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"I provide a number of options to treat spinal disorders — particularly degenerative spine disorders and failed back surgeries — that promote optimal outcomes. When frontline, conservative treatments fail, I implement a complete armamentarium of tools to correct spine problems in the safest and most effective manner possible, with reduced blood loss and surgery time." — William J. Sonstein, MD, FACS, Senior Partner at Neurological Surgery, P.C., Chief of Neurosurgery at North Shore- LIJ Plainview Hospital PLIF surgery requires Dr. Sonstein to remove the lamina of the unstable vertebrae and retract the nerves within the bone. He shaves the cartilage and forms an open space within the vertebra, in which he places a spacer made up of bone, a cage or an artificial plastic device filled with bone material to foster bone growth around the segment. "Spacing devices provide better fusion between two bones because I can fuse more of the spinal surface," Dr. Sonstein says. "To get the spacers in, a good amount of the joint has to be removed, which means the spine has been destabilized. We augment that with pedicle screws, which go through the bridge between the front and back of the spine, and connect the screws with rods." Patients spend several days in the hospi- tal, and although full spinal recovery can take months, patients often feel less pain before the bones fully heal. Operating in Concert Dr. Sonstein performs revision pro- cedures in tandem with an orthopedic surgeon. The different but overlapping training each specialist brings to the operat- ing table enhances surgical efficacy. "You need two people to operate on the spine," Dr. Sonstein says. "It's important to collaborate with an orthopedic spine surgeon for these procedures because there are two sides to the spine. Operating with a good assistant who understands how to retract without damaging nerves and allows safe decompression to prevent spinal fluid leaks is critical to optimal outcomes. When you've been working together for a long time, you learn to anticipate each other's maneuvers, so it's much safer for the patient." Each surgeon assists to perform certain maneuvers required by dif- ferent procedures. For example, in a PLIF operation, surgeons operate on either side of the spine, placing screws simultaneously for more efficient and safer surgeries that reduce anesthesia time, reduce blood loss and promote optimal outcomes. For more information about revision spine surgery at NSPC, visit nspc.com. ■ COV ER FE AT UR E R E A D I N G B E T W EEN T H E R E V I S I O N R AT ES SURGICAL REVISION FOR failed back syndrome can result from unresolved pain following the initial surgery, device failures or surgical complications. William J. Sonstein, MD, FACS, Senior Partner at Neurological Surgery, P.C., Chief of Neurosurgery at North Shore-LIJ Plainview Hospital, notes that when he meets patients who have undergone previous surgeries but found no relief, "they are miserable because of persistent pain or weakness" and are often willing to consider another operation. A study in the journal Spine found that approximately 19 percent of patients who underwent spine surgery required revision within 11 years. Of these, most needed the additional procedure to treat the same cause of pain symptoms prompting the original surgery. Studies in Acta Neurochirurgica and Spine show that success rates for revision surgeries stand between 30 and 35 percent nationwide. To achieve greater success rates, Dr. Sonstein carefully selects patients for his revision pro- cedures based on personal factors, results of conservative treatments, diagnostic imaging and clinical examination. He also collaborates with an orthopedic surgeon to ensure the neurological and musculoskeletal systems involved are thoroughly examined at each stage of the operation. Patients at Dr. Sonstein's Bethpage office are treated with care by his capable staff. 1 0 | Long Island MD NEWS ■ M D N E W S . CO M