New spinal fusion option available

Friday, April 30, 2021

For those who need a correction to a prior spinal fusion or have put it off, there is a new option available at Cookeville Regional Medical Center.

Neurosurgeon Dr. Walter Jermakowicz offers a relatively new procedure called XLIF – eXtreme Lateral Interbody Fusion. He’s completed this procedure on six patients since he joined the team at Tier 1 Orthopedic and Neurosurgical group last August, all experiencing great outcomes.

“I completed my residency at Jackson Memorial Hospital/University of Miami Miller School of Medicine, the largest academic spine practice in North America,” he said. “This type of surgery is relatively new to Tennessee.”

Typically, spine fusions are done by going through the back, which is very painful and requires the surgeon to navigate critical structures. This new procedure can be done through a different angle – in the side, below the ribs, avoiding all those critical structures and nerves.

“There is less pain, less complications and patients can go home quicker and get back to normal faster,” he said.

This is a type of interbody fusion, a category in which the disc in the front of the spine is removed and replaced with an implant containing a bone graft to set up the condition for the two vertebrae to fuse together through the disc space.

It is an option a surgeon may recommend to treat specific types of lumbar spinal disorders, such as lumbar degenerative disc disease, spondylolisthesis, scoliosis and deformity and some recurrent lumbar disc herniations and types of lumbar stenosis. It is also useful for those who have already undergone a prior spinal fusion and require a correction.

This procedure is also unique in the fact that it is guided by x-ray, which helps the surgeon in obtaining an accurate location of where the disc is.

“It’s a team effort, from scrub techs to the radiology techs,” he said.

But there are some limitations to this procedure.

“It is not useful at the lowest levels of the spine, but recent advances are allowing us to access the lower levels,” he said.

For those who are not candidates for this type of procedure, he also offers some alternatives, such as spinal cord stimulation and spinal cord pain pumps, both ways of addressing back pain without having to do traditional spine surgery.

To schedule an appointment with Dr. Jermakowicz, call Tier 1 at 526-9518.