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$40 million spine, stroke center aims to reduce surgeries, opioid use

A new spine and stroke center that will open later this year in the Northtowns is expected to cut the number of spine surgeries in the region and help more patients manage their pain and limitations without opioid medications.

This is what leaders predict for the $40 million project that combines the talents of University at Buffalo Neurosurgery, Dent Neurologic Institute and several related health practices.

The effort taking shape off Wehrle Drive in Amherst will bring together neurologists, neurosurgeons, radiologists, chiropractors, physical therapists and others.

"In this day and age of virtual, online and electronic resources, the interaction between a physician and a patient here will be face-to-face, hands-on,” said  Dr. Douglas Moreland, a UBNS neurosurgeon directing the medical side of the new project. “In the same way, the best interaction between myself and my partners is face-to-face and now they will never be more than 75 feet away from me."

The first phase of the UBNS Comprehensive Neuroscience Center, a collection of related clinics, is expected to open by fall, with a free-standing outpatient surgery center to premier on the same grounds by early 2021.

UBNS will consolidate three offices in the new clinics, and partner with Dent, which will provide comprehensive neurological services and advanced diagnostic imaging at the new center.

Dr. Elad Levy — president of UBNS, medical director of neuroendovascular services at Gates Vascular Institute and chairman in the Department of Neurosurgery with the UB's Jacobs School of Medicine and Biomedical Sciences — and Dr. Laszlo L. Mechtler, medical director of Dent Neurologic Institute, have talked about such a collaborative center for years.

They and their partners aim to set a new standard in the region for evidence-based, comprehensive treatment for back-, spine-, and stroke-related conditions, movement disorders including Parkinson’s disease and pain management.

“The goal is to avoid patients traveling to five different doctors for care plans and help provide all the care under one roof,” said Levy, also co-director of the Gates Stroke Center at Kaleida Health.

Today, those with back conditions, for instance, need to schedule separate appointments — usually on different days and in different offices — for a primary care visit, X-rays and other diagnostic testing, and a trip to a back or spine specialist, before starting a standard treatment protocol with a physical therapist and/or chiropractor.

In the new center, patients can see the specialist first, be sent down the hall to a Dent clinic for X-rays or other radiology services and, if necessary, scheduled in the same building for physical therapy, chiropractic care or to see a neurosurgeon.

Nurse practitioner Laura Mason also has been hired to run a Wellness Center on-site to provide nutrition, exercise and other holistic strategies designed to dial in on the best treatment possible.

"The point of this comprehensive care center is we're going to use data and computer algorithms to streamline care so it's efficient, cost-effective and leads to the best outcomes. It's no more, 'My gut says this, my gut says that,' " says Dr. Elad Levy, left, with Michael Cournyea, CEO of UB Neurosurgery, pictured standing on the second floor of the UBNS Comprehensive Neuroscience Center. (Sharon Cantillon/Buffalo News)

"We're in a unique situation where we can care for any patient, whether they prefer Kaleida Health and their mission or Catholic Health and their mission, or Erie County Medical Center," said Michael Cournyea, CEO of UB Neurosurgery.

All three regional hospital companies issued letters of support for state approval of the new center, which they expect to provide better support for chronic neurological conditions while easing pressure on emergency rooms, Cournyea said.

"If we can move appropriate patients into the outpatient setting," Levy added, "we decrease the cost because it's much less expensive to do it in the outpatient setting and patients don't have to wait three months for surgery."

Specialists who treat the sickest patients with spinal and stroke conditions meet to discuss comprehensive care of those patients every Wednesday at Gates Vascular Institute, on the Buffalo Niagara Medical Campus.

The new center will allow a similar collaborative “care pathway” to work with patients at risk for those conditions, as well as those with chronic challenges or in rehab, Levy said. It has been designed, he said, to move patients during one appointment to the right clinic for assessment, a treatment plan and treatment schedule.

Dr. John Pollina, a UBNS neurosurgeon, estimated only about one in 10 people who come into the practice with back pain eventually need surgery. Those who don’t, he said, often create a bottleneck in current treatment protocol, delaying surgery for those who do.

“The surgical patients will get to the surgeon sooner at the new center because we’ll have this conservative therapy happening at the same time," said Pollina, who will co-direct the spine clinic there.

Dr. Thomas Pfiffner, the other co-director, is a neurologist at Dent. He specializes in outpatient neurology, spinal trauma and different forms of arthritis and has a background in diagnostic imaging and chiropractic care.

"I think the insurers and payers realize that there is a lot of spine surgery going on in this part of the country and maybe having a patient evaluated at a multidisciplinary spine center could re-focus the treatment of these patients not only from surgery but from other modalities," said Mechtler, who also is chief of neuro-oncology at Roswell Park Comprehensive Cancer Center.

The neuroscience center staff of about 120 will share information to develop and use treatment plans proven to bring patients the most relief and function. Patients, when warranted, also will be invited to participate in clinical trials for new treatments.

"Evidence-based medicine is the future,” Levy said, “and data-driven decisions have to be now. The point of this comprehensive care center is we're going to use data and computer algorithms to streamline care so it's efficient, cost-effective and leads to the best outcomes. It's no more, 'My gut says this, my gut says that.'"

Moreland is among those who hope the new system also will give greater confidence to those with back, spinal and stroke challenges that they are receiving comprehensive care.

"It's the Wild West out there with the internet with some treatments," said Moreland, a clinical assistant professor of neurosurgery with UB medical school. "There are so many things out there that are not appropriate for the spine. You're wasting your time and your money. Our goal is to help patients avoid those and streamline the entire patient experience."

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Comprehensive spine and stroke center

The University at Buffalo Neurosurgery (UBNS) Comprehensive Neuroscience Center is expected to open this summer.

What: The 60,000-square-foot outpatient center will include radiology, neurology, rehab medicine, chiropractic, and pain medicine clinics to provide one-stop, multidisciplinary treatment.

Mission: To better manage care and promote health care savings.

Where: 40 George Karl Blvd., Amherst.

Key players: UBNS, Dent Neurologic Institute, UBNS Chiropractic, UBNS Interventional Pain Management, Buffalo Rehab Group and Bennett Physical Therapy. Regent Companies of East Amherst has handled project development.

Treatment specialties: Stroke, back pain, brain tumors, Parkinson’s, seizures and other movement disorders.

Staff: About 120.

Phase II: Outpatient neurosurgical center to include procedures using robotics and minimally invasive techniques; scheduled to open by early 2021.

email: refresh@buffnews.com

Twitter: @BNrefresh@ScottBScanlon

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