In the last decade, spine surgery has seen some of the most significant technological advancements in the surgical field. We recently sat down with Casey Davidson, M.D. of Bone and Joint Institute of Tennessee to learn more about the latest changes and technologies implemented at Bone and Joint Institute of Tennessee.
Williamson Source: What are some of the latest technologies you are using to treat spine patients in the OR?
Dr. Davidson: A lot of the new and exciting technologies we are using are related to motion-sparing surgery. Motion-sparing surgery allows patients to retain motion throughout the spine, as opposed to a fusion surgery, which is a more traditional approach.
In the lower back, there are times when you have to either remove a portion of the disc or a portion of the bone to take pressure off the nerves. Traditionally we had to fuse those levels, using screws and rods to take away motion. Fusion changes the mechanics of the spine, including the underlying motion and flexibility. This has repercussions manifested as pain and discomfort. Following a fusion surgery, the discs above or below the operative area often degenerate more rapidly, resulting in a second surgery 5-10 years later.
At Bone and Joint Institute, we are using a motion-sparing approach to try to retain motion and prevent a second surgery, especially in younger patients in their 30s and early 40s. Today, many of those younger patients are not undergoing a fusion, whereas in the past it was their only option.
WS: What can you tell us about the use of minimally invasive surgery at Bone and Joint Institute?
Dr. Davidson: We’re moving towards different techniques, instrumentation and technologies that allow us to place hardware in a minimally invasively way with less disruption of the soft tissues. Ultimately, this decreases the recovery time and increases the patient’s mobility.
The largest portion of minimally invasive surgery is happening in the mid- and low-back, The approach generally allows for a quicker recovery. In the past, traditional lumbar fusion had patients staying for three to five days in the hospital. Now with a combination of our anesthesia and recovery protocols, people are often staying just one night. It’s possible in the near future that lumbar fusion surgeries may become outpatient procedures with many of our other minimally invasive procedures.
WS: What’s coming up next in spine surgery?
Dr. Davidson: At this time the medical community is looking at technologies such as robotics, intraoperative navigation, and augmented reality. These technologies allow safer placement of implants, such as screws, cages and replacements.
When doing a decompression, for example, these technologies can guide the surgeon on how much bone to remove and precisely where to remove that bone, using preoperative imaging with a CT scan or MRI to calibrate to a patient’s anatomy. Technology doesn’t take the equipment out of the surgeon’s hand, but guides them to a more repeatable, consistent, and safe outcome.
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