Technology making back surgery less invasive

March 8, 2010 6:53:13 PM PST
For patients with back pain, major surgeries like disc fusion are often a treatment of last resort. Now, an emerging technology is allowing doctors to perform those procedures through incisions less than two inches long.

Joyce can only dream of some of the places she used to go and things she used to do.

"I love to hike, Prairie Creek Redwoods over to Fern Canyon, it was over a 13 mile hike, and I was able to do that," she recalls.

Now, Joyce, who asked us not to use her last name, is often in so much pain she cannot get out of bed. But, she is hoping that an advanced surgical technique will allow doctors to fuse badly-deteriorated vertebrae in her back with less recovery time.

"So, what we're going to do, is going to go in, side of the spine, lift and separate the vertebrae, and push the vertebrae back into anotomical alignment and we're going to fix it there," explains Dr. Kenneth Light.

Instead of an open surgery through Joyce's abdomen, Light marks a small "x" on her side. In an operating room at St. Francis Hospital in San Francisco, he will insert a tube which once in place expands, allowing surgical tools to reach the spine without endangering major organs.

Light says, "The advantage is that there is very little exposure and surgical trauma to the patients."

The technique is known as XLIF, or Extreme Lateral Interbody Fusion. X-rays help the surgeon guide the instruments and electrodes sound an alarm if they are nearing any nerves. A specially-designed tool cuts and removes disc material between the two vertebrae. Again, using the x-ray, Light then places a spacer to allign the vertebrae.

Once the bones fuse together, they will stay in position, hopefully relieving irritation on surrounding nerves. Because of the limited trauma during surgery, patients typically recover several weeks faster than traditional methods.

John Diebold, who underwent the same procedure last fall, says he was able to begin walking in his Oakland neighborhood the following week.

"Had a brace on, and I got tired easily but as far as pain, I didn't have much pain at all," he says.

The surgical tools and the tube itself are ultimately removed through the same 1.5-inch incision, leaving the fused bones to heal and hopefully allow Joyce to live pain-free.

"To be able to hike that 13 mile hike back to Fern Canyon from Faye Creek... Redwoods are so beautiful, if I could do that again," she says.

While the recovery times are typically faster, the cost of the procedure is still similar to open chest methods because of the monitoring and technology involved in the operating room. The procedure is covered by most insurance.


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