What Has Bioengineering Brought to the Operating Room?
Spine surgery has come a very long way. Due to the advent of new technology and advancements in the field of spine surgery, we are now able to do many of the traditional spine surgeries as an out-patient basis without any hospital stay. For example, a person who has had a big herniated disc and has failed all conservative modalities may be considering surgery. Yet, our innovative methods of treatment allow for us to cure the patient with a small incision of approximately 1 inch. With small microscopic equipment used in the OR, we are able to access and treat the spine with only a tea spoon of lost blood. The translational benefit of microscopic spine surgery is that the patient can usually return home within a few hours and is back to work in matter of days.
In addition to progresses in herniated disc operations, patients in need of fusion operations involving the head and neck can now be operated on with minimally invasive incisions, thereby preventing extreme blood loss and trauma. What was once an operation that kept people out of work for weeks is now something we perform on a daily basis, leaving patients free to return home in a fraction of the time. Thus, a key benefit of new biomedical instrumentation for spine surgery is its enabling effects on the prognosis and recuperation of the patient being treated.
The introduction of new surgical techniques in concurrence with advanced operating room equipment propelled us into an era in which spinal deformation can be fixed with extreme precision and accuracy. Bioengineered pedicle screws may be inserted all throughout the spine, and in combination with posterior osteotomies enables an increased correction shift of the curved spine. These technologies also enable spinal surgeons to increase the fushion rate in patients, and even obviate a need for an anterior procedure.
A very innovative approach to curing spinal disorders and leg pain that has not responded to previous treatments is called XLIF. By teaching surgeons how to access the space between each spinal disc from the patient’s side, major back muscles, bones and ligaments are avoided. Using patented nerve monitoring technology, the surgeon gains lateral (side) access to the spinal column, avoiding any major nerves in the area between the incision and the column. The XLIF procedure does not require an anterior (front) or posterior (back) exposure, and thereby does not present the same risks of vascular and/or neural injury as traditional approaches. XLIF can be completed in less than an hour, which reduces the time the patient is under anesthesia. Furthermore, XLIF allows for less blood loss and scarring, and overall less pain because of the clearer entrance way to the spinal disc which the surgeon may take.
In collabration with Hooman M. Melamed, MD FAAOS, Director of Scoliosis at Marina Del Ray Hospital, Assistant Professor of Orthopedic Surgery