Treatment / Revision / Complex Referral Cases

MOTION PRESERVING

REVISION | LAS VEGAS

Complex Referral Cases

Dr. Andrew Lee, MD | Nevada Spine Clinic, Las Vegas, Nevada

When Standard Solutions Are Not Enough

Not every orthopaedic case follows a straightforward path. Complex fracture patterns, failed prior surgeries, unusual anatomy, or combinations of pathology can make standard approaches insufficient. These are the cases that require a surgeon with broad experience across multiple joint types and a willingness to think beyond conventional protocols.

 

Dr. Andrew Lee at Nevada Spine Clinic in Las Vegas welcomes surgical referrals from other orthopaedic surgeons and sees patients who have been told their case is too complex or that no further options exist. His training at Northwell Health and his experience across spine, hip, shoulder, and knee allow him to approach complex cases with perspective that narrow specialization does not provide.

Types of Complex Cases Seen

  • Failed Multi-Level Spine Surgery: Patients with persistent symptoms following prior spinal fusions, decompressions, or disc replacements requiring revision evaluation.
  • Multi-Joint Pathology: Patients with concurrent arthritis or pathology across multiple joints requiring coordinated surgical planning.
  • Complex Revision Arthroplasty: Revision cases involving severe bone loss, infection, or multiple prior surgeries requiring specialized implants.
  • Unusual Fracture Patterns: High-energy or periprosthetic fractures with complex fixation requirements.
  • Patients Declined by Other Surgeons: Cases considered too difficult for standard surgical approaches by other providers.

Evaluation Before Surgery

Every complex referral begins with a thorough evaluation by Dr. Andrew Lee. This includes review of prior imaging and operative reports, updated imaging as needed, laboratory evaluation, and a candid discussion of what can realistically be achieved with surgery.

Not every complex case has a surgical solution, and Dr. Lee will honestly advise patients when surgery is unlikely to improve their situation. When a surgical path forward exists, a detailed preoperative plan is developed.

Individualized Surgical Planning

Complex cases do not follow a standard template. Each is approached with individualized surgical planning based on the patient’s specific anatomy, functional goals, medical status, and prior surgical history. Dr. Andrew Lee uses advanced imaging, computer planning tools, and specialized implant systems to address the unique challenges each case presents.

Surgeries are performed at Southern Hills Hospital in Las Vegas with appropriate team support, intraoperative imaging, and specialized implant availability. When cases require multidisciplinary input, Dr. Lee coordinates with other specialists to optimize outcomes.

The primary goals of this procedure are to:
  • Develop an honest and realistic surgical plan for complex cases
  • Address the primary source of pain and dysfunction
  • Achieve the best possible functional outcome given the patient’s specific circumstances
  • Provide a path forward for patients who have been told no options remain

Risks in Complex Cases

  • Complex cases carry higher complication rates than standard primary procedures.
  • Realistic expectations are discussed extensively before surgery in all complex cases.
  • Not all complex cases have a surgical solution that is likely to provide meaningful benefit.
  • The benefit to risk ratio is carefully evaluated individually for each patient.
  • Dr. Lee will recommend non-surgical management when the risk of surgery outweighs the potential benefit.

Recovery

Recovery from complex surgical cases is individualized to the specific procedure performed. Dr. Lee provides detailed recovery guidance tailored to the surgery completed and the patient’s overall health and functional status.

Most complex cases require three to twelve months for full functional recovery depending on the extent of reconstruction performed.

What to Expect After Surgery

Outcomes from complex cases are discussed candidly before surgery. While many patients achieve significant improvement, Dr. Lee does not promise results that cannot be reliably delivered.

The goal is always to meaningfully improve the patient’s quality of life in a way that justifies the risks and demands of surgery.

Do not soak your wound.

No bathtub, swimming, or hot tub until cleared by Dr. Lee.

Wound Care and Medication Management

Wound care instructions are individualized to the specific surgery performed. Follow all discharge instructions carefully and contact Nevada Spine Clinic immediately for any wound concerns.

Take all prescribed medications as directed and contact your pharmacy with adequate advance notice for any refills needed.

Activity Guidelines After Surgery

Activity and weight bearing restrictions following complex surgery are tailored to the specific reconstruction performed. Dr. Lee reviews these in detail before discharge and at each follow-up appointment.

Contact Nevada Spine Clinic or the nearest emergency room immediately for any sudden neurological changes, fever, or wound concerns following surgery.

CALL US IF YOU EXPERIENCE

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No bathtub, swimming, or hot tub until cleared by Dr. Lee.

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Dr. Andrew Lee, MD | Nevada Spine Clinic, Las Vegas

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