New York City Spine

For any inquiries call 212-506-0240

Manhattan Office

New York City Spine Surgery, PLLC
343 West 58th Street
New York, NY 10019
Call: 212-506-0240
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NJ Office

New York City Spine Surgery, PLLC
261 James Street, Suite 2G
Morristown,
NJ 07960
Call: 973-998-9651
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HISTORY

  • The patient is a 68-year-old male, British banker, with diabetes and severe sacroiliac pain after a prior spinal fusion. He had terrible difficulty negotiating uneven terrain and difficulty with prolonged sitting.

PHYSICAL EXAM

  • The patient had severe gluteal spasms and quadriceps weakness.
PREOPERATIVE IMAGING

AP and lateral X-rays, showing severe SI (sacroiliac joint) arthritis and L3-4 adjacent segment degeneration in the setting of a prior L4-S1 decompression and fusion

DIAGNOSIS

  • Sacroiliac (SI joint) arthritis as a result of adjacent segment degeneration

SURGERY

  • MIS (minimally invasive surgery) SI (sacroiliac) fusion with percutaneous screws and L3-4 XLIF (extreme lateral interbody fusion) with lateral plate
  • One hour of operative time
  • 20 cc blood loss
POSTOPERATIVE IMAGING

AP fluoroscopic images showing three screws across the right and left SI (sacroiliac) joints placed through a minimally access tubular retractor under fluoroscopic guidance with preservation of the gluteal muscles.

POSTOPERATIVE IMAGING

AP and lateral X-rays showing three screws across the right and left SI (sacroiliac ) joints and L3-4 interbody cage and plate placed through a muscle splitting corridor through the iliopsoas muscle (hip flexor), avoiding muscle stripping of the posterior lumbar musculature.

OUTCOMES

  • The patient was discharged home four hours after surgery on mild oral pain medications.
  • In a patient with his characteristics (diabetic and high-level banker), correct diagnosis and MIS surgery allowed us to perform two different surgeries in the same sitting. MIS surgery via a lateral approach avoided massive muscle stripping and increasing scar formation in classic revision spine surgery. MIS surgery for the sacroiliac joint avoided gluteal muscle stripping.
  • The patient was able to sit and return to his job the following day.
  • Note that in a patient with this complex picture, correct diagnosis and surgical planning are critical for optimal results.
***Disclosures

Hospital Affiliations

Outpatient Surgery Centers

Malo Surgery Center 201 Route 17 North 12th floor
Rutherford, NJ 07070
Phone: 201-549-8890
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Midtown Surgery Center 305 East 47th St.
New York, NY 10017
Phone: 212-751-2100
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Advanced Spine Surgery Center 855 Lehigh Ave,
Union, NJ 07083
Phone: 908-557-9420
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Denville Surgery Center LLC3130 Route 10 West
Denville, NJ 07834
Phone: 973-328-3475
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Daveed D. Frazier, MD is the medical director of New York City Spine Surgery PLLC and specializes in non-surgical and minimally invasive surgical treatments for back/neck pain and spine-related disorders. New York City Spine Surgery PLLC has 2 main locations in New York City and New Jersey with the main office located at 343 West 58th Street, New York, NY 10019. Call 212-506-0240 for an appointment at either location. Fax 212-265-0739.