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EXPERIENCE LEADS TO EXPERTISE WILLIAM J. SONSTEIN, MD, FACS, Senior Partner at Neurological Surgery, P.C., Chief of Neurosurgery at North Shore-LIJ Plainview Hospital, earned his medical degree from Temple University School of Medicine and completed a general surgery internship and neurosurgical residency at Montefiore Medical Center, the University Hospital for Albert Einstein College of Medicine, where he was also Chief Resident in the Department of Neurosurgery. Dr. Sonstein concluded a prestigious fellowship in spine surgery at Tampa General Hospital, which is affiliated with the University of South Florida College of Medicine. His extensive neurosurgical training has led Dr. Sonstein to author and co-author numerous book chapters, journal articles and scientific abstracts. He is also committed to advancing the practice of neurosurgery, and to that end, he has participated in various clinical trials. Providing care for the spectrum of spine injuries, including traditional herniated disc repair and laminectomy, Dr. Sonstein uses minimally invasive approaches whenever indicated to reduce blood loss and postoperative pain, which lead to reduced hospitalization. A board-certified Diplomate of the American Board of Neurosurgery, Dr. Sonstein also holds membership in the American Association of Neurological Surgeons, the Congress of Neurological Surgeons and the North American Spine Society. Additionally, Dr. Sonstein seeks to advance local medical care through membership in the Nassau County Medical Society and the Nassau Academy of Medicine. For more information about Dr. Sonstein, visit nspc.com/dr.sonstein.html. "There aren't many devices that have improved spinal surgery outcomes with their introduction," he says. "The basic tools we use haven't changed dramatically in the last 25 years. But the Medtronic Aqua ma nt ys System a nd Misonix Ultrasonic Surgical Aspiration System have revolutionized some of the things I do. They address two of the major complica- tions commonly associated with revision spine surgery — blood loss and spinal fluid leakage. I use these devices for nearly every spine surgery I perform." The Aquamantys System uses trans- collation technology to hemostatically seal soft tissue and bone, which reduces blood loss and transfusion rates and saves operative time. Transcollation — the transmission of radiofrequency energy to cauterize blood vessels in tandem with continuous application of saline to the ves- sels' surface — quickly shrinks veins, which prevents excessive burning and achieves optimal hemostasis. Previous electrocautery devices didn't allow wide coverage areas, which extended procedural time. "The Aquamantys covers a wide sur- face area, so you're able to shrink many blood vessels to allow faster and more efficient surgeries that reduce blood loss," Dr. Sonstein says. The Aquamantys System is used in a number of additional spine surgeries, including anterior lumbar interbody fusion, decompression, discectomy, laminectomy, transforaminal lumbar interbody fusion (TLIF), posterior cervical laminectomy and fusion, posterior lumbar interbody fusion (PLIF), scoliosis surgery, and minimally invasive TLIF. Better Bone Emulsification When surgeons resect bone around critical structures, such as the spinal cord and the nerve bundles located within the spinal column, their sharp tools can cause serious complications if even the slightest targeting discrepancies arise. Biting instru- ments and high-speed drills have sharp edges that can tear proximal soft tissue and critical nerve bundles. Dr. Sonstein uses ultrasonic emulsification equipment for precise maneuvering that spares soft tissues, reduces bleeding and preserves bone. Ultrasonic devices feature blunt metal tips that rapidly vibrate in two directions. Because there are no sharp surfaces on the tips, ultrasonic emulsification devices allow Dr. Sonstein the capability to navigate small spaces in the spinal canal without having to protect critical structures from catching on the tip of a serrated edge. "Ultrasonic devices address the bone, not the soft tissue," Dr. Sonstein says. "This allows me to decompress the nerves by going over them without having to worry about affecting the nerve or soft tissue. In many revision procedures, we encounter significant amounts of scar tissue, which attaches to neural tissue. This makes approaching the compressed nerve challenging and can lead to tears during the decompressions and dissections required to access the surgical site. These are common complications, occurring in approximately 10 to 20 percent of revision procedures, but ultrasonic bone emulsification devices greatly reduce the risk of such complications." Hand tools and high-speed drills remain important components for spine surgery, but treating with the instruments requires sculpting bone around nerves to Dr. Sonstein analyzes a lumbar MRI scan. M D N E W S . CO M ■ MD NEWS Long Island | 7