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Orthopedics & Spine Medicine

Orthopedics and Spine Medicine at Central Vermont Medical Center

Dr. John Braun provides comprehensive evaluation and management of adult patients with diseases and conditions of the spine in the cervical, thoracic and lumbar regions.

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Orthopedics & Spine Medicine
Orthopedic Center
1311 Barre-Montpelier Road
Berlin, VT 05602

Phone: 802-225-3970
Fax: 802-371-2508

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Monday - Friday: 8:00 am-5:00 pm
Saturday - Sunday: Closed
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Dr. John Braun provides comprehensive evaluation and management of adult patients with diseases and conditions of the spine in the cervical, thoracic and lumbar regions. This includes the treatment of less complex problems, such as those associated with disc herniations, spinal stenosis and spondylolisthesis, as well as the treatment of more complex problems involving fractures, tumors, adult scoliosis or previous surgery.

Our Approach to Care

Treatments, whether operative or non-operative, are individualized and patient centered. Patient education, counseling and shared decision making are employed to ensure that the most appropriate treatment option is chosen.

Evidence-based medicine is also used to guide treatments. If surgery is chosen as the best option, the most advanced, modern surgical treatments are offered, including minimally invasive approaches to the spine.

Dr. Braun works closely with his nurse practitioner, Sarah Britton, APRN, FNP and a team of Physical Therapists skilled in facilitating your recovery.

Our Procedures

Orthopedic Lumbar Surgery

Lumbar Fusion

A lumbar fusion stabilizes the vertebrae of the low back with the goal of decreasing pain. Bone grafts are often inserted between the vertebrae and then rods and screws are placed.  Sometimes, there is a 2 part process for fusion surgeries which entails surgery from the front (anterior) and the back (posterior).

This staged process involves an incision in the abdomen (stomach) as well as the back. The anterior stage of the surgery requires the help of a general surgeon to assist during the procedure.

Lumbar Laminectomy

A laminectomy involves removal of bone to make more room for the nerves. The purpose of this procedure is to decrease symptoms such as numbness, weakness and pain.

Lumbar Discectomy

In general, a lumbar discectomy is performed to remove disc material that may be putting pressure on a nerve in the lumbar spine.  This pressure can be caused by a disc bulge or disc herniation which can cause pain, numbness, and weakness in one or both legs.

Orthopedic Cervical Spine Surgery

Anterior Cervical Disectomy and Fusion

Anterior cervical discectomy and fusion stabilizes the cervical spine with the goal of decreasing pain. Neck pain can be caused by degenerative changes or arthritis as well as disc bulges and disc herniations. Pain that radiates down your arms may be due to a disc bulge or disc herniation.

A discectomy is the removal of the piece of disc that is putting pressure on your nerves or spinal cord, causing arm numbness, tingling, pain, and/or weakness.

This procedure creates more room for the nerves by inserting bone graft (from the bone bank) between the vertebrae. The cervical spine is then stabilized with a plate and screws.

Posterior Cervical Fusion

A posterior fusion also stabilizes the cervical spine. Arthritis and bone spurs are removed allowing more space in the canal for your nerves to run. Rods and screws are placed to stabilize the spine.

About Your Surgery

We understand that surgery can cause anxiety and worry. Our goal is to make you more comfortable with your plan of care and recovery by sharing information about:

  • your preparation for surgery
  • what to expect during and after your surgery
  • your recovery process

Please review our Guide to Surgery under the Resources tab of this page. You are an important part of your recovery process so we encourage you to be involved. Please do not hesitate to ask questions.

John Braun, MD
Orthopedic Surgeon
Sarah Britton, APRN, FNP
Advanced Practice Registered Nurse

We understand that surgery can cause anxiety and worry. Our goal is to make you more comfortable with your plan of care and recovery by sharing information about:

  • your preparation for surgery
  • what to expect during and after your surgery
  • your recovery process

You are an important part of your recovery process so we encourage you to be involved. Please do not hesitate to ask questions.

Preparing for Surgery

Once you have chosen your date of surgery, you will be scheduled for the following:

  1. Blood work may be done at CVMC’s walk-in lab within 30 days of surgery.
  2. Medical Clearance visit with your Primary Care Provider within 30 days of surgery.
  3. A meeting with an Anesthesiologist and a surgical nurse. This depends on your health history. At this visit you will discuss what to expect on the day of surgery, including what time to arrive at the hospital. You will be notified by our office if this visit is needed.
  4. You may also need additional testing such as a chest X-Ray and EKG (heart moni­tor). This depends on your medical history.
  5. Pre-Operative appointment with one of our Spine Rehabilitation Therapists to go over the recovery process.

AVOID THESE MEDICATIONS PRIOR TO SURGERY:

  • Anti-Inflammatory Medications (Advil, Aleve, Naproxen, Ibuprofen and steroids). Should be stopped 7 days prior to surgery.
  • Aspirin and Anti-coagulants (Plavix, Coumadin).  Please discuss with your Primary Provider on how this should be done. A low dose, or baby aspirin is okay to continue until surgery.
  • Herbal Supplements and certain Vitamins. These should be stopped 7 days prior to surgery since some can thin your blood.
  • Avoid any other medications as recommended by your Primary Care Provider and Anesthesiologist.

Day of Surgery

  • Please arrive at the hospital at the time given to you by the Surgical Nurse at your pre-operative visit or phone call.
  • You will be attended to by nurses in the pre-operative area. An IV will be inserted in your arm where fluid and medications can be given.
  • You will also have a meeting with Dr. Braun prior to surgery. Please ask any additional questions you may have.
  • The Anesthesiologist will also meet with you prior to the start of surgery.
  • After you are put to sleep, a Foley catheter will be inserted into your bladder to empty it during surgery. The catheter may still be present when you wake up from surgery.

After Surgery

When you wake up from surgery, you will be in the recovery room. Once it is determined that you are stable, you will be transferred to a regular room in the hospital.

Some procedures do not require an overnight stay in the hospital. Dr. Braun will determine when you are able to go home.        

What are your restrictions?

  • No Bending
  • No Lifting
  • No Twisting

Some people will be required to wear a brace after surgery. Dr. Braun will let you know if a brace is required.

Our Physical and Occupational Therapists will work with you in the hospital to help you to resume walking. They will also help you apply the movements you learned in your pre-operative Rehabilitative Spine Class to avoid bending, lifting and twisting.

Going Home

Medications

You will be discharged from the hospital with a prescription for pain medication. Be sure to drink plenty of fluids while taking this medication as they tend to cause constipation.

  • You should begin to wean yourself off of the pain medication as tolerated with the goal of being off of the medication within 3 months of surgery.
  • You should continue to avoid anti-inflammatory medication for up to 6 months while healing your fusion.

Surgical Incision Care

  • If you notice any increased drainage, redness or swelling, or have a fever greater than 101.5, please call your surgeon or go to the Emergency Room.
  • For those that have sutures, these will be removed 2 weeks after surgery in the office.

Sexual Activity

Sexual activity may be resumed when you are feeling up to it. You may find that some positions are more comfortable than others.

Driving

You may resume driving in approximately 2-3 weeks when you feel up to it and you are no longer taking narcotic pain medication.

Physical Activities

  • No Bending
  • No Lifting
  • No Twisting

For the first 6 weeks after surgery, walking is the best activity.

Physical Therapy

Physical Therapy with one of our Spine Rehabilitation Therapists will start 6 weeks after your surgery.

  • Your initial post-operative evaluation will include a customized Recovery Program based on your response to surgery.
  • Your therapist will also review your restrictions and help you learn how to perform daily activities while avoiding bending, lifting and twisting.
  • Initially, you will be scheduled for one therapy sessions every three weeks so you can slowly and gradually increase your functional abilities.
  • Based on your functional goals, 6 months after your surgery your therapy may become more frequent and intense to optimize your physical function.