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.

5 Ways Movement Enhances A Parkinson’s Disease Diagnosis

By Erica Hornthal, MA, LCPC, BC-DMT; CEO Chicago Dance Therapy

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I’m not here to tell you why exercise or a certain type of activity like dance or yoga, is beneficial.  Anyone can type “PD and exercise” into Google and read one of 63 million results. What I would like to share are the psychosocial implications that arise from engaging in movement.  How movement enhances our emotional, social, and cognitive well-being is imperative following a diagnosis of Parkinson’s disease.

Movement, our earliest form of communication, seems to be taken for granted only until we see it deteriorate or are faced with a degenerative disease that reminds us that our movements are so much more.  They are a connection to ourselves and our environment. Engaging in movement is not just about maintaining our physicality, but about preserving our existence.


Assists in symptom management: Research has shown that movement can help manage problems with gait, balance, tremors, flexibility, and coordination.  Improved mobility has been shown to decrease the risk of falling as well as other complications from PD. This often occurs because the brain is learning to use dopamine more efficiently.  

Promotes self-awareness and identity: Every person has a different way of moving and certain affinities toward movement.  It is those differences that promote a capacity for introspection and the ability to stand out as an individual.  Muscle memory even has the ability to tap into memories stored in the brain. Movement has the ability to retain our memories and create new ones.  

Maintains a sense of control: Connection to our breath, the most primitive form of movement, enables us to control our pulse rate, circulation, and even our thoughts.  This is so important for when we feel like things are out of our control or when our body is not functioning the way we would like, we have the power through our own breath to take back a sense of control.  

Builds psychological resilience: Movement has the ability to actually increase our adaptability to stress and adversity.  Reinforcing our own connection to the body empowers our psyche and encourages inner core strength.  This core I’m referring to isn’t your abdominals, but rather your identity. Connecting to the muscles in your chest, torso, and pelvis tap into your belief system, identity formation, and personality.

Maintains social connections: From early on in human existence, there is documentation of celebration and rejoicing through song and movement.  Movement has the ability to connect us with others without verbal communication. We can join in someone’s experience just by witnessing and empathically embracing their body language.


These 5 ways in which movement enhances our mind body connection are just the tip of the iceberg.  Movement is more than just exercise and physical fitness. Movement is body language, expression, and creativity.  Movement is an innate part of being human and just because that ability changes when diagnosed with PD, that does not mean that we should give up all that it entails.  It is even more imperative that we engage in movement to preserve that very part of who we.

Erica Hornthal is a licensed professional clinical counselor and board certified dance/movement therapist. She received her MA in Dance/Movement Therapy and Counseling from Columbia College Chicago and her BS in psychology from University of Illinois Champaign-Urbana.  

Erica is the founder and president of North Shore Dance Therapy and Chicago Dance Therapy. As a psychotherapist in private practice, Erica specializes in working with older adults who are diagnosed with dementia and movement disorders. Her work has been highlighted nationally in Social Work Magazine, Natural Awakenings, and locally in the Chicago Tribune as well as on WCIU and WGN.  


Parkinson’s Awareness Month: #StartAConversation

Every April, the Parkinson’s Foundation engages the global Parkinson’s community to support Parkinson’s Awareness Month. When we raise awareness about Parkinson’s and how the Foundation helps make lives better for people with PD, we can do more together to improve care and advance research toward a cure.

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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10 Reasons To Go For A Walk Right Now

On an average day, 30 percent of American adults walk for exercise and with good reason. Walking doesn’t require special equipment or athletic skills, yet it offers a host of health benefits — from helping you lose weight and lifting your mood to controlling diabetes and lowering your blood pressure. In fact, a study published in the journal PLoS Medicine showed that adding 150 minutes of brisk walking to your routine each week can add 3.4 years to your lifespan.

Here are 10 surprising ways to use walking to boost your health, along with tips to make starting and sticking to a walking routine more fun.

1. Walk to Manage Your Weight
Avoiding weight gain might be as simple as taking a walk. Researchers at Harvard University and Brigham and Women’s Hospital in Boston followed more than 34,000 normal-weight women for more than 13 years. They found that, over time, the women who ate a standard diet and walked for an hour a day (or did some other similar moderate-activity exercise) were able to successfully maintain their weight.

Fun fitness tip: Buddy up for fitness — walk with a friend, neighbor, or a four-legged pal. A study published in the Journal of Physical Activity & Health found that dog-owners walked more each week and were more likely to reach the recommended levels of physical activity than those who do not own dogs.

2. Walk to Get Blood Pressure in Line
A heart-pumping walking routine can help lower your blood pressure, studies show. A study conducted at Lawrence Berkeley National Laboratory found that moderate-intensity walking was just as effective as jogging at lowering risk of high blood pressure.

Fun fitness tip: Can’t find a full 30 minutes to walk? Spread it out throughout your day — 10 minutes here and 10 minutes there will add up if you stick with it. According to the Center for Disease Control and Prevention, breaking your workout into several shorter workouts throughout the day is just as effective as one longer workout session, while also making it easier to fit exercise into your schedule.

3. Walk to Protect Against Dementia
Walking, which improves cerebral blood flow and lowers the risk of vascular disease, may help you stave off dementia, the cognitive loss that often comes with old age. According to the 2014 World Alzheimer’s Report, regular exercise is one of the best ways to combat the onset and advancement of the disease. In addition, researchers at the University of Pittsburgh conducted brain scans on seniors and found that walking at least six miles a week was linked to less brain shrinkage.

Fun fitness tip: Download upbeat music you love to listen to on your iPod, and take it with you while you walk. An analysis conducted by the American Council on Exercise found that music not only makes exercise more enjoyable, but it can also boost endurance and intensity.

4. Walk to Prevent Osteoarthritis
Walking is a great form of weight-bearing exercise, which helps prevent the bone-thinning condition osteoporosis, as well as osteoarthritis, the degenerative disease that causes joint pain, swelling and stiffness. Researchers from the University of California, San Francisco, found that people who participated in moderate aerobic activities such as walking have the healthiest knees because walking can help maintain healthy cartilage.

Fun fitness tip: Reward yourself. After you stick to your new walking routine for a few weeks, treat yourself to a new pair of shoes, a manicure, or something else that will keep you motivated.

5. Walk to Reduce Cancer Risk
Walking may reduce your chances of developing some cancers. Research published in Cancer Epidemiology, Biomarkers & Prevention found that women who walked at least seven hours per week were 14 percent less likely to develop breast cancer. Similarly, a study conducted by scientists at the University of California, San Francisco and Harvard University, found that men who were treated for prostate cancer and who walked briskly at least three hours a week reduced their chances of a recurrence.

Fun fitness tip: Explore. Try a new route around the neighborhood, pick a different trail at the park, or go walking in a new location altogether to keep it interesting.

6. Walk to Prevent or Control Diabetes
Brisk walking can help prevent and manage diabetes. “A 20- to 30-minute walk can help lower blood sugar for 24 hours,” says Tami Ross, RD, LD, a spokesperson for the American Association of Diabetes Educators. Plus, The Diabetes Prevention Program, a major government study, found that even a small weight loss — for example, 10 to 15 pounds for a 200-pound person — can delay and possibly prevent the onset of the disease. Adding a brisk walk to your daily routine is one of the easiest ways to reach and maintain a healthy weight.

Fun fitness tip: Dress for the occasion. A good pair of walking shoes and comfortable clothes that are easy to move in are essential for a successful workout.

7. Walk to Lower Your Heart Disease Risk
Walking may help lower your cholesterol and, in turn, your risk for heart disease. According to the American Heart Association, walking just 30 minutes per day can lower your risk for heart disease and stroke. And since regular walking can keep cholesterol and blood pressure in check, it is a great way to boost your overall heart health.

Fun fitness tip: Challenge yourself to walk more steps every day and make fitness more fun, by using a pedometer or other fitness tracking device to chart your progress. You can set new step goals each week and even join challenges with friends and family to motivate yourself to get moving.

8. Walk to Improve Your Mood
A brisk walk can boost your mood and may even help you treat depression. A Portuguese study published in the Journal of Psychiatric Research found that depressed adults who walked for 30 to 45 minutes five times a week for 12 weeks showed marked improvements in their symptoms when medication alone did not help.

Fun fitness tip: Get outdoors! When the weather permits, take your walk outside, for a dose of vitamin D and an even bigger mood boost. Research published in the journal Ecopsychology revealed that group walks in nature were associated with significantly lower depression and perceived stress, as well as enhanced mental well-being.

9. Walk to Reduce Pain
It might seem counterintuitive, but to reduce pain from arthritis, start moving. Research shows that walking one hour per day can help reduce arthritis pain and prevent disability. The study, published in Arthritis Care & Research, determined that 6,000 steps was the threshold that predicted who would go on to develop disabilities or not. Plus, a recent study found that walking significantly improved mobility loss among patients with peripheral artery disease (PAD), a condition where clogged arteries in the legs can cause pain and fatigue while walking.

Fun fitness tip: Add some healthy competition to your walk. As you move down the sidewalk or trail, imagine the people in front of you are rungs on a ladder. Then, focus on walking fast enough to overtake them one by one.

10. Walk to Reduce Stroke Risk
A large, long-term study reported in Stroke, a journal of the American Heart Association, found that women who walked at a brisk pace for exercise had a much lower chance of having a stroke than those who didn’t walk. Researchers credit this to walking’s ability to help lower high blood pressure, which is a strong risk factor for stroke.

Fun fitness tip: Join or start a regular walking club with friends or coworkers and make fun fitness plans for your outings. Recent research published in the British Journal of Sports and Medicine found that participants were enthusiastic, less tense and generally more relaxed after regular, organized walking groups.

By Beth W. Orenstein for Huffington Post

The Runner’s High

By Dev Mishra, M.D., President, Sideline Sports Doc, Clinical Assistant Professor of, Orthopedic Surgery, Stanford University

Key Points:

  • When your body comes under stress or experiences pain, neurochemicals called endorphins and endocannabinoids are produced in the brain. This happens in all age groups.
  • Endorphins and endocannabinoids are considered natural painkillers because they activate receptors in the brain that help minimize discomfort
  • These brain chemicals are naturally produced as a result of exercise and are likely responsible for the feeling called “a runner’s high”

Whether you’re a young athlete or an adult, many of you have experienced a post-workout high. People love the feeling so much that “endorphin junkie” has even become synonymous with someone who’s constantly chasing that exercise high.

When your body experiences physical or even emotional stress, neurochemicals called endorphins are produced in the brain. Endorphins, which are structurally similar to the drug morphine, are considered natural painkillers because they activate receptors in the brain that help minimize discomfort. They can also help bring about feelings of euphoria and general well being.

The idea that exercise creates a huge endorphin rush entered popular culture soon after endorphins were discovered around 40 years ago. The legendary Dr. Jim Fixx started America’s running revolution back in the 1970’s, and there was thinking that endorphins could play a big role in the psychological benefits of running and exercise. But no one really knew for sure.

The problem with jumping to the conclusion that endorphins cause your “exercise high” is that in large-scale studies, scientists measure endorphins present in the blood — not the brain. Then, they make the assumption that if endorphin levels rise in the blood, then it must be because of an increase of endorphins in the brain. It’s a logical assumption but the reality is a bit more complex.

In fact, a German study found that, while endorphin levels are higher after a run, the real brain chemicals responsible for the runner’s high are called “endocannabinoids”. These substances are similar to the key chemical in marijuana. At least that’s true in running mice, who kindly volunteered for the study…

So if you aren’t an endorphin junkie, then what are you? You’re probably an endocannabinoid junkie! That just doesn’t have the same nice ring to it though, does it?

Regardless of what the actual reason is for the good feelings after exercise, the point is that you need to just get out and do something. It’s good for what ails you.

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