The ChristianaCare and Delaware Neurosurgical Group PA joint spine surgery center

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ChristianaCare and Delaware Neurosurgical Group, PA, Announce Joint Venture Partnership for Comprehensive Spine Surgery Center

Partnership positions Center for Spine Surgery to be preferred provider in Delaware

Wilmington, Del, Feb. 25, 2021 — ChristianaCare, one of the most dynamic health systems in the mid-Atlantic region, and Delaware Neurosurgical Group, PA, a preeminent neurosurgical practice in our community for over 35 years, today announced a joint venture partnership to develop a comprehensive, state-of-the-art spine surgery center at the Roxana Cannon Arsht Surgicenter on ChristianaCare’s Wilmington Hospital campus.

The new center will focus on delivering high-quality care and an unparalleled experience for patients who need spine surgery, with hyper-efficient operations that enable the delivery of spine care at affordable costs.

The name of the new partnership will be the Center for Spine Surgery, LLC. This partnership will enable the Center for Spine Surgery to become the preferred provider of spine surgery services in Delaware and surrounding communities.

The Center for Spine Surgery will be owned equally (50-50) by ChristianaCare and Delaware Neurosurgical Group, PA. The governing board will consist of three individuals from each organization.

“This partnership is about delivering the right care, at the right place, with an expert team and an unwavering focus on value,” said Ken Silverstein, M.D. MBA, chief physician executive of ChristianaCare. “It builds on a long history of collaboration between two expert teams — ChristianaCare and Delaware Neurosurgical Group. The partnership will provide our community with access to high-quality spinal care and pain management services at a much lower cost. And we’re proud to launch this new service at the Roxana Cannon Arsht Surgicenter in the heart of Wilmington, which has been delivering an outstanding surgical experience for decades.”

The Center for Spine Surgery combines ChristianaCare’s long-standing reputation for high-quality surgical services and Delaware Neurosurgical Group’s experience as a leading provider of spine surgery services.

“We are thrilled to partner with ChristianaCare to deliver comprehensive spine surgical services in the Roxana Cannon Arsht Surgicenter,” said Pawan Rastogi, M.D., board president for Center for Spine Surgery, LLC. “Our patients will continue to experience exceptional physician expertise, comprehensive services and a strong commitment to making a significant difference in their day-to-day lives.”

The Center for Spine Surgery will:

• Enhance quality of care by solely focusing on outpatient spine surgical procedures that deliver the right care in the right place to reduce health risks and increase patient comfort.
• Decrease costs of care by transitioning appropriate spine surgeries that are currently all performed in an acute hospital setting to an appropriate outpatient setting.
• Increase access and care coordination with a single focus by caring for patients only in need of spine surgical procedures and treatment.
• Serve as an ideal location for surgeons in the community to schedule spine surgical procedures.

The Center for Spine Surgery will have six operating rooms, six overnight rooms, a post-surgical recovery space and 23-hour stay capacity for spine surgical patients. It will perform a full range of spine procedures (low acuity to high acuity) including injections, laminectomies and more complex procedures such as, but not limited to, multilevel cervical fusions, posterior cervical, thoracic and lumbar fusions.

The establishment of the Center for Spine Surgery is reflective of the national industry shift from inpatient surgeries to outpatient surgeries to improve patient access and achieve reductions in health care costs. During the first year of operation, the Center for Spine Surgery expects to achieve approximately $13.6 million cost savings in Delaware.

Inpatient spine surgery at ChristianaCare will remain available for people who need urgent or emergency care, and for cases in which outpatient spine surgery is not medically appropriate.

About ChristianaCare
Headquartered in Wilmington, Delaware, ChristianaCare is one of the country’s most dynamic health care organizations, centered on improving health outcomes, making high-quality care more accessible and lowering health care costs. ChristianaCare includes an extensive network of primary care and outpatient services, home health care, urgent care centers, three hospitals (1,299 beds), a free-standing emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health. It also includes the pioneering Gene Editing Institute and was rated by IDG Computerworld as one of the nation’s Best Places to Work in IT. ChristianaCare is a nonprofit teaching health system with more than 260 residents and fellows. With the unique CareVio data-powered care coordination service and a focus on population health and value-based care, ChristianaCare is shaping the future of health care. For eight consecutive years, ChristianaCare has both been named one of America’s 100 Best Hospitals for Spine Surgery by HealthGrades and recognized by the American College of Surgeons for achieving “meritorious” outcomes in surgical patient care. Learn how ChristianaCare delivers greater quality and value here.

About Delaware Neurosurgical Group
The Delaware Neurosurgical Group is a leading neurosurgical practice in the region offering world-class neurosurgical care and treatment for more than 35 years. The group brings together the resources, exceptional expertise, comprehensive services and a strong commitment to make a significant difference in the lives of neurosurgical patients (both brain and spine) in the region. Its expert physicians specialize in degenerative, oncologic (cancer), and traumatic conditions of the brain, as well as cervical, thoracic, and lumbar disk surgery, spinal fractures, spinal fusion and arthroplasty, peripheral nerve surgery, pain pumps and stimulators, hydrocephalus and brain tumors and aneurysms. Its physicians are focused on providing healthy outcomes through both nonsurgical and surgical treatment options using the latest minimally invasive surgical approaches. The Delaware Neurosurgical Group has four locations (North Wilmington, Newark, Dover and Rehoboth Beach) conveniently located throughout the state of Delaware. Physicians in the group have received Top Doctor awards for many years including in 2020.

Awake Brain Surgery

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Neurosurgeons perform first awake brain surgery in Delaware

Procedure allows special sensitivity to speech and communication.

In a procedure performed in Delaware for the first time, Christiana Care neurosurgeons Pulak Ray, M.D., and Leif-Erik Bohman, M.D., conducted brain surgery while their patient was awake and talking with them.

The procedure, called an awake craniotomy, has a long history of use for different conditions, but was performed for the first time in Delaware to treat a brain tumor.

Awake brain surgery was essential in this case because the patient’s tumor, called a glioblastoma multiforme, was pushing on centers that control speech and language comprehension, causing problems with speech. Surgeons needed the patient awake and communicating to guide them physiologically in order to protect and preserve those critical functions.

“Our ability to perform awake craniotomies at Christiana Care makes it possible to treat brain tumors in sensitive regions where surgery may not have been possible ,” Dr. Ray said. “Awake brain surgery can allow better outcomes and less damage to healthy brain tissue.“

A team approach

Among the multidisciplinary team of experts involved in the procedure were speech pathologists, intraoperative neuromonitoring specialists, specialized neurosurgical nurses and anesthesiologists under the guidance of Christiana Care anesthesiologist Sophia Cisler, M.D.

“For an awake patient to feel comfortable in the operating room environment, we also must incorporate very careful and strategic sedation medication,” Dr. Cisler explained. “This is particularly important in a craniotomy procedure, where close control of the patient’s breathing, blood pressure and heart rate are essential for safety.”

Recent advances in intraoperative brainmapping technology and the evolution of more sophisticated anesthetics have opened new possibilities for treating infiltrating brain tumors like glioblastomas that are difficult to remove.

Using advanced imaging guided navigation, the team created a detailed map of the patient’s brain and confirmed the functional location of speech centers using a technique called direct cortical mapping, where electrical discharges are systematically delivered to the tumor bed and surrounding brain tissue.

Preserving speech

During this process, Christiana Care speech pathologists Jessica Bahls, MS CCC-SLP, and Kristen Palmer, MA, CCC-SLP, BCS-S, kept the patient talking and alerted the team to any difficulties or lapses in speech that might signal a no-go zone.

“Using direct cortical mapping, we were able to identify safe corridors within the temporal lobe to approach the tumor and to delineate precisely where we could remove tumor tissue without damaging critical functions,” Dr. Bohman explained.

After reviewing the medical literature, Palmer and Bahls developed a patient-specific speech pathology protocol for the awake craniotomy.

“We carefully considered the patient’s baseline level of functioning as well as anticipated areas of speech difficulty based on the location of the brain tumor,” Palmer said. “Our biggest challenge was to anticipate how we might need to refine or customize the speech and language tasks needed as the procedure progressed.“

While the operation progressed, they continued to assess the patient’s ability to perform automatic speech tasks such as counting numbers or reciting the days of week, to follow directions, or to use expressive language to describe a picture or list items in a category. All the while, the surgeons were removing the tumor, guided by the information provided by navigation as well as the patient’s speech, to decide which areas they could safely remove without endangering the ability to talk.

“This was indeed a team effort and one that speaks to our nationally recognized model of multidisciplinary cancer care,” said Nicholas Petrelli, M.D., Bank of America endowed medical director of the Helen F. Graham Cancer Center & Research Institute. “The ability to offer advanced neurosurgical procedures such as awake craniotomy is one more reason why our patients can expect leading cancer treatment right here in Delaware.“

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Dr. Koyfman Remembered

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Dr. Koyfman, a member of the early Delaware Neurosurgical Group “key three” partnership, has died. He was integral to our practice, and helped lay much of the cultural groundwork that is still in place today. He was one day short of his 76th birthday. He will be missed.

Top Doctors 2019

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Delaware Today Magazine’s Top Doctors 2019

All 7 Delaware Neurosurgical Group Neurosurgeons were voted “Top Docs”

Why A Neurosurgeon? More than just the brain.

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Neurosurgeons complete some of medicine’s most challenging training, and that expertise is passed directly to you, the patient. Choosing a neurosurgeon means choosing a professional not only versed in matters of the brain, but also the spine. In fact, the majority of cases seen by a neurosurgeon are based around the spine. So while other specialties may also work on the back, why not choose a neurosurgeon who has utmost expertise for the central nervous system? A neurosurgeon is a physician who has completed:

  • 4 years of pre-medical studies at a college or university
  • 4 years of medical training at an accredited medical school
  • 1 year of general surgery residency
  • 5 to 7 years of neurosurgery residency
  • Some neurosurgeons complete one more year of fellowship studies

This puts neurosurgeons at the top of their game, providing procedures that may result in smaller openings/scars, shorter recovery times, less pain after surgery, shorter hospital stays and, yes, the most optimal outcomes. DNG brings some of the country’s greatest universities to Delaware, offering a wide range of expertise to better help our patients.

Dr. Bohman’s Podcast

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3rd Annual Delaware Brain Tumor Walk and 5k

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November 9, 2019

Join us and walk in solidarity with everyone affected by brain tumors.

It is important for us at Delaware Neurosurgical Group to support our patients and survivors who have been affected by this disease in as many settings as possible, particularly when those settings extend beyond the clinical.

The 3rd Annual Delaware Brain Tumor Walk and 5k was held November 9, 2019 in Wilmington, Delaware at Bellevue Park. We encourage everyone to join us each year for this great cause and, most importantly, to help raise money for brain tumor research.

Brain tumors affect entire families, and we support those who are going through this process in all aspects of treatment and recovery. Not only does Delaware Neurosurgical Group comprise some of the most experienced Neurosurgeons in the state, we pride ourselves on providing the best bedside manner possible when it comes to coping with this diagnosis.

For full event details, please visit the walk homepage at braintumor.org To join our team or to donate, do the following:

  • Go to our team page.
  • Click either Donate Now or Join Team
  • If you would like to join our team, the next page will prompt you to join as a new participant. Minimum registration amounts for adult runners is $35 and for adult walkers is $25.
  • Youth runners are $10 and youth walkers do not have a fee, though higher donation amounts are encouraged for everyone registering if you feel so led.

If you have any questions, please feel free to contact Terry Masella, 302.366.7671 x1116 or email tmasella@deneurosurgical.com and she will be happy to assist you.

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