Vijay Yanamadala, MD

05/07/2021

So grateful to work with an amazing team of nurses, inpatient and outpatient, who tirelessly care for our patients every day in the face of daily challenges that would feel insurmountable to most of us.

04/18/2021

This 52 year old woman underwent an osteoblastoma resection at L3 previously and presented to me two years later unable to walk more than a few feet due to severe pseudarthrosis. The fusion had failed at L2 and L3, with near complete destruction of the pedicles and significant erosion of the body at L2. I elected to approach this from a lateral approach with an L2-3 lateral interbody with plate to augment this level and extended the fusion with cement augmentation and a quad rod construct. She is now three months out and able to walk without assistance. This is a robust rescue technique for pseudarthrosis. Belts and suspenders to give us the best chance this is the last spine surgery she will need!

04/06/2021

Spine care involves a multidisciplinary team of physiatrists, pain management physicians, physical therapists, occupational therapists, chiropractors, acupuncturists, surgeons and others. Surgery is generally a last resort unless there is an urgent indication!

Hartford HealthCare Vijay Yanamadala

Dr. Vijay Yanamadala, a neurosurgeon with the Ayer Neuroscience Institute’s Spine Wellness Center in Westport, discusses spine deformities such as scoliosis,...

04/01/2021

This 28 year old young man developed progressive difficulty walking, using a cane by the time he saw me in the clinic. He had been worked up for thyroid deficiency, vitamin deficiencies, and genetic disorders before this MRI revealed spinal cord compression in his thoracic spine due to a thoracic disc. He was an avid MMA fighter prior to his deterioration over a year. Spinal navigation and ultrasound have enabled us to safely and effectively perform these surgeries via a posterolateral approach (in this case a bilateral costotransversectomy approach). He is now one year out, walking without assistance and recovering well with rehab and physical therapy.

03/18/2021

Alignment Matters! This 63 year old woman presented to me with ten years of low back pain and progressive neurogenic claudication to the point where she could only walk about 10 feet without stopping. She had undergone extensive physical therapy and a number of injections over the previous four years with diminishing benefit.

Her x-rays showed a grade 1 spondylolisthesis at L4-5 with 8mm of motion on flexion/extension views. MRI showed severe stenosis at L4-5 and L5-S1 with moderate stenosis at L3-4. Importantly, x-rays also showed complete loss of lordosis at L4-S1, where normally 2/3 of the lumbar lordosis should reside. She compensated for this by developing hyperlordosis in the upper lumbar spine. I performed an L3-S1 fusion with L4-5 and L5-S1 TLIF with osteotomies at both levels, restoring the normal lordosis from L4-S1. This allowed her to develop a more harmonious upper lumbar lordosis which also improving her back and leg pain. TLIF can be a very kyphogenic operation, but we can restore lordosis through the use of a full posterior column osteotomy.

Planning and attention to the details of alignment, decompression and appropriate stabilization can result in a durably superior outcome for our patients!

03/13/2021

This 70 year old gentleman underwent three major spine surgeries and unfortunately developed a flatback deformity (flatback syndrome). He was largely using a wheelchair by the time he came to me, mainly due to the pain of walking even a few feet. He had staunchly avoided opioid medications, but physical therapy, chiropractic care and injections were no longer helping him. His Oswestry Disability Index (ODI) was 60%, indicating severe disability with nearly all of his activities of daily living.

After a six week prehabilitation course, I performed a two stage surgery to correct his deformity. Stage 1 involved lateral lumbar interbody fusion at L1-2, L2-3 and L3-4. Stage 2 involved an L3 pedicle subtraction osteotomy as well as fusion from T2 to the pelvis. This combined strategy allowed me to restore his sagittal balance, and he is now walking independently now four months out from surgery. Big thanks to my plastic surgery colleague Joe Ricci and our team of physical therapists and occupational therapists who got him back to walking!