A world-first operation using advanced software and clever robotics has demonstrated the benefits of a new approach to spinal surgery.
Last month, at The Valley Private Hospital in Melbourne, Dr David Edis used a breakthrough development in the Mazor Renaissance Robotic Guidance system to undertake an entire spinal operation with the patient lying on their side, reducing the time needed for the procedure.
‘‘This addition to the Mazor Renaissance system, the PROlat mounting option, means we don’t have to turn the patient face down halfway through the operation,’’ Dr Edis says.
‘‘Not doing ‘the flip’ saves about 60 minutes, which means less time under anaesthetic for the patient.’’
Many degenerative problems of the spine occur when the cushioning discs between the vertebrae become damaged or diseased.
This may reduce space between the vertebrae and compress nerves that branch off from the spinal cord, causing chronic back pain.
On Friday 20th July the Sydney Morning Herald published an article relating to a case that I performed at The Valley Private Hospital in Melbourne a few weeks ago.
The case was novel in the sense that I was able to utilise the Mazor Renaissance Spine Guidance Robot to place pedicle screw fixation with the patient in the lateral position. This was the first case that the ProLat system had been used in Australasia.
The patient initially had 2 levels of OLIF interbody cages placed in the mid lumbar spine to manage a degenerate scoliosis and stenosis problem that was causing considerable pain and dysfunction for the patient. Pedicle screws are routinely placed to stabilise the spinal segments after placing interbody cages so that the correction is maintained and healing rates improved.
Sometimes I am ashamed to be a member of the medical profession, when I hear from my patients how they have been mistreated by my colleagues. I don’t mean that the treatment they received did not follow reasonable medical guidelines or was incompetent. I mean that they were not treated with respect. They were treated as inferiors or of lesser intelligence and they came away feeling they were not worthy of the doctor’s time or efforts.
Surgeon Fees and Out of Pocket Costs for Private Surgery
The benefits and downfalls of private health care have been a hot topic of late. In his latest
report for the ABC’s investigative journalism program Four Corners (aired May 28 th 2018),
Norman Swan has again delivered a piece that is more worthy of A Current Affair. Although
the primary aim was to shed some light on the practice of some surgeons who charge
excessive fees, I found the whole program was delivered in a ‘shockjock’ type approach by
comparing healthcare to buying a new Holden and the report did not help consumers to
understand the real drivers to increased costs of healthcare.
Sciatica is a term to describe pain that radiates from the back or buttock area and down the leg and into the foot or toes. The pain originates in the lower spine where the lumbar nerve roots (L4, L5 or S1) that make up the sciatic nerve can be irritated by pressure or inflammation. Although the pathology is in the spine, the pain is often worse in the leg along the course of the dermatome for the given nerve root. The medical term is radiculitis or radiculopathy of a specific nerve root and is more precise.
The normal spine is balanced with regards to the position of the head over the pelvis. This is true for the front view(coronal) plane and side view (sagittal plane). Scoliosis refers to abnormal curve of the spine in the coronal plane and these curves may be balanced or imbalanced where the head sits off to one side or the other compared to the centre of the pelvis. The spine has a normal curved shape in the sagittal plane. In the lumbar and cervical region there is a concavity at the back termed lordosis, whereas in the truncal or thoracic spine there is a convexity (kyphosis) to the spine at the back. Overall the head sits well balanced over the pelvis to neutralize the forces and the amount of work the spine muscles need to do to maintain upright posture.