There are concerns among patients and relatives about the safety and outcome of spine surgery. In recent years, a lot of advances has been made in this field to give assurances to the patients and their loved ones that spine surgery is safe and effective, if the correct indications are applied, and the surgeon is well trained in this field.
Various Advances in Spine Surgery
It is inconceivable that nowadays surgery is done without monitoring of the heart and the respiratory system. Similarly, using nerve and spinal cord monitoring should be the norm if surgery is performed close to those structures. These technologies are now available on a routine practice to enhance the safety of the spine surgery, and invariably improve the outcome.
The monitoring involves placing small needles under the skin in the lower limbs (for back surgery) and both upper and lower limbs (for neck surgery). Small needles will also be placed on the scalp of the head. There will be a trained personal staying with the patient throughout the entire surgical procedure. He or she will be monitoring the integrity of the nerve signals between the brain and the limbs.
The availability of high quality imaging device and navigation allow the execution of spine surgery safely. These technologies enable the spine surgeons to place the screws, as well as perform other aspects of the spine surgery safely.
The use of operating microscope greatly increases the safety of the spine surgery. It allows magnification and illumination of the operative field, enabling the surgeon to perform spine surgery (especially the decompression portion of the procedure where the nerves are freed by the surgeon from compression) safely and accurately.
Pediguard is a hand held surgical device to allow surgeons to place the screws safely and effectively. Basically this high technology device features a hand held drilling mechanism for the surgeon to create a track in the vertebrae. It also has an inbuilt audible alert warning system which will emit warning signals should the device be off the ideal track. With this device, there is significantly less chance for malposition of the screws.
The advent of minimally invasive or minimal access spine surgery allows surgery of the same magnitude to be done with less collateral damage to the surrounding tissues. This technique is done together with the operating microscope to increase the level of safety of the spine surgery. There will be improvements in terms of pain, hospital stay, and return to work and daily activities using this technology.
6. Biological products
The availability of biological products e.g. bone morphogenetic protein and demineralized bone matrix allow for greatly improved fusion or healing rates between vertebrae after a fusion procedure. This is important during multi-level fusion procedures where the patient’s own bone supply may be limited. Allowing for earlier and faster fusion will increase the stability of the spine and reduce the stress on the spine implants.
In selective cases, especially the younger patients, there may be a role for non fusion technologies. This will potentially maintain the mobility and flexibility of the spine, which is important for the younger cohort of patients. Examples of non fusion spine technologies include artificial disc replacement and dynamic spacers.
Our spine surgeon Adjunct A/Professor Hee Hwan Tak makes use of the medical advances in spine surgery to improve the safety and recovery process for patients. Contact us for a comprehensive consultation. Visit Dr Hee Hwan Tak’s Google+ page here.