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Spine

PROGRAM DESCRIPTION 
The diagnosis and treatment of disorders of the spine and spinal cord has long been an integral part of the Department of Neurological Surgery at Washington University School of Medicine. Now with five fellowship-trained neurosurgeons focused primarily on treatment of the spine, the Spine Division offers complete care of spinal disorders at Barnes-Jewish and St. Louis Children’s hospitals.

The Spine Division sees approximately 1,350 new patients in consultation and performs approximately 665 spinal surgeries each year.

We treat the entire spectrum of disorders of the spine and spinal cord – from the routine to the highly complex. The Spine Division has expertise in the treatment of craniocervical, cervical, thoracic, lumbar and sacral disorders. Spinal disorders resulting from degenerative disease, trauma, tumors, inflammatory conditions, congenital and vascular problems, and infectious disease are all treated by the Division.

The faculty members of the Spine Division are making significant contributions to the advancement of spinal surgery through the development of new techniques, involvement in clinical studies and publishing groundbreaking material on spinal disorders.

Translaminar fixation, a surgical technique of the upper cervical spine, was developed by one of the faculty. This technique greatly reduces the operative risks during treatment of instability of the atlantoaxial (C1-2) junction.

In addition to all traditional approaches to the spine, the Spine Division offers the most up-to-date minimally invasive techniques to obtain the best possible outcome. The Division has expertise in all approaches to the spine, including anterior, posterior, lateral and endoscopic.

The Spine Division actively participates in clinical studies on new and emerging technologies, including the FDA-approved multi-center trial on the Cervicore artificial disc.

Stem cell transplantation for spinal cord repair is a groundbreaking paper authored by a faculty member in the Spine Division.

Faculty members have published extensively and have lectured on spinal disorders both nationally and internationally.

CONDITIONS & TREATMENTS
The Spine Division receives a significant number of patient referrals from the region. We are equally skilled in treating straightforward spinal disorders, such as herniated discs and neck and back pain, and complicated disorders such as C1-2 instability and tumors of the spine.

Multi-disciplinary Approach
The Spine Division is part of a larger multi-disciplinary approach to spinal disease at Washington University so that spine patients have at their disposal the leading specialists in each field, including surgical partners in thoracic surgery, vascular surgery, and ear, nose and throat surgery.

For conservative care and the non-operative treatment of spinal disorders, the Spine Division collaborates with physical and occupational therapy, rehabilitation and physiatry services, and pain management.

The Spine Division is associated with the Rehabilitation Institute of St. Louis, providing world-leading rehabilitation services for patients with spinal injuries.

PROBLEMS WE TREAT

Degenerative spinal conditions

  • Back pain
  • Herniated discs (cervical, thoracic, lumbar) can occur in any part of the spine. Most herniated discs affect the lower back (lumbar spine). Some occur in the neck (cervical spine) and, more rarely, in the upper back (thoracic spine).
  • Neck pain is most often caused by repeated or prolonged movements of the neck’s muscles, bones, tendons or ligaments. It usually results in a strain, a sprain, spasm of the neck muscles or inflammation.
  • Ossification posterior longitudinal ligament (OPLL)
  • Osteoarthritis is found primarily in the hips, knees, hands and back and is most common in older people.
  • Radiculopathy
  • Spondylolisthesis is a condition that happens when a bone in your back slides over the bone below it. It usually occurs in the lower spine. In some cases, your spinal cord or nerve roots are compressed or squeezed. This can cause pain and numbness or weakness in your legs.
  • Spondylosis
  • Spondylotic myelopathy
  • Synovial cysts

Traumatic spinal conditions

  • Atlantoaxial instability is characterized by increased mobility at the articulation of the first and second cervical vertebrae (atlantoaxial joint).
  • Spinal cord injury is damage to the spinal cord that can interfere with how messages travel back and forth between the brain and the rest of the body. An injury to the spinal cord can result in complete or partial loss of movement (paralysis) and feeling and complete or partial loss of bladder and bowel function.
  • Spinal fractures

Tumors of the Spine and Spinal Cord

Benign spinal tumors

  • Aneurysmal bone cysts (ABCs)
  • Eosinophilic granuloma
  • Giant cell tumor
  • Hemangioma
  • Osteoblastoma
  • Osteochondroma
  • Osteoid osteoma

Malignant Spinal Tumors

  • Chondrosarcoma
  • Chordoma
  • Ewing's sarcoma
  • Lymphoma
  • Osteosarcoma
  • Plasmacytoma
  • Schwannoma M or B
  • Spinal astrocytoma M or B
  • Spinal meningioma M or B

Vascular spinal disorders

  • Spinal fractures
  • Spinal arteriovenous malformations
  • Spinal A-V fistulae

Congenital spinal disorders

  • Arachnoid cysts are fluid-filled sacs that occur on the arachnoid membrane that covers the brain (intracranial) and the spinal cord (spinal).
  • Myelomeningocele
  • Diastematomyelia
  • Os odontoideum
  • Spina bifida is a birth defect in which the bones of the spine (vertebrae) do not form properly around the spinal cord.

Inflammatory spinal disorders

  • Rheumatoid arthritis-related spinal conditions
  • Ankylosing spondylitis
  • Osteoarthritis is a disease primarily found in the hips, knees, hands and back and is most common in older people.

FACULTY
Adult Spinal Neurosurgeons
 Robert L. Grubb, MD
 Eric C. Leuthardt, MD
 Paul Santiago, MD
 Todd J. Stewart, MD
 Neill M. Wright, MD

Pediatric Spinal Neurosurgeons*
 Jeffrey Leonard, MD 

*Pediatric spine patients are typically seen by Dr. Leonard. However, our adult spinal neurosurgeons will see pediatric patients with complicated spine conditions on a scheduled, case-by-case basis.

CONFERENCES
The Neurosurgery Spine Division recently created the multi-disciplinary Spine Tumor Board to optimize the care and treatment of patients with tumors of the spine and/or spinal cord. This board brings together neurosurgery, orthopedics, medical oncology and radiation oncology to collectively discuss the best treatments for each patient. Physicians wishing to submit cases for review should contact the Spine Division Nurse Coordinator at (314) 747-6561.

MAKE AN APPOINTMENT
Adult Patients
Contact us at (314) 362-3577 (Option 2)

Adult Referring Physicians
Contact us at (314) 362-3577 (Option 1)

Adult Spine Health History Form 

Pediatric Patients or Physicians
Contact us at (314) 454-2810

PATIENT OFFICE LOCATIONS
Adult Patients
Neurosurgical Cervical Spine Institute and Spine Center
Center for Advanced Medicine
4921 Parkview Place, Suite 6B
St. Louis, Missouri 63110

Barnes-Jewish West County Office
1040 North Mason Road, Suite 211
Creve Coeur, Missouri 63141

Pediatric Patients
St. Louis Children’s Hospital
1 Children’s Place, Suite 4E
St. Louis, Missouri 63110

Helpful Maps

SPECIALTY LINKS
 Pediatric Neurosurgery at St. Louis Children's Hospital

Pain Center at Washington University School of Medicine

Rehabilitation Institute of St. Louis

Washington University Institute for Minimally Invasive Surgery

Spine Universe