Printing Spines
By Admin | November 13, 2019
Spinal surgeons in Phoenix are working to reduce risks for individuals living with scoliosis by printing 3-D models of the spines of patients they are treating.
Surgeons at Barrow Neurological Institute opted to create these models to help reduce surprises and the potential for complications on the operation day.
Scoliosis is defined as the abnormal curvature of the spine. Abnormal curvature can be side to side or an "S" or "C" shape.
There are several types of this condition; the patient's type is determined by the cause of the curvature and age when the abnormal curve appears.
Risk factors for the condition include age, with most cases developing between 9 and 15 years of age; family history; and gender (more females than males develop scoliosis).
The majority of patients do not have a known cause, and there is no cure for the condition. The treatments for scoliosis range from observation to bracing to surgery, depending on the expected progression of the condition.
The Barrow surgeons used their 3-D model on a patient, Megan Johansen, who was diagnosed with the condition at age 9.
Johansen experienced consequences of her condition as an adult, three years after having her fourth child.
These consequences included heart palpitations and difficulty breathing. After experiencing these effects, Johansen opted for a surgical solution.
Doctors at Barrow set out to print the spines, which costs between $50 and $75, to understand the biomechanical performance of the patient's vertebrae better. They found that their models helped especially with complicated cases like Johansen's, by not only giving surgeons an idea of how the spine looks but also how it moves and bends.
Before Johansen's procedure, the surgeons worked with the 3-D model to test their approach. The surgeons treating Johansen found that the pedicle bones on the inside curves of her spine were too small for screws, which are commonly used to help straighten the spine.
As a result of their discovery, the surgeons changed their plan to place the screws elsewhere.
Johansen's surgery was initially slated to be 12 hours long and only result in a correction of around 50 degrees.
As a result of her surgeon's pre-operative work with the 3-D model and planning, her surgery was only five hours long. She also was corrected to 13 degrees. As a bonus, she woke up 5 inches taller.
Johansen is living more comfortably, is back to work, and is able to hike with her family.
"The ability to see how the surgery will impact patients is invaluable," said Dr. Faisal Jahangiri of AXIS Neuromonitoring in Richardson, Texas.
AXIS provides another way to see how surgery impacts patients through intraoperative neuromonitoring. Intraoperative neuromonitoring allows patients to be monitored through a range of neurophysiological tests, including Sensory Evoked Potentials (SSEP), Motor Evoked Potentials (MEP), Electromyography (EMG) and Electroencephalography (EEG), etc.
"These neurophysiological tests show changes in the patient signals during different types of surgeries, including spinal procedures for scoliosis," Jahangiri said.
Neuromonitoring tracks how nerves behave or respond during a surgical procedure.
"If changes are noted in the patient's neural structures during surgery, intraoperative neuromonitoring technologists immediately alert the surgeon of the changes," Jahangiri said.
In a scoliosis case, an AXIS IONM technologist alerted surgeons that placing pedicle screws into the spinal canal of a patient caused a change in the patient's leg muscles.
"Had the IONM technologist not been present, the change may not have been noted until after the procedure, which could have resulted in lifelong negative consequences," said Jahangiri.
Source: WQAD. YOUR HEALTH: Creating a spine before actually doing spinal surgery. 11 October 2019.
