Once you decide to have surgery, you will be contacted by my coordinator, Tracy Barth, for the details of the preoperative clearance process that includes medical clearance, laboratory and other diagnostic tests. After these have been completed, your surgical date will be determined and you will show up to the hospital at a specified time. You will be checked into the hospital the morning of surgery, and paperwork is verified for type of surgery, level and if there is a side (left or right).
Dr. John M. Abrahams is an experienced, fellowship-trained, spine surgeon who has constructed an experienced surgical team to take care of you during your surgery. The team consists of (1) Neuroanesthesiologists, (2) Neuro-Ortho Nurses, (3) Neurosurgical and Orthopedic Surgeons, and (4) Neuromonitoring. Our Neuroanesthesiologists are fellowship-trained physicians who focus on taking care of our spine patients on a daily basis. You will meet the Neuroanesthesiologists on the morning of surgery. They will go over your medical history with you again that day as they have reviewed your medical information prior to your surgery date. If you have any concerns or questions, you can review these at this time. The Nursing team then comes in to review your history, specific surgery, levels indicated, as well as side of surgery when indicated. As soon as you meet the Nurse, the Neuromonitoring team will then come in and meet with you to discuss their purpose during the surgery. The Neuromonitoring team will place electrodes on your arms and legs at this point but while you are sleeping during surgery, the technician is at a computer monitoring your nerve function to add another level of safety during your surgery. Next, as your surgeon, I will come in to speak with you and mark the surgical site with my initials. This has to be done prior to bringing you into the operating room. The Neuroanesthesiologist will put you to sleep in a matter of minutes; prior to going into the operating room, intravenous medication will be given to you to sedate you in case you are nervous.
Dr. Abrahams has constructed an experienced team of Neurosurgeons and Orthopedic Spine Surgeons to assist in surgery. In addition to the support team, two surgeons add another level of safety and significantly reduce errors and complications. During surgery, there are usually two key parts – the decompression of the spinal cord or nerves, and possibly a fusion of the vertebral bodies. Dr. Abrahams and his colleagues perform these parts of the surgery together. Prior to any significant bone removal or fusion, the level of surgery is confirmed by both surgeons by using “live” X-Ray also known as fluoroscopy. In complex cases, image guidance may be used which incorporates a CAT Scan or MRI image and imports these images into a computer system. This is particularly helpful to place pedicle screws into the bone.
Each part of the team adds another level of safety to your surgery. Quality control measures such as nursing “team leaders”, accurate multidisciplinary “time outs”, and a comprehensive team reduce complications and improve outcomes.