5 Reasons Why Outpatient Spine Surgery Is Here To Stay From Dr. Kern Singh

human spine

Dr. Kern Singh, co-founder of the Minimally Invasive Spine Institute at Rush in Chicago, recently penned an article on the safety of outpatient spine surgery for Vertebral Columns, a publication of the International Society for the Advancement of Spine Surgery.

The article responds to a USA Today and Kaiser Health News article highlighting the risk of cervical hematoma after outpatient spine surgery, among other potential complications after outpatient surgery. Here are five key points.

1. As technology advances, it has become safe to perform more complex spine surgeries in the outpatient setting, which is typically a lower cost setting. “Outpatient surgery centers are more easily accessible than large facilities, and the streamlining of services allows for maximum efficiency and minimal wait times,” he wrote. “These advantages have led to outpatient surgery centers achieving an overall patient satisfaction rate of 92 percent.”

2. Spine-focused ASCs have staff who are trained in outpatient spine surgery and focused on providing the high quality care for patients.

3. Complications are a concern for surgeons regardless of the operative setting, but especially for the outpatient setting because the staff are not equipped to handle a life-threatening complication. ASCs and surgeons should have an action plan to transfer patients to the hospital quickly if there are signs a complication occurred.

“Though rare, a cervical hematoma can develop in the first few hours after surgery,” wrote Dr. Singh. “For this reason, patients in the outpatient setting are monitored closely during the immediate postoperative period so emergent treatment can be initiated if needed.”

4. Dr. Singh cited an article published by McClelland et al., showing complication rates among outpatient cervical fusion patients from 1996 to 2016. The complication rate was 1.8 percent and mortality rate was 0.1 percent, much lower than up to 5 percent rates that have been associated with hospital-performed cervical fusions.

5. According to Dr. Singh, most ASCs where surgeons perform outpatient spine procedures are owned and operated by hospitals or health systems; however even among centers owned by surgeons, the surgeons have an obligation to prioritize patient safety.

“Surgeons must rigorously assess a patient’s eligibility for outpatient surgery, as pre-existing conditions may put patients at a higher risk for complications,” he wrote.

He argues that surgeons who are proficient in outpatient spine techniques and responsible patient selection can safely perform the appropriate procedures in the ASC and achieve high patient satisfaction as well as positive outcomes.

How Stem Cells Will Shape Tomorrow’s Health Care

Experts discuss stem cell treatments for cancer, neurosurgery, orthopedics, pediatrics:

The use of stem cells in medical treatments already is yielding exciting results and may yield greater medical advances in the future. At a recent event hosted by Rush University Medical Center, experts at Rush discussed the role of stem cells in neurosurgery, orthopedics, pediatrics and oncology and how their breakthrough research may dramatically improve the lives of people afflicted by disease and severe injury. An edited transcript of that discussion appears here: https://www.rush.edu/news/how-stem-cells-will-shape-tomorrows-health-care.

Larry Goodman, MD, CEO of Rush University Medical Center and the Rush system, moderated the conversation. The panelists included Brian Cole, MD, MBA, professor in the Department of Orthopedic Surgery and section head of the Center for Cartilage Restoration at Rush; Richard G. Fessler, MD, PhD, professor in the Department of Neurological SurgeryTimothy M. Kuzel, MD, chief of the Division of Hematology, Oncology and Cell Therapy; and Anna Spagnoli, MD, the Woman’s Board Chair of the Department of Pediatrics.

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Weightlifter Gets Her “World Class” Shoulders Back

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As a four-time national masters weightlifting champion, Chicagoan Gwen Chamberlin is an athlete whose success in the sport came later in life. After starting Crossfit, Gwen slowly gravitated toward weightlifting at the age of 45. One decade later, she’s developed an impressive resume in the world of competitive weightlifting – even after overcoming a few obstacles along the way.

A few years ago, the demands of the sport began to affect her shoulders. She sought general medical advice at first before realizing she needed more extensive care. Her physical therapist recommended Dr. Gregory Nicholson, a sports medicine shoulder specialist at Midwest Orthopaedics at Rush. After meeting him, Gwen was impressed with his experience in shoulder care and his supportive attitude. “He didn’t treat me like an old lady. He treated me like an athlete,” she shares.

Dr. Nicholson diagnosed her with a torn supraspinatus tendon and posterior cuff. The supraspinatus muscle is located on the back of the shoulder and is part of the three muscles that make up what is referred to as the rotator cuff, which helps to lift and rotate the arm. Rotator cuff repair surgery reattaches these muscles to the bones of the shoulder.

Dr. Nicholson recommended repair surgery to get her back to health and back to the gym. After undergoing surgery with Dr. Nicholson, Gwen found that the recovery time away from the gym was well worth it. In fact, she achieved her personal lifetime best weight lift.

Despite a newly repaired and thriving shoulder, she started to experience nagging pain in her other shoulder, threatening her goals. Naturally, Gwen went back to Dr. Nicholson. Almost two years to the day after her first surgery, he performed a second rotator cuff surgery on the opposite shoulder, during which he also discovered the need to repair the bicep muscles.


“I am so grateful that I’m now back to health and competing with what he calls my ‘world class shoulders.’”


Today, Gwen is showing no signs of slowing down. Within eight months of her second shoulder surgery, she was back lifting at full strength and with full range of motion. This allowed her to prepare for the Masters National Championship this month. She’s also set to compete in the Pan American Masters in June and the Masters World Championship in August.

“Dr. Nicholson is one of the best,” Gwen explains.

To schedule an appointment with Dr. Gregory P. Nicholson, call 877-MD-BONES. For more information about keeping your shoulders healthy, visit www.shouldersforlife.org or https://chicagoshoulderdoc.com/.

FAI Patients Who Practice Yoga Respond Well to Surgery

person doing yoga

Femoroacetabular impingement (FAI) is a painful hip condition that is most often diagnosed in younger patients who perform activities that require hip flexibility, like yoga. In patients with FAI, extra bone develops along the acetabulum (socket of the hip) or on the femoral head (ball of the hip). This bony overgrowth damages the soft tissues of the hip during movement. This condition can be effectively treated with hip arthroscopy, a surgical process during which a small camera and tiny instruments are inserted into a narrow incision to treat the affected area.

Midwest Orthopaedics at Rush hip arthroscopy specialist, Dr. Shane Nho, has been following hip arthroscopy patients who practice yoga to identify at what rate they returned to yoga after the procedure. The study reported that a full 93% of patients were able to return to yoga approximately 6 months post-surgery.

See the full study published in SAGE Journals here.

Competitive Ice Hockey Player Kicks Foot Injury

From Midwest Orthopaedics at Rush University Medical Center

Last year, Holly Barocio, 34 of Chicago, skated with gusto onto the ice, ready to defendHolly2.jpg her co-ed hockey team’s championship title. She never thought that rather than skating away with a trophy in hand, she would be carried off the ice by an ambulance.

Holly remembers the moment she was injured vividly. “Every part of me went left except for my foot. My blade got caught in a groove in the ice and I immediately felt acute pain. After that, I think I was in a state of shock trying to understand what happened.”To make matters worse, her team lost by a two point margin. She says it didn’t help that her teammate and husband, Jason, also left the game when he accompanied her to the hospital. “My husband and I have this brain synergy. We always know where the other is on the ice without even looking.”

At the emergency room, Holly was told she had a clean break and likely wouldn’t need surgery. However, she was not confident in this assessment and sought a second opinion.

“Without a doubt Rush kept coming up, specifically Dr. Kamran Hamid’s name,” she explains. “I liked him right out of the gate; he had great bedside manner and a level of attention and care that I found unique.”


“I liked him right out of the gate; he had great bedside manner and a level of attention and care that I found unique.”


Dr. Hamid took thoughtful measures to consider how Holly’s treatment would affect her commitment to return to hockey. He performed a “Stability Test” to definitively determine whether she needed surgery or not. The results confirmed that her ankle was unstable and would benefit from a surgery.

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Dr. Hamid used a special low-profile metal plate that he felt would best accommodate Holly’s ability to skate. This plate lies closer to the bone to have less irritation with a skate while still providing excellent stability.

Holly’s recovery revolved around her passion for hockey. “I was direct with Dr. Hamid and told him, this is not a deterrent for me. I will return to hockey.” In fact, she was determined to help her team qualify for playoffs. “I am going to play hockey again no matter what. That is how much I enjoy the sport,” she remembers telling Dr. Hamid. “I have a hard time seeing myself as a non-hockey player.”

Now, equipped with her newly repaired ankle, Holly has officially returned to her second home on the ice and reports, “I have been smiling non-stop! No pain, no discomfort.”