Spine surgeon redefinines care at Medical City Fort Worth

At Medical City Fort Worth (Texas), Paul Henry Cho, MD, is pushing forward spine innovation.

Dr. Cho completed the hospital’s first motion-preserving surgery for lumbar spinal stenosis and degenerative spondylolisthesis. 

For that case, other spinal fusion alternatives were considered, but a motion-preserving implant was chosen since it would best address the underlying pathology in the spine, Dr. Cho told Becker’s.

“Other alternatives are things where we don’t implant hardware and we do a decompression without any metal devices,” Dr. Cho said. “The problem with that is the more areas of the spine we decompress, the more areas of the spine that have nerves being pinched. With more instability we introduce into the spine, folks recover from that surgery, but that area can become unstable, generating a brand new set of symptoms.”

Dr. Cho said the motion-preserving implant was a relatively quick sell to hospital leaders, and it took less than three months from the time he requested the device to having it approved and used in surgery. 

“Right now there’s not many products available that provide an alternative to fusion,” he said. “The ones that had previously been available such as lumbar artificial discs have unfortunately had a high complication and failure rate, so that there are quite a few surgeons that will not implant them. There have been devices such as interspinous spacers, which are little devices that go in between the bones, but those similarly also have a high failure rate as well.” 

While the hospital was open to the new procedure, Dr. Cho said insurance was a challenge. While the device he used was FDA-approved, most insurers were calling it “experimental.”

Dr. Cho’s patients who had motion-preserving spine surgery stayed at the hospital at least one night, but he said Medical Fort Worth has been forward thinking when it comes to outpatient care.

“The vast majority of inpatient cases that we admit for these procedures are complex spine,” he said. “We have a [facility] here where we are able to perform outpatient surgery. They have a very robust spine program and a spine team here that really helped to facilitate patient care and follow up in the outpatient setting. Medical City Fort Worth has been very responsive and to adapt other things to that changing environment and shifting some of these procedures to an outpatient.”

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