the moment of their surgery.
6. Over 70% of patients travel from out-of-state and 10% from outside the country seeking Laser Spine
Institutes unique expert treatment and unparalleled service.
7. 427 dedicated employees including 21 expert surgeons and physicians, and nearly 200 medical
professionals, who have dedicated their careers exclusively to Laser Spine Institute ensuring completecomfort and the delivery of our Above and Beyond Service for patients and their families.
* Some patients individual medical conditions may require additional testing that Laser Spine Institute will facilitatethrough a third-party service provider.
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Is endoscopic spine surgery right for you?
This first easy step in determining if Laser Spine Institutes endoscopic approach is right for you is having
your MRI or CT scans reviewed by one of our board-certif ied physicians or medical professionals. For your
convenience we offer three ways you can take advantage of this complimentary service.
Review by phone
The MRI Review Department reviews hundreds of studies on a daily basis delivered from around the world.
Our expert physicians review MRI and CT scan films, CDs and reports to assess the prospective patients
pathology to determine if Laser Spine Institute can help.
One-on-one medical consultationOne-on-one consultations are available in each of our surgical facilities as well as our medical consultation
centers in Fort Lauderdale, San Diego, and The Villages. This is a unique opportunity to meet with a Laser
Spine Institute medical professional to review reports, discuss the patients pathology and symptoms, and
determine if an endoscopic procedure is the right solution for you.
Medical seminar
Laser Spine Institute seminar staff travels the continental United States and Canada educating those who
suffer from back and neck pain. The program begins with personal face-to-face discussions with a physician
to assess each potential patients pathology, symptoms assessment and initial determination of candidacy for a
Laser Spine Institute procedure. Visit SpineSeminar.com to view upcoming seminars throughout North America.
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Streamlined patient experience
Through our streamlined process, patients receive all necessary treatments related to their spinal condition
in as little as one week. Receiving the highest quality of care, patients go from evaluation to recovery and return
to their lives after the Laser Spine Institute experience.
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* Diagnostic procedures in Philadelphia and Oklahoma City are facilitated by Laser Spine Insti tute through a third-party provider.
Once the patient is discharged and returns home, a patient services liaison continues to provide continuous
patient support and superior postoperative care. In doing so, the liaison plays a key role in all aspects of patient
recovery and outcome, helping each patient optimize improvement in their quality of life.
Laser Spine Institute spinal diagnostic center
Spinal Diagnostics is a division of Laser Spine Institute, established to serve the preoperative needs of surgical
patients with the primary goal of optimizing surgical outcomes. The majority of patients seeking treatment at
Laser Spine Institute have clearly identifiable areas of anatomic compression, allowing straight-forward surgical
treatment decisions. However, a few patients have subtle or complex MRI pathoanatomy, which requires
additional evaluation prior to receiving a surgical order.
Who needs additional diagnostic testing?
The most common indications that a patient would need additional diagnostic testing are those with MRI findings
of multilevel degenerative disc disease, producing more than one area of nerve root compression. Information
provided through a diagnostic selective nerve root block can isolate the primary area of pain from a particular
spinal level, allowing the surgery to be directed at the optimal site. Due to the focally decompressive nature
of endoscopic procedures, this step can be essential to the surgical order.
Common diagnostic procedures performed at Laser Spine Institute are diagnostic facet injections, selective
nerve root blocks (SNRB), and discograms. All diagnostic procedures are performed by a board-certified
physician with specialized training and experience. Our dedicated state-of-the-art procedure suite is equipped
with fluoroscopic X-ray equipment to safely and accurately complete each procedure.* These procedures
are reserved for those patients medically cleared and scheduled for endoscopic treatment.
Some patients individual medical conditions may require additional testing that Laser Spine Institute will facilitate through a third-party service provider.
Day One and Two
Evaluation
Physical andDiagnostic testing
Day Three
Surgery
Day Four
Rest andrecovery
Day Five
Postoperativeappointment
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James St. Louis, D.O.
Chairman of Surgery Emeritus,Founder
Board certified in Orthopedic
Surgery by The American Board of
Physician Specialists
Appointed to the state Board of
Osteopathic Medicine by thegovernor of Florida
2005 and 2008 Physician of
the YearAmerican Association of
Physician Specialists
Meritorious Service Award
United States Army
Michael Weiss, D.O., FAOAO
Chairman of Surgery
Board certified in Orthopedic
Surgery by The AmericanOsteopathic Board
of Orthopedic Surgery
Fellow, American Osteopathic
Academy of Orthopedics
President of the American
Osteopathic Academy of
Orthopedics, Spinal Surgery Section
Member, North American
Spine Society
Board of Trustees, Florida
Osteopathic Medical Association
Meet our surgeons
The surgeons at Laser Spine Institute specialize exclusively in relieving back and neck pain through minimally
invasive, outpatient procedures. With more than 70 years of combined experience in these advanced
techniques, our surgeonsled by Chairman of Surgery Emeritus, Founder Dr. James St. Louisperform moreendoscopic procedures each month than any other spine surgery center in the nation.
Craig Wolff, M.D.
Orthopedic Spine Surgeon
Board certified in Orthopedic
Surgery by The American Board of
Physician Specialists
Graduated Magna Cum Laude
from Princeton University
Fellow, American Academy of
Minimally Invasive Spinal Medicine
and Surgery
Named One of the Best Doctors
in America for 200506Best
Doctors Inc.
Vernon Morris, M.D.
Orthopedic Spine Surgeon
Board certified in Orthopaedic
Surgery by The AmericanBoard of Orthopaedic Surgery
Board certified in
Pain Management
AMA Award for
Physician Recognition
Member, Florida
Medical Association
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Zoltan Bereczki, D.O.
Orthopedic Spine Surgeon
Member, American Academy of
Orthopedic Surgeons
Member, American Osteopathic
Academy of Orthopedic Surgeons
Member, American
Osteopathic Association
Licensed Doctor of Osteopathic
Medicine in Florida
Stefan Prada, M.D.
Orthopedic Spine Surgeon Board certified in Or thopaedic
Surgery by The American Board of
Orthopaedic Surgery
Fellow, American Academy of
Orthopedic Surgeons
Decorated Military Service Member
Timothy Luke, M.D.
Orthopedic Spine Surgeon
Named Americas Top
Orthopedist2008
Two-time winner of Patients Choice,
a coveted award received by less
than 6% of physicians nationwide
Member, North American
Spine Society
Member, American Association of
Orthopedic Surgeons
Member, American
Medical Association
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Meet our surgeons
Keith Girton, M.D.
Orthopedic Spine Surgeon
Board certified by the American
Board of Orthopaedic Surgery
Board certified by the
American Board of Independent
Medical Examiners
Member, American Academy of
Orthopaedic Surgeons
Mark A. Flood, D.O.
Orthopedic Spine Surgeon Board certified in Orthopedic Surgery
Fellowship trained in Spine Surgery
Fellowship trained in Scoliosis and
Pediatric Orthopedic Surgery
Member, American Osteopathic
Board of Orthopedic Surgery
Kit C. McCalla, D.O., M.B.A.
Orthopedic Spine Surgeon
Board certified by the
American Osteopathic Board of
Orthopedic Surgery
Board certified by the
National Board of Osteopathic
Medical Examiners
Member, American Academy of
Orthopaedic Surgeons
Member, American
Osteopathic Association
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State-of-the-art facilities
Laser Spine Institute has built its comprehensive medical facilities to provide an integrated service where
all required services are coordinated for the patient, including: complete clinical evaluation, state-of-the-art
imaging, diagnostic testing, pain management, surgery, and postoperative assessment.
Our dedicated employeesincluding an expert surgical team led by Chairman of Surgery Emeritus, Founder
Dr. James St. Louis, esteemed medical professionals and patient care personneldedicate their time and
energy exclusively to Laser Spine Institute, ensuring complete comfort and delivery of Above and Beyond
service for patients and their families.
You will receive the best quality of care and feel comfortable in our environment. From the moment you walk
in the door, our professional staff welcomes you and guides you throughout the Laser Spine Institute experience.
Our commitment to endoscopic spine surgery has made Laser Spine Institute the largest health care
provider of this technique in the nation. This advantage grows every week, leading to a higher level of
expertise, as Laser Spine Institute helps thousands of patients get their lives back.
Surgical Centers
1. Oklahoma City, Oklahoma
2. Philadelphia, Pennsylvania
3. Scottsdale, Arizona
4. Tampa, Florida
Consultation Centers
5. Fort Lauderdale, Florida
6. San Diego, California
7. The Villages, Florida
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Patient stories
Captain Norm Isaacs story
It is hard to describe a man like Captain Norm Isaacs. If you wereto meet him, you would quickly realize that a life with back pain
was not an option for Norm. He has lived an exciting life from signing
a contract with the New York Yankees right out of high school
to working as a flight instructor to becoming a professional big
game fisherman.
Since 1986, Norm has dedicated his life to his career of professional
big game fishing and shows on Fox Sports Network such as
Big Game Fishing the World, Big Game Bites and Inside Big Game
Fishing. Big game fishing involves tremendous physical strength
and balance hooking up fish like 800-pound marlin, which would bea difficult task for anyone to accomplish.
Living an active lifestyle for many years, Norm experienced low back pain and pinched nerves down
his right leg that worsened over time. He was diagnosed with degenerative disc disease, bulging disc,
foraminal & spinal stenosis and facet hypertrophy. Between fishing excursions, Norm tried several dif ferent
forms of conservative treatment like chiropractic, physical therapy and acupuncture to relieve the
aggravating pain.
He was apprehensive at the thought of spine surgery and concerned it would affect his career and true
passion for fishing. Norm knew that after failing conservative treatment it was the best option. Once he
came to Laser Spine Institute, he was pleasantly surprised by the atmosphere, caring staff, and five-star
service he received throughout his outpatient treatment.
In September 2008, Dr. James St. Louis performed a laminotomy & foraminotomy and a few days later,
Norm was amazed at the difference. He commented that you dont realize how much you missed feeling
good until you feel good!
Ten months after his surgery, Norm stressed that his back is no longer bothered by bending down and
picking up fish or spending days on the boat. He mentions that Laser Spine Institute is nothing short
of a miracle. Excited about his life after the surgery, he commented on his experience saying, Absolutely
a life-changing experience. Im back on the boats. Im back to doing the things I normally do. Im back
to playing golf and Im not hurting.
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Patient stories
Ingrid Honzaks story
Ingrid Honzak, 59, finished the 2007 New York City Marathon six weeksafter her endoscopic spine surgery at Laser Spine Institute. Her surgeon
performed a laminotomy and foraminotomy on the left side of her lumbar
spine in September prior to the November race. One year later, Ingrid reports
great improvement with little to no pain in her lower back and left leg.
For over 10 years, she suffered from lumbar pain and a pinched nerve,
which affected her left leg. The pain went from tolerable to unbearable early
last year. Ingrid was chosen out of 100,000 applicants to run the marathon
but she grew weary of her current condition. She was concerned about
running on pavement, which has a greater impact on muscles and joints than
mountain trail racing. With limited improvement from conservativetreatment, Ingrid contacted Laser Spine Institute to have a procedure scheduled
in anticipation of the big race.
She submitted her MRI for review by Laser Spine Institute Medical Director, Dr. Michael Perry. During
the conversation regarding her candidacy, Ingrid voiced her concern regarding the ability to participate in
the marathon in November. Encouraged by the fact most patients walk the day of surgery, she knew
Laser Spine Institute was the best option.
After a complete medical evaluation and surgical consultation, Ingrid had minimally invasive endoscopic spine
surgery at Laser Spine Institute in Tampa, Florida. She was comforted by the caring clinical nursing staff and
the anesthesiologist who held her hand throughout the surgery. Her hopes were fulfilled when she was able to
walk the day of her surgery. After her postoperative appointment, Ingrid returned home to continue physicaltherapy and training.
In response to her Laser Spine Institute experience, she commented, It is amazing what they can do! While
they might not be able to fix everyone, the experience for me was fabulous! I have never been treated so well at
a medical facility. I can remember the anesthesiologist holding my hand before surgery and it truly comforted
me. Everyone at Laser Spine Institute was very kind to me. I would encourage anyone who is interested in having
back or neck surgery to contact them.
After her surgery at Laser Spine Institute, Ingrid returned to work within one week and training in only four weeks.
A combination of stationary bike riding and intense water aerobics including water-jogging with a weight
belt prepared her for the race. Reunited with her true passion of running, Ingrid crossed the finish line with the
same tremendous sense of accomplishment.
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Frequently asked questions
We understand that you want to be fully informed before making a decision about surgery. We have
listed a few of the questions we receive on a daily basis. For more frequently asked questions, please visit
www.LaserSpineInstitute.com or contact a Patient Coordinator.
Q: How long have your surgeons been performing this procedure?
A: Our surgeons have over 70 years of combined experience performing these procedures. Members of the
surgical team have been proprietary fellowship trained at our facility, in addition to bringing significant
experience with minimally invasive endoscopic surgical techniques gained at other respected healthcare
providers. They are also highlighted by over four decades of general surgical experience to add to
their procedure-specific experience.
Q: Why arent more doctors performing this type of procedure?
A: These sophisticated procedures are specialized and perfected by Laser Spine Institute. This type of surgery
employs advanced medical technology, and Laser Spine Institute is at the forefront of this movement.
Though training is available at minimally invasive residency programs, there is a steep learning curve to
master these procedures. In addition, most programs do not provide the patient volume for a resident
to achieve the level of expertise that characterizes our surgeons.
A traditional spine surgeon would have to sacrifice his practice and be trained by a senior surgeon at a facility
specializing in these procedures. Many surgeons do not want to make that kind of commitment. While
similar procedures are offered by other practit ioners, our highly skilled surgeons are able to advance the
minimally invasive approach to spine care through their extensive experience at Laser Spine Institute.
The advancement that our surgeons practice here would take years to develop in other practices.
Q: How should I prepare for surgery?
A: If a patient is planning to have surgery, he or she must discontinue all anti-inflammatories, multi-vitamins,
and herbal supplements fourteen days prior to surgery. If a patient is taking anti-coagulates, such as
Plavix or Coumadin, he or she must obtain a clearance from their prescribing physician prior to discontinuing
those medications. Laser Spine Institute provides a medical consultation and clearance department
that will communicate with you over the phone and answer any questions that you may have in regards to
medication or treatment prior to arrival. Finally, every patient must bring a friend or family member to
accompany them for the day of surgery.
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Frequently asked questionsi
Q: When may I resume my normal/physical activity?
A: After experiencing endoscopic spine surgery at Laser Spine Institute, most patients are able to walk under
their own power the day of surgery. The next day is a day of rest and recovery. Finally, there is a
postoperative appointment, and then patients are discharged. Patients with a job that requires little or no
manual labor may return to that job within a matter of days. Our physicians will limit lifting to 15 pounds
for the first few weeks. Gradually, the patient may return to normal physical activity as their body strengthens
itself. Patients typically experience a full recovery in between four to six weeks. However, it is important
to follow the instructions of our licensed medical professionals as each patient has a different path to recovery.
Q: Is endoscopic spine surgery covered by healthcare insurance?
A: Laser Spine Institute accepts most insurance. Our team has worked with health insurance companies to
make our outpatient surgery more accessible to you. The result is that out-of-pocket expenses havedropped significantly over the past year. In fact, average out-of-pocket costs for Laser Spine Institute patients
have decreased from 90% to 30% since 2008.
To confirm your health insurance benefits, call today to speak to a Laser Spine Institute Patient Coordinator.
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Join our online community.
Find us on Facebook and become a fan
www.facebook.com/laserspine
Keep up to date on our blog
blogs.laserspineinstitute.com
Follow us on Twitter
www.twitter.com/laserspine
Find a free medical seminar in your area
www.SpineSeminar.com
Contact
www.LaserSpineInstitute.com
1-866-847-4816
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