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When Two is Better Than One - A Unique Collaboration of Orthopedic Surgery and Neurosurgery

Gregory R. White, MDJamal Mcclendon, MD

Gregory R. White, MD, is an orthopedic surgeon and the director of the Center for Spine Care at Phoenix Children's. He specializes in pediatric scoliosis, spinal deformity and sports medicine.

Jamal Mcclendon, MD, is an expert neurosurgeon who specializes in spinal procedures for children and adults.

Together, Dr. White and Dr. Mcclendon perform complex spine surgeries. On the same patient at the same time.

"We work as a team. We've created a unique culture at Phoenix Children's where the two disciplines of orthopedics and neurosurgery can work together successfully -reducing risk for the patient and increasing positive outcomes," said Dr. White.

"Regionally, Phoenix Children's Center for Spine Care is the only institution that collaborates in this way. And nationally, we're one of only a few" said Dr. Mcclendon. "We do very challenging spine cases that give families hope that their children will have a better life."

Helping children with complex spinal anomalies and traumatic injuries

This dynamic doctor duo operates on children with a ·wide range of complicated spinal deformities - such as cerebral palsy, muscular dystrophy, spinal muscular atrophy and spina bifida. Many of their patients have other serious health problems that complicate their surgeries.

"For example, we might treat a child with cerebral palsy who also has pulmonary or cardiac issues, plus a 90- to 100-degree curve:' said Dr. White. "As surgeons working together, we can complete cases like these in approximately two hours, minimizing risks. At other centers, the same procedure might take much longer."

As a team, they help patients ·with all types of curves. And they specialize in helping patients with curvatures greater than 100 degrees.

"Together, Dr. White and I operated on a patient who had a 140-degree curvature" said Dr. Mcclendon.

Using their combined neurosurgical and orthopedic skills, they also perform revision surgeries for children who had unsuccessful procedures in the past. And they treat accident victims with spinal cord trauma.

"When children are in car wrecks and suffer both spine f actures and neurological injuries, we team up to fix them," explains Dr. White. "Then, we jointly follow our patients after surgery to give them the best possible chance to recover Jost neurologic function."

Why two? The benefits of a neuro-ortho team

When this neurosurgeon and orthopedic surgeon team up for complex cases, they work proficiently. Shorter surgical times result in significant benefits for the patient, including:

  • Less blood loss
  • Reduced risk of infection because the incision is not open as long
  • Less time under anesthesia
  • Potential to leave the hospital sooner

The reduced length of surgery is extremely beneficial for young spine patients who also have other medical issues that require special attention.

"Some of these kids don't have the reserve to last for six to eight hours on the operating table. So, if we can get them off the table in two hours and into the intensive care unit, then their recovery begins sooner," said Dr. White. "Our collaboration is a big positive for patient safety and care quality for these kids with complex spinal issues."

With an orthopedic surgeon and neurosurgeon in the operating room at the same time, we're highly qualified to handle unexpected surgical scenarios.

"For example, if the child has some sort of pump to decrease spasticity of the muscles, we will have to work around that. And if something goes wrong with the pump, Dr. Mcclendon knows what to do to fix that," explained Dr. White. "Or, if the child has an underlying tethered spinal cord that we need to release, we can do that at the same time."

A trusted surgical team - all on the same page

What does it look like when two surgeons perform surgery in the same room?

Dr. White shared it's as simple as, "Dr. Mcclendon works on one side of the patient, and I work on the other." They equate their relationship to that of a NASCAR pit crew since their synchronization and ability to work well together lead to much of their success.

Not only do they trust and respect each other's surgical skills, they have a trusted team of anesthesiologists, circulating nurses and surgical scrub technicians.

To help ensure success for the patient, their teamwork starts well in advance of surgery. Typically, Drs. White and McClendon have a pre-op care conference that includes surgeons, pediatricians, anesthesiologists and any other specialist on the patient's case - such as a cardiologist or pulmonologist

They hold a meeting with the child's parents to discuss the risks and benefits of surgery. After the meeting, everyone knows the surgical plan.

Making a difference in a child's long-term health and well-being

For Team Mcclendon and White, the goal of their complex surgeries is not always to get their patient's spinal curves perfectly straight. For some patients, the goal is to restore and maintain sitting balance, so they don't lose more pulmonary function. For others, it's to restore function after a traumatic accident or to prevent pain or increased disability later on in life. For all, the goal is a better quality of life.

"Sometimes we receive a graduation notice from a child we did surgery on five years ago or run into them in the community, and they now have their own families. We hope we've helped to improve their quality of life, body image and self-esteem," said Dr. White. "Or maybe we've just helped to make their life easier in some way or to make it easier for their parents to care for them. They aren't in so much pain. That's the satisfying part of our teamwork."

"When we can improve a patient's life by doing what we love, it means the world to us." shared Dr. Mcclendon.

At Phoenix Children's, collaboration is at the forefront of our work. If you would like to connect with Dr. Greg White or Dr. Jamal Mcclendon, please contact nurse coordinator Kelli Gawel, RN, at