Spine surgery has become more common as patients live longer and want to stay physically active. Frequently, these surgeries require placement of hardware such as artificial disks or screws to hold the spine in a certain position. Until now, this hardware was placed manually by surgeons using the patients anatomy as a guide.
UCLA spine surgeons are redefining this practice in an effort to more accurately, and safely, place spinal hardware. Using intra-operative imaging, neurosurgeons scan the patient during surgery to create a precise anatomical roadmap and then rely on a guidance system to place the hardware with millimeter precision.
“Although we as surgeons are very good at this, nothing beats leaving the operating room knowing that the spinal hardware is in perfect position,” said Luke Macyszyn, MD, an assistant professor in the UCLA Department of Neurosurgery that specializes in complex spine surgery. Spine surgeons typically train for years and commonly use two-dimensional X-rays in the operating room to help them place spinal hardware such as pedicle screws. In a healthy patient, this task is already complex, but it becomes even more challenging if patients have unusual anatomy or if they had previous spine surgery.
Now, instead of relying on anatomical landmarks and two-dimensional pictures to approximate where a certain implant should go, spine surgeons use an intra-operative scanner to create a three-dimensional picture of a patient’s spine. Using this picture as a roadmap, surgeons then place implants using pinpoint accuracy.
“These guidance systems are expensive; hence, the majority of spine surgery is still performed without them,” said Langston Holly, MD, UCLA professor of neurosurgery and co-director of the spine center. “That is the benefit of working at a place like UCLA, we can offer patients cutting-edge treatments that are safer and lead to a shorter recovery.”
In addition to the improved accuracy and safety these systems provide, using intra-operative navigation also allows surgeons to perform surgery using smaller incisions.
This not only reduces postoperative pain but also helps patients recover faster and return to their normal activities.
“This technology enables patients to feel more at ease when undergoing major spinal surgery, knowing that every step has been taken to ensure their safety and recovery,” Dr. Macyszyn said. UCLA spine surgeons continue to expand the use of this technology, treating patients with more complex disorders such as scoliosis and spinal tumors in a manner that previously wasn’t possible.