By Mark W. McFarland, DO
Orthopaedists get to do a lot of high-profile surgeries. Taking folks apart and putting them back together, like with a superstar athlete who’s suffered a sports injury. However, pathologists are the unsung heroes of health care. Without fanfare or applause, they toil in labs, culture samples, slice tissue specimens with a microtome and look at slides under the microscope. They provide the rest of the medical community with the answers critically needed for their patients’ health.
Here are some of the ways pathologists assist orthopaedists in our work every day:
Providing pathology results from a bone biopsy after vertebroplasty or kyphoplasty – Before treatment, a routine part of the procedure is obtaining a bone specimen from the vertebral compression fracture to ascertain if there is an underlying condition, other than osteoporosis, that is causing bone fragility or brittleness. I need to know if tumors, multiple myeloma, or other malignancies may need to be treated after the spinal stabilization procedure is completed.
Providing pathology results from a bone biopsy before joint revision surgery – We commonly take a sample of bone to be examined before doing a joint revision surgery, especially if there are signs of prosthetic loosening. We need to know if we are dealing with a bone infection that may be raging or simmering and isolate what type of bacterial infection so that we know how to appropriately treat it with medications or intraoperative wound debridement, antibiotic inserts, and weeks/months of IV antibiotics if the infection is within the soft tissues and bone.
Providing pathology results from a skin biopsy/histology for pre & post Electric Cell Signaling Therapy – Before we begin treating patients with neuropathy, we get skin biopsies to baseline the number of nerve fibers and vascularity in a particular area of their skin to be treated. After treatment, we get biopsies for histological benchmarking of improvement (or decline) in both indicators as empirical evidence of the efficacy of the therapy and the patient’s feedback.
Providing Cytopathology results for synovial, bursa, and spinal disc fluid – infection (viral, bacterial, or fungal) – Orthopaedists see lots of painful joints and bursa. Thankfully, we can count on our colleagues in the lab to culture the purulent material we aspirate out of those swollen and infected body parts. Pathologists let us know what bugs have set up housekeeping in our patients so that we can effectively exterminate them with antibiotics, antifungals, antivirals, drainage, or debridement.
Providing Cytopathology results for synovial fluid – Gout, and Crystalline Deposition Disease – Sometimes we encounter intraarticular fluid that isn’t infected but looks cloudy and not quite normal. Where there’s crystalline smoke, usually there’s gout fire and our pathology friends help us determine whether the patient has gout or pseudogout, so we know how to treat it appropriately.
Dr. Mark McFarland joined OSC in 2005. He is a Board certified and fellowship-trained Spine Specialist. His practice is focused primarily on the care and treatment of injuries and disorders of the spine. He specializes in Less-Exposure Spine Surgery (LESS). osc-ortho.com