Melding technology and expertise for optimal spinal surgery

April 26, 2019

Spinal surgery at Mayo Clinic combines advanced technology with the personalized expertise of a multidisciplinary treatment team. Consultations and surgery are available at all three Mayo Clinic campuses for people with the gamut of spinal conditions, including focal degenerative disease, larger spinal deformity such as scoliosis, and primary and metastatic tumors of the spine. Mayo Clinic's neurosurgeons work closely with physiatrists to evaluate patients, including people referred for possible revision surgery.

"We have a weekly spine conference where we obtain input on patient management from our specialists in physical medicine and rehabilitation, pain medicine and neuroradiology, as well as neurosurgery. Together, we're able to address spinal conditions in a variety of ways, to optimize outcomes for our patients," says Selby G. Chen, M.D., a neurosurgeon at Mayo Clinic in Jacksonville, Florida.

Neuroradiologists at Mayo Clinic have extensive experience reviewing spinal imaging, including CT myelograms and single photon-emission computerized tomography scans. "That advanced imaging is very helpful for us to identify where a patient's problem and pain originate and to recommend treatment," Dr. Chen says.

Because Mayo Clinic is a fully integrated practice, treatment decisions are based on patients' individual needs. "Many patients don't necessarily need spinal surgery, or may not be good surgical candidates," Dr. Chen says. "If that's the case, our physical medicine and rehabilitation specialists are able to take the helm and provide the kind of care these patients need, such as physical therapy, injections or spinal cord stimulation. We can always offer an opinion and suggest a treatment option, either surgical or nonsurgical, even for patients who come to us needing revision after previous surgeries."

Latest OR technology

Mayo Clinic has a new robotic system for spinal surgery that allows for preoperative and intraoperative planning, as well as robotic-guided surgical execution in multiple trajectories. The system's robotic arm connects directly to the patient's anatomy during surgery to enhance stability and precision.

In addition, Mayo Clinic uses intraoperative CT with spinal navigation. "That's especially helpful in revision cases, where the spinal anatomy may not be completely normal," Dr. Chen says. "We also have a full range of neuromonitoring during surgery, supported by our neuroanesthesiologists."

These technologies facilitate the use of minimally invasive spinal surgery when appropriate. "Misalignment of the spine at one or two levels; spinal stenosis or instability at a few levels; and herniated disks can definitely be treated through a minimally invasive approach. It is a great option that we can provide for patients," Dr. Chen says. Minimally invasive spinal surgery uses smaller incisions and generally requires less disruption of soft tissue around the spine, less blood loss and pain, lower rates of infection, and faster recovery.

"The multidisciplinary aspect of our spine care is really unique and definitely helps us improve outcomes," Dr. Chen says. "That, plus our state-of-the-art technology, means we have a lot of options to offer patients."