Spine Center lets patients in pain get back on track

Susan Cusano and Nina Kadan-Lottick, M.D., share an unhappy distinction: Far too early, they felt like frail, elderly women. Cusano, 55, could barely walk. Kadan-Lottick, associate professor of pediatrics, spent her early 40s gradually cutting back on activities until she was no longer playing outside with her children.

Both women are patients at the new Yale-New Haven Hospital Spine Center in New Haven, where spine surgeons Khalid M. Abbed, M.D., and Jonathan N. Grauer, M.D., stopped their debilitating pain and helped them reclaim their lives. Abbed, assistant professor of neurosurgery, and Grauer, associate professor of orthopaedics and rehabilitation and of pediatrics, are part of an interdisciplinary team at the Spine Center that brings a variety of specialists under the same roof for optimal treatment of any spinal ailment, surgical or not, in the most convenient and efficient manner possible.

The Spine Center team, which also includes spine surgeons Peter G. Whang, M.D., and James J. Yue, M.D., both associate professors of orthopaedics and rehabilitation, and Maxwell S. Laurans, M.D., assistant professor of neurosurgery, and Associate Professor of Neurosurgery Michael L. DiLuna, M.D., are aiming to set up a system that will allow a patient under a surgeon’s care to be sent down the hall to a medical spine specialist or some other caregiver. “We can send them to physical therapists whom we routinely communicate with,” says Grauer. The center also plans to recruit a physiatrist—a clinician who specializes in treating pain and helping patients regain function.

The new center, at One Long Wharf, is located in a large suite complete with X-ray machines, and the physical therapy gym has windows that overlook Long Island Sound. Clinicians work in a hub surrounded by exam rooms, so it is simple for providers to review a diagnostic scan together or collaborate on a treatment plan.

Cusano and Kadan-Lottick were treated with surgery, but they say they found it reassuring that they were able to evaluate all their options.

Cusano came to Grauer with significant symptoms in her legs related to her lumbar spine. She had seen other doctors, but was still looking for a physician who would spend the time necessary to get to the root of her complex problem. “I felt like I was 100,” remembers Cusano. Grauer recommended surgical treatment known as decompression and fusion. Though Cusano didn’t relish having an operation, she is now happy with her decision. “I’m raking. I’m shoveling snow. I just lifted a dishwasher with my daughter,” she says.

As for Kadan-Lottick’s symptoms, she says, “I really had to psych myself up to walk from my garage to my office” due to compression of her spinal cord that caused her severe pain. An associate professor of pediatrics at the School of Medicine, Kaddan-Lottick says she was immediately impressed with Abbed, whose training includes fellowships in orthopaedic and neurosurgical spine surgery. Ultimately, she chose a surgical procedure that drew on this specialized training—a multilevel, minimally invasive decompression and stabilization procedure that dramatically decreased her recovery time, blood loss, muscle injury, and hospital stay compared with conventional surgical options.

Kadan-Lottick was walking the day after surgery, and Abbed helped her craft a rehabilitation plan.

“I really feel like I had been living the life of someone decades older,” says Kadan-Lottick, now two years out from her surgery. She says she is now hiking, skiing, and biking with her family again.

Most patients don’t need surgery, so Abbed and Grauer always seek alternatives for those who can benefit from them. “It used to be the hardest part of my job when I saw someone who was hurting and they weren’t candidates for surgery, so I couldn’t help them,” Abbed says. “Now we have the ability to get them the non-operative treatment they need.”

The Spine Center’s physicians stay in close touch with physical therapists, who routinely discuss the patient’s progress with the surgeon and adjust rehab techniques when necessary.

“Therapy is very specific to the individual,” says Jhasson Brooks, lead physical therapist for the center. “We can bring them to a point where we reduce their pain, teach proper body mechanics, and prevent further injuries,” he says.

Cusano first saw the Spine Center’s new facility on a recent follow-up visit, and she says she loved it. But the change she sees in herself is even more impressive, she says. Of her first visit, she says, “I remember sitting there crying,” but today there are no more tears.