| Posted April 22, 2015 | By John Klekamp, M.D. | Categorized under Men's Health, Women's Health |

The spinal surgeries we are performing today at Williamson Medical Center are decidedly different than those we did 10 years ago. Nobody wants to think about having surgery on their spine, but with advances in technology, equipment and imaging, we can do more minimally invasive surgeries on the spine as an outpatient.

New Tools

Over the last 10 years, huge advances have been made in the tools we use to perform surgeries.  MRI technology now provides a much clearer image and with open MRIs, they are now more comfortable for the patient. We currently utilize intra-operative imaging and we have better visualization thanks to three operating microscopes that help us detect smaller issues that could have gotten overlooked by the naked eye.

Smaller incisions

Now we are able to do a wide range of spinal surgeries with minimally invasive procedures. I use what is called a "pipeline" approach to gain access to the spine. This means a 2- to 3-centimeter incision instead of a 5- to 6-centimeter one. There is less dissection, which drastically improves recovery time. With the microscopes we use, we are able to direct surgical care where it's needed most so we don't need to make a larger incision.

Thimble vs. Cup

For the more complicated spinal surgeries we are starting to be able to use different biologic agents such as bone graft substitutes, which allows us to get away from having to do a large bone graft process. One surgery we perform is a spinal fusion. It is used to stabilize spinal segments that are unstable and therefore cause pain. In order to do that we have to use a bone graft, where we would make a large incision and take bone from the patient's pelvis to use in stabilization of the spine. We still do that part of the process, but are now able to rely more on synthetic bone products. So instead of having to go in and remove, say, a cup of bone from the pelvis, we only have to remove about a thimble full now. This helps recovery time immensely.

Neuro-monitoring

Yet another advance that is helping to change spinal surgery is intra-operative neuro-monitoring. A technician places sensors on the patient from head to toe and during surgery, will perform live neuro-monitoring to ensure that whatever procedures being performed around the nerves aren't causing any damage. Prior to having this technology, nerve damage wouldn't be realized until after surgery.

Common ailments

Unlike any number of ailments that can be prevented with lifestyle changes or other preventative measures, the most common cause of spinal surgery is disc herniation or compression, which causes sciatica, or pain that radiates down the back of the leg via the main sciatic nerve. This is not preventable, but just a natural part of the aging process. But like I tell my patients, aging can be difficult, but it beats the alternative! This problem can be alleviated, however, with a procedure called a discectomy. I'd say 90 percent of these are outpatient procedures. In some cases the patient will leave the hospital the next morning, but more often than not the patient leaves the same day and can feel immediate relief.

Viable option

Surgery on the spine seems scary, and it should be taken very seriously, but with the newest technology combined with the right expertise, people are recovering in a fraction of the time and returning to normal life quicker than ever before. There was a study done recently on discectomy surgeries on NFL football players and it showed the vast majority of them returned to playing football after surgery.

Performed locally

Another misconception about spinal surgery is that you have to go to a large, major hospital to have many of these procedures. That just isn't true. My partners and I at Vanderbilt Bone & Joint Clinic here in Franklin do all of our procedures either at Williamson Medical Center or in our outpatient facility here.

In fact, Williamson Medical just won a prestigious designation as being in the top 10 percent in the nation for medical excellence in spinal fusion.  They also have one of the lowest infection rates in the state. All of those things, combined with the size of Williamson Medical Center, make it the perfect place to do what we do.