Spinal surgery redefined

Spinal surgery redefined

With the advent of new medical technologies, surgical techniques and treatment philosophies; surgery on the spine has entered into a new realm of what's possible. More patients than ever can benefit from these advances, as the balance of ‘downside' and ‘reward' for many spine surgeries is now tipping in favor of ‘reward'. Healthy Life spoke to neurosurgeon Ross Moquin, MD of Empire State Neurosurgical Institute in Syracuse about the latest advances in spinal surgery, in particular how minimally invasive procedures are changing the field in profound ways.

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Dr. Moquin described minimally invasive spine surgery as a mindset as much as it is a technology. Advances in technology have led to rethinking how spine surgery can be performed. Years ago, large incisions were utilized to access the spine at all levels. Improvement in imaging technology has allowed surgeons to more accurately pinpoint the problem or what is called the pain generator. Once the exact cause of the pain has been determined, treatment can be directed specifically at that problem. Improvements in the actual tools and implants in spine surgery have allowed for a smaller surgical footprint when surgery is chosen. Not all back and neck pain can be treated by surgery. But, when deemed appropriate, spine surgery can improve patient's lives by taking pressure off of nerves, stabilizing abnormal movement of the spine and correcting deformities of the spine.

Minimally invasive spine surgery is a technology that restricts disruption of normal tissues when fixing the pain generator. The same surgical goals need to be accomplished, but they're achieved in a less invasive way than through the older or more standard techniques. This benefits the patient through shorter recovery times from the procedure, shorter hospital stays and fewer complications such as infections and pain. In many cases, surgeries that resulted in hospital stays of a week or more, have been decreased to one or two days.

The new minimally invasive technology allows the surgeon to see more through smaller incisions. More importantly, it allows the surgeon accomplish as much or more through the same small incisions as they could have through the large incisions of the past. New imaging capabilities such as intraoperative x-rays and intraoperative CT scans also allows the surgeon to verify that the intended job has been accomplished.

This new spinal surgery technology is perfect for our changing demographic environment. Less invasive techniques can benefit the aging baby boomers who want to stay active into their later years. Problems such as spinal stenosis, a common condition in older patients, can be addressed through minimally invasive techniques and will allow the patient to return to more of an active lifestyle than would have been possible for previous generations. Minimally invasive technologies are also a significant improvement when treating bariatric spinal problems-problems related to obesity or in those significantly overweight.

There will never be one technology or one procedure that will benefit all patients. Any treatment must be tailored to the specific needs and problems of that individual. Having more tools at the disposal of a spine surgeon will give more possibilities for a better outcome for the patient. Experience is showing what technologies will help in different situations. Most dramatic is the change in mindset brought about by the advent of minimally invasive spine surgery; it's been a significant advancement in improving outcomes for patients with spinal problems.

Ross Ryan Moquin, M.D.
Empire State Neurosurgical Institute
Syracuse, NY
Johnson City, NY