Collaborative Expertise Key to Complex Spine Repair

Collaborative Expertise Key to Complex Spine Repair

For Zachary Tempel, M.D., a neurosurgeon at Mayfield Brain & Spine, there is nothing more gratifying than to see patients’ lives transformed by complex spine deformity surgery. It can be an onerous process, from consultation through recovery, for both the patient and the surgeon, he says. But to see a person once severely disabled due to a crippling spine deformity now able to stand upright, with a renewed sense of pride and happiness, well…it’s why he and the other Mayfield neurosurgeons who perform these arduous operations do what they do.

These operations require a multidisciplinary team effort, Tempel notes. Or, as he likes to say, it takes a village to raise a patient who undergoes complex spine deformity surgery.

"When consulting patients who are on the road to spine reconstruction surgery, the first thing I tell them is they cannot sign the consent for surgery form without a member of their family, or support system, present," Tempel explains. A post-surgery support system is necessary, and needs to be established beforehand, because most complex spine deformity surgery patients require extensive recovery.

"The discussion around surgery is a lengthy one because, for example, if there is a hint of underlying depression, the patient needs to be treated by a psychiatrist for that depression beforehand because patients with depression tend to do worse after spinal reconstruction," Tempel continues. If the patient is anemic or has poor bone quality or needs a few coronary or pulmonary tune-ups, all must be addressed before surgery can take place. Patients who smoke must go through a smoking cessation program prior to surgery, as well.

A lengthy process, indeed.

"The time from when I first meet a spinal deformity patient to the time I see them in the operating room can be anywhere from three to six months," says Tempel. "With operations of this magnitude and complexity, there are so many moving parts that must be accounted for. There are so many things that can go wrong, so many ways outcomes can be compromised, we must be proactive in taking all the steps we can to maximize the success of the operation. It’s a massive undertaking for the patient, the surgeon and the hospital."

The Mayfield Difference

Does the magnitude of a patient’s symptoms match the magnitude of the intervention?

That’s the imperative question when deciding if complex spine deformity surgery is the answer for his patients, says Robert Bohinski, M.D., Ph.D., a Mayfield veteran neurosurgeon known for his skill in performing this type of operation. Not every patient with a spine deformity is a candidate for undergoing this type of operation, he points out.

"To benefit from this kind of surgery, a patient has to be suffering from the deformity itself. Usually, it will affect every facet of their life, from sleeping to walking to bathing to dressing – just getting around their home. My first step is to make sure we’re not just looking at their X-rays but that we’re listening to what the patient is saying about what their daily life is like."

Complex spine deformity surgeries often last for an entire day, or sometimes two, and sometimes involve more than one surgeon. This type of surgery provides the most dramatic change and is the most involved in terms of surface area operated on, length of surgery and need for multidisciplinary care.

Some of Bohinski’s complex spine deformity surgery patients have suffered for years before calling Mayfield Brain & Spine because they were told by other practitioners that either the surgery required to fix their problem was too dangerous, or there was absolutely nothing anyone could do for them.

That’s why Mayfield stands out among the other spine clinics, he notes.

"Mayfield has been around for a long time – more than 75 years. We learn from each other and rely on each other for counsel and advice. We crosscheck each other. We’ve been doing spine deformity surgeries long enough that we know where the ‘landmines’ are, and how to avoid them. We know the risks, the possible complications, and we are well prepared to encounter them and to successfully navigate the patients through them." 

Mayfield Brain & Spine is located at 3825 Edwards Road #300, Cincinnati, OH 45209åç. For more information, call 513.221.1100, email or visit

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