Collaborative Care in Spinal Stenosis: Breaking Barriers for Better Patient Outcomes
Author— Ajay Antony MD, John Stevenson MD
Published
October 11, 2023
Key Terms: collaborative care, Advanced Practice Providers (APPs), clinical decisions, practice growth, patient well-being, quality of care, optimizing patient care.
In the evolving landscape of medical care, collaboration between different specialties is proving to be a game-changer for patients dealing with complex conditions. One such collaborative effort that stands out is the partnership between interventional pain physicians and spine surgeons in managing lumbar spinal stenosis (LSS). This contemporary approach aims to provide patients with a continuum of care that merges the expertise of both fields, resulting in better outcomes and improved patient experiences.
Historically, the divide between pain management and surgical intervention was palpable. However, this narrative is rapidly changing, as exemplified by the journey of Dr. Stevenson, a veteran neurosurgeon, and Dr. Antony, an interventional pain physician. Their collaboration, cautious at first, quickly evolved into a transformative model of patient care.
Transforming the Landscape of Lumbar Spinal Stenosis Treatment
The key to this success lies in breaking down perceived barriers. Both specialists found that open communication, transparency, and a shared goal of patient well-being were the bridges that brought them together. Instead of focusing on the contrast between their specialties, they recognized the value of mutual learning. This synergy allowed for comprehensive discussions surrounding spinal stenosis treatment options. Topics of open discussion included MRI interpretations, indications for different procedures, and when surgery should be considered as an early option. It was a shift from a mindset of “last resort” to “best-suited solution.”
“The environment we created in our practice has led
to a better patient-care model.”
One of the most remarkable aspects of this collaboration was the way it empowered advanced practice providers (APPs), such as physician assistants (PAs), to become integral members of the patient care team. Armed with the ability to read imaging, understand evidence-based outcomes, and confidently make clinical decisions, APPs played a crucial role in identifying suitable patients for various treatments. This streamlined approach enabled faster diagnoses, quicker referrals, and ultimately, better patient experiences.
Innovative Collaborations: Advancing Lumbar Spinal Stenosis Treatment Through the mild® Procedure
An excellent example of this collaboration in action was the mild® Procedure, a minimally invasive technique for treating lumbar spinal stenosis. This procedure served as a catalyst for discussions that led to deeper understanding and synergy between pain management and surgical interventions. With shared imaging interpretation and a clear algorithmic approach, the team was able to offer patients tailored solutions that ranged from minimally invasive interventions to spinal stenosis surgery, depending on the individual case.
The success of this collaborative approach was reflected not only in patient outcomes but also in practice growth. The combined efforts of pain management and surgical teams resulted in an increased patient volume, dispelling the notion that collaboration might hinder individual specialties. Instead, it enhanced the quality of care across the board.
The success story of Dr. Stevenson, Dr. Antony, and their team serves as an example for all medical professionals seeking to bridge the gap between specialties. The barriers that once stood between pain management and surgical intervention are now seen for what they truly are—perceived limitations that can be dismantled through open dialogue, shared expertise, and a genuine commitment to patient well-being. Through collaborative efforts, the medical community can continue to optimize patient care and shape a brighter future for all.
To hear more about this collaboration in action, from Drs. Antony and Stevenson themselves, please click the link below to listen to “The Pain Physician & Spine Surgeon Relationship” on ASPN’s Pain Unfiltered podcast.
About Dr. Ajay Antony Dr. Ajay Antony is an interventional pain physician, working at The Orthopedic Institute after 4 years as a faculty member at the University of Florida (UF). He earned his bachelor of science at the University of Florida and earned his medical degree at St. George University School of Medicine. He went on to complete his anesthesiology residency and pain medicine fellowship training at UF. After joining the faculty, Dr. Antony served to: grow the fellowship program to national recognition, bring several new procedures to the Florida community, and continue to be a recognized leader in his specialty. Dr. Antony is a member of many professional academic societies such as the Alpha Omega Alpha Honor Medical Society, the North American Neuromodulation Society (NANS), and the International Neuromodulation Society (INS). He has lectured both nationally and internationally and teaches national training courses for fellows and practicing physicians.
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2012 data from Health Market Sciences report for Vertos Medical 2013.
Data on file with Vertos Medical.
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Based on mild® Procedure data collected in all clinical studies. Major complications are defined as dural tear and blood loss requiring transfusion.
MiDAS ENCORE responder data. On file with Vertos Medical.
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Treatment options shown are commonly offered once conservative therapies (e.g., physical therapy, pain medications, chiropractic) are not providing adequate relief. This is not intended to be a complete list of all treatments available. Doctors typically recommend treatments based on their safety profile, typically prioritizing low risk/less aggressive procedures before higher risk/more aggressive procedures, but will determine which treatments are appropriate for their patients.
Although the complication rate for the mild® Procedure is low, as with most surgical procedures, serious adverse events, some of which can be fatal, can occur, including heart attack, cardiac arrest (heart stops beating), stroke, and embolism (blood or fat that migrates to the lungs or heart). Other risks include infection and bleeding, spinal cord and nerve injury that can, in rare instances, cause paralysis. This procedure is not for everyone. Physicians should discuss potential risks with patients. For complete information regarding indications for use, warnings, precautions, and methods of use, please reference the devices’Instructions for Use.
Patient stories on this website reflect the results experienced by individuals who have undergone the mild® Procedure. Patients are not compensated for their testimonial. The mild® Procedure is intended to treat lumbar spinal stenosis (LSS) caused by ligamentum flavum hypertrophy. Although patients may experience relief from the procedure, individual results may vary. Individuals may have symptoms persist or evolve or other conditions that require ongoing medication or additional treatments. Please consult with your doctor to determine if this procedure is right for you.
Reimbursement, especially coding, is dynamic and changes every year. Laws and regulations involving reimbursement are also complex and change frequently. Providers are responsible for determining medical necessity and reporting the codes that accurately describe the work that is done and the products and procedures that are furnished to patients. For this reason, Vertos Medical strongly recommends that you consult with your payers, your specialty society, or the AMA CPT regarding coding, coverage and payment.
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Abstract presented at: American Society of Pain and Neuroscience Annual Conference; July 22-25, 2021; Miami Beach, FL.
Mobility Matters: Low Back Pain in America, Harris Poll Survey, 2022. View data and full summary here.
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About Dr. Ajay Antony