John Galeno, MD

04/20/2021

Minimally Invasive Techniques

Minimally invasive surgery (MIS) or endoscopic surgery can effectively correct problems with far less trauma to surrounding tissues than traditional or “open” surgery, in which a large incision is made. Patients usually experience faster recovery times, reduced infection and blood loss, and faster return to their regular activities.

Surgery is performed using an endoscope — a slim tube with a tiny camera to convey detailed video images of the brain or spine. Small instruments are slipped through the tube to cut, biopsy, or destroy abnormal tissue or tumors in the brain, or remove herniated discs or perform other procedures involving the spine. Access is gained through either small incisions of less than an inch — incisions so small that damage to surrounding muscles and other tissues is avoided — or through existing openings, such as nasal passages.

More and more spine procedures can be performed this way, to the benefit of patients. For example, patients can leave the hospital four hours after a microdiscectomy is performed to remove a herniated disc.

03/12/2021

About

Get to know Dr. Galeno

Dr. John Galeno is a board-certified orthopaedic surgeon specializing in Spinal Surgery and General Orthopaedics. He is also an Assistant Professor of Orthopaedics at New York Medical College.

He received his undergraduate degree from Fordham University and a medical degree from the University of Bologna School of Medicine. His residency in Orthopaedic Surgery was completed at New York Medical College.

After residency training, he completed a fellowship in spinal surgery with Dr. John Kostuik at the University of Toronto. In the field of spinal surgery, Dr. Galeno performs complex surgical procedures for spinal deformities such as scoliosis and kyphosis; he also specializes in spinal trauma and degenerative problems involving the spine. He is trained in minimally invasive spinal techniques, as well as artificial disc replacement. He has also trained in the robotic navigation technique to improve accuracy during spine instrumentation surgery.

Dr. Galeno has presented at the International Scoliosis Research Society Meeting and has been a guest lecturer on topics involving the Spine and General Orthopaedics.

“Although I perform many General Orthopaedic procedures, including arthroscopic surgeries, total joint replacements, and minor hand and foot surgeries, my main area of expertise is the Spine,” says Dr. Galeno. “Most degenerative problems of the spine can be treated conservatively, with physical therapy, pain management, and rest.”

Dr. Galeno also stated that he spends a significant amount of time discussing treatment options with his patients, carefully explaining the advantages and disadvantages of each.

“Only after non-operative treatment is exhausted do we consider surgery to correct the problem,” he said. “My patients are directly involved in the decision-making process. In my mind, it is of the utmost importance for my patients to understand their problem and how we embark on a treatment plan for any orthopaedic problem.”

03/10/2021

Robotic Navigation Technique

Robots in Spine Surgery

The use of a robot is one of the newest technologies in spine surgery. It is a guidance system allowing surgeons to perform a wide range of spinal surgeries with greater accuracy, safety, and speed. Since there is reduced use of fluoroscopy or x-rays, radiation exposure to the patient is significantly minimized. We have been using the Mazor Renaissance robot since 2014. It is based on a computerized pre-operative plan and increases precision to an accuracy of 1 mm. It is especially effective for pedicle screw placement. In the past, surgeons inserted screws into the spine by “freehand” or by obtaining x-rays images using the long repeated fluoroscopic exposure. These older techniques posed a significant risk of misplacing the screws. Without robotic guidance, the rate of screw misplacement is up to 10% and nerve injury up to 2%. Using our Mazor robot, the rate of accurate screws placement increases to at least 98%.



Robotic Spine Surgery Benefits

Spine surgery can be a scary prospect for a lot of patients. Worries about accuracy, patient outcomes and recovery time are common.

Independent clinical research has shown that minimally-invasive surgery provides the following benefits:

Promotes Faster Recovery: Patients can experience faster recovery time, allowing them to return to their normal daily activities in less time than those who received surgeries via traditional methods.
Reduced Post-Operative Pain: Clinical studies have shown patients may experience less pain following spine procedures performed with the assistance of robotics.
Lowered Complication Rates: Clinical studies based on robotic surgeries have shown increased favorable patient outcomes, including lowered surgery complication rates.
Increased Accuracy: With the help of Robotics, spine surgery accuracy is increased. 3D planning software maps out the procedure.

03/09/2021

Non-Spinal Treatments

Arthroscopic Surgeries

Hand and Foot Surgeries

Total Joint Replacements

02/27/2021

Total Joint Replacements

It becomes necessary on occasion to replace a joint that has become damaged or arthritic with a plastic, ceramic or metal substitute called a “prosthesis.” Joints, of course, describe the place where two bones meet, and often function as hinges (elbow, knee) or as “ball and socket” fittings (shoulder). The prosthesis works to duplicate the function of a joint that was performing properly before becoming problematic. Most total joint replacement surgeries are usually performed on knees and hips, but may occasionally be used when problems arise with the wrist, elbow, shoulder or ankle.

Joint replacement surgery is usually considered because the patient is experiencing a great deal of pain – pain often caused by damage to the cartilage that lies at the ends of bones and prevents them from grinding one another. Such damage is usually the result of a fracture or arthritis. Joint replacement surgery is the usual “next step” when other nonsurgical treatments – physical therapy, medication, etc. – have failed to alleviate the pain.

Where surgery is indicated, the procedure usually takes a few hours. Occasionally complications may ensue in the form of blood clots, infections, nerve injuries and problems with the prosthesis itself, but most of these complications can be treated without problem.

02/18/2021

https://brooklyn.news12.com/people-brave-cold-weather-to-wait-on-line-for-covid-19-vaccinations-in-white-plains?fbclid=IwAR3J7swV3237JZjKyKCz5FaydKkyZ8a6FmfJOo3Q0O61gdEMLNtleUZo-68

Many residents in White Plains have to brave the cold weather as they wait outside in line for their COVID-19 vaccinations.

02/04/2021

Artificial Disc Replacement

Artificial disc replacement (ADR), also referred to as TDR (total disc replacement) is used to correct pain, tingling, and loss of mobility resulting from a degenerative or herniated disc.

The main premise of TDR in the cervical spine is preserving natural motion in the cervical spine and minimizing or avoiding adjacent-segment degeneration. Additionally, several clinical studies have demonstrated a decreased chance of reoperation. At the present time, total cervical disc replacement has emerged as a “gold standard” for the treatment of a number of degenerative spine disorders. TDR is used in addition to anterior cervical discectomy and fusion, and in some cases, the same patient will undergo total cervical disc replacement at one level and anterior cervical discectomy and fusion at another level to create a so-called hybrid construct.

01/28/2021

Dr. Galeno meeting with a patient.

01/25/2021

Degenerative Spinal Issues
Low Back Pain and Lumbar Disc Degeneration
Some medical conditions and injuries make themselves known immediately, but others do not reveal themselves until over the course of time they have grown progressively worse. This is often true of lumbar disc degeneration which is often unseen on x-rays, MRIs and CT scans until the condition becomes more advanced. Lumbar disc degeneration can lead to disc herniation, spinal stenosis. disc protrusion, reduction of disc size and instability. Severe back and/or neck pain, numbness, and weakness as a result of nerve compression may also ensue.

Medical research indicates that there is a genetic predisposition for disc degeneration, but other factors may also contribute, including smoking, obesity, adverse environmental conditions, physical labor, high body mass index, whole-body vibrations and automobile driving.

Where lower back pain is reported and lumbar disc degeneration is suspected, a complete medical history and physical examination should be conducted, followed by appropriate imaging studies, such as x-rays, MRI and CT scan, as indicated. These should aid in a proper diagnosis. It is also extremely important to determine the presence or absence of infection, tumor, spinal instability, or deformity.

01/19/2021

If you are searching for more information on new treatments for back pain and to see if you would be a candidate, contact Dr. Galeno for a consultation.

Back pain treatments on the horizon may help bridge the gap between failed conservative therapy and back surgery. Reviewed by a board-certified rheumatologist.