Technological developments in spine surgery are occurring at an ever-increasing rate, but what does this mean for you?
Most new technologies in spinal surgery typically focus on achieving the following goals:
- Developing less invasive approaches
- Preserving motion in the spinal segment
- Enhancing spinal fusion between adjacent segments
- Reducing postoperative pain
- Speeding recovery
To achieve these goals, technological advances, such as the use of robotics to place spinal instrumentation during a surgical procedure have become more popular these days. This technology uses computer-assisted navigation, 3D cameras, and lesser exposure to radiation to perform certain spinal surgeries.1-3
Newer surgical technologies and procedures for the spine
A few of the more recent advancements in spinal surgery that use the latest technologies are listed below:
Cervical artificial disc replacement
Insertion of an artificial disc for treatment of cervical disc pathology is standing the test of time (with 4 to 7 years of clinical results reported in the US) and emerging as a mainstay alternative to anterior cervical discectomy and fusion (ACDF). More recently, cervical artificial disc replacement surgeries have even been performed on two-level procedures as well.4,5
Outcomes of fusion surgeries are improving over time, with enhanced fusion rates and less postoperative pain and complications. Areas of improvement include less invasive approaches, more bone graft options, and innovations in cages/implants to enhance their materials and methods of fixation.
Minimally invasive sacroiliac (SI) joint fusion
With newer, less invasive fusion approaches now available, SI joint fusion is a more commonly offered treatment option for those with pain caused by sacroiliac joint dysfunction.
Surgical treatment of a painful fractured vertebra now allows patients to choose from many options, including minimally invasive options, such as vertebroplasty and kyphoplasty. Prior to these innovations, a patient with an osteoporosis compression fracture would typically only have nonsurgical treatment options, but vertebral augmentation has now become a mainstay option that offers certain patients a relatively reliable path to pain relief.
While vertebroplasty stabilizes the fractured vertebra using bone cement, kyphoplasty is more advanced and uses an inflated balloon catheter to help restore the vertebral height in severely fractured vertebral segments before stabilizing with bone cement.
Limitations of spinal surgery technologies
None of these technologies, however, change two important fundamentals for patients to keep in mind:
- The importance of getting an accurate preoperative diagnosis, which is surprisingly difficult when it comes to identifying the cause of many types of back and neck pain. Even the best technology will not be useful if what is operated on is not what was causing your pain.
- Choosing a surgeon who has expertise in your specific pathology (diagnosis) and treatment. Take your time in selecting a surgeon—don't rush into a decision about surgery. Many people get a second or third opinion before making a decision, and surgeons are used to this so don't be concerned about consulting with more than one surgeon.
Spine surgery is like any other field of medicine in that it is a combination of science and art. Advancement in spine surgery involves trying to improve techniques for accurately diagnosing patients’ problems, and then enhancing surgical technologies.
Just as in the rest of life, with spine surgery, there are no simple answers. Relying on new technologies alone to improve outcomes is probably not a good idea. A combination of the judicial use of newer technologies combined with rigorous scientific study and the surgeon's skills and expertise holds the promise of providing an increased probability of good outcomes.