Minimally Invasive Surgery for Complex Scoliosis
Adam Kanter, MD and David Okonkwo, MD, PhD
Hello, I’m Dr. John Whyte, chief medical expert at Discovery Channel. Neurosurgeons at UPMC are among the first in the country to adopt a new approach to spinal surgery for patients diagnosed with complex scoliosis.
This new minimally invasive procedure accesses the spine from the side of the body instead of the front or back. Patients may experience less postoperative pain, a shorter recovery time, and lower likelihood of long-term complications. At UPMC, neurosurgeons work side by side to perform this extreme lateral interbody fusion or XLIF procedure.
Scoliosis is a problem that affects patients all the way from childhood through senescence and our senior citizens. And one of the unique things that we do here at UPMC is that we can, in a certain group of patients, permit a minimally invasive approach to this problem that allows for more rapid recovery and better outcomes.
A unique way that we are approaching spinal deformity surgery here at UPMC, is that we are employing an XLIF approach — or a lateral access minimally invasive approach — to treating scoliosis and spinal deformity. What’s unique about the XLIF procedure is that we are attacking it in a minimally invasive lateral access fashion, so avoiding the damage and the injury to all the structures, all the adjacent structures on the way to the spine. We are using neuromonitoring techniques that allow us to very safely perform this procedure.
And our goal is to come in from the side and see if we can open up these disc spaces increasing the space between the vertebrae to open up the foramen, the areas where the nerve roots try to travel.
So we are able to remove the disc pathology in a very minimalist fashion and replace it with bone. The fusion procedure has been around for years and years, but this is unique in the sense that we are able to do it in a minimally invasive fashion using very unique monitoring techniques that allow us to do it safely.
The benefits have become crystal clear, we are having shorter hospitalizations, we are having shorter operating times, less blood loss, fewer anesthetic complications, and we are getting people back to their regular lives faster than with the more traditional approaches to scoliosis.
It’s not always deformity correction as much as it’s symptom relief. Some patients may have terrible spinal deformity and be in terrible sagittal imbalance, and our goal isn’t necessarily to line them up and keep them straight and make them tall again. What it is is to make them so that they can become functional, active, contributing members of society.
We have partially corrected your scoliosis. But more importantly we have been able to take away the trouble that was giving you all the pain.
UPMC is able to help lots of patients who otherwise would not be candidates for surgical intervention. We are able to help these patients in certain circumstances with minimally invasive approaches.
For more information, contact us at 412-647-3685.