Spine

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Our spine specialists are renowned for treating a wide range of spinal diseases and conditions of the cervical, thoracic, and lumbar spine. Our specialists treat both adult and pediatric spinal conditions

Our specialists are nationally and internationally recognized for their leadership in both clinical care and research efforts in spine surgery. Our spine service receives patient inquiries and referrals from around the world and has one of the best-known clinical practices in the United States for the surgical management of adult and pediatric spinal deformities, spinal tumors, and complex degenerative conditions. Each of our spinal surgery patients receive an individualized, comprehensive treatment plan that includes access to a Spine Journey Guide to prepare them for surgery. 

By conducting basic science and clinical research, our spine specialists have contributed enormously to the understanding of various spinal disorders. Our team is one of the few centers in the United States to receive both governmental and non-governmental grant funding to conduct high-level research.

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Commonly Treated Conditions

Degenerative conditions

  • Compression of spine/spinal nerves
    • Myeloradiculopathy
    • Myelopathy
    • Neurogenic claudication
    • Radiculopathy
  • Degenerative disc disease/arthritic conditions of the spine
  • Disc herniations of the cervical, thoracic, or lumbar spine
  • Spinal stenosis of the cervical, thoracic, or lumbar spine
  • Spinal trauma, fractures, pars fractures
  • Spinal tumors
  • Spondylolisthesis
  • Spondylolysis (pars fracture)
  • Synovial cyst

Deformity

  • Congenital deformities
    • Congenital cervical dislocation
    • Hemivertebra
  • Kyphosis
    • Acquired kyphosis, such as fixed sagittal imbalance (flat-back syndrome)
    • Age-associated kyphosis
    • Junctional kyphosis
    • Post-traumatic kyphosis (post laminectomy)
    • Scheuermann's kyphosis
  • Scoliosis
    • Adult degenerative (De Novo) scoliosis
    • Idiopathic scoliosis (infantile, juvenile, adolescent, adult)
    • Neuromuscular scoliosis (muscular dystrophy)
    • Syndromic scoliosis, occuring from Marfans, Ehlers-Danlos

Complex Spine Deformities

  • Coronal imbalance
  • Failed fusion/pseudoarthrosis
  • Postoperative deformity
  • Sagittal imbalance (flat-back syndrome)
  • Transition syndrome/adjacent segment disease

Treatment Approach

Nonoperative Care 
Our spine specialists begin with a conservative, nonoperative approach to treating spinal injuries and conditions, with a primary goal of restoring function and limiting pain. We provide comprehensive services at numerous locations across the St. Louis area, and most general spine problems are managed in an outpatient setting. Our spine specialists work in close collaboration with our physical medicine and rehabilitation specialists to develop a customized treatment plan based on the needs of each individual patient. Conservative management may include physical and occupational therapy, medications, injections and other nonoperative treatment modalities.

Surgical Care
When nonoperative treatment has been found unsuccessful in providing relief from symptoms, our spine specialists explore surgical management as an option. Surgical treatment is tailored to each individual patient and may vary in scope depending on the condition, the patient’s health, and their expectations. 

When appropriate, we offer many minimally invasive surgical options such as a microdecompression or spine fusion. Minimally invasive surgery typically provides patients a quicker recovery because of less tissue disruption and a smaller incision, among other benefits.

In some circumstances, a more traditional spine surgery may be recommended for the patient. Our spine surgeons are renowned experts in performing complex spine procedures for pediatric and adult spinal deformities, degenerative conditions affecting the spine, spinal tumors, and traumatic spinal injuries. By working together with a team of expert anesthesiologists, operating room personnel, and an electrophysiologist to monitoring spinal cord function, we are able to perform surgery in a safe and efficient manner. 

We provide our spine surgery patients with a comprehensive Spine Journey Guide, to help prepare them for surgery and their postoperative recovery. Postoperative care is focused on optimizing the patient’s recovery. Rehabilitation begins in the hospital and continues on an outpatient basis after the patient is discharged with the goal of restoring the patient’s quality of life. By working in collaboration with physical and occupational therapists, physical medicine and rehabilitation specialists, and the patient, we strive to obtain the best results possible.

Specialized Services

Complex Spinal Deformity Reconstruction
We provide nationally and internationally recognized surgical treatment of complex spinal deformity. These complex surgeries include laminectomies, laminectomies with spinal fusions, spinal osteotomies from simple Smith-Petersen osteotomies to complex three-column osteotomies that include pedicle subtraction osteotomies and vertebral column resection. Complex reconstruction is done for severe deformities and also revision cases in patients who have had multiple failed procedures require these complex reconstructions. These procedures are highly technical and require surgical expertise that is not found in many centers in the United States. The care of the complex spine patient also requires a highly specialized spine team of nurses, therapists, and operating room personnel for a safe and efficient surgery.

Spine Center
Acute back and neck pain can be evaluated and treated at the Washington University and Barnes-Jewish Orthopedic Spine Center. Members of a multidisciplinary team work together to coordinate the best care for each patient, offering both nonsurgical and surgical solutions. The Spine Center also offers on-site imaging, physical therapy, manual medicine, massage therapy, and acupuncture. 

Spinal Tumor Center
The Washington University Orthopedics Spinal Tumors Center provides comprehensive, specialized care to patients with tumors of the spine, including metastatic spinal tumors and benign and malignant primary spinal tumors. Although many metastatic spinal tumors can be treated with radiation therapy and chemotherapy, some  metastatic spinal tumors require surgical treatment. Surgery can range from a minimally invasive procedure to complex reconstruction depending on the severity of cancer involvement. Benign primary spinal tumors also frequently require surgical intervention, and can sometimes be treated nonoperatively; however the vast majority of malignant primary spinal tumors require surgical treatment.

Research & Clinical Trials

For information on current clinical trials related to orthopedics, or to make an appointment with a specialist with Washington University Orthopedics, please call (314) 514-3500 or toll free (866) 867-3627.

Meet Our Team

Jacob Buchowski, MD, MS

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Keith Bridwell, MD 

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John Clayton Clohisy Jr., MD 

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Matthew L. Goodwin, MD, PhD, FACS

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Munish Gupta, MD, MBA

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Brian Kelly, MD

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Mark Lambrechts, MD

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Scott Luhmann, MD

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Blake K. Montgomery, MD

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Brian J. Neuman, MD

Chief, Division of Spine Surgery

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Nicholas Pallotta, MD, MS

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Padmini Prabhu, PA-C, PT, MBA

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Patient Stories

Chris Carenza

Chris Carenza

Chris is a marathon runner who is back to racing after suffering a near-death spinal injury. Spine surgeon Jacob Buchowski, MD, MS, performed a procedure known as an anterior cervical discectomy and fusion, which involved decompressing Carenza's spinal cord, and repairing broken vertebrae and fusing the C3 and C4 vertebrae.

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Read Chris' Story

Patient Education

Spine Surgery Patient Journey GuideSpine Journey Guide

 

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