Dr. Lauren Matteini is no stranger to this kind of operation, but doing it in an outpatient surgery center? Now, that’s innovative. Her latest achievement is a testament to patients’ desire to recover at home.
That no Chicago-area outpatient clinic had done this kind of operation still surprises Dr. Lauren Matteini. Still, the spine surgeon at Fox Valley Orthopedics was the first in Illinois to perform the anterior to psoas (ATP) approach to spinal fusion in an outpatient ambulatory surgery center.
The operation took place this winter in Fox Valley Orthopedics’ ambulatory surgery center, one of the clinic’s seven facilities in Elgin, Geneva, Algonquin and Barrington.
“This is not a new procedure,” says Matteini. “ I’ve been doing this a long time. It’s one of my favorite kinds of cases. Patients do really well with it.”
There are many ways to perform a spinal fusion. The procedure is performed by a spine surgeon, who removes a disc between two vertebrae and “knits” the bones together in the space the disc once occupied. Typically, this operation helps to relieve pain associated with unusual movement in the discs as a result of injury or disease.
While some surgeons choose to perform this operation from the patient’s back or front, the ATP approach takes an oblique approach, meaning patients lay on their side through much of the operation. While Matteini’s recent procedure involved work on the lower lumbar spine, almost near the tailbone, the approach can work on any part of the spine.
One of the chief benefits is that it requires minimal cutting of soft tissue.
“We’re not doing a lot of muscle disruption on the lower back, which is where a lot of the post-operative pain comes from,” says Matteini. “So, if we can avoid opening up the back entirely, I will. That will shorten recovery time and it will shorten your return to normal activities. A lot of patients won’t even take narcotics for this kind of surgery.”
Most patients are recovering at home the same day and using only a few days’ worth of painkillers, Matteini adds. Recovery begins with physical therapy and easy movements, primarily walking, for the first few weeks.
Office workers can generally return to work in about a month, while jobs that require some heavy lifting might need closer to three months to recover. Matteini follows patients for about a year to ensure they’re healing properly.
Matteini has performed the ATP surgery plenty of times in Chicago-area hospitals, and she’s performed plenty of other spinal surgeries at Fox Valley Orthopedics’ ambulatory surgery center in Geneva, where common procedures include joint replacements and hand or foot operations. For many patients, the benefits of an ambulatory surgery center aren’t just about recovering at home. It’s also about the bottom line, as ambulatory surgery centers typically have 60% lower out-of-pocket costs.
“Especially since COVID, we have really tried to figure out how to keep people out of the hospital and how to get people home sooner,” says Matteini. “This is one of those procedures that is so well tolerated by patients that I’ve been able to send them home quickly from the hospital for many years.”
Most people who are considering a spinal fusion could be a candidate for the ATP approach, says Matteini, yet not all area physicians are comfortable or familiar with this particular approach. With any operation, it’s a good idea to seek a second opinion, she adds, because surgeons often have different philosophies and approaches.
For Matteini, it’s an easy choice, as she’s not only fellowship trained but also trains other physicians in how to perform the ATP procedure. The result, she says, is a better all-around patient experience and a faster return to daily activities.
“I truly care about my patients,” she says. “I want them to have a great life. I want them to get better. I want their pain to go away. If I can do that, and if I can do that in a less-aggressive or less-painful procedure, I will do that.”