A cut above the rest

Technology is changing the way spinal surgeons operate. Improved imaging techniques and smaller ‘hardware’ allows surgeons to minimise incisions.

That’s good news for patients as they are left with less of a wound and faster recovery times.

Dr Raj Reddy is a neurosurgeon with experience in minimally invasive spine surgery, paediatric neurosurgery, and brain tumour surgery.

He operates at Sydney’s Prince of Wales Private Hospital.

Dr Reddy says each spinal surgeon will have a different approach to surgery. The main difference is the size of the incision made on a patient.

‘‘Some surgeons will do a big, open cut so they can move all the muscle aside and completely visualise the spine,’’Dr Reddy says.

With the right technology, and where clinically appropriate, it is now possible to undertake keyhole, or minimally invasive, surgery on the back.

‘‘New technology has made the screws and implants we use smaller,which helps when we are wanting to limit the size of the incision that we make,’’ he says.

Depending on the equipment available at a particular hospital, keyhole surgery is typically performed using multiple X-ray images.

Dr Reddy says that is not ideal.

‘‘It carries with it the problem of radiation, the staff have to wear lead gowns and it only provides a 2D image,which isn’t ideal when operating in a three dimensional person.’’

At Prince of Wales Private Hospital, Dr Reddy and other specialists are now able to perform these operations using an Airo CT scanner.

He says the technology has radically improved surgery for patients.

‘‘The Airo CT scan allows for far more accurate placement of your screws because it gives you a 3D picture,’’ he says. ‘‘Also, you can scan a patient before you get them off the operating table, to ensure that all of the screws are in the right place.

‘‘Without Airo CT, there are rare occasions where everything looks good during the operation, but a follow-up scan the next day shows that the placement of one or more of the screws is sub-optimal.’’

In those rare cases, a surgeon has to get the patient back on the operating table, reopen them and re position the screws.

Patients who undergo keyhole spinal surgery can expect less pain and faster recovery times, Dr Reddy says.

‘‘With the standard ‘big cut’ operation, most patients are in hospital for seven- to ten days, but when the surgeon uses a keyhole technique it is typically half that time,’’ he says. ‘

‘It’s also a shorter operation, meaning less blood loss for the patients and less anaesthetic time.

‘‘Overall it means much safer outcomes for patients.’’