Spine surgery: Just the thought of it is enough to make one cringe. The pain, the risks, the recovery time can make anyone with a spinal stenosis, disc issues, curved spine or other back conditions dread the prospect of surgery so much they wonder if it’s even worth it.
At UVA, experts at our Spine Center are actively developing innovations in spine surgery to improve the patient experience and outcomes.
We asked Frank Shen, MD, about some of the latest developments in the field of spine surgery research. He specializes in minimally invasive surgery, image-guided spine surgery and microsurgery.
Spine Surgery Research: The Prospect of Regeneration
At UVA, tissue engineering – getting growth factors to grow cells on a scaffold – is about as futuristic and advanced as you can get.
“Everyone talks about surgery and interventions to address an issue, but not regeneration,” Shen says. And yet, “Bone is one of few tissues that can grow back – even the bone itself.”
The research into using bone regeneration, and even nerve and spinal cord repair, to heal spine disorders has so far been successful in the lab; however. the next challenge: translating the process to humans.
“As you can imagine, that’s not easy,” Shen says.
Going Small for a Big Improvement
But the advancements aren’t just happening in research labs. “We’re actively developing new approaches to the spine and new surgical techniques,” Shen says.
“We really are trying to take reconstructive surgical procedures – realigning and stabilizing the spine –that are typically done through larger incisions, and use the smallest amount of incisions, create the smallest amount of damage and the least amount of tissue injury,” Shen explains.
Spine surgeons achieve this less-invasive approach using special microscopes and a specific arrangement of light. Using parallel lighting in the operating room, instead of a headlight on the forehead, allows for perfect or near-perfect lighting, giving greater precision to work on a very small field and object. This allows the surgeon to create smaller, deeper holes, reducing the size of incisions on the back.
UVA surgeons can combine this with intraoperative CT scans and high-tech computer imaging that reconstructs the bone and disc in question. So they’re able to do less injury during spinal surgery.
The benefit to patients? Typical back surgery can lead to a painful, lengthy recovery. Reducing the size of incisions, increasing the precision of the procedure, can minimize that recovery time and make returning to your daily routines a less painful process.
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Changing the Approach
But they aren’t only trying to improve on current procedures. “We’re actually changing what we’re doing from traditional strategies,” Shen says. “We’re exploring new anatomic approaches, new corridors to get to the spine, far-lateral and direct-lateral access from the side instead of front and back, getting to the front of the spine.”
Fusion (the joining of two or more vertebrae using bone grafts) has typically been the go-to fix for spine curvature, slipping discs and nerve compression. The problem with fusion is that it inhibits a person’s range of motion, limiting flexibility. Instead of fusing the spine where fractures have happened, Shen is hoping to find technologies that preserve motion. “We’re changing the way we think about it, like using physical replacements on the spine.”