Carolinas HealthCare System
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Orthopaedics Helps Elevate Levine Cancer Institute to National Prominence in Renal Cancer Treatment

A 59-year-old entrepreneur suffering from severe, unexplained neck and shoulder pain came to Carolinas HealthCare System in 2012 looking for help. When imaging scans and biopsies revealed stage 4 renal cell cancer that had metastasized to the cervical spine, Carolinas HealthCare System, which is just one of five locations nationwide with an orthopaedic surgeon trained in complex spinal and musculoskeletal oncology to treat spinal tumors, treated the most symptomatic lesion first: the spine tumor. The case was an ideal fit for Joshua Patt, MD, MPH, the aforementioned specialist, who worked with his team to successfully remove both the patients cervical spine lesion and a thoracic spine tumor that was later diagnosed.

The case also highlights how Levine Cancer Institute has developed a national referral base for stage 4 renal carcinomas. While Charlotte has long had a robust spine surgery community, Dr. Patt's contributions have added expertise in spine tumors that wasn't previously present. "Dr. Patt is well received because he's a known entity. He came here to develop this narrow niche in which we happen to have a high volume," said orthopaedic surgeon Jeffrey Kneisl, MD, former president of Levine Cancer Institute. "Very few places in the country can do the spine work he does."

A Legacy of Excellence

Dr. Patt is one of a few 'super specialists' in the country with this combination of education and expertise. Dr. Patt is our regional go-to physician for patients with these complex disease processes.

– Mark Scarborough, MD,
Orthopedic Oncologist,
Chair, Department of Orthopaedic Surgery and Rehabilitation,
University of Florida

Even before Dr. Patt's arrival, Carolinas HealthCare System and Levine Cancer Institute had built a national referral base for stage 4 kidney cancers, thanks in large part to the efforts of medical oncologist Asim Amin, MD, PhD, who is active in many clinical trials, and surgical oncologist Richard White, MD, who started Levine Cancer Institute's immunotherapy program many years ago. There's a long, established history of taking care of these problems with active clinical trials and excellent patient care," Dr. Patt said. "With the introduction of the Levine Cancer Institute infrastructure, our collaborative efforts have only improved."

Similarly, the arrival of Edward Hanley Jr., MD, at Carolinas Medical Center more than 25 years ago formalized the System’s orthopaedics training program and built a nationally revered education model that has incorporated both academic physicians and the local private orthopaedics community. Dr. Hanley also established a spine research lab that has amplified Carolinas Medical Center's national reputation in orthopaedics. "Members of our department have been the presidents of almost every major orthopaedic association nationally and internationally," Dr. Patt said.

Added Focus on Spine Tumors: Data Collection Leads to Quality Benchmarking in Spine Care

On another front, Dr. Patt, as a member of the Carolinas HealthCare System Neuroscience Institute, has been working with Anthony L. Asher, MD, FACS, a neurosurgeon and co-medical director of Carolinas HealthCare System Neurosciences Institute, and Matt McGirt, MD, to try and broaden the scope of the data collection efforts and benchmarking in spine surgery throughout Carolinas HealthCare System. The National Neurosurgery Quality and Outcomes Database (N2QOD), directed by Dr. Asher, is the largest cooperative spine registry in North America.

By prospectively collecting data on patient-based outcomes in spine surgery in cooperation with the national database, surgeons at Carolinas HealthCare System will be able to drive change and advance quality in spine care delivery with reference to national benchmarks. Dr. Patt is leading efforts from the orthopaedic spine care community to make this a multi-disciplinary collaboration. Dr. Asher says information available through the clinical registry will be "absolutely foundational"  for advancingquality and value in neurosurgical care delivery.

To learn more about the N2QOD, visiti