Tyler Neurosurgeon Jon T. Ledlie, MD, Introduces Laparoscopic Procedure For East Texas Back Pain Sufferers

A new spinal fusion procedure introduced in May is now even more convenient and feasible for East Texas back pain sufferers with the introduction of laparoscopic methods.

Jon T. Ledlie, M.D., a Tyler-based neurosurgeon with the East Texas Medical Center Neurological Institute, will perform the procedure at ETMC Tyler Tuesday. Assisted by Tony F. Altimari, M.D., a nationally renowned Chicago-based expert in this procedure, and Kent Webb, M.D., a Trinity Mother Frances vascular surgeon, Dr. Ledlie will be performing the first such procedure in East Texas.

"We're excited about the possibilities this procedure will offer patients who suffer from chronic back pain." Dr. Ledlie said, "and it's an honor to have Drs. Altimari and Webb assisting with this first for East Texas.

"The level of neurosurgical care being offered in this area continues to expand every year. Being able to perform this procedure, especially laparoscopically, is something we couldn't have done just a year ago," he said.

Dr. Ledlie added that Robert S. Knego, M.D., and Mark B. Renfro, M.D., neurosurgeons with the ETMC Neurological Institute, will also be performing the techniques at ETMC Tyler.

"The courses we've been through and the research we've looked at point to one thing: ETMC Tyler is about to embark on a whole new era of neurosurgical spine surgery," Dr. Ledlie said.

Use of the laparoscopic procedure will mean the difference between four minor incisions in the abdominal cavity and a large incision that causes discomfort and increased time to heal. Other advantages to the patient include a decreased hospital stay, potential cost savings and decreased time in rehabilitation.

According to Dr. Ledlie, "the benefits of this technique are almost innumerable. Much of the patient feedback indicates that they are much happier with smaller scars, less rehab and a quicker discharge."

Patients with debilitating back pain who are unresponsive to conservative treatment for at least six months are considered candidates for the procedure. All patients that are enrolled are placed in a study protocol to continuously monitor the outcome.

Patients who have been operated on in the past will also see advantages. Using this techniques, the surgeon is not required to go through a previously operated spine. They can also avoid further muscle shrinkage and chronic pain that often occurs in fusions done from the back.

The anterior lumbar interbody fusion (ALIF) procedure, which was introduced in May, features human allograft donor bone tissue which is connected with a hollow, thimble-size cylindrical dowel into the patient's spine. The procedure usually replaces metallic instrumentation previously needed to enhance the bone fusion process.

Using human allograft bone tissue - as opposed to conventional metal-based bone-grafting devices - may help bring long-term relief to thousands of chronic back pain suffers throughout East Texas.

This ALIF procedure was developed in the early 1990's by surgeons and researchers in Memphis, Chicago and the University of Florida Medical School to eliminate the use of metal instrumentation, simplify the back surgery procedure and reduce patient hospital stays.

Hospital stays have already been successfully reduced to an average of two to three days, compared with the four to five days associated with previous preferred spinal fusion techniques at other centers. By incorporating the laparoscopic techniques, the patient stays can be cut even further, possibly even to one to two days, Dr. Ledlie said.

"We are very excited about this advance in technique," Dr. Ledlie said. "We now have something that should give us greater fusion rates without depending on metal screws, bolts, rods and cages. The use of the laparoscopic technique also adds to patient advantages."

In many patients, the space between two vertebral bodies can begin to collapse, thereby reducing the height of the space and causing nerve compression and back pain. By restoring and maintaining the disk space to its original height, the pain can, in many cases, be either reduced or eliminated completely, Dr. Ledlie said.

Traditionally, surgeons have attempted to restore the space between the vertebrae by using wedges or blocks made from bone.

Using a wedge, the surgeon then returns the space between the vertebrae to normal height. A portion of the disk is removed, thereby reducing the pressure on nerves between the vertebrae, which in many cases provides significant relief or even eliminates pain caused by spinal nerve compression.

The new threaded cortical bone dowels offer significant benefits over conventional bone wedges and blocks by placing two threaded bone dowels side-by-side in the previously collapsed disk space.

"Most of the patients requiring back surgery are in their 40's and 50's and have a lot of active years ahead of them," Dr. Ledlie said. "Some concerns have been raised about the long-term effects of metal instruments in the body. Until we know more, the laparoscopic ALIF procedure with threaded bone dowels provides us with a sensible, feasible and cost-effective alternative."

Dr. Ledlie said every individual is subject to degenerative changes in the spine as part of the natural aging processes. The severity of that deterioration is determined by a person's overall physical condition, the type of work the individual has performed and related physical considerations, he said.

Board certified in neurological surgery, Dr. Ledlie is a member of Tyler Neurosurgical Associates. A graduate of the University of Oklahoma Medical School, Dr. Ledlie's clinical interests include spine reconstructive surgery, general neurological surgery, brain tumors and radioneurosurgery.

Founded in 1972 by neurosurgeon Ronald J. Donaldson, M.D., TNA was a beginning for Tyler's development as a regional neurosurgical medicine center. In keeping with its commitment to quality patient care, TNA physicians have joined with ETMC Tyler to form the ETMC Neurological Institute. Over the past 25 years, ETMC Tyler has been the site of approximately 20,000 neurosurgery procedures.

Using the comprehensive medical resources at ETMC Tyler, Institute physicians offer a continuum of neurological care designed to meet each patient's specific needs - from diagnostic and treatment services to rehabilitation. ETMC Neurological Institute physicians include neurosurgeons Drs. Ledlie, Knego, Renfro and Thomas W. Grahm, M.D.; conservative spine specialists Kevin J. Pauza, M.D., Paul Dreyfuss, M.D., and Christopher J. Rogers, M.D.; neurologists Lester B. Collins, M.D., and Susan D. Rountree, M.D.; and occupational medicine specialists Andrew Prychodko, M.D., and Kal Shwarts, M.D.