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Lisa Butler, age 12, wearing her Milwaukee brace Research Promotes Better Decision-making Surgeons at Twin Cities Spine Center have participated in a variety of research projects focusing on care plan decision-making. Using this information, the team is better equipped to map out individualized treatment programs and help patients meet their care goals. The following are examples of past and ongoing studies: + The question of whether pain, deformity or spinal imbalance motivates patients to seek a spine surgeon, a topic addressed in a recent publication by Timothy A. Garvey, MD + An examination of short-term complication rates among patients receiving surgery for low-grade spondylolisthesis, reported upon by Joseph H. Perra, MD + The relationship between obesity and post-operative complications among patients with degenerative spondylolisthesis, recently presented by Eiman Shafa, MD, at the North American Spine Society annual meeting + The relative benefits of various surgical approaches to fusion of the low back, an effort led by Manuel R. Pinto, MD + The question of how best to repair a nonunion after a transforaminal lumbar interbody fusion procedure, answered by Kevin J. Mullaney, MD, and other Twin Cities Spine Center surgeons + The relative rates of revision surgery following open versus minimally invasive transforaminal lumbar interbody fusion, being studied by Christopher Alcala- Marquez, MD, and others + The comparative effectiveness of nonoperative management of spinal fractures compared to surgery among neurologically intact patients, initially studied by Dr. Garvey; Amir A. Mehbod, MD, completed a 22-year follow-up on some of these patients + The clinical factors that should be considered to reduce the risk of complications among patients receiving low back surgery, part of a stratagem developed by Dr. Mehbod and Ensor E. Transfeldt, MD + The value of minimally invasive surgery (MIS) to improving patient experiences and shortening hospital stays, by James D. Schwender, MD, a past president of the Society for Minimally Invasive Spine Surgery and leader in the development of new instruments for MIS + The validity of EuroQOL-5D (a newer way to measure quality and cost effectiveness) compared to other outcome tools among patients with degenerative disease of the low back, a topic of interest to Benajmin Mueller, MD For more information about research, call 612-775-6233 or visit tcspine.com/education-resources/research-publications. "I wa nted to be exposed to multiple surgeons, the most cha lleng ing spina l patholog y and a wide variety of surgica l cases," Dr. Sha fa says. "At Twin Cities Spine Center, I cou ld lea r n f rom t he innovators in minima lly invasive spine surgery as well as complex pediatric and adult deformit y correction." For a l l t he l a s t i n g ch a n ge s T w i n Cities Spine Center is ma king in the f ield of spine ca re, the basic philosophy rema ins the sa me a s that of Dr. Moe: Patient ca re is at its best when tech- nica l ly ski l led prov iders work w ith a g rowing knowledge base of conditions a nd treatments. The tea m likes to say it focuses on "decisions, not incisions." " Prov iding ca re is not a s simple a s looking at an X-ray and saying, ' We'll do X or Y,'" Dr. Ga r vey expla ins. "Say your patient is a n 82-yea r-old who wouldn't benefit from a major operation. You need to listen to the person a nd know what the goa ls a re. If you ca n provide what is needed with a minor operation, then the decision-ma king is more important tha n the sophisticated operation you could technica lly per form. There a re other patients who might not meet the t y pica l prof i le of people on whom we would perform surgery, those who might be better ser ved by sma ll inter ventions a nd getting a scooter, but if they wa nt to travel a nd wa lk a round severa l cit y blocks, we have to spend time making a decision rather than going with a formula. The persona lized care we provide for patients with our individualized consider- ation and collaborative decision-making are just as important as the sophisticated technology we may utilize. Together, they ensure optimal outcomes." The idea of "decisions, not incisions" is why "providing optima l ca re" is the f irst item in Twin Cities Spine Center's mission statement. It 's why people will approach team members at hea lth fairs a nd say t hei r g ra nd mot her ca me t o t hem for spi ne surger y decades a go. The T w i n Cities Spi ne Center tea m has provided leading spine ca re in the reg ion for generations, a nd at 70 yea rs, that shows no sig n of cha ng ing. For more infor mation about Twin Cities Spine Center, visit tcspine.com. ■ 0 9 M D N E W S .C O M /// M D N E W S M I N N E S O TA ■ 2 017