[MUSIC PLAYING] NARRATOR: At University of Virginia Health System, we are for sharing the latest health information from top minds to keep you and your family healthy. With UVA Health System radio, here's Melanie Cole. MELANIE COLE: For some patients with spine conditions, minimally invasive surgery may just be an option. My guest today is Dr. Hamid Hassanzadeh-- he's an orthopedic surgeon who's specialties include minimally invasive spine surgery at UVA. Welcome to the show, Dr. Hassanzadeh. tell us a little bit about the difference between minimally invasive surgery and traditional spinal surgeries. HAMID HASSANZADEH: Thanks very much for having me. So minimal invasive surgery is a newer technique which has been promoted or been developed over the last decade. The benefit over open-- classic open surgery is that you don't need to get [INAUDIBLE] or cut through the muscle. So it's a muscle sparing procedure. By just dilating the muscle, we get in the area we want to work. And we could perform the work we want to do without creating new damage to the muscle and the soft tissue around the spine. And you have to know that there are a lot of late complications of the spine is related to the soft tissue of coverage of the spine. And so we try to minimize that complication with approaching the spine through minimally invasive-- not only skin incision, also muscle sparing procedures. MELANIE COLE: As back problems and spinal pain are such a huge problem in this country, what patients might be candidates for this type of minimally invasive surgery to help them with their problems? HAMID HASSANZADEH: So this is a very good question. Absolutely-- there's-- unfortunately about 80% of the population will have experienced some type of back pain in their life. Not every back pain requires surgery. Obviously that's a good thing. And the first line for every back-- first line treatment for every back pain is actually non-operative management. But in patients who have [INAUDIBLE] degeneration or some stability, then the minimum invasive procedure is a very good approach, a technique, to address their problem. And it usually is-- recovery is a little bit faster. Actually much faster. They don't need that much rehabilitation, so they return fast to work and to the activity of daily living. MELANIE COLE: How do you determine whether somebody is a candidate? So when they do have this pain, it's not really working to use anti-inflammatories or whatever else that they've tried. Then what's the next step? HAMID HASSANZADEH: So in the spine surgery or the indication for spine surgery, [INAUDIBLE] have to speak the same language. Their clinical presentation, the complaint they have, should show the same problem in the imaging side and MRI and so on. And once we have the same problem, and we know we can help it with a surgical procedure, then it's usually surgery indicated. In the cases where we exactly know if we do this, then the patient will improve significantly, in a 90% chance, or higher than 90% chance. So the first line treatment's always activity modification. We try to do it non-operative-- anti-inflammatory medication. And also [INAUDIBLE] is a huge part of prevention of the treatment of the spine and problem. But there's also a point that non-operative management just are enough to provide enough relief, then the next step is, obviously after having the appropriate imaging, to perform the appropriate surgery. MELANIE COLE: So with minimally invasive spinal surgery, how long usually somebody in the hospital? And then what is it like afterward? How soon can they return to activity. HAMID HASSANZADEH: So obviously it depends on the extent of the surgery. For just a decompressive surgery, [INAUDIBLE] spinosis or discectomy, the patient leaves the same day. Patients are able to leave the same day. 80% of all my decompression or discectomy patients leave the same day. And they're back to work within a week if they have a desk job-- if they have a desk or a light duty job. In cases of the heavy duty job, then it takes about six weeks to return to work. MELANIE COLE: And then how soon should they see results? I know it it depends on the type of surgery and what their problem was to begin with. But generally, how soon can people feel a reduction in pain, or the shooting pains that go down through their legs, or whatever reason that they came in to see you? HAMID HASSANZADEH: Yes, this is a very good question. It's question asked a lot by my patients. So in terms-- as you said, the pathology differs the outcome. In terms of acute disc herniation, having a disk problem, compressing on a nerve, it's immediate relief. And this is really-- the patient wake up and they have no pain [INAUDIBLE]. All it's a very gratifying moment for us as a physician to see the patient being pain free, and so very grateful for that. There's some other pathology as what takes time. Usually the majority of benefits-- you see the majority the first six weeks to three months, a complete recovery is about six months. In larger cases, a few deformity cases, where multi-level fusions involved and a very long surgery, then recovery could take up to a year. MELANIE COLE: Is there physical therapy needed after this type of surgery? HAMID HASSANZADEH: Again, it depends on the type of surgery and depends on the patient's activity level. Some patients are very active to start with, but they're usually-- yes, especially after fusion surgery, we send them back to rebuild their core muscle to prevent further problems in the future. MELANIE COLE: So let's talk about some of that prevention and strengthening. You've mentioned the core. What do you like people do to keep a really good, strong spine? HAMID HASSANZADEH: I think working out is very important. It's not only the back muscle-- it's the abdominal muscles, chest muscles, [INAUDIBLE] hip muscles-- they're all important to keep a stable core. And what I mean by that is, you can divide this so much pressure [INAUDIBLE] have when we walk, when we run, when we do things. And you can guide the entire [INAUDIBLE] spine, you will have back pain. Or you can divide the pressure to your muscle and spine. By having a very strong core muscle or strong core muscles, then you will-- the muscle will take a lot of that pressure or force away from the spine. So it's a divided work, so you will see less pain as a result. And also less degeneration-- you can decrease the rate of degeneration of the [INAUDIBLE] joints and discs and so on. MELANIE COLE: Dr. Hassanzadeh, tell us about what's going on in the horizon picture for minimally invasive spine surgery. What's really exciting that you're doing there at UVA? HAMID HASSANZADEH: I think the beauty of the spine surgery is that we can transfer this to other fields. One of the major advantages we have here by collaborating with other teams, not only within the orthopedic, also outside the orthopedic department, we start treating some of the complex factors to the minimum invasive techniques. And that's a huge advantage we are currently studying and [INAUDIBLE] could [INAUDIBLE] biomechanics study to prove it. That's really [INAUDIBLE] stable as open procedure. We're convinced that's going to be the future. We think the future will be less soft tissue damage, more precise surgery through small incision. Having the technology behind us, it makes our work much easier. This is the exciting part to be in this. UVA is a great place because of the resources that UVA has as a major institution. And also people who are around. Medicine's always a multidisciplinary and a teamwork-- if you have the right people in the right positions, and the work is easy and the patients benefit the most. MELANIE COLE: Great information. Thank you so much. For more information on the UVA Spine Center, you can go to uvahealth.com-- that's uvahealth.com. You're listening to UVA Health Systems Radio. This is Melanie Cole. Have a great day. [MUSIC PLAYING]