Not Your Father’s Back Surgery

Minimally Invasive Spine Surgery Leads to Faster Recovery

Dr Berkowitz smallMost all 20th century back surgery was done via “Open Surgery.” In this more traditional approach, the doctor makes an incision that is 5 to 6 in. long and “opens” or moves the surrounding tissue to access the area needing surgical treatment.  Now, thanks to advances in technology and technique, patients can have Minimally Invasive Spine Surgery (MISS), which uses a small (one inch or smaller) incision, along with specialized instruments, to gain targeted access to the problem area in the spine.

The benefits of MISS come from less surrounding tissue disruption and damage. As Dr. Robert Berkowitz, MISS specialist at The Center for Orthopedics explains, “With this minimally invasive technique, we can get to the affected area with a small tube, and in doing so, dial right into the problem spot. This means less ligament, muscle and bone disruption in the surrounding area, which leads to less bleeding, less pain, and faster recovery time.”  The MISS procedure can be used to treat herniated discs, spinal stenosis, spondylolisthesis and chronic leg or back pain. Fusion, laminectomy and microdiscectomy surgeries can all be done with MISS, which is a technique also used in cervical (neck) spinal surgery.

Dr. Berkowitz sees MISS as a great option for those suffering from herniated discs. “With minimally invasive spine surgery on a herniated disc, I will spend 30-45 minutes in the operating room. Essentially, we make an incision less than an inch long, remove the part of the disc impinging on the nerve, and then you go home the same day.  Most people have immediate relief of their pain. The bottom line is that those with less pain can start physical therapy sooner and then see a reduction in recovery time.”   

While patients can appreciate faster recovery, as a surgeon, Berkowitz appreciates the risk reduction associated with MISS. “I have not yet had to give an MISS patient a blood transfusion. Going minimally invasive significantly reduces that risk.”

Considering the obvious benefits of MISS, patients might wonder why open surgery is still common practice. One reason is that open surgery makes more sense for those with multi-level problems and diseases. Too many problems would lead to a higher volume of small incisions and at some point the larger incision simply makes more sense. However, for those with one or two level problems or disease, using a smaller incision is often the better option.   

But, according to Berkowitz, even those who are ideal candidates, are not always offered MISS, simply because the practice is not yet commonplace. “In fifteen years time, MISS will be standard care, once the technology and training comes further into the mainstream,” he says, “In the meantime, there are surgeons with additional training and experience who do MISS as their standard, and, for many patients, this can be more advantageous than traditional open surgery.”

If you’re interested in learning more about MISS as a treatment option, call to schedule an appointment with Dr. Berkowitz at The Center for Orthopedics. 330.329.2800.

Robert Berkowitz, MD is a board-certified orthopedic surgeon who specializes in minimally invasive surgery of the spine and was the first surgeon in Lorain County to perform a cervical disc replacement.  A visit with Dr. Berkowitz will ensure you treatment with the most current state of the art technology available today for operative and non-operative spine conditions.   

Add comment Posted in  Back and Spine October 31, 2016

Sisters Get Knee Replacements on Same Day

Dr. Stanfield does bilateral knee replacements, on the same day, for sisters Jill and Sheila.

img_0672Sisters share a lot of things — clothes, secrets, orthopedic surgeons. Well, that last one is probably unique to Sheila Pavlik and Jill Mourino, who both had total knee replacement surgery, on both knees, with Dr. William Stanfield. And, yes, they got them done on the same day.

As it turns out, sharing genetics meant sharing deteriorating knee cartilage at approximately the same rate. Both Jill and Sheila’s parents had total knee replacements, so they knew there may come a time when they would opt for the procedure. They didn’t necessarily expect to do it in tandem, however.

It was Sheila who was first referred to Dr. Stanfield and she recommended Jill go shortly thereafter. Before long, they attended their appointments together and even got corticosteroid injections at the same time before their vacation up in the Smoky Mountains.

But eventually, shots were not cutting it, and the women were candidates for total knee replacement at the ages of 55 and 57.  Jill has seen a different orthopedic surgeon a few years earlier that didn’t want to do the procedure on someone that young.  But she said Dr. Stanfield had different information about technology available and a sharper focus on quality of life.

Jill says, “He was more on top of the latest advancements in knee replacement and told me the tech he used could potentially last 20-25 years. My last doctor said 10 years, and I sense he just wasn’t willing to take me on as a patient. Dr. Stanfield was way more flexible and knowledgeable. We agreed that it came down to experiencing a better quality of life out of these next 25 years.”

The two sisters were in agreement about returning to their active lifestyles and about the date for surgery, July 11th.  Dr. Stanfield performed the bilateral knee replacements that day and both woman were in the hospital for only three days. Afterwards, they were transferred to a short term rehab facility in Avon for a week.

They are now on their 9th week of recovery and Sheila has returned to work. Jill says she would “absolutely recommend” TKR with Dr. Stanfield and The Center for Orthopedics.

“Everyone has been so supportive and nice. The physician’s assistant, Eric, is amazing. The staff is great. We’ve had on-time appointments. Over labor day I was telling people. ‘When you’re ready go see someone about your knees, go see Dr. Stanfield. He is knowledgeable, caring and concerned about what you want.’ I always felt he was talking with me and not at me.”

If you’re suffering from knee pain, call the Center for Orthopedics for a consultation with Dr. Stanfield today at 440.329.2800. You do not need a sister to be a good candidate for knee replacement.

Add comment Posted in  Replacements September 28, 2016

Arthritis of the Spine Seminar

Dr. Robert Berkowitz will be giving a community education seminar on the topic, Arthritis of the Spine, Monday, September 28 at 1pm at the O’neill Healthcare Skilled and Assisted Living Facility in North Ridgeville.  The event is free and open to the public. Those wishing to attend should RSVP by Friday, September 23rd by calling 440.387.4975.




Arthritis of the Spine, sometimes called, Spinal Osteoarthritis, occurs when cartilage breaks down in discs and joints of the neck and back. This can sometimes put pressure on nerves in the spinal column and cause stiffness, weakness or pain in the neck, back, arms or legs. Once diagnosed, there are many ways to treat this condition, and many include changes in lifestyle including weight management, exercise and other non-drug treatments.

Learn more by joining Dr. Berkowitz at 1pm in the Assisted Living Bistro at O’neill Healthcare in North Ridgeville. Enjoy light refreshments and learn how to help yourself and loved ones who may have Arthritis of the Spine.

If you suspect you have Arthritis of the Spine and want immediate treatment, don’t delay. Call and schedule an appointment with Dr. Berkowitz by calling 440.329.2800.

Add comment Posted in  Arthritis ,Back and Spine September 7, 2016

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