Four Questions to Ask Before Spine Surgery

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If you’ve been told you need spine surgery, it’s smart to get a second opinion. Here are questions to ask any surgeon to help decide where to be treated.

Q: Do they have spine surgery specialists?

A: “For any problem, you want a team that specializes in that surgery, because more experience leads to better success rates,” explains Christopher J. DeWald, MD, spine surgeon. “At Midwest Orthopaedics at Rush, we have the largest team of neck, back and spine specialists in the region. And our surgeons are leaders in their field, teaching the techniques and procedures we have helped pioneer.”

Q: Do they offer less invasive options?

A: “Two-thirds of patients who come here expecting surgery, do not end up having surgery,” says April Fetzer, DO, physiatrist. “At Midwest Orthopaedics at Rush, we have experts in non-surgical alternatives, including injections, pain medicine and rehabilitation options. And, if surgery is needed, many of our spine surgeries are done minimally invasive, because our surgeons invented techniques used throughout the world.”

Q: How experienced are they at this procedure?

A: “Once you know the type of procedure they recommend, the next question is how many have they done?” asks Frank M. Phillips, MD, spine surgeon. “Spine surgery teams at Midwest Orthopaedics at Rush perform the same type of surgeries day in and day out. In fact, no spine surgery team in the region has more experience. And for surgery- especially complex surgeries—the more experience the better.”

Q:What are their success rates?

A: “Hospitals and surgeons are required to report their success rates for every surgical procedure,” explains Kern Singh, MD, spine surgeon. “So, it’s important to ask your surgeon about his or her success rates. The spine surgeons at Midwest Orthopaedics at Rush are very experienced and our success rates are among the best in the country. Which is one of the reasons why the orthopedic program at Rush is ranked among the nation’s best by U.S.News & World Report.”

The section of spine, back, and neck surgery at Midwest Orthopaedics at Rush is comprised of board certified orthopedic doctors, physician assistants and registered orthopedic nurse specialists. Together, this team of leading experts can help diagnose, evaluate and treat patients with varying degrees of neck pain and back pain. Our spine doctors are among the best in Chicago—and the nation—and can help relieve your neck pain or back pain.

Jamari’s Story

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Jamari’s diagnosis

Jamari Sanders’ mother, Sharenne Shumate, didn’t worry when Jamari returned with complaints of leg pain after a day of playing basketball at his uncle’s house. The eight-year-old said he had fallen, but Sharenne didn’t see any bones that appeared to be broken. Just to be sure, she took him to the nearest emergency room where doctors confirmed no broken bones, tendon or ligament tears. But two days later, when Jamari woke in the middle of the night in tears and complaining of pain, his mom knew something was very wrong.

After returning to a local doctor for more tests, Jamari was diagnosed with osteosarcoma of the right femur, or cancer in his right thigh bone. This is the most common form of bone cancer in children. Worried about Jamari’s spirits, Sharenne focused on finding a doctor who could both heal her son and continue to treat him like the strong, outgoing, and active little boy he is.

Finding a care team

Sharenne immediately contacted experts at Midwest Orthopaedics at Rushbecause she was familiar with Rush University Medical Center’s reputation. After a long visit, the family chose the team of Dr. Matthew Colman, orthopedic oncologist; Dr. Monica Kogan, pediatric orthopedic surgeon; Patti Piasecki, N.P., and Dr. Paul Kent, pediatric hemotology-oncology specialist at Rush University Medical Center. With the medical team decision made, Jamari and his family relocated from Wisconsin to Chicago to be closer to his care team.

As part of a carefully constructed treatment plan, Jamari began chemotherapy right away at Rush University Medical Center. Within a month, his tumor had shrunk by 95%, but Drs. Colman and Kogan discussed the importance of surgery to ensure that his cancer wouldn’t return. They approached Jamari’s family with two surgical options.

The first option was a series of several surgeries to remove the tumor and parts of the surrounding bone, then replacing that section with an implant. The procedure would mean lots of time in and out of the operating room and the possibility that the implant could break as he continued to grow. The second option was a rotationplasty, a procedure in which the knee joint is removed along with the tumor from the mid-thigh. Then, the lower leg, ankle joint, and foot – all unaffected by the tumor – are reattached backwards onto the remaining thigh bone. This allows the ankle bone, now rotated, to serve as the “new” knee joint and the foot to serve as an attachment point for a prosthetic lower leg.

Rotationplasty procedures are extremely unusual, with fewer than ten performed in the U.S. each year. This is because the diseases which make rotationplasty an option are rare and the nature of the procedure is unconventional. The procedure is typically the best option for very young children who still have significant growth remaining. This is not only because their bodies are more adaptable and resilient, but because the other main option, a metallic knee replacement prosthesis, is commonly associated with multiple complications and re-operations in this age group. Rotationplasty is complex and Drs. Colman and Kogan are among a short list of surgeons with the required skills to perform a successful rotationplasty.

Jamari’s medical and surgical team provided his family with research, websites, and videos which explained both procedures in layman’s terms. They even connected Jamari and his family with other patients who had had the procedure in the past. The family took a leap of faith and decided on the rotationplasty procedure.

“I would do it all again with the same team of doctors, nurses, and social workers,” Sharenne explained. “They gave us all the resources we needed to make the best decision.”

Sharenne was confident that the doctors, her son’s strength of spirit, and the support of her family would result in a successful outcome. “Rush really accommodated Jamari and our family,” Sharenne explained. “They made sure that we had a room big enough for all of us to be together on the day of the surgery. They gave us an update through every step of the procedure. Dr. Colman spoke with us immediately after the surgery to tell us that things went well. That meant the world to us.”

Wearing a cast to stabilize his new knee joint, Jamari underwent one more round of chemotherapy and then began physical therapy to build up his strength and get accustomed to walking with his new joint and prosthetic leg.

Reflecting on Jamari’s journey

“He’s been much stronger than we have,“ Sharenne says. “He has stayed positive and worked very hard to turn a tough situation into the best possible outcome.”

When she reflects on her family’s journey, Sharenne is almost at a loss for words when she talks about the Midwest Orthopaedics at Rush medical team. “They’re just amazing. I am in awe. This whole experience made us appreciate life and the little things. It is clear to us that God touched the doctors’ hands to do such an awesome thing for Jamari.”

While he’ll need to be watched regularly for the next five years, Jamari, who’s now 10, is excited to join his friends back at school this fall and to continue being the bright, active boy that he has always been.

For more information on rotationplasty or treating bone tumors, contact Dr. Colman’s office at 877-MD-BONES.

Matthew’s Story

Matthew Lee, 22, of Oak Park, discovered his passion for playing lacrosse at a youngmatthew lee age. Although he also excelled in baseball and tennis, it was the ‘brotherhood’ of lacrosse that drew him into the sport.  Playing lacrosse gave him a supportive foundation throughout his years at Oak Park River Forest High School and when it was time to make college decisions, his love of lacrosse played a big part. He enrolled at Beloit College in Beloit, WI and joined its NCAA Division III lacrosse team.

College life and lacrosse were going very well for Matthew until his spring break trip to Washington, DC his sophomore year. This was a special time during which the team had an opportunity to scrimmage against the U.S. Naval Academy. While attempting a shot on goal, Matthew fell on his hand and wrist. He immediately felt a ‘pop’ followed by intense pain and swelling. To his disappointment, the team’s trainer had to sideline him for the rest of the trip.


After returning to Wisconsin, he was evaluated at a local hospital where he was diagnosed with a fracture to the scaphoid bone, one of several small bones in the wrist. He was casted for six months and then underwent occupational therapy. It was tough time, but he looked forward to returning to lacrosse.

A Second Opinion

Unfortunately, after the cast was removed, he still felt pain and an unusual grinding sensation in his wrist. Matthew felt something was still wrong and his mother insisted they get a second opinion. After researching several specialists, they chose Dr. John Fernandez, a hand, wrist, and elbow specialist at Midwest Orthopaedics at Rush. They liked Dr. Fernandez’s reputation for treating high level athletes and for performing particularly challenging cases.  Coincidentally, Dr. Fernandez also has three sons who play lacrosse and is a big fan of the sport himself. He immediately connected with Matthew and understood his frustration.

Dr. Fernandez carefully assessed Matthew’s wrist.  He used simple measures like examining the normal side which no one had done previously.  He also used high-tech techniques including examining his wrist under a live video xray to see what the wrist was doing in real time and under stress. This led to the discovery that Matthew hadn’t suffered a wrist fracture at all.  Instead, he had torn a very important ligament in the wrist.

This ligament is a crucial connection between the carpal bones in the wrist. Without it healing, Matthew would likely have continued problems, including long term arthritis and disability.  This would make it hard for him to use his hand for simple tasks, much less playing lacrosse. He explained that Matthew needed surgery to repair the torn ligament and restore function. This was devastating news because it meant more time away from lacrosse.

“Even though it was tough to hear that the casting period was a waste of time, Dr. Fernandez and his amazing physician assistants were so helpful throughout the whole process.”

Dr. Fernandez recommended a technically demanding and unusual surgery to reconstruct the scapholunate ligament of the wrist. This required transplanting one of Matthew’s tendons to replace the ligament he had lost.  Stainless steel pins would be used across the bones to maintain alignment during the recovery process. This cutting-edge technique was designed for higher demand individuals with and a better success rate.

Complicating matters further, before his surgery Matthew fell and injured his other wrist. This time he truly did fracture his scaphoid bone.  But, instead of casting it, Dr. Fernandez suggested a method of repairing the bone internally with a screw. This would then act as an internal cast and decrease healing time.

Now, the stakes were higher. Matthew required a staged surgical approach so that he could use one of wrists during the healing process, but not compromise the outcome. Several surgeries and nine months of recovery were needed to make this work.  Dr. Fernandez and Matthew confidently agreed to take this plan head on. As hoped, the surgeries were successful and Matthew’s recovery was smooth.  Finally, eighteen months after his initial injury, Matthew was functioning well and pain free. He finally scored his ‘goal’ — with Dr. Fernandez making the assist.

Back on the Field

Dr. John Fernandez

Dr. John Fernandez

After a long time away from lacrosse, Matthew was able to join his teammates back on the field during his senior year. “I was able to score over 25 points this season and could not be more thankful to Dr. Fernandez, his PAs, and MOR for making my senior year a great one to remember,” he says.

During this process, Matthew received a unique look into the practice of orthopedics and expressed an interest in a career as a physician assistant. Dr. Fernandez admits that he has seen this happen before and encouraged Matthew to follow his passion. He hopes that one day Matthew will be able to pay it forward by performing a surgical assist of his own to help someone else score their goals.

To schedule an appointment with Dr. John Fernandez, call 877-MD-BONES.

Furniture Refinisher Restored After Successful PRP Treatment

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When asked how important having a pain-free elbow is, professional furniture refinisher Bill Belmonte, 48 of Westmont, IL replied, “on a scale from 1 to 10, it’s 100.”

Four years ago when Belmonte started having elbow pain, he feared what it might mean for his future. He worried that his affected elbow would sideline him from his recreational activities, like coaching youth baseball and skiing; but he was most concerned that his livelihood as the owner of a furniture restoration company was in jeopardy. “I didn’t know what the future was going to look like if the pain didn’t go away,” he explained.

His everyday work tasks such as sanding, painting, lifting and manipulating furniture was a struggle. Eventually, just writing at his desk hurt and the pain migrated to his shoulder. This really concerned him and he knew ignoring the problem was only making it worse. Belmonte saw a physician who diagnosed him with epicondylitis, also called ‘tennis elbow.’ His physician told him that in most cases, this condition resolves itself with rest. But, with the physical demands of his job, Belmonte didn’t consider rest an option. “I don’t have a desk job,” he explains. “In my very physical line of work I use my elbow all the time and using it is how I support my family.”

While at work one day, Belmonte became engaged in conversation with a client who noticed the band on his elbow and recommended that he see Midwest Orthopaedics at Rush sports medicine physician Dr. Nikhil Verma.

He took the advice and made an appointment with Dr. Verma who encouraged Belmonte to try platelet-rich plasma (PRP), a concentrated source of healing factors taken from a patient’s own blood. He explained that after a blood draw, platelets and liquid plasma are separated out in something called a centrifuge. Then, the platelets and plasma are re-injected into the injured area to stimulate and maximize healing.

Belmonte agreed to the treatment and afterward, he quickly saw improvement. “All of a sudden [within a week],” he explained, “I could do things without pain that I couldn’t do before.”

“I could do things without pain that I couldn’t do before.” 

Since then, he has repeated the PRP treatment to address some lingering pain and after which he has experienced even more improvement in pain reduction and mobility. “I’ve been recommending [PRP] to everyone I know,” he jokes.

He’s come a long way from taking daily pain medication and barely able to turn a steering wheel. Belmonte is now happily back fully to his daily work and passions.