Tamil Nadu - Coimbatore

New technology to make spine surgery safe

COIMBATORE: After the computer navigated surgery technique introduced seven years ago, a system to monitor spinal function during surgery has been introduced now and this make operations to the spine safe, according to Director and Head of the Department of Orthopaedics and Spine Surgery at city-based Ganga Hospital S. Rajasekaran.

The first one ensured precision in driving titanium screws through the spinal bone, without damaging the main blood vessel and the spinal chord. And, the intra-operative neuro monitoring system acquired now by the hospital obviated the need to wake up patients before the surgical wound was closed in order to check whether they were neurologically normal.

The use of both technologies in tandem became all the more relevant when the Association of Spine Surgeons had given ‘Safe Spine Surgery’ as the theme for this year, Dr. Rajasekaran who is the president of the association, told presspersons here on Thursday.

Surgeons approached spine surgery with the fear of two risks. One was that of the screws damaging the chord or blood vessel. The computer navigated surgery enabled the placing of the screw exactly in the 5.5 mm to 6 mm gap. While this enabled surgeons to overcome the first risk, the second one persisted. Now, the new monitoring used two methods – Surface Sensory Evoked Potential (SSEP) and Motor Evoked Potential (MEP) – to check whether the patient had regained normal neurological status after the spine damage repair surgery.

Dr. Rajasekaran explained that under SSEP, small neural impulses were sent from the peripheral muscles in the legs to the brain. If the normal neurological status had been restored, the impulses would travel up to the brain through the spinal chord. The MEP was another test in the reverse direction to check whether the command from the brain resulted in the muscle movement in the leg. This system also alerted surgeons on any harm to the spinal chord or neural structures.

Earlier, spine surgeons did not dare straighten a bent spine beyond 60 per cent. “Now, with the advanced monitoring system, we can assess at every stage such as 60 per cent or 70 per cent and go beyond this after ascertaining the safety level. We can be bolder now,” Dr. Rajasekaran said.

“Why we emphasise technology for safety is that a spine surgeon’s worst nightmare is a patient becoming a paraplegic (paralysed below the waist) after the surgery. As more complicated cases come to the hospital, we need more than mere human skill to provide safe and accurate treatment,” he pointed out.

Dr. Rajasekaran emphasised early detection of spinal problems.

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