Dramatic improvements in spine and neck surgery.
Due to recent improvements in technology — from nerve monitoring equipment to computer-aided navigation — spinal and neck surgeries have advanced dramatically. In the past, “open” surgeries on the neck or spine involved making a large incision to allow the surgeon to view and access the anatomy. However, due to technological advances, back and neck conditions can now be treated with minimally invasive surgical techniques. Instead of removing muscle attachments from bone, during MIS, the muscle is spread and pushed out of the way. The result is that the risks and surgical complications are less and there is a much faster recovery time.
Dr. Thomas Francavilla, a board-certified neurosurgeon who is known for his early adoption of MIS for the treatment of chronic back pain, neck pain and degenerative disc disease, has built his medical expertise on meticulous and conservative spine treatments that have shortened patient’s rehabilitation times, preserved native tissues and maximized treatment outcomes. “For some patients, minimally invasive spine surgery works better than ‘open’ surgery,” Dr. Francavilla says. “Because we can make a shorter incision, one inch as opposed five inches, there is less disruption of the muscle and tissues, and we can avoid significant damage to the muscles surrounding the spine. In most cases, MISS results in a less blood loss, lower infection rates and faster recovery times.”
Dr. Francavilla, who brings his 32 years of expertise to patients at the Tulane Covington Neuroscience Clinic, also performs surgeries at Lakeview Regional Medical Center and is the Clinical Assistant Professor of Neurosurgery at the Tulane University School of Medicine’s Center for Clinical Neurosciences. His impressive background includes a medical doctorate from the Tufts University School of Medicine, neurosurgery training at George Washington University (where he received numerous awards) and a Fellowship in studying brain tumors at the National Institutes of Health.
After growing a successful practice as a neurosurgeon, Dr. Francavilla recognized that minimally invasive spine surgery was a major advance in helping patients suffering from neck- or spinal-related pain. Although he performed minimally invasive procedures since 2002, his fellowship with the Laser Spine Institute established him as a leader in MIS.
“Often when a patient experiences back pain, there is something pushing on something else,” Dr. Francavilla says. “Technology has made MIS easier because we can use x-rays, computer-aided navigation techniques and specialized tubes or retractors with special cameras or microscopes to pinpoint the exact source of the pain without disrupting any of the body’s other functions.”
If a patient is experiencing back pain, whether from misaligned bones, wear and tear, trauma or from a decompression procedure, another option may be spinal fusion. Spinal fusion corrects problems with the small bones of the spine (vertebrae) by fusing together the painful vertebrae so that they heal into a single, solid bone. Minimally invasive spine surgical techniques can be used for these types of patients also. “Patients who were once told that there was nothing that could be done to help them or that they had to have screws and rods placed in their spine in order to get some type of relief, now have other options,” Dr. Francavilla says. “Most people have wear and tear when it comes to the spine or neck area, so instead of trying to fix everything all at once, we figure out what is causing the patient pain and focus on correcting that specific area.”
Dr. Francavilla focuses on relieving debilitating neck and back pain caused by spinal stenosis, degenerative disc disease, pinched nerves, bone spurs, bulging/herniated discs, scoliosis and sciatica. He explains that when spine surgery is recommended, it is important for patients to discuss MIS surgery options with their surgeon. “Before undergoing a spinal surgery, patients should make sure they have a solid understanding of the procedure itself and what to expect during the recovery process,” he says. “Although pain and recovery are personal and individualized for each patient, for many patients, an MIS option may result in a smoother and more successful outcome. Since MIS is an outpatient surgery, most of the time our patients are walking the day of surgery and driving within a few days.”
On why he became a doctor: “I grew up outside New York City and my father was the neighborhood family doctor,” Dr. Francavilla says. “During childhood, kids would come up and tell me, ‘Your father delivered me,’ so from an early age I knew I wanted to be a doctor. Once in medical school, I discovered I liked working with my hands and became fascinated with the brain and spine.”
His advice on three ways to take care of your neck and back: “First, keep moving,” he says. “When you exercise, you strengthen your back and neck muscles. Second, make sure you keep the pounds off. When you have extra weight, especially in the stomach area, you put an increased strain on your muscles and ligaments. Third, stop smoking. Many people don’t know that smoking increases the risk for spinal diseases because the nicotine in tobacco causes a decrease of blood flow to the disk.”
On one of his most memorable patients: “In 1994, I had just starting my practice when I received a call in the middle of the night regarding a women who was having a brain hemorrhage and was in comatose due to lack of blood flow,” Dr. Francavilla says. “She was having a hemorrhagic stroke and required emergency surgery. She came through the surgery fine and continued with her recovery and rehabilitative care through other physicians. Over 20 years later, while I was working in Tampa, she called and asked if I would meet with her. We met and she thanked me. It was a wonderful experience that I will always cherish.”
On moving to New Orleans: “I met my wife, Karen, who is from Louisiana while I was living in Birmingham,” he says. “We are the proud parents of seven children and four grandchildren and moved to New Orleans because Karen wanted to come back ‘home.’ I agreed because not only do I love my wife; I am also an avid Saints fan!”
Thomas Francavilla, M.D.
Tulane Covington Neuroscience Clinic
101 Judge Tanner Blvd., Ste. 402
Covington, LA 70433
Medical School: Tufts University School of Medicine
Residency: George Washington University
Fellowships: National Institute of Health
Laser Spine Institute