Groundbreaking Technology Drives Innovations and Improved Outcomes in Spine Surgery at Mount Sinai West

Updated on Sep 20, 2024 | Featured

Mount Sinai Spine is at the forefront of innovation in spine surgery, combining leading-edge technologies like machine-vision navigation and augmented reality (AR) with a strong commitment to minimally invasive approaches. These advancements enhance surgical precision, improve patient safety, and reduce recovery times.

By integrating AI algorithms and robotics, Mount Sinai Spine is paving the way for a new era in spinal care, where each procedure is tailored to you, ensuring exceptional outcomes and setting the stage for future breakthroughs in the field.

Greater Precision With Machine-Vision Navigation

Machine-vision navigation utilizes visible light, eliminating the need for intraoperative radiation. This approach eliminates radiation exposure for patients. Unlike traditional methods that require preoperative computerized tomography (CT) scans and intraoperative fluoroscopy, the system at Mount Sinai Spine relies on camera-based technology and machine-vision algorithms.

The benefits are significant: zero radiation exposure, rapid image acquisition in under 30 seconds, and exceptional accuracy across every level of the spine.

At Mount Sinai Spine, the integration of machine-vision navigation has revolutionized spine surgery.

Jeremy M. Steinberger, MD

Jeremy M. Steinberger, MD, Director of Minimally Invasive Spine Surgery and Associate Professor of Neurosurgery, Orthopedics, and Rehabilitation and Human Performance, says this technology significantly enhances surgical precision, which is essential for preventing nerve damage and optimizing screw placement.

“By tailoring care to your unique anatomy, this advanced approach improves safety, streamlines surgical workflows, reduces procedure time, and ultimately enhances patient outcomes,” he says.

Augmented Reality Enhances Surgical Detailed Visualization

Augmented reality is transforming spine surgery, making procedures more precise than ever before. Originally developed for brain surgery, this advanced technology has been adapted for spinal procedures, giving spine surgeons a new way to visualize and perform complex surgeries, according to Dr. Steinberger.

AR works by combining detailed CT or magnetic resonance imaging (MRI) scans with an immersive virtual environment. Surgeons can use this technology to plan and simulate surgeries with significantly improved accuracy, seeing vital structures like blood vessels and nerves in real time.

“By overlaying these virtual images onto the actual surgical site through AR headsets, surgeons can guide their instruments with unmatched precision, leading to safer surgeries and better outcomes for patients,” says Dr. Steinberger.

Minimally Invasive Approaches to Improve Accuracy, Safety, and Outcomes

At the heart of Mount Sinai Spine’s approach is a dedication to minimally invasive spine surgery, where precision and patient safety come together. These techniques minimize tissue damage and shorten recovery times, and when combined with advanced robotic technologies like machine learning and AR, they further reduce the risks typically associated with traditional open surgeries.

Predicting the Best Surgical Outcomes

“Looking forward, the fusion of robotics and augmented reality in spine surgery is set to bring even more breakthroughs,” says Dr. Steinberger. “The research our team is conducting on AI algorithms that predict surgical outcomes highlights Mount Sinai’s dedication to advancing technology and enhancing patient care.”

Learn more about Mount Sinai Spine

Mount Sinai Offers a Safe Way to Discard Your Old Prescription Medications

Sep 18, 2024 | Community, Featured

Vivian Leonard, RPh, Director of Pharmacy for Mount Sinai Queens, stands beside a drug collection kiosk.

Have you ever noticed old bottles of prescription medications in your medicine cabinet and wondered how you can properly dispose of them?

Experts say you shouldn’t flush unwanted pharmaceuticals down the toilet or throw them in the trash.  Studies over the last decade reveal potential environmental and public health hazards associated with this practice.

To provide the community with a safer, more sustainable method of discarding over-the-counter and prescription drugs, Mount Sinai offers free, 24/7 drug collection kiosks at six locations—Mount Sinai Pharmacy on Madison, The Mount Sinai Hospital, Mount Sinai Morningside, Mount Sinai Queens, Mount Sinai West, and Mount Sinai South Nassau. The service is the result of a collaboration with an organization called MED-Project, which offers a drug take back program. Med-Project is a nonprofit formed by the pharmaceutical industry.

Gina Caliendo, PharmD, BCPS,

“This program gets unwanted drugs out of homes and into a secure location, so that they don’t end up with children and teens, or pets, or on the street for illicit use,” says Gina Caliendo, PharmD, BCPS, Senior Director of Pharmacy at The Mount Sinai Hospital. “It is an effort to get drugs out of circulation as much as possible.” The service is available at no charge for employees and members of the public.

The medication can be in the original container or sealed in a plastic bag. The program does not accept medical devices, batteries, or “sharps,” like needles or injectors. Mount Sinai will send everything deposited in the kiosks directly to a waste management company that incinerates the boxes and their contents.

The program is one of many prevention, treatment, and recovery efforts funded by the settlements reached with drug manufacturers for their role in the opioid crisis. It is one of many collaborative interventions between environmental and health care scientists to establish more sustainable practices at all stages of the pharmaceutical lifecycle.

“It’s a public safety measure,” says Dr. Caliendo. “We are inviting the community to do this as an effort to protect children and the environment, and to decrease access to drugs on the street.”

Keeping unused medications around the house or disposing of them through less secure means can be hazardous, especially for children and adolescents. According to a study published in the Journal of the American Academy of Child and Adolescent Psychiatry, teenagers often obtain drugs via leftover prescriptions they find at home. If not disposed of safely, opioids, stimulants, and other drugs with potential recreational uses may also be diverted into illegal markets, contributing to harmful cycles of drug misuse, addiction, and even overdose.

Also, virtually all medications can pose a threat if consumed by the wrong person, at the incorrect dosage, or past its expiration date.

While flushing drugs down the toilet may seem like a safe alternative, this can contaminate the water and expose others to potentially harmful chemicals.

“While water purification eliminates a lot of things, it does not necessarily eliminate all of these soluble chemicals,” says Dr. Caliendo.

In addition, research shows that pharmaceuticals released to the environment through flushing or other means can hurt the environment, including fish and other animal populations. Consuming active pharmaceutical ingredients can harm a diverse range of wildlife, leading to death or interfering with their ability to reproduce.

Pharmaceuticals discarded in the environment can also increasingly contribute to the problem of antimicrobial resistance—in both animal and human populations—which occurs when germs develop the ability to defeat the drugs designed to kill them.

Since opening its first kiosk in 2022, Mount Sinai has collected more than 700 pounds of discarded medication, making it a leader of this effort among New York City hospitals, according to Dr. Caliendo.

If Mount Sinai’s three collection kiosk locations are not convenient for you, you can find additional kiosks near you by searching the New York State Department of Environmental Conservation Drug Drop Sites map, or find a collector authorized by the U.S. Drug Enforcement Administration (DEA) in your community.

In addition to permanent collection sites at participating pharmacies and hospitals, you can also find community take-back sites sponsored by the DEA during the twice-annual National Prescription Drug Take Back Day, which are held in April and October.

If you are unable to bring your unwanted or expired medications to a free disposal site or event, you can request mail-in packages from the New York State Department of Health.

New Mount Sinai Express Care-Queens Offers Expert Care in a Modern Facility, Expanding Services for the Community

Sep 18, 2024 | Community, Featured, Mount Sinai Queens

Wendy Chung, MD, is shown with a patient at the new Mount Sinai Express Care-Queens.

Mount Sinai Queens has opened Mount Sinai Express Care-Queens, a new facility specifically designed to enhance the overall experience for patients looking to receive fast, efficient, and expert care for minor illnesses and injuries.

Located on the first floor of Mount Sinai Queens-Crescent Street, the service will build on the hospital’s vision to transform care for all residents across Queens and beyond.

The modern facility will offer walk-in services for all types of conditions, such as colds, flu, sprains, skin rashes, minor cuts and lacerations, and certain types of infections.

Patients who typically use the Emergency Department for these conditions will find shorter wait times and faster service at Mount Sinai Express Care-Queens. However, if further care is needed, the Emergency Department at Mount Sinai Queens is located across the street from Express Care, so patients do not need to travel far to receive the care that they would need after initial evaluation.

“Mount Sinai Express Care-Queens is backed by a network of experts from across the Health System that is conducive to optimizing the way we care for our patients,” says Ugo Ezenkwele, MD, MPH, Chief of Emergency Medicine at Mount Sinai Queens and Professor of Emergency Medicine at the Icahn School of Medicine at Mount Sinai. “We all get sick and need to have access to walk-in services and get the help we need as easily and quickly as possible, and this facility will fulfill a need in the community making residents feel more empowered in taking care of their health and safety.”

With five exam rooms for providing care, the location also offers testing for COVID-19, influenza, RSV, strep throat, and urinary tract infections, along with a glucometer for glucose testing, and a separate X-ray room. The new facility is the latest in several improvements at Mount Sinai Queens, whose mission is to provide compassionate, innovative care to the diverse patient community throughout the borough.

“The opening of Mount Sinai Express Care-Queens is a game changer for our hospital,” says Cameron R. Hernandez, MD, Executive Director and Chief Operating Officer at Mount Sinai Queens. “The new facility is among several projects to improve the full range of care for our patients, and we are thrilled to expand our services to better serve our community.”

Mount Sinai Express Care-Queens will accept all insurance plans; walk-ins are welcome and no appointments are necessary. Patients can also expect easy referrals to Mount Sinai specialists if you need additional, less-urgent care, as well as seamless access to medical records via MyMountSinai.

Learn more about Mount Sinai Express Care-Queens

Are Women Who Drink More at Risk Than Men?

Updated on Sep 13, 2024 | Featured, Your Health

There are many areas where women and men face different health and medical issues. Now there is evidence that one area where they may differ is in a key part of our culture: how they respond to consuming alcoholic beverages.

For example, according to a recent study published in JAMA Health Forum, alcohol-related health issues rose faster among women than men during the pandemic. And surprisingly, women ages 40 to 64 experienced the fastest rate of increase. Another recent study found that women who binge drink are more likely to develop heart disease.

Timothy Brennan, MD, MPH

In this Q&A, Timothy Brennan, MD, MPH, Chief of Clinical Services for the Addiction Institute of Mount Sinai, discusses some of the ways alcohol can be harmful, including how alcohol can affect women differently than men and what you can do if you think you may have a drinking problem.

Why do women and men respond differently to alcohol?

People born biologically female or born with two X chromosomes, have a higher percentage of body fat and a lower percentage of water on average compared to men of the same weight. Alcohol is water soluble. So, if you’ve got a lower percentage of water, the alcohol concentration in a woman is higher after consumption of the same quantity of alcohol.

Here’s a scenario to illustrate: a biological XX person and biological XY person who have the same weight each consume three 12-ounce beers. The biological XX person will have a higher blood alcohol concentration compared to the other person and is therefore more impaired.

There’s also a difference in the way that women process alcohol. There’s an enzyme in our livers called alcohol dehydrogenase (ADH), that’s responsible for metabolizing alcohol in our bodies. Women have lower levels of ADH, meaning they have less ability to metabolize that alcohol. So bottom line, the alcohol hangs around longer and exerts more of an effect on women.

What amount is considered safe for a woman to drink?

Our understanding is evolving quickly, but what we now know is, no alcohol is best. Alcohol simply does not appear to convey any health benefit, whatsoever. There used to be some belief that drinking certain types of alcohol, red wine, for example, might lower your risk of cardiovascular disease. That doesn’t seem to be the case anymore. Different countries have looked at this question differently. The Canadian government has been much more emphatic than the United States that no alcohol is best.

However, if we’re defining “safe” as not being at risk to develop an alcohol use disorder, then we can look to the National Institute on Alcohol Abuse and Alcoholism for some general guidelines. They recommend that women have no more than seven drinks per week and no more than three drinks on any one day. By comparison, their recommendation for men is no more than 14 drinks per week and no more than four drinks on a single day. That means no more than a drink a day for a woman, which might strike the lay person as pretty low.

Isn’t it hard to limit drinks when we regard alcohol as a social lubricant and ingrained in our society?

Alcohol is pervasive in our cultures and in our social interactions. It’s ritualized across a variety of our holidays and traditions. It’s part of our everyday vernacular. It’s hard to even ask someone to do something in the evening without drinking being implied. Happy hour is a big component of our recreation.

But alcohol is technically a neurotoxin, which means that it is destructive to nerve tissue. I heard someone suggest that instead of using the term “alcohol,” we should use the term “neurotoxin.” It’s a provocative thought, but imagine someone saying, “Hey, would you like to get a couple neurotoxic beverages after work?” The response would most likely be, “Not really.” Just the way we talk about alcohol is very interesting.

A recent study found that women ages 40 to 64 were the fastest growing segment of people with alcohol related health problems during the pandemic. Why is that?

Most likely a lot of factors are involved. First, there’s the anxiety of society as a whole with the pandemic, so people turn to what they think are anxiety relieving products. However, the anxiety-relieving effects of alcohol diminish over time and actually promote anxiety. Someone may say, “Well, my wine is the only thing that helps,” and it becomes the thing that hurts the most with their anxiety in the long run. But on top of that, women tend to be responsible for the family, have the increased stress of children at home, and are managing an entirely new routine.

Plus, our social norms are that you really couldn’t drink on the job for the most part. But if you’re suddenly working at home, how would the boss know if you grab that glass of wine at 3 pm versus 6 pm? Nobody has any idea what you’re doing. And the normalization of drinking at home has been promoted with the advent of Zoom happy hours and social media memes.

Why is it important to discuss the health effects of alcohol?

It’s hard to find an organ system that’s not affected by alcohol. Classic examples that we talk about start off with the liver and liver damage. Types of liver damage can vary from what is called a fatty liver and advance to alcoholic hepatitis or alcoholic fibrosis. It can progress all the way to cirrhosis and liver failure, when the person will need a transplant.

Cardiovascular issues are pervasive among people who are heavy drinkers. Not only does it promote hypertension and high blood pressure, but heavy drinking also weakens the heart muscle and promotes arrhythmia, or irregular heartbeat, and stroke.

The gastrointestinal system or GI system can be irritated and develop ulcers or GI bleeds. The pancreas can frequently be acutely inflamed with alcohol and oftentimes people can develop pancreatitis. Alcohol is not safe for our brain, and long-term alcohol use can lead to cognitive impairment. It affects our psychiatric health and emotional health in many ways. Heavy alcohol use can interrupt our ability to metabolize certain vitamins and minerals such that people can develop chronic dementia. And alcohol can promote a variety of cancers. The way alcohol affects our body is very profound.

What is the difference between a heavy drinker and an alcoholic?

When we talk about alcoholism, the clinical term we use is alcohol use disorder. That’s a disease that’s been codified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or DSM-5. Alcohol use disorder is diagnosed by 11 different criteria. It’s not something you can diagnose with a blood test. If you’ve got two to three criteria, it’s mild. If you’ve got four to five, it’s moderate. If you’ve got more than five, that’s considered a severe alcohol use disorder. Heavy drinking is not defined in the DSM-5. But the guidelines from the National Institute on Alcohol Abuse and Alcoholism we discussed earlier define low risk drinking to high-risk drinking based on the number of drinks consumed in a week. Let’s say for example, a biological female has more than seven drinks per week. But a clinician goes through that DSM-5 criteria with them, and they have none of criteria. You can’t diagnose them with an alcohol use disorder. You wouldn’t call them an alcoholic, but technically, they’re a high-risk drinker. And I think it’s reasonable to classify high risk and heavy drinkers in the same way.

Now that the pandemic is over, would you expect less drinking-related health concerns?

It’s well established in our field that once a substance use disorder takes hold, it does not go away by simply changing one factor in our environment. Alcohol hijacks the reward pathway in our central nervous system. It’s very hard to break that cycle, without any treatment and without any actual abstinence.

What should people do if they think they have a problem with alcohol?

First, there are some patient-facing websites that allow a person to quantify their alcohol use and explore it. The National Institute of Alcohol Abuse and Alcoholism has a lot of great information and interactive tools. I also encourage people to talk to their doctor. Often, people don’t realize the damage alcohol is doing to their body. And they may be self-medicating because of some other issue, like struggling with sleep or anxiety. And revealing that to their doctor can address the primary issue.

If you think you have an alcohol use disorder, I encourage people to check out a meeting of Alcoholics Anonymous. You don’t need to be an alcoholic to go to an AA meeting—there are Open Meetings where anyone can attend. And if you determine that you do have an alcohol use disorder, I always recommend that people get formal addiction treatment. And by that, I mean finding someone who is board-certified in addiction medicine. I trained in pediatrics, and then followed that with an addiction medicine fellowship. Unlike addiction psychiatry, addiction medicine is a multi-specialty subspecialty so there are a lot of different paths into it. Mine was pediatrics, but others might be internal medicine or family medicine. The good news is, there is a lot of help and resources for people seeking help.

Learn more about the Addiction Institute of Mount Sinai

Off-Broadway Musical About Penicillin Features Members of Mount Sinai Community

Updated on Sep 12, 2024 | Community, Featured

Members of Lifeline musical’s health care professionals chorus stand behind the hospital bed of an actor whose character is dying of an antibiotic-resistant post-op infection. Brandon Oby, an MD student at the Icahn School of Medicine at Mount Sinai, is second from left. Photo credit: Bob Farese

An inspiring Off-Broadway musical, Lifeline, tells the story of Scottish scientist Alexander Fleming’s world-changing discovery of penicillin in 1928, charting the rise and fall of antibiotics. Interwoven with a modern storyline of a doctor trying to save her childhood sweetheart under the current, looming threat of antibiotic resistance, the musical features local scientists and health care professionals, including members of the Mount Sinai community, alongside the show’s touring professional company.

Cameron R. Hernandez, MD, Chief Operating Officer and Executive Director at Mount Sinai Queens, will be featured in the chorus on Tuesday, September 10, through Sunday, September 15. Mount Sinai’s Eva Chebishev, a PhD student, and Brandon Oby, an MD student, performed during the opening week of the musical, which debuted Wednesday, August 28.

“Lifeline tells the astounding story of one of my heroes, Dr. Alexander Fleming, and I could not be more excited to be a part of an ensemble cast to tell the important story of the development of antibiotics,” says Dr. Hernandez. “It is a very special experience to represent Mount Sinai and to be featured alongside local scientists and health care professionals who work every day to keep our communities safe and healthy. I hope to see you in the audience.”

Cameron R. Hernandez, MD, far left, poses for a group photo backstage with cast members from the Lifeline musical

The musical is more than a historical narrative about the discovery of penicillin. It’s an engaging form of science communication that promotes awareness and advocacy for the rising global threat of antimicrobial resistance (AMR) by telling the stories of those affected by antimicrobial resistance every day: patients and their loved ones, health care practitioners, and advocates fighting for policy change. Each character is based on a real person who has had experiences with AMR.

“Being involved in Lifeline has been a quite literal dream come true,” says Ms. Chebishev. “I had thought my vision of incorporating my lifelong passion for musical theatre into a career in effective science communication was too niche to be possible, so it was incredibly validating to learn there are already some people doing it (and doing it well) in such an effective, powerful way.”

Mr. Oby is a second-year medical student who spends his free time combining his love for music and medicine—playing for patients at hospitals, performing in jazz combos at medical conferences, and playing in bands at medical fundraising galas. He says joining the cast of Lifeline felt like a natural next step.

“I had never done musical theater before this, so I was incredibly excited for the new experience. Bridging my two worlds of music and medicine makes both so much more special. Lifeline is a one-of-a-kind show, and I hope you all get to experience this incredible feat of science communication,” he says.

Eva Chebishev, PhD student, second row, far right, and Mr. Oby, back row, far right, pose backstage for a group photo with Lifeline’s health care professionals chorus.

The musical is a two-time Edinburgh Festival Fringe sell-out and has toured to London, Glasgow, and the U.S. East Coast in 2022. It also was performed at the U.K. Houses of Parliament and in Barbados for Prime Minister Mia Mottley before it made its debut Off-Broadway in August.

“It is an honor to be part of this endeavor and to represent Mount Sinai alongside other scientists and health care professionals passionate about AMR and accessible, effective science communication,” adds Ms. Chebishev. “Lifeline is real, it’s raw, it’s powerful, and I hope you go see it.”

Lifeline is being staged at The Alice Griffin Jewel Box Theatre at The Pershing Square Signature Center at 480 W. 42nd Street, Jim Houghton Way until Saturday, September 28. To learn more about Lifeline or to purchase tickets, please visit their website.

Dermatology Resident Awarded a $1 Million Research Grant to Develop a Comprehensive Molecular Map of Hidradenitis Suppurativa

Updated on Sep 11, 2024 | Featured, Research

Kristina Navrazhina, MD, PhD

Kristina Navrazhina, MD, PhD, a first-year dermatology resident at the Icahn School of Medicine at Mount Sinai, has received a $1 million grant for research to provide a comprehensive molecular map of hidradenitis suppurativa (HS)—a skin condition that causes painful lumps deep in the skin—that may define specific subtypes and identify novel therapeutic targets.

Emma Guttman, MD, PhD, the Waldman Professor and Chair of Dermatology and Immunology at the Icahn Mount Sinai, is Co-Principal Investigator on this study.

“Hidradenitis suppurativa is a chronic, debilitating inflammatory skin disease with a highly unmet therapeutic need. There are currently no standardized HS biomarkers, which delays diagnosis and the monitoring of treatment response,” says Dr. Guttman.

Patients present with painful inflamed nodules and abscesses that progress to draining tunnels, commonly affecting places where two skin areas may touch or rub together, such as the armpits or the groin. The disease has an average onset of early adulthood and disproportionately affects underserved communities.

Despite the profound impact on the quality of life, there is still a high unmet need for better treatments. “This grant gives our team the opportunity to discover novel therapeutic options to help bridge this gap,” say Dr. Navrazhina. The grant is from Sanofi, the Paris-based pharmaceutical company.

Molecular mapping may identify early biomarkers of disease progression and capture an earlier window of opportunity for therapeutic intervention. Minimally invasive approaches of tape stripping to collect thin layers of skin and blood serum biomarker analysis will be used to study the molecular profile of HS. The data gathered from this research has the potential to connect clinical practice and therapeutic trials, thereby developing innovative and individualized treatment for HS.

Dr. Navrazhina adds, “We are inspired by our patients to conduct ground-breaking research that can ultimately be used to improve the quality of life for all HS patients.”

“This grant award highlights how the Kimberly and Eric J. Waldman Department of Dermatology at Mount Sinai is encouraging and fostering young physician/scientists to become leading scientific investigators of the future,” says Dr. Guttman.

Learn more about the Kimberly and Eric J. Waldman Department of Dermatology at Mount Sinai

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