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Back surgery expertise in NH draws curious doctor from Japan

New Hampshire Sunday News

April 04. 2013 10:09PM
Orthopedic spine surgeon Thomas Kleeman talks about the O-arm device used to perform spinal surgery at Catholic Medical Center in Manchester on Thursday. (DAVID LANE/UNION LEADER)

MANCHESTER - An orthopedic surgeon from Japan observed a Bedford colleague Thursday perform less invasive back surgery that reduces a patient's medical costs, length of hospital stay and recovery time.

At Catholic Medical Center, Dr. Thomas Kleeman, an orthopedic spine surgeon, uses a scanning machine, the only one of its type in New Hampshire, to keep back surgery more contained.

"Instead of large incisions, large blood loss and disruption of muscles, we use little tiny incisions, we don't cut any muscles and there's almost no blood loss," Kleeman said after performing such a surgery Thursday morning. "In order to do that, we have to be able to see inside the body and that's what this technology allows us to do."

A patient lies in the circle of the C-shaped machine, called an O-arm and costing upwards of $900,000, that scans the body in 13 seconds, similar to a CAT scan.

"It allows us to take images of the body with the patient in the operating room and then a computer links our instruments to those images, so we can use pinpoint accuracy through a small incision and see the spine as though we had opened it up," he said.

Patients are discharged in less than 24 hours on average compared to three to five days hospitalization with open back surgery, he said.

"They're able to go back to work faster," said Kleeman, who has performed about 50 such operations in the past year. Rather than being out of work three to six months, a person having the less-invasive surgery faces four weeks recuperation.

Dr. Joseph Pepe, CMC's president and CEO, said Kleeman is ahead of his peers.

"He has really brought spine surgery to the forefront and has done procedures here that they haven't done even at major academic institutions," he said.

Kleeman's work brought Dr. Osamu Shirado from Japan to witness two surgeries Thursday.

Shirado said he observed "very small blood loss" and a shorter surgical time.

"It's very good for a patient as well as for the surgeon," he said.

Shirado, who called Kleeman "a master," said his hospital might buy the equipment this summer and begin the newer type of surgery.

Kleeman said surgery takes about two hours compared to five to six hours with traditional surgery.

"It's very much like a flying an airplane on instruments," said Kleeman, a pilot for the past 25 years.

Kleeman, who founded the New Hampshire Spine Institute that later went on to become the New Hampshire NeuroSpine Institute, said a surgeon often can operate more on a person's side, like for a hernia or appendix operation, rather than going through the back or abdominal muscles.

Pepe said the surgery pays off in several ways.

"The more you can get patients to go home early the better it is for the patients, the less risk of infections and less costs," he said. "We're trying to reduce overall costs and improve quality and this is something that does both."

Kleeman said the savings can add up in lower hospital bills and less loss time from work.

"The savings to patients could be hundreds of thousands of dollars," he said. "How do you put a number on someone being able to return to activities like skiing, water skiing, hiking? It's hard to put a number on that."

Health Technology Manchester Photo Feature

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