New technology reduces need for invasive surgery


By Monroe Roark
Times Correspondent


A Stockbridge medical office is treating back and spine issues using unique methods in an attempt to greatly reduce the need for invasive surgery.



Dr. Shahram Rezaiamiri discusses treatment with a patient at The All Spine Center. Photo by Nick Vassy



The All Spine Center has a couple of locations on the south side of Atlanta, including the main one on Eagle’s Landing Parkway. In three years in Stockbridge the size of the facility has grown dramatically as its services become better known and more desired by patients.

Back and neck problems are what Dr. Shahram Rezaiamiri and his staff see most often. They try to evaluate all of their patients in a way that results in the most effective pain management and identifying the cause of the problem so it can be eliminated and not just treated.

For a large number of back patients the typical method of addressing the problem is lumbar fusion, which involves placing screws and rods in the back. The United States does more of this kind of surgery than any country in the world. While that is a very good procedure for a select group, Rezaiamiri maintains that the majority of such patients can improve with less surgery.

“In many cases I could put screws in your back and you could be better for six months or a year, but the pain could come back with a vengeance,” he said. “Most people don't know that.”

Rezaiamiri likes to use what is known as focal compression, which concentrates in a specific area and can be done more quickly. Most of his surgeries are done in one hour.

“Imaging could show pressure in different places, but only one of them is really causing your problem. We go after that,” he said. “A lot of doctors would want to compress everything, like taking your car to the shop for one bad tire and changing all four tires. We just change one tire, the one where the problem is.”

Doing more than is needed puts the patient at risk for infection and more problems, not to mention more pain.

“We try to narrow down the diagnosis,” said Rezaiamiri. “We focus on getting the proper diagnosis and using minimal surgery to get it done.”

With traditional fusion a surgeon goes in at the back where the discs are (the bones are in the front). The bone is removed and screws are installed near the joint, which eventually damages a healthy joint and makes it age unnaturally. That, of course, can lead to more surgery or a lot of medication, or both.

This facility is the first in Georgia to use XLIF (extreme lateral interbody fusion), with a one-inch incision from the side and the removal of the disc which is replaced by a block that is large enough to make screws unnecessary.

All of the procedures required by an All Spine Center patient, including surgery, can be done in its facility without having to go to a hospital. That includes laser surgery, which is still considered experimental by some for insurance purposes and often not covered even though it has been around for decades.

There are several types of laser surgery, but the type usually performed by Rezaiamiri and his staff involves inserting a long needle (similar to that used for an epidural) into the disc and using it as a conduit to run a laser fiber through which then blasts the center of the disc to shrink whatever bulge is there. It takes 30-40 minutes on average.

Using the needle and laser means no cuts, and studies show that the success rate with laser surgery is higher than with lumbar fusion, Rezaiamiri said. Some laser techniques blast over a wider area, whereas his method is more controlled and more effective.

His office is in the process of acquiring a more modern and much smaller laser machine that will improve that effectiveness even more. It will be the only location in Georgia with that particular equipment.

Everything from the initial evaluation to imaging, from pain management to surgery, is done under one roof at the All Spine Center. There are now five doctors and an overall staff of nearly 30, but that number is expected to grow in the coming weeks.

For more information, visit www.allspinesurgerycenter.com