Remarkable new research into the way environmental factors affect the development of the brain has opened up the possibility that an infant’s future mental abilities and susceptibility to mental illness can be permanently altered by dietary changes in early life.

Evidence that changes in early diet can have long term effects on brain structure, verbal IQ, eyesight, appetite regulation and possibly on neurodevelopmental outcome will be presented at the international symposium on Early Nutrition Programming in Granada, Spain (23 April).

This is an area of research in which the EC is investing heavily as it offers huge potential in terms of improving the health and reducing health care costs of future generations. Neuropsychiatric disorders, such as depression, are the second most important cause of ill health in the EU after cardiovascular disease(1). The EC has already invested over ?‚¬13 million in the Early Nutrition Programming Project (EARNEST) and has now committed another ?‚¬6 million into the NUTRIMENTHE project (launched 22April 2008).

NUTRIMENTHE will build on the work of EARNEST by addressing key issues in mental health where early diet could play a role, for example, perception, memory, intelligence, anxiety, Attention Deficit Hyperactivity Disorder (ADHD), depression and other related areas.

The Granada International Symposium will bring together researchers from both the Early Nutrition Programming Project (EARNEST) and NUTRIMENTHE to present their recent findings on the way in which early diet affects long term health. In addition to sessions on brain development and mental performance, other sessions will discuss the impact of early diet on later obesity and insulin resistance and on immune function.

The final session will be devoted to what new mothers think about these ideas and the extent to which they are reflected in nutrient recommendations for infants in Europe.

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Few treatments are available to help obese adolescents who are unable to lose weight and are already suffering from obesity-related health problems. Laparoscopic adjustable gastric banding (LAGB), an option for adults in the United States since 2001, is showing promise for teens. The Center for Adolescent Bariatric Surgery, which opened at NewYork-Presbyterian Morgan Stanley Children’s Hospital in 2006, recently performed its 100th LAGB procedure.

“Adolescent obesity continues to be under-treated,” says Dr. Charles J.H. Stolar, surgeon-in-chief at NewYork-Presbyterian Morgan Stanley Children’s Hospital and chief of the Division of Pediatric Surgery, and the Rudolph N. Schullinger Professor of Surgery at Columbia University College of Physicians and Surgeons. “We know that obese 14- to 18-year-olds are at risk for significant and even fatal conditions as they grow older. In cases where medical therapy doesn’t work, surgery is an effective treatment option.”

“Our program prefers to perform LAGB rather than other types of bariatric surgery because this technique has been shown to be the safest and least traumatic,” says Dr. Jeffrey L. Zitsman, director of the Center for Adolescent Bariatric Surgery at NewYork-Presbyterian Morgan Stanley Children’s Hospital and associate professor of surgery at Columbia University College of Physicians and Surgeons. “It does not reroute patients’ digestive anatomy, is completely reversible, and the laparoscopic technique is minimally invasive.”

The band slows the passage of food through the stomach so that a person is hungry less often, feels full more quickly and longer, eats smaller portions, and loses weight over time.

According to Dr. Zitsman, nearly 90 percent of adolescents with a body mass index (BMI) greater than 40 are ultimately unable to achieve or maintain adequate weight loss despite intensive medical regimens. The National Institutes of Health (NIH) considers a BMI of 25 overweight, while 30 or above is considered obese. The average pre-operative BMI for adolescents undergoing LAGB at the Center for Adolescent Bariatric Surgery is about 48, although patients with a pre-operative BMI of 35 may undergo surgery if they are already suffering from diabetes or obesity-related illnesses.

“Although the average age of our patients is younger than 17 years, with BMIs this high they are already having significant health issues,” Dr. Zitsman says. “Many have elevated cholesterol, hypertension, heart problems, joint problems, and markers for insulin resistance. Girls have irregular periods and polycystic ovary syndrome. By interrupting the progression of health problems while these patients are still young, we hope to prevent irreversible damage and improve their lifelong health prospects.”

Bariatric surgery has not been performed as commonly in adolescents largely because the long-term consequences have not been fully studied. The Center for Adolescent Bariatric Surgery is one of only four U.S. centers that are part approved by the FDA currently evaluating the outcomes of LAGB in teens.

All potential surgical candidates undergo a comprehensive assessment by a team that includes a pediatrician, a pediatric endocrinologist, a gastroenterologist, a pulmonologist, a psychiatrist, an exercise physiologist, a nutritionist, a bariatric surgeon, an anesthesiologist, and a pediatric nurse practitioner. Before they can be considered candidates for LAGB, patients must complete a program of thorough screening and comply with rigorous weight-loss education and therapy.

Although LAGB is showing promise for helping morbidly obese youngsters lose weight, it should not be thought of as a magic bullet but rather another tool in the arsenal.

“Our initial numbers show that about a year after surgery, most of our patients have lost about one-third of their excess body weight. We have a few patients who have even lost 100 percent of their excess weight after two years,” Dr. Zitsman says. “But even with surgery, the patient and his or her family still have to make a real commitment to changing what the youngster eats and to making certain lifestyle changes.”

Recently, researchers from the Center for Adolescent Bariatric Surgery found that obese adolescents who had undergone LAGB showed improvement in metabolic syndrome. This syndrome includes a number of risk factors — high blood pressure; low levels of HDL or good cholesterol; excessive abdominal fat; and elevated levels of blood sugar, C-reactive protein and triglycerides — that increase the chances of developing cardiovascular disease or diabetes later in life. The single biggest risk factor is obesity; metabolic syndrome usually improves when a person loses weight.

“With the rise of adolescent obesity in the U.S. to nearly 20 percent and with all the complications that come from this condition, understanding the role for banding surgery in adolescents is critical,” Dr. Zitsman says.

The Center for Adolescent Bariatric Surgery is affiliated with the Center for Obesity Management at NewYork-Presbyterian Hospital/Columbia University Medical Center, which has helped thousands of obese adults manage their weight through laparoscopic weight-loss surgery. The Center is directed by Dr. Marc Bessler, assistant professor of surgery at Columbia University College of Physicians and Surgeons.

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A new study suggests technology can help prevent misdiagnoses and the healthcare costs associated with them. In the study, a computer-based software system designed to assist in the diagnosis of dermatologic and other visual medical conditions performed better than physicians in correctly identifying common skin infections.

The study, published today in the Dermatology Online Journal, found the physicians in two hospital emergency departments misdiagnosed 28 percent of patients with inflamed skin conditions as having cellulitis (deep skin infection). Based on symptoms which were then input into the computer, the software, called VisualDx, correctly diagnosed 64 percent of cases where the physicians had misdiagnosed cellulitis at one of the hospitals. The same system is also available on mobile devices and can be carried by physicians in their pockets to the bedside.

“Misdiagnosing non-infectious diseases as cellulitis is a common error and can result in unnecessary hospitalization and antibiotic use,” said Noah A. Craft, MD, PhD, the principal investigator at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) and the corresponding author of the study. “This study shows that technology can help physicians make the correct diagnosis so that patients receive the best care possible and avoid unnecessary, expensive treatments.”

Cellulitis is a common bacterial skin infection that, if left untreated, can become life-threatening. It appears as a swollen, red area of skin that feels hot and tender, and other studies have found less serious skin infections are often misdiagnosed as cellulitis.

In the new study, which was conducted by LA BioMed researchers, specialists found emergency department physicians misdiagnosed cellulitis in 41 of 145 patients admitted to two hospitals. The researchers then entered symptoms and other health information from the 28 misdiagnosed patients into VisualDx. In 18 (64 percent) of those patients, VisualDx suggested the correct alternative skin condition as a diagnosis. Asked to evaluate the same 28 patients, the physicians caring for the patients offered the correct alternative diagnosis in just four (14 percent).

“While this is a small sample, misdiagnosis of cellulitis can result in the unnecessary costly hospitalizations and potentially dangerous use of intravenous antibiotics that may further fuel the emergence of antibiotic resistant bacteria,” said Dr. Craft. “Conversely, if physicians fail to correctly diagnose patients who do have cellulitis, the patients could suffer worsening infection and serious complications, if they’re not treated promptly. Clearly, improved diagnostic accuracy is needed for cellulitis and a structured approach to diagnosing it could decrease misdiagnosis and improve the quality of care.”

The VisualDx technology used in the study takes physicians through a series of categories to fully describe their patients, the symptoms and circumstances surrounding the disease. Based on that information, VisualDx displays information about potential diagnoses and treatments, and it displays the relevant images from the world’s most comprehensive collection of digital medical images. Ultimately, this technology still depends on doctors to make the correct final diagnosis. But VisualDx can help physicians by suggesting a more accurate list of possibilities to consider.

LA BioMed researchers-Dr. Craft, Loren Miller, MD, MPH, and Carol Berkowitz, MD-contributed their expertise to the development of the VisualDx technology. Dr. Miller also participated in the study. Dr. Craft is a consultant for Logical Images, Inc., the makers of VisualDx, and another of the study’s authors, Art Papier, MD, is the company’s chief medical information officer. The study was supported in part by GCRC Grant M01-RR00425 National Center for Research Resources. To read the study, please visit: anagen.ucdavis.edu/1703/1_originals/1_10-00308/article.html

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Conference Dates: 27-28th July, 2011

Venue: Radisson BLU Brussels, Belgium

PK/PD Modeling is quickly becoming a timely and cost efficient means of assessing the activity of a compound on the target.

The benefits of an effective PK/PD modeling setup include more informed decision making at earlier stages which can lead to increased understanding of a compounds safety, particularly in special populations such as pediatric/geriatric and also populations who would normally be excluded from clinical studies. Recently several new PK/PD software platforms have been released and these will also improve the ability of PK/PD scientists to bring more accurate predictions and understanding of the work they perform. This training course is aimed at more junior PK/PD scientists and also those who wish to be able to assess the new software’s ability to perform as they desire.

The course will introduce participants to the more advanced concepts, methodologies and applications of Pharmacokinetic and Pharmacodynamic modeling and simulation and quickly progress through several case studies using real, but hidden datasets which will enable them to gain a perspective of the advantages that a well-run PK/PD program can deliver to the entire development process.

Benefits to the participants:

– How to translate biological processes into a mathematical framework (compartment analysis, turnover processes, etc.) and how to use built in libraries stored in Phoenix Winnonlin.

– How to perform Population data analysis using response data from real clinical trials and how to perform a population analysis using Phoenix Non Linear mixed effect modeling engine.

– How to optimally use the results of these analyses to guide optimal future clinical trial design. They will learn how to perform simulation using the Phoenix simulation engine.

– They will possess new tools to both either increase the probability of success in having the drug approved or making earlier no go decision for drug that would appear to be not enough efficacious or not enough safe. Many case studies will be discussed where it will be shown how modeling and simulation tools helped during the entire drug development process to prove drug efficacy and prevent false positive conclusions.

Agenda request

To request the full agenda please follow the link here.

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Thirteen states and the District of Columbia will get more than $547 million in grants over five years to build Medicaid long-term care programs that will help keep people at home and out of institutions, Leslie V. Norwalk, Acting Administrator of the Centers for Medicare and Medicaid Services (CMS) announced today.

Today’s awards are the second round of grants that will total $1.75 billion over five years (2007-2011) to help shift Medicaid’s traditional emphasis on institutional care to a system offering greater choices that include home and community-based services.

This “Money Follows the Person” initiative was included in the Deficit Reduction Act of 2005 (DRA), currently being implemented by CMS. It is a component of the administration’s New Freedom Initiative, a nationwide effort to remove barriers to community living for people of all ages with disabilities or chronic illnesses.

“There is more evidence than ever that people who need long-term care prefer to remain in their own homes and communities whenever possible,” said Ms. Norwalk. “This new program will help states shift Medicaid’s traditional emphasis on institutional care to a system offering greater choices that include home-based services.

“States will also benefit by giving the elderly and people with disabilities more control over how and where they receive the Medicaid services they need.”

States expect to be able to move more than 14,000 people into community settings using these grant awards.

The Medicaid program traditionally pays for care for elderly and disabled individuals living in institutions who need help with activities of daily living. To fund home and community-based services, states must obtain waivers of normal program rules designed to pay for care in institutions.

“The concept of money following the person to the most appropriate setting improves beneficiary satisfaction while reducing Medicaid costs,” Ms. Norwalk said. “We intend to keep taking steps to remove barriers and rebalance the options for Medicaid-funded long-term care.”

States receiving grants today (see list below) will design programs with four major objectives:

– Eliminate barriers or mechanisms that prevent Medicaid-eligible individuals from receiving support for appropriate and necessary long-term services in the settings of their choice;

– Increase the ability of the state Medicaid program to assure continued provision of home and community based long-term care services to eligible individuals who choose to move from an institutional to a community setting; and

– Ensure that procedures are in place to provide quality assurance for individuals receiving Medicaid home and community-based long-term care services and to provide for continuous quality improvement in such services.

All states were eligible to participate in the five-year demonstration program and had to commit to provide demonstration services for at least two years.

States receiving grant funds will qualify for a higher percentage of federal matching dollars to help cover the costs of moving people out of nursing homes and into community settings. The higher matching rate will be paid for one year after an individual moves out of an institution and into the community. The state must continue to provide community services after that period as long as the person needs community services and is Medicaid eligible.

“These demonstration grants are a clear sign of our continued commitment to expand choice to all Medicaid beneficiaries as well as allowing them the independence to live at home and contribute to their communities,” said Ms. Norwalk.

For more details about the New Freedom Initiative, of which this demonstration is part, visit the CMS web site at:
www.cms.hhs/newfreedom.

2007 MONEY FOLLOWS THE PERSON – REBALANCING DEMONSTRATION AWARDS

– Delaware
Transitions – 100
Year 1 Award Amount – $132,537
5 Year Commitment – $5,372,007

– District of Columbia
Transitions – 1110
Year 1 Award Amount – $2,546,569
5 Year Commitment – $26,377,620

– Georgia
Transitions – 1,347
Year 1 Award Amount – $480,193
5 Year Commitment – $34,091,671

– Hawaii
Transitions – 415
Year 1 Award Amount – $231,250
5 Year Commitment – $10,263,736

– Illinois
Transitions – 3,357
Year 1 Award Amount – $6,879,166
5 Year Commitment – $55,703,078

– Kansas
Transitions – 934
Year 1 Award Amount – $102,483
5 Year Commitment – $36,787,453

– Kentucky
Transitions – 431
Year 1 Award Amount – $4,973,118
5 Year Commitment – $49,831,580

– Louisiana
Transitions – 760
Year 1 Award Amount – $524,000
5 Year Commitment – $30,963,664

– New Jersey
Transitions – 590
Year 1 Award Amount – $230,000
5 Year Commitment – $30,300,000

– North Carolina
Transitions – 552
Year 1 Award Amount – $16,055 5
Year Commitment – $16,897,391

– North Dakota
Transitions – 110
Year 1 Award Amount – $18,089
5 Year Commitment – $8,945,209

– Oregon
Transitions – 780
Year 1 Award Amount – $80,785
5 Year Commitment – $114,727,864

– Pennsylvania
Transitions – 2600
Year 1 Award Amount – $130,609
5 Year Commitment – $98,196,439

– Virginia
Transitions – 1041
Year 1 Award Amount – $13,793
5 Year Commitment – $28,626,136

– Totals
Transitions – 14127
Year 1 Award Amount – $16,358,647
5 Year Commitment – $547,083,848

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The Autism Society, the nation’s leading grassroots autism organization, will launch several awareness activities to commemorate National Autism Awareness Month this April. Highlights include:

- Attend the Wretches & Jabberers tour. This April, the Autism Society has teamed up with AMC Theatres© and Area 23a, an event-based distribution company, for a unique, national theatrical run of the feature documentary Wretches & Jabberers about two-self-advocates with autism. Join us at 40 theatres this month and help to change attitudes about disability, intelligence and communication: see here.

- TAKE ACTION. The Autism Society works daily to help individuals and families through national and state advocacy efforts. Learn about current initiatives and legislation (such as the TEAM Act, Reauthorization of the Combating Autism Act, the IDEA Fairness Restoration Act and much more) and how you can help here.

- Put on the Puzzle! The Autism Awareness Puzzle Ribbon is the most recognized symbol of the autism community in the world. This month, the Autism Society encourages all friends and advocates to wear their puzzle ribbons in a display of support.

- Spread the word about the Autism Society’s online information and referral database Autism SourceTM. We help individuals and families find accurate information about autism and identify the service providers they need close to their homes.

- See a movie! The Autism Society and AMC Theatres have teamed up to present Sensory Friendly Films each month. A family trip to the movies is often not an option for many affected by autism, but Sensory Friendly Films provides an accepting environment where people can get up and move around as they please. Our special showing of Hop is coming to AMC theatres nationwide on April 2 in most locations and Rio will be showing on April 30. For more information, visit here.

- Find local events. Nationwide, 150 Autism Society chapters hold a number of special events in their communities throughout April. See our calendar here: www.autism-society/calendar. An online tool, 1Power4Autism, also makes it easy for supporters to mobilize friends and family and help make a difference by holding their own event.

- Text AUTISM to 50555. Text “AUTISM” to 50555 to donate $10 to the Autism Society, 100 percent of which will go to support the Autism Society’s mission of improving the lives of all affected by autism.

The Autism Society can also provide experts, parents or other knowledgeable media sources for any autism-related stories you may be working on this month – from the challenges facing adults with autism to the need for early intervention to community efforts at social inclusion, the Autism Society is a great place to get balanced, contextual information.

About National Autism Awareness Month:

Established in the 1970s to highlight the growing need for concern and awareness about autism, April is a special opportunity for everyone to educate the public about autism and issues within the autism community. With 1 in 110 Americans now being diagnosed, the need for services and supports is greater than ever, and this year the Autism Society hopes to raise awareness of the many issues faced by families affected by autism.

About the Puzzle Ribbon:

The puzzle pattern reflects the mystery and complexity of the autism spectrum. The different colors and shapes represent the diversity of the people and families living with the condition. The brightness of the ribbon signals hope-hope that through increased awareness of autism, early intervention and appropriate treatments, people with autism will lead fuller, more complete lives.

About Autism:

Autism is a complex neurodevelopmental disability that typically appears during the first two years of life and affects a person’s ability to communicate and interact with others. Autism is defined by a certain set of behaviors and is a “spectrum disorder” that affects individuals differently and to varying degrees. There is no known single cause for autism, but increased awareness and funding can help families today.

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The Christian Science Monitor on Tuesday examined how the Florida Medicare Fraud Strike Force last year combined “traditional investigative methods and heightened interagency cooperation to quickly identify patterns of irregular billing” to charge 197 defendants, who accounted for 25% of defendants in Medicare fraud cases in the U.S. According to the Monitor, state and federal officials established the task force in March 2007 as a “joint experiment” that involved the Federal Bureau of Investigation, the U.S. Attorney’s Office in Miami and CMS to address Medicare fraud in the South Florida area, a region considered the “country’s worst offender.”

Alexander Acosta, U.S. attorney in Miami, said, “Four years ago, there were maybe one-quarter the number of the cases that we’re bringing now” in South Florida, adding, “Does that mean the fraud wasn’t here? No. That just means we weren’t looking for the fraud.” Kirk Ogrosky, who manages the strike force for the Department of Justice, said that other areas of the nation — such as the Los Angeles and Houston regions — have begun similar efforts based on the effort in the South Florida area (Frogameni, Christian Science Monitor, 3/25).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

The American Medical Group Association (AMGA) and the American Medical Group Foundation (AMGF) are pleased to announce an opportunity for AMGA members to participate in a learning collaborative on care management for patients with COPD. The Best Practices Learning Collaborative is for organizations that are striving to improve the care of patients with COPD. Participants will work together to develop an optimal care framework that includes a comprehensive, patient-centered, value-based approach to chronic care.

The learning collaborative will support improvements in chronic care management systems that focus on improving the care of patients across care settings. Up to fifteen groups will be invited to participate in the collaborative; five will receive $10,000 in educational support over a one-year period; an additional ten organizations will receive travel stipends to attend the collaborative meetings.

Medical groups, IPAs, academic practices, and integrated delivery systems that wish to incorporate the management of COPD into their chronic care models are encouraged to submit an application. Organizations interested in a population-based effort or wanting to launch a pilot program are welcome to participate.

An expert panel of judges will review each application for commitment to common goals such as:

– Early identification and diagnosis of patients at risk for or currently suffering with symptoms of COPD

– Improved medication adherence and compliance

– Continuity of care across settings and transitions of care

– Increased efficiency and reduction of unnecessary or duplicative services and waste

– Increased ability to self-manage symptoms and disease progression through healthier lifestyles

– Improved health and well-being, and patient satisfaction

– Improved physician/patient relationships

– Overall impact on patient care in the community or region

Chronic Obstructive Pulmonary Disease Best Practices Learning Collaborative is an educational service supported by Boehringer Ingelheim Pharmaceuticals, Inc.

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BioHorizons announces that its 2009 Global Symposium will take place Thursday, April 30, to Saturday, May 2, at the Hilton Chicago. This educational event will focus on recent advances in digital dentistry, treatment planning, implant surface treatments, tissue regeneration and implant specific restorations.

Scientific sessions will bring together the outstanding and diverse expertise of top dental clinicians such as Drs. Carl E. Misch, Michael A. Pikos, Maurice Salama, Edward P. Allen, and Scott Ganz to provide insight into today’s most challenging implant and regeneration topics, including technical advances in diagnostic three-dimensional imaging and treatment planning software. Each clinician-moderated session will feature a panel discussion of audience-submitted questions that fosters a highly interactive learning environment. The three days of continuing education will include hands-on training sessions and dedicated educational tracks for auxiliary and office staff.

Presenters and moderators include Drs. Carl E. Misch, Maurice Salama, Michael A. Pikos, Scott Ganz, Edward P. Allen, David Garber, Jack Ricci, Natalie Wong, Ray Yukna, Michael Reddy, Hamid Shafie, Jay Malmquist, Michael Klein, and Murray Arlin.

BioHorizons continues to be one of the fastest growing dental implant companies in the industry because of unique offerings like Laser-Lok(R) microchannels, VIP 2.1 treatment planning software and gold-hued esthetic abutments provided with every bone level implant system. Symposium presentations will illustrate the unique position of BioHorizons to assist dental clinicians throughout the continuum of care.

“Each year, the BioHorizons Global Symposium stimulates invaluable interaction within the dental implant community,” said Steve Boggan, BioHorizons President & CEO. “In the current global economic climate, it is important to develop advanced knowledge and strong relationships to achieve superior esthetic results for patients and generate new opportunities for dental practices.”

About BioHorizons, Inc.

BioHorizons is a leading oral reconstructive device company at the forefront of digital dentistry. The company has a broad product offering, including dental implants, surgical planning software, regenerative products, CAD/CAM and traditional dental restorations. BioHorizons has a direct sales force in the U.S., Canada, Germany, Spain, United Kingdom, Australia, Mexico, and Chile. Products are distributed in the rest of the world via a network of independent distributors.

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Kelly Weber’s tennis racket hasn’t been retired, after all.

A car accident five years ago destroyed two disks between three bones in Weber’s spine, bringing her active lifestyle to a sudden stop. But minimally invasive spine surgery performed at Cedars-Sinai Medical Center is giving the Greeley, Colo., resident a chance to return to the tennis court and ski slopes without the pain that made even sitting in a car a difficult task.

“I couldn’t extend my right leg because I’d have pain going down it. So I’d have to keep the steering wheel really close and my leg bent, and sometimes I couldn’t even drive because of the pain,” said the 40-year-old mother of two.

According to Weber, who used to play on a United States Tennis Association (USTA) league and is a water aerobics and water therapy instructor, after the accident, she was unable to even hug her then 3- and 5-year-old daughters in a normal way. “I’d have to sit down and then have them sit on my lap,” she remembers.

After the crash, Weber underwent a surgical procedure called lumbar laminectomy in which pieces of damaged disk material were removed to take pressure off a pinched nerve root exiting the spinal column. Disks act as firm cushions between the vertebrae.

Surgical fusion of the area – lumbar vertebrae 3, 4 and 5 – was discussed, but knowing that this would require a long period of recuperation and limited mobility, Weber wanted to wait until technology provided a less-invasive option for multiple-disk replacement.

While waiting, Weber sought pain relief and healing through medical treatment and a variety of complementary approaches, including massage therapy, acupuncture, chiropractic, water therapy, and Bikram yoga. If nothing else, she reasoned, she would be in good physical condition when it was time to try surgery. Selective nerve root blocks, in which an anesthetic and a steroid were injected into the inflamed area, provided some short-term relief but no long-term solutions.

Last May, Weber learned of a minimally invasive operation to replace two or more adjacent disks. She researched the work of neurosurgeon Burak Ozgur, M.D., a minimally invasive spine surgery specialist who is one of the top surgeons experienced in the technique. Weber arranged a Nov. 2 consultation with Ozgur, who had joined Cedars-Sinai’s Department of Neurosurgery in October. Surgery was performed Nov. 14.

Ozgur said the procedure, which was completed in about three and a half hours, is performed in two steps. “First, we approach from the side, exactly 90 degrees from the spine, and access the two disk spaces. We remove the disks and put in ‘cages’ that contain bone graft materials and a protein that enhances and speeds up the fusion process. Then from the back, we insert screws and rods to stabilize the spine.”

Using a scope and special instruments, the entire operation is performed through four incisions, each measuring about an inch and a half. These are closed with melt-away stitches and glue, resulting in very small scars. More importantly, the procedure spares the muscle injury and significant blood loss that is common with traditional back surgery, along with the long, painful months of recuperation.

Weber was discharged from the hospital after three days and stayed with family in the Los Angeles area. Her mother returned with her to Greeley on Nov. 23, staying about three weeks for support.

“I cannot believe how good I felt right afterward. I went Christmas shopping. My mom had to make me slow down,” said Weber, noting that without constant pain she has more energy and feels “full of life.” Although she has to pace herself for a while, she expects to gradually resume her normal routine.

“I think this procedure is revolutionizing spinal fusions because it’s changing how people are recovering,” Ozgur said. “Compared to invasive surgery, the end result looks the same as far as the construct, but the recovery is much improved. And it can be an option for other indications, such as adult degenerative scoliosis, which is usually more complicated and involving more levels. I’ve done five- and six-level cases with this type of approach.”

The first in Southern California and one of only 10 hospitals in the state whose nurses have been honored with the prestigious Magnet designation, Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For 19 consecutive years, it has been named Los Angeles’ most preferred hospital for all health needs in an independent survey of area residents. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities as well as breakthroughs in biomedical research and superlative medical education. It ranks among the top 10 non-university hospitals in the nation for its research activities and is fully accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP).

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