Spine

Video 1: Shared Decision Making in Lumbar Spine Surgery at Olympia Orthopaedic Associates 
Hello, and thank you for joining me for this video. I’m Dr. Andrew Manista with Olympia Orthopaedic Associates. Today, I will discuss shared decision-making regarding lumbar spine surgery. 
 
You may wonder, “What is shared decision-making?” It is a collaborative process where you and I discuss your options and decide if surgery is the right choice for you. If you’re watching this video, it’s likely that conservative efforts have not provided sufficient relief for your symptoms. These efforts might include rest, activity modification, non-steroidal anti-inflammatory drugs (NSAIDs), physical therapy, home exercises, or epidural steroid injections. If these treatments haven’t worked, surgery may be an option. 
 
When considering surgery, it’s important to evaluate the risks, benefits, and goals of the procedure. We will discuss what we hope to achieve, the expected outcomes, and the likelihood of success. We provide informational materials, including lists of what you can and cannot do after surgery, and videos that explain the procedure in more detail. 
 
As part of preparing for surgery, we must ensure you have a support system in place. You need to know who will help you with tasks like changing bandages or preparing meals. This could be a simple discussion if you have family or friends to help, but it may require more planning if you are alone. 
 
We will also review your allergies, current medications, and any specific end-of-life care wishes. If you have a living will or healthcare directive, now is the time to discuss it. 
 
At Olympia Orthopaedic Associates, we are involved in research regarding lumbar spinal fusion procedures. You will be asked to complete surveys before and after surgery—some up to four years post-op—to help us improve patient care and safety. Your participation contributes to making spine surgery safer and more effective for future patients. 
 
Shared decision-making is a team effort between you, as the patient, and me, as your surgeon. We will discuss the risks and benefits specific to your situation. Once all your questions have been answered and we agree to proceed, we will sign an informed consent document confirming our mutual understanding and decision. 
 
Thank you for taking the time to learn about shared decision-making in lumbar spine surgery. I wish you the best of luck with your procedure. 
 
Video 2: How Has Spine Surgery Changed in the Last Decade? 
In the past decade at Olympia Orthopaedic Associates, we’ve seen remarkable advancements in spine surgery. With the development of minimally invasive techniques, we can now perform procedures that previously required days in the hospital as outpatient surgeries. Using smaller incisions and expandable cages, we can correct spinal deformities that once required complex surgeries from both the front and back, now just through small incisions from the back alone. 
 
One area I am particularly passionate about is robotic spine surgery. With robotics, we have virtually eliminated the risk of missing our target, and it’s an exciting, growing field. Over the past three and a half years of using robotic technology, we’ve seen significant improvements in patient outcomes. 
 
If you are considering spine surgery, please consider Olympia Orthopaedic Associates. We are committed to educating our patients, reviewing your studies, and providing you with all the options. We don’t tell you what to do; we inform you of your options so that you can make the best decision for yourself. 
 
Video 3: Learning About Robotic TLIF Spine Surgery with Dr. Andrew Manista 
Hello, and welcome to Olympia Orthopaedics’ YouTube page. This is the first of many videos we are creating to help you better understand your surgical procedure. Today, I’d like to talk to you about robotic spine surgery. 
 
I’m Dr. Andrew Manista, the Director of the Robotic Spine Surgery Program here. If you’re watching this video, you’re likely interested in robotic spine surgery or are preparing for an upcoming procedure. I will be discussing a robotic-assisted Transforaminal Lumbar Interbody Fusion, or TLIF. This procedure aims to create more space for your nerves and align your spine’s bones better, holding them in place permanently. The decompression process is often medically referred to as a laminectomy, while the alignment and fusion process involves linking the bones together permanently. 
 
You might have questions like, “What can I expect? Will it hurt a lot? What will I need at home?” These answers can vary as technology and techniques evolve. That’s why we update these videos every 12 months to ensure the information remains current. 
 
For example, one common concern is the risk of infection. We ask patients to use a special antibacterial wipe on their body the evening before or the morning of surgery. We also administer antibiotics intravenously during and after the procedure and use strict sterile techniques to minimize infection risk. 
 
Patients also worry about nerve damage during surgery. We minimize this risk by using careful surgical techniques, robotics to guide instrumentation, and neuro-monitoring to track nerve function. If a nerve shows signs of stress, we can adjust our approach immediately. 
 
Regarding recovery, we aim to get you up and moving within the first 24 hours post-surgery to prevent pneumonia, reduce blood clot risks, and encourage muscle recovery. You will meet with a physical therapist either on the day of surgery or the next morning, depending on your procedure time. Mobility is key to a successful recovery. 
 
Before going home, you’ll need to be able to walk independently, manage pain with oral medications, and urinate after catheter removal. Preparing your home beforehand, ensuring safe spaces, and potentially arranging for a home healthcare aide can also help facilitate a smoother recovery. 
 
I hope this overview has answered many of your questions. We aim for you to have a speedy recovery and encourage you to explore more of our videos for additional information. 
 
Video 4: Does Seeing a Spine Specialist Mean You’re Going to Need Spine Surgery? 
When you visit a spine specialist, you might wonder if it means you will need spine surgery. The answer is no. Many conservative treatments are available for most conditions, such as physical therapy, oral medications, chiropractic care, massage, acupuncture, and epidural steroid injections. We always aim to treat patients the way we would want to be treated—by exhausting all other options before considering surgery. 
 
If you or a family member is experiencing back or neck pain, please visit Olympia Orthopaedic Associates. We are here to evaluate your condition and provide the best possible care. 
 
Video 5: Understanding Degenerative Disc Disease and the Treatment Options 
Degenerative disc disease (DDD) is a broad term describing several conditions that can occur as the spine ages. As we age, the discs between our vertebrae lose water content, becoming less spongy and more brittle, like “crab meat.” This loss of cushioning can cause discomfort. In some cases, the disc bulges backward and presses on a nerve, causing pain down the leg—a condition known as sciatica if it occurs at the L5-S1 segment. 
 
Degenerative disc disease is not a disease but a description of the aging process of the spine. Treatment options depend on the specific condition. For axial pain or general back pain, treatments may include physical therapy to strengthen core muscles, NSAIDs, and lifestyle changes to avoid heavy lifting, bending, and twisting. If the disc presses on a nerve, additional treatments like steroid injections, oral steroids, or, as a last resort, surgery may be needed to relieve nerve pressure. 
 
Video 6: Sacroiliac Joint Dysfunction 
Hello, I’m Dr. Manista with Olympia Orthopaedic Associates. Today, I want to discuss an often overlooked cause of lower back pain: sacroiliac (SI) joint dysfunction. 
 
The SI joint connects the spine to the pelvis and is stabilized by ligaments and muscles, allowing limited movement. Like other joints, it can degenerate or suffer ligament injuries, leading to dysfunction and pain. Common symptoms include lower back, hip, groin, or buttock pain, which can worsen with prolonged sitting or at night. 
 
Diagnosis involves a thorough history and physical exam, including special tests like the 14-2 finger test and provocative maneuvers, along with diagnostic injections into the SI joint. 
 
Treatment options range from activity modifications, specific exercises, physical therapy, medications, injections, and even radiofrequency ablation. For those who do not find relief with conservative measures, a minimally invasive fusion using the iFuse implant may be considered. This small, triangular implant stabilizes the joint and promotes long-term fusion, with a high rate of patient satisfaction and proven efficacy in improving pain and function. 
 
Thank you for learning about SI joint dysfunction. If you think this might be a problem for you, I’d be happy to evaluate you in my clinic. Please call to schedule an appointment.