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Picture a surgery room. A neurosurgeon is performing surgery on the patient's spine. But only after a state-of-the-art X-ray machine does a 360-degree scan of the patient - creating an interactive picture, or template of the person's spine that allows the surgeon to see precisely where his surgical tools are going inside the patient's back.

"It's like GPS for the spine," neurosurgeon Dr. Matthew Davies explained, pointing to a large screen that shows the spine model on the table before him and a guide probe he's holding, pictured like a pink laser going into a vertebrae. "When we do our traditional fusion surgeries, we have to put screws into the bone to hold it in place. This system helps us do that safely and accurately."

In addition to the doctors and nurses, there are a handful of other experts in the surgical room. For example, a "navigation guide," an expert in the Q Guidance system that turns the X-ray into a real-time interactive image, would be there for the surgery.

"There are a bunch of different representatives in the room for everything we do," Davies said. "If we bring in instrumentation, like a screw, there is a rep who knows every possible little thing that can happen with that to troubleshoot, should we run into problems."

Now picture this scenario at Community Memorial Hospital in Cloquet. With the new technology now delivered, the surgeons and officials at CMH say it will be a reality as soon as next week.

Davies will be joined at CMH by fellow neurosurgeon Dr. Jared Broadway. Both are independent surgeons. Davies is a member of Orthopaedic Associates and is in partnership with Broadway as co-owners of Arrowhead Surgery Center in Duluth. Broadway was head of the neurosurgery program at Essentia for many years and now has a practice in Fargo, as well as Duluth.

Davies and Broadway perform a variety of procedures - many of them minimally invasive - including various fusion surgeries, carpal tunnel release, removal of spinal tumors and synovial cysts, decompression and laminectomy, a surgical operation to remove the back of one or more vertebrae, usually to give access to the spinal cord or to relieve pressure on nerves. They also offer disc replacement, which they can do from the front of the body, with the patient on their back, by adding general surgeon Dr. John Bollins to the mix in the operating room.

"The benefits of that surgery are multiple: there's no muscle cutting," Davies said. "So when we see the front of the spine, it's much less painful, there's less muscle distortion and it allows me to see the spine in a different way and allows me to do different procedures such as disc replacements."

The neurosurgeon stressed that both doctors try to preserve movement of the spine whenever possible.

"A fusion isn't the only thing that's going to be offered to you if you see us; it's usually the last thing," he said. "We try the more conservative approach up front, but some people's backs need this."

Davies - who also holds clinics in Duluth, Hibbing and Virginia on a regular basis - expects both doctors will be doing surgeries one or two days a week in Cloquet, drawing patients from across the region and even Wisconsin, Michigan and Canada.

Small but mighty

"The goal is to increase the availability of care to rural areas," said Justin Gulden, CMH surgical services director. "And Cloquet is a nice little hidden gem, right outside the Duluth market, and there are a lot of individuals who don't want to go into the big city. Great parking, accessibility, and the individual care for everybody is a huge asset here."

Davies said he and Broadway are thrilled to be partnering with CMH.

"It's been great, patients have loved it here," said Davies, who's already been working for three months in Cloquet, while Broadway has been partnering with CMH for a year. "Everything about this hospital is conducive to healing, compared to the bigger centers. The floor is quiet. Patients have their own private room, private bathroom, private shower. The bigger hospitals get crowded so it gets noisy. Here, it's more like recovering in a hotel room."

The new equipment for the spinal surgeries also allows CMH to level the playing field in terms of technology, "so we can kind of compete against the bigger-name facilities, but offering the same care," said Gulden, who came to Cloquet from a Duluth hospital about seven months ago.

Cloquet's small town culture is a draw for staff, too. Gulden said he likes walking down the hallway at work and having people say hello. "That's a big difference," he said. "You definitely feel appreciated here."

Davies said it's been easier working with Gulden and CMH because of the greater access to "the people who make the decisions" at the smaller facility.

Jana Peterson

Dr. Matthew Davies used a guide probe as part of the demonstation Monday.

CMH offers orthopedic, total joint replacement, eye, ear, nose and throat surgery, some general surgery and even plastic surgery, as well as endoscopic (think colonoscopy or EGDs) procedures. Some of the surgeries are provided by doctors employed by CMH, others by independent surgeons.

"It's hard to employ multiple surgeons at a smaller hospital," Gulden said. "Having that independent working relationship brings in bigger-name people that are doing hundreds of these cases and offering it to the smaller hospitals.

"We're just trying to be the best that we can be, and kind of be a step above everybody else," he added. "And, honestly, I think this is just the beginning here. Working with these two and getting the name on a map is just going to bring more providers here and, hopefully, more patients."