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Winter 2009 (return to main News page)
This article is reprinted with permission from Northern Colorado Medical and Wellness, November 2009, published by STYLE Media & Design, Inc.
Back to Back Successes
by Corey Radman
Two surgical specialties, orthopedics and neurosurgery, when combined, pack a powerful punch. They change lives, in fact.
It’s a statement that seems obvious but has little meaning until one really looks at the individual lives that have been impacted.
Without surgery, Alan Braga would have spent the rest of his life looking at his feet. Without medical intervention, Colorado Eagle’s former Head Coach and current General Manager might have had to leave hockey altogether. Without that treatment, the Colorado Eagles might not have won the 2007 Central Hockey League Championship.
Chris Stewart, General Manager of the Colorado Eagles, with orthopedist Douglas Beard, M.D. - Photography by Warren Diggles
In 2007, Eagles’ President and General Manager, Chris Stewart, was a Head Coach who couldn’t stand or sit comfortably for any period of time. Stewart had planned to take a hiatus for a portion of the season while he addressed the degeneration of his lumbar discs. The bone on bone grinding in his lower back had reached a point where bumping down the road on the team bus was excruciating.
He had even been mistakenly assumed dead by an opposing team’s equipment manager one day when, during a pre-game skate, he had stretched out flat on the floor under the stands. He laughs as he remembers the temporary panic his prone position caused. “The only way to reduce pain was to go in under the stands and lay flat on my back to take the pressure off. The guy must have thought I’d had a heart attack or died or something.”
Stewart explains that his back problems hadn’t been caused by a specific hockey injury but probably had been exacerbated by a career that involved a lot of activity and many, many miles on the road. The pain wasn’t responding long term to any of the multiple therapies he had tried, so Stewart started looking for a surgeon. The name he heard again and again was orthopedist, Douglas Beard, M.D. At the time, Dr. Beard was practicing in Denver.
Patient Alan Braga is seen by surgeon Timothy Wirt, M.D. for his post-surgical appointment.
Dr. Beard explains the lumbar disc arthroplasty he performed with consultation from his neurosurgical colleagues: “Coach Stewart had a two level, lumbar disc replacement. The procedure is done retroperitoneally (from the front side, going through the abdomen). Usually we make a small incision and work carefully around or behind organs. And no, we don’t pull the guts out of the abdominal cavity and plop them aside while we work on the spine,” Dr. Beard jokes. “It’s a common misconception.”
“We find the diseased disc level and spend a lot of time remobilizing the disc – getting it to move again the way it’s supposed to - getting off bone spurs, and making sure there is nothing bulging backwards towards the nerves. In older days, we would have removed the diseased disc and placed a block of bone between the two sites, where they would have grown together and forever more been fused. With the arthoplasty procedure, we assemble a plastic ball and metal cup arrangement that allows the vertebrae above and below to continue moving naturally.”
Dr. Beard uses the ProDisc prosthesis from Synthes, which has two metal endplates and one plastic in-lay. The metal endplates are carefully fitted to the upper and lower vertebrae. According to Synthes, the plastic inlay snap locks into the lower endplate and provides the ball that rides in the socket of the upper endplate that is intended to allow motion. By replacing spinal fusion surgery with arthroplasty (literally meaning surgical repair of the joint), patients’ spines have better mobility and less stress on joints surrounding a fused site.
Coach Stewart says, “The procedure and recovery went very well. I was back on the bench within six to eight weeks - a lot quicker than initially anticipated. I had planned to be on sabbatical potentially for the whole season… We went on to win the national Championship that year.” Stewart gives credit to the Eagle’s staff, and especially his assistant coach, Ryan Bach for their excellent work. However, he feels that it was Dr. Beard’s care that made winning the cup a possibility at all. “It absolutely helped accommodate that opportunity to win the championship,” he says.
Before X-ray of Alan Braga’s spine. Weakened neck and back muscles prevented him from straightening his neck.
Results like Chris Stewart’s caught the attention of the partners at Front Range Center for Brain & Spine Surgery, P.C. (FRCBS) whose then 29-year-old neurosurgery practice was thriving. Already renowned for exceptional head work and top quality spine care, the partners agreed that adding Dr. Beard would bring a new level of technical ability, allowing them to care for patients who had complex deformities.
Senior surgeon, Timothy Wirt, M.D. who has practiced at FRCBS since 1980, says, “It has been a great partnership.” Since Dr. Beard joined in 2008, the practice has benefited from the synergy of surgical excellence in orthopedics and neurosurgery. FRCBS’s four surgeons, Timothy Wirt, M.D., Donn Turner, M.D., Hans Coester, M.D., and Douglas Beard, M.D., are all board certified in their specialties. All but Dr. Beard are also fellows in the American College of Surgeons.
Dr. Wirt, known throughout the region for swift, safe, accurate surgeries appreciates Beard’s skills in the operating room. “Doug and I have similar approaches. When we operate together, things really click which makes surgeries much faster and thus reduces risks to patients from exposure to the air and long periods under general anesthesia.”
The practice’s approach to surgery seems to get results. Care Science, a national, independent quality management firm reported that surgical patients of FRCBS had half the morbidity rate of the national average (.9 percent versus 1.8), and had 5.8 percent fewer surgical-related complications than usual.
FRCBS’s practice draws patients from all across Colorado, western Nebraska, and southern Wyoming. In many cases, people bypass other major medical centers to come to Fort Collins specifically because of the reputation for excellence that has been built by the partners.
After X-ray which shows the 20 screws attached to the metal rod used to straighten Braga’s neck.
Such was the case for Alan Braga. The 75-years-old semi-retired farmer lives in Encampment, Wyoming. When it was clear that his severely humped neck was not going to straighten up through physical therapy, his friends suggested he go see Dr. Wirt.
“The trouble with my neck started 15 years ago. My neck and back muscles were not strong enough to lift my head up any more. My face was perpendicular to my body. I couldn’t look people in the eye and just felt like there was a barrier between me and the world,” Braga explains.
Dr. Wirt performed a C2 to T4 fusion from the bottom of Braga’s cranium to his shoulders by screwing a nine inch titanium rod into the spine. “He’s got a metal rod for a neck,” Dr. Wirt sums up.
“Mr. Braga’s procedure went well,” recalls Dr. Wirt. “We set him up in the operating room to be physiologically and anatomically neutral. He was curved downward, so under general anesthesia, we repositioned his head to be neutral with his eyes level. Then we opened up the cervical/thoracic spine [inserted the rod] and put screws into every lateral mass. We connected the 20 screws to the rod, roughed up the bone and laid down material that will make it all fuse together.”
“It feels good to finally greet people eye to eye,” Braga says by phone from his home in Encampment. “I think I had the best care – I couldn’t have had better surgeons anywhere.”
At one point, FRCBS might not have attempted to correct Braga’s deformity. However Dr. Beard’s previous experience with cervical fusions added the extra know-how that was needed to ensure a successful outcome.
Because of the integration of neurosurgery and orthopedic surgery, Front Range Center for Brain & Spine Surgery now offers more depth in spine care. Because of the collaboration of talented physicians like these, Chris Stewart and Alan Braga are living fuller, less painful lives… and Northern Colorado is home to a CHL national championship team. |
