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Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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we also have a large number of younger, more athletic types with rup- tured discs or injuries from motor vehicle accidents. The largest group of patients is made up of people who are frustrat- ed by their limitations. They used to play tennis and golf, but find they can't anymore. They used to take trips or visit their kids, but now, if they drive long distances, they spend the whole weekend in bed because their backs hurt so badly. Comorbidities are the one signifi- cant inhibiting factor, but as long as our team is confident that we can manage and educate a given patient, we can handle a broad range. We've had patients in their 90s who've been highly motivated and who've done very well. Of course, surgery isn't the first option. Our surgical patients are people who've tried anti-inflammatories, or other approaches, like chi- ropractics or acupuncture. It's when those things fail that we'll look at X-rays and MRIs and discuss findings and options. Keep in mind, how- ever, that payers are steering volume to high-value programs and requiring conservative management before surgical consultation for low back pain. A patient may have an epidural, may have physical therapy or may go straight to surgery. It depends on the pathology. Once they've had surgery, it's usually about 6 weeks before they can start physical ther- apy, but they're usually back at work very quickly. It's amazing how much spine surgery has progressed in the last 20 years. Incisions are smaller, and with microscopes and very fine instruments, tissue dis- ruption is minimal and recovery is fast. Most importantly, it's giving people back the lifestyles they want. OSM 6 0 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 7 Dr. Bray (lsotoodeh@discmdgroup.com) is the founder and CEO of the Diagnostic and Interventional Surgical Center (DISC) in Marina del Rey, Calif., and DISC Surgery Center at Newport Beach, Calif. Ms. Reiter (kreit- er@discmdgroup.com) is the administrator.

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