Seth K. Williams, MD
Orthopedics
Summary

Dr. Williams has a particular interest in minimally invasive spine surgery and CT-navigated spinal fusion techniques. He has developed novel methods and is regularly asked to speak at national conferences and meetings as a result. He performs all manner of conventional spine surgeries as well, treating issues in the cervical, thoracic, and lumbar spine, ranging from straightforward disk herniations to complex multi-level deformity reconstructions. Dr. Williams treats both spine and extremity fractures, serving in both the Orthopedic Surgery Spine and Trauma Divisions.

View CV
Education
  • Fellowship - Spine Surgery
    University of Miami Miller School of Medicine/Jackson Memorial Hospital, Miami, FL, 2006-2007
  • AO Trauma Fellowship
    Middlemore Hospital, Auckland, New Zealand, 2007
  • Residency - Orthopaedic Surgery
    University of California, San Diego Medical Center, San Diego, CA, 2001-2006
  • Internship - General Surgery
    University of California, San Diego Medical Center, San Diego, CA, 2000-2001
  • Medical Doctorate
    University of California, San Diego School of Medicine, La Jolla, CA, 2000
  • Bachelor of Science
    University of California, Berkeley, Berkeley, CA, 1995
Research Interests
  • Minimally-invasive spinal surgery techniques in the treatment of spine trauma
  • Percutaneous minimally-invasive lumbopelvic stabilization techniques in the treatment of sacral fractures with spino-pelvic dissociation patterns
  • Comparison of blood loss in minimally-invasive transforaminal lumbar interbody fusion compared to conventional open surgical techniques
  • Posterior lumbar interbody fusion rates using structural allograft bone and local autograft bone graft
  • Minimally-invasive percutaneous and open techniques for iliac screw placement with CT confirmation
  • Intraoperative fluoroscopic techniques to detect pedicle screw breech
  • Biomechanical analysis of short-segment spinal fixation techniques in the treatment of thoracolumbar trauma
  • Minimally-invasive stabilization in spine trauma, tumors, and infection
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For My Patients

Preoperative:

There are no specific preoperative exercises or preparation. Since the surgical approach is through the front of the neck, I do ask that gentlemen with long beards trim them prior to surgery. Since there will be a bandage in place on the front of the neck after surgery, bring a loose fitting shirt or blouse to wear post-operatively.

Hospital Stay:

Most patients are discharged home the day following their surgical procedure. The surgical procedure should take about 90 minutes for a single-level surgery, longer if multiple levels are treated. Following surgery, there will be a somewhat bulky bandage in place on the front of the neck. I do leave a small drainage tube in place, so that any bleeding that occurs overnight will be collected. In the morning, one of our spine fellows, residents, or nurse practitioners will remove the drainage tube. Sutures are dissolvable and do not need to be removed.

Post-Operative:

You will have a customized Pain Plan that will be formulated during your pre-operative clinic visit. Usually, several different medications are used, and are weaned over a 2-3 week period.

The dressing that you are discharged with should remain in place for 24-48 hours. You can shower, but please keep the incision and bandage dry for 4-5 days. The steri-strips can get wet after day 5, and will begin to peel off. Any steri-strips still in place by two weeks can be removed. You will be given a soft, cervical collar if you so desire. It is not necessary to wear the collar or to wear any type of brace. However, some patients may find it more comfortable to have the collar during the first week or two following surgery. Please request this in the hospital if you feel this would be helpful. You are free to turn and nod your head as you feel fit. Non-impact aerobic exercise can be initiated as soon as you feel comfortable. Heavy exercise or impact activity should not be performed in the first 6 weeks, until after you see me in clinic for your first post-operative visit.

You may find it more comfortable to eat soft foods for the first 24 to 48 hours after surgery. Some patients may experience some swallowing difficulty or may have a sore throat post-operatively. You may find that ice applied to the front of the neck can help reduce this irritation. Pain medication should be weaned down after the first week of surgery. Tylenol and NSAIDs (ibuprofen, naproxyn, etc) are okay at any time, provided there is no other medical reason that you should avoid these medications.

At your first follow-up visit, you will be instructed in skin massage techniques to minimize scar formation. I will also review the post-operative X-rays with you, although we usually do not obtain new x-rays until your second post-operative visit at 3 months. After that first visit, you will likely no longer have any activity restrictions. I do ask that future follow-up appointments be kept at 3 months and 1 year following surgery for routine X-rays.

Seth K. Williams, MD

Pre-Operative:

There are no specific preoperative exercises or preparation. Since the surgical approach is through the front of the neck, I do ask that gentlemen with long beards trim them prior to surgery. Since there will be a bandage in place on the front of the neck after surgery, bring a loose fitting shirt or blouse to wear post-operatively.

Hospital Stay:

Most patients are discharged home the day following their surgical procedure. The surgical procedure should take about 90 minutes for a single-level surgery, longer if multiple levels are treated. Following surgery, there will be a somewhat bulky bandage in place on the front of the neck. I do leave a small drainage tube in place, so that any bleeding that occurs overnight will be collected. In the morning, one of our spine fellows, residents, or nurse practitioners will remove the drainage tube. Sutures are dissolvable and do not need to be removed.

Post-Operative:

You will have a customized Pain Plan that will be formulated during your pre-operative clinic visit.

The dressing that you are discharged with should remain in place for 24-48 hours. You can shower, but please keep the incision and bandage dry for 4-5 days. The steri-strips can get wet after day 5, and will begin to peel off. Any steri-strips still in place by two weeks can be removed. You will be given a soft, cervical collar if you so desire. It is not necessary to wear the collar or to wear any type of brace. However, some patients may find it more comfortable to have the collar during the first week or two following surgery. Please request this in the hospital if you feel this would be helpful. You are free to turn and nod your head as you feel fit. Non-impact aerobic exercise can be initiated as soon as you feel comfortable. Heavy exercise, high impact activity, and heavy lifting (more than 20 pounds) should not be performed in the first 6 weeks, until after you see me in clinic for your first post-operative visit.

You may find it more comfortable to eat soft foods for the first 24 to 48 hours after surgery. Some patients may experience some swallowing difficulty or may have a sore throat post-operatively. You may find that ice applied to the front of the neck can help reduce this irritation. Pain medication should be weaned down after the first week of surgery. Tylenol is okay at any time. I prefer you not take NSAIDs (ibuprofen, naproxen, etc.) until after your first post-operative visit.

At your first follow-up visit, you will be instructed in skin massage techniques to minimize scar formation. I will also review the post-operative X-rays with you, although we usually do not obtain new X-rays until your second post-operative visit at 3 months. After that first visit, you will likely no longer have any activity restrictions. I do ask that future follow-up appointments be kept at 3 months, 6 months, and sometimes 1 year following surgery for routine x-rays.

Seth K. Williams, MD

Pre-Operative:

There are no specific preoperative exercises or preparation. Since the surgical approach is from the back of the neck, you may wish to have a haircut that includes a close trim on the back of the neck prior to surgery. This will facilitate us being able to shave this area during surgery and apply a post-operative bandage. Since there will be a bandage in place following surgery, please bring a loose-fitting shirt or a blouse to wear post-operatively.

Hospital Stay:

Most patients are discharged home the next day following the surgical procedure. In some circumstances, you may stay a second night. The surgical procedure should take approximately 3 hours. Following surgery, there will be a bandage on the back of the neck. I do leave a small drainage tube in place, so that any bleeding that occurs overnight will be collected in the drain canister. This drainage tube will be removed the day after surgery by one of our spine residents, fellows, or nurse practitioners.

Post-Operative:

You will have a customized Pain Plan that will be formulated during your pre-operative clinic visit. Usually, several different medications are used, and are weaned over a 1-3 week period.

The dressing you are discharged with should remain in place for 24-48 hours. There are sutures holding the skin incision together. You may wish to put a lightweight gauze dressing over these staples for the first two weeks prior to their removal. You can shower, but please keep the incision and bandage dry. You will be given a soft cervical collar to wear for the first two weeks. You can remove this to shower and/or shave but use it for comfort during these first two weeks. You can turn and nod your head in the collar as you wish. Please refrain from any heavy lifting or impact activities for the first six weeks following surgery. Non-impact aerobic exercise can be initiated as soon as you feel comfortable.

You will be given a follow-up appointment for two weeks following surgery. At this visit, we will inspect your incision and remove the surgical sutures.

We will discuss the cervical collar at the two-week follow-up visit. By this visit, I do expect that you will have weaned off of your post-operative narcotic pain medication. It is fine to use Tylenol at any point following surgery, provided there is no other medical reason that you should be avoiding it.

I will see you at the 6-week post-surgery visit as well as at 3 months and 6 months. I would expect by the 3-month point there will be minimal activity restrictions.

Seth K. Williams, MD

Pre-Operative:

There are no specific preoperative exercises or preparation. Since the surgical approach is from the back of the neck, you may wish to have a haircut that includes a close trim on the back of the neck prior to surgery. This will facilitate us being able to shave this area during surgery and apply a post-operative bandage. Since there will be a bandage in place following surgery, please bring a loose-fitting shirt or a blouse to wear post-operatively.

Hospital Stay:

Most patients are discharged home the next day following the surgical procedure. Infrequently, you may stay a second night. The surgical procedure should take approximately 2.5 hours. Following surgery, there will be a bandage on the back of the neck. I do leave a small drainage tube in place, so that any bleeding that occurs overnight will be collected in the drain canister. This drainage tube will be removed the day after surgery by one of our spine residents, fellows, or nurse practitioners.

Post-Operative:

You will have a customized Pain Plan that will be formulated during your pre-operative clinic visit. Usually, several different medications are used, and are weaned over a 1-3 week period.

The dressing you are discharged with should remain in place for 24-48 hours. There are sutures holding the skin incision together. You may wish to put a lightweight gauze dressing over these staples for the first two weeks prior to their removal. You can shower, but please keep the incision and bandage dry. You will be given a soft cervical collar to wear for the first two weeks. You can remove this to shower and/or shave but use it for comfort during these first two weeks. You can turn and nod your head in the collar as you wish. Please refrain from any heavy lifting or impact activities for the first six weeks following surgery. Non-impact aerobic exercise can be initiated as soon as you feel comfortable.

You will be given a follow-up appointment for two weeks following surgery. At this visit, we will inspect your incision and remove the surgical sutures.

You should try to discontinue the cervical collar at the two-week follow-up visit. At that point, I would encourage you to begin gentle flexion, extension, and rotation exercises to maximize your neck motion. By this visit, I do expect that you will have weaned off of your post-operative narcotic pain medication. It is fine to use Tylenol and/or Ibuprofen or Aleve at any point following surgery, provided there is no other medical reason that you should be avoiding these medications.

I will see you at the 6-week post-surgery visit as well as at 3 months and 6 months. I would expect by the 3-month point there will be no activity restrictions.

Seth K. Williams, MD

Pre-Operative:

With a disc herniation, you should refrain from heavy lifting or impact activities. These activities may worsen your disc herniation prior to surgery. At your preoperative visit with one our physician assistants or nurse practitioners, options for anesthesia will be discussed. Most lumbar microdiscectomies can be performed under an epidural anesthetic. A light sedative is given during the epidural as well. You will not recall being in the operating room, but you will wake up without the after-effects of a general anesthetic.

Epidural anesthesia is not appropriate for every microdiscectomy patient. These specifics will be discussed at your pre-operative visit.

Surgery:

A microdiscectomy surgery typically takes about one hour. Once your anesthetic has worn off, you will be able to walk around the postoperative area prior to discharge home that same day.

Post-Operative:

The bandage that you go home with should be kept on for 48 hours. Underneath, there are steri-strips, or tapes, across the incision. These should be kept dry for four days. Once they get wet, they should peel off on their own. If they have not peeled off by two weeks they can be removed.

It is okay to shower postoperatively, just keep the dressing out of the water.

You will have a customized Pain Plan that will be formulated during your pre-operative clinic visit. Most patients use post-operative pain medication only for several days. If you are finding that your pain is still significant following one week, you should let us know. Many patients find it helpful to use Tylenol and/or Ibuprofen or Aleve at any point following surgery, provided there is no other medical reason that you should be avoiding these medications. You may drive, walk, and return to normal sedentary activities as soon as you are comfortable. Typically, this is within a few days. Please refrain from any lifting while bent at the waist, or high-impact activities for the first four weeks. Once your first post-operative visit has occurred, activities will be increased at that point. Return to full activity is expected between 8 and 16 weeks post-operatively, depending on the level of desired activity and the findings in surgery.

Seth K. Williams, MD

Pre-Operative:

At your preoperative visit with one our physician assistants or nurse practitioners, options for anesthesia will be discussed. Some single-level laminectomies can be performed under an epidural anesthetic. A light sedative is given during the epidural as well. You will not recall being in the operating room, but you will wake up without the after-effects of a general anesthetic.

Epidural anesthesia is not appropriate for every laminectomy patient. These specifics will be discussed at your pre-operative visit.

Surgery:

A laminectomy surgery typically takes about two hours, but can take longer if multiple levels are addressed. Some patients are able to go home the same day as surgery. Once your anesthetic has worn off, you will be able to walk around the postoperative area prior to discharge home that same day. If multiple levels are addressed, you will usually stay overnight. Most patients do not have a urinary catheter during or following the procedure, but sometimes do. A small drain tube will be removed on the day after surgery.

If you stay overnight in the hospital, on the first post-operative day, you will be assessed by a physical therapist and an occupational therapist, and usually stand and walk. Prior to discharge, you will be independent in walking, getting in and out of bed, and going to the bathroom. If you have stairs to climb at home the therapist will practice this with you in the hospital prior to discharge.

Post-Operative:

The bandage that you go home with should be kept on for 48 hours. Underneath, there are steri-strips, or tapes, across the incision. These should be kept dry for four days. Once they get wet, they should peel off on their own. If they have not peeled off by two weeks they can be removed.

It is okay to shower postoperatively, just keep the dressing out of the water.

You will have a customized Pain Plan that will be formulated during your pre-operative clinic visit. Most patients use post-operative pain medication only for several days. If you are finding that your pain is still significant following one week, you should let us know. Many patients find it helpful to use Tylenol and/or Ibuprofen or Aleve at any point following surgery, provided there is no other medical reason that you should be avoiding these medications. You may drive, walk, and return to normal sedentary activities as soon as you are comfortable. Typically, this is within a few days. Please refrain from any lifting while bent at the waist, or high-impact activities for the first four weeks. Once your first post-operative visit has occurred, activities will be increased at that point. Return to full activity is expected between 8 and 16 weeks post-operatively, depending on the level of desired activity and the findings in surgery.

Seth K. Williams, MD

Why do patients have a lumbar fusion?

There are numerous indications for posterior lumbar fusion. These include spinal deformity, spondylolisthesis, or severe disc degeneration. Spinal fusion can be performed with bone graft alone, bone graft plus screw and rod instrumentation, or with a spacer cage placed within the disc space. The specific indications for which type of fusion you will be receiving will be discussed at your preoperative office visit.

There are minimally invasive techniques and more traditional open techniques, and I choose the technique that I think will best take care of the problem. In your case, this is a minimally-invasive anterior lumbar interbody fusion, or mini-ALIF.

Usually, the mini-ALIF procedure is coupled with posterior percutaneous pedicle screw instrumentation. Through 2 or 3 small incisions on your back, screws are placed into the bones above and below the disk being fused, to stabilize the spine while the fusion heals. In some circumstances, the mini-ALIF is performed alone, without posterior instrumentation.

Surgery:

The mini-ALIF surgery, when performed with posterior percutaneous instrumentation, typically takes about four hours to perform, but can take longer in more complex surgeries. You will be under a general anesthetic during this time period. You will most likely stay as an inpatient in the hospital for one night. Most patients do not have a urinary catheter during or following the procedure, but sometimes do.

On the first post-operative day, you will be assessed by a physical therapist and an occupational therapist, and usually stand and walk a short distance. Prior to discharge, you will be independent in walking, getting in and out of bed, and going to the bathroom. If you have stairs to climb at home the therapist will practice this with you in the hospital prior to discharge.

Post-Operative:

You will have a customized Pain Plan that will be formulated during your pre-operative clinic visit. Usually, several different medications are used, and are weaned over a 1-3 week period.

Please keep the dressing intact over your wounds for 48 hours. Underneath the dressing there are steri-strips covering your incisions. These should be kept dry for four days. You may shower, but please keep the dressing and steri-strips out of the water over the first four days.

You may begin a walking program immediately upon discharge. A short 10- to 15-minute walk per day is all that we ask you to do over the first three to four weeks, and you can increase your walking distance as you see fit. Please refrain from any excessive bending, twisting, or lifting over 10 pounds. There will not be a brace prescribed following surgery.

Your first postoperative office visit should occur by six weeks. At this point we will go over your X-rays, and increase your activities as appropriate. Most patients have no restrictions by 12 weeks post-operatively, though we will discuss strategies to protect your back in the long run.

Seth K. Williams, MD

Why do patients have a lumbar fusion?

There are numerous indications for posterior lumbar fusion. These include spinal deformity, spondylolisthesis, or severe disc degeneration. Spinal fusion can be performed with bone graft alone, bone graft plus screw and rod instrumentation, or with a spacer cage placed within the disc space. The specific indications for which type of fusion you will be receiving will be discussed at your preoperative office visit.

There are minimally invasive techniques and more traditional open techniques, and I choose the technique that I think will best take care of the problem. In your case, this is a minimally-invasive lateral fusion.

Usually, a lateral fusion procedure is coupled with posterior percutaneous pedicle screw instrumentation. Through 2 or 3 small incisions on your back, screws are placed into the bones above and below the disk being fused, to stabilize the spine while the fusion heals. In some circumstances, the lateral fusion is performed along with a lateral plate, without posterior instrumentation.

Surgery:

A lateral fusion, when performed with posterior percutaneous instrumentation, typically takes about 3-4 hours to perform, but can take longer in more complex surgeries. You will be under a general anesthetic during this time period. You will most likely stay as an inpatient in the hospital for one night. Most patients do not have a urinary catheter during or following the procedure, but sometimes do.

On the first post-operative day, you will be assessed by a physical therapist and an occupational therapist, and usually stand and walk a short distance. Prior to discharge, you will be independent in walking, getting in and out of bed, and going to the bathroom. If you have stairs to climb at home the therapist will practice this with you in the hospital prior to discharge.

Post-Operative:

You will have a customized Pain Plan that will be formulated during your pre-operative clinic visit. Usually, several different medications are used, and are weaned over a 1-3 week period.

Please keep the dressing intact over your wounds for 48 hours. Underneath the dressing there are steri-strips covering your incisions. These should be kept dry for four days. You may shower, but please keep the dressing and steri-strips out of the water over the first four days.

You may begin a walking program immediately upon discharge. A short 10- to 15-minute walk per day is all that we ask you to do over the first three to four weeks, and you can increase your walking distance as you see fit. Please refrain from any excessive bending, twisting, or lifting over 10 pounds. There will not be a brace prescribed following surgery.

Your first postoperative office visit should occur by six weeks. At this point we will go over your X-rays, and increase your activities as appropriate. Most patients have no restrictions by 12 weeks post-operatively, though we will discuss strategies to protect your back in the long run.

Seth K. Williams, MD

Pre-Operative:

There are no specific preoperative exercises or preparation. Since the surgical approach is from the back of the neck, you may wish to have a haircut that includes a close trim on the back of the neck prior to surgery. This will facilitate us being able to shave this area during surgery and apply a post-operative bandage. Since there will be a bandage in place following surgery, please bring a loose-fitting shirt or a blouse to wear post-operatively.

Usually, a lateral fusion procedure is coupled with posterior percutaneous pedicle screw instrumentation. Through 2 or 3 small incisions on your back, screws are placed into the bones above and below the disk being fused, to stabilize the spine while the fusion heals. In some circumstances, the lateral fusion is performed along with a lateral plate, without posterior instrumentation.

Hospital Stay:

Most patients are discharged home the next day following the surgical procedure. In some circumstances, you may stay a second night. The surgical procedure should take approximately 3 hours. Following surgery, there will be a bandage on the back of the neck. I do leave a small drainage tube in place, so that any bleeding that occurs overnight will be collected in the drain canister. This drainage tube will be removed the day after surgery by one of our spine residents, fellows, or nurse practitioners.

Post-Operative:

You will have a customized Pain Plan that will be formulated during your pre-operative clinic visit. Usually, several different medications are used, and are weaned over a 1-3 week period.

The dressing you are discharged with should remain in place for 24-48 hours. There are sutures holding the skin incision together. You may wish to put a lightweight gauze dressing over these staples for the first two weeks prior to their removal. You can shower, but please keep the incision and bandage dry. You will be given a soft cervical collar to wear for the first two weeks. You can remove this to shower and/or shave but use it for comfort during these first two weeks. You can turn and nod your head in the collar as you wish. Please refrain from any heavy lifting or impact activities for the first six weeks following surgery. Non-impact aerobic exercise can be initiated as soon as you feel comfortable.

You will be given a follow-up appointment for two weeks following surgery. At this visit, we will inspect your incision and remove the surgical sutures.

We will discuss the cervical collar at the two-week follow-up visit. By this visit, I do expect that you will have weaned off of your post-operative narcotic pain medication. It is fine to use Tylenol at any point following surgery, provided there is no other medical reason that you should be avoiding it.

I will see you at the 6-week post-surgery visit as well as at 3 months and 6 months. I would expect by the 3-month point there will be minimal activity restrictions.

Seth K. Williams, MD

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Locations

1 S. Park Clinic

Phone: (608) 287-2700

UW Health at The American Center

Phone: (608) 265-3207

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Administrative Assistant
Amsatou Ndiaye