New Techniques in Spine Surgery

MINIMALLY INVASIVE SPINE SURGERY 

The surgical care of the patient with a lumbar spine problem continues to develop and evolve each year. In our practice, minimally invasive surgical technique is proving to be a great aid in helping our patients to recover more quickly. What follows is an explanation of the minimally invasive surgical techniques that are used by our practice.

As this is presented, please appreciate that not all lumbar surgical problems are the same. Two patients may each present with a back problem but require entirely different surgeries. The particular surgery that is recommended to a patient occurs after the physician’s review of the history, physical exam, and MRI, X-ray, myelogram or CT. In addition, a particular surgeon will only perform the surgery that he or she feels both capable of and comfortable with.

ARTIFICIAL DISC SURGERY

One of the most promising developments for spinal surgeons to utilize in caring for their patients is the artificial disc. Another term for the artificial disc surgery is motion preservation. The term motion preservation summarizes what the goal of the artificial disc is. In a patient with degeneration of a disc level, the traditional approach has been to fuse this segment. The fusion is accomplished either by anterior (through an abdominal approach) or by a posterior back incision. With a fusion, however, there is a greater mechanical stress on the both the disc segment above and below the fused level. Over years, this increased mechanical strain on the adjacent disc spaces can potentially result in the need for surgery at these new levels later on. When an artificial disc is implanted, motion at the segment then creates less stress at the adjacent disc levels than a fusion would. There is less risk for imparting further degeneration at the next spinal level.

Stereotactic Radiosurgery for Precision Radiation:

Cyberknife is a therapy that involves no incision, operating room, or hospital stay. It is a form of stereotactic radiosurgery which is a very precise radiation allowing the Neurosurgeon to extend his or her treatment of patients with primary and metastatic tumors brain and spine, or to non-tumor conditions such as arteriovenous malformation, or trigeminal neuralgia. With Cyberknife, the Neurosurgeon can treat complex tumors growing into areas of brain or spine that traditionally would involve great risk of neurological deficit after a very prolonged surgery and post-operative recuperation. Cyberknife cannot treat every tumor or neurological condition. However, using the Cyberknife, we have treated patients with intracranial meningiomas, pituitary adenomas, acoustic neuromas, arteriovenous malformations, trigeminal neuralgia, and metastatic tumors of the brain and spine.

Cyberknife is a form of Stereotactic Radiosurgery. The term Stereotactic Radiosurgery means the delivery of precise doses of radiation to very specific targets in the body. Traditionally, this was limited to only specific tumors and areas of the brain. The Cyberknife provides precise stereotactic radiation to any area of the body.

FDA Approved:

The Cyberknife is FDA approved for patient care and has been in use in the United States and over the world for several years. There are over fifty centers in the United States that have a Cyberknife to treat patients. At this writing, Saint Francis Hospital and Medical Center in Hartford is the only hospital in Connecticut that has a Cyberknife in its Cancer Center.