Case report: Use of the Mazor Robotic System in adult scoliosis surgery
Robotic Spine Surgery (KSAT)
About six million people in the U.S. have scoliosis, an abnormal curvature of the spine. When left untreated, it can get worse and cause chronic back pain. Now with the help of a robot, surgeons can tackle more complex cases with less risk- and better results.
Bonnie Wilson is walking tall today, but she suffered with severe scoliosis for years.
“I was bent to one side.” Bonnie Wilson told Ivanhoe.
She tried everything from nerve blocks to cortisone shots, but the intense back pain persisted.
“They’d always say one to 10 and I’d say 50. 20,” said Wilson, “I don’t know. It was terrible. It was off the chart.”
Dr. Andrew Cannestra was able to straighten Bonnie’s back through a two-part surgery using new robot technology known as Mazor Robotics Renaissance Guidance System and a 3-D map of the spine.
“It’s precise,” said Andrew Cannestra, M.D., Ph.D., Neurosurgeon and Director of the Robotic Spine Surgery Program at Baptist Medical Center in Jacksonville, “It’s accurate and I can maximize the size of the screw I put in there and that then allows me to exert as much force on the spine as possible to straighten the spine.”
Bonnie went from a 38 degree curve, down to eight degrees.
“She has very close to a normal curvature of her spine,” Dr. Cannestra told Ivanhoe.
Bonnie is now an inch taller.
“Clothing fits normally, sitting is normal. I don’t’ have all those muscles getting tired from being leaned one way or the other,” Wilson told Ivanhoe.
Letting Bonnie take long walks with Cole without feeling pain.
The robot technology can be used to help with other spine conditions like fractures, reconstructive spine surgery, degenerative disc disease and herniated disc. The new technology has also been used for bilateral deep brain stimulation for Parkinson’s disease.
Contributors to this news report include: Cyndy McGrath, Supervising Producer; Jennifer Jefcoat, Field Producer; Kim Coley, News Assistant and Jamie Koczan, Videographer/Editor.
SCOLIOSIS: Scoliosis is a curvature of the spine that can be caused by cerebral palsy and muscular dystrophy; however the main cause for patients without these conditions is unknown. Typically, scoliosis most often occurs during growth spurts just before puberty. Most cases of scoliosis are mild, and can be corrected in children by having them wear a brace. Severe cases can be disabling, as a severe spinal curve can reduce the amount of space in the chest, causing lungs to function improperly. These types of cases may require surgery to straighten the spine.
TYPES OF BACK SURGERY: Typically, people with back pain or spinal conditions resort to surgery when many other treatments have failed. Each type of back surgery comes with its own risks and benefits. Spinal fusion is the most common back surgery; the vertebrae are joined together, limiting motion between the bones of the spine, as well as the stretching of nerves. In a laminectomy, bone spurs (or ligaments) are removed alleviating pressure on spinal nerves. A foraminotomy procedure is one in which the surgeon cuts away bone at the sides of the vertebrae to widen the space where the nerve roots exit the spine, thereby relieving pressure on the nerves. When a patient has a bulging or slipped disc, which cushions the vertebrae, a surgeon will perform a discectomy to remove all parts of the disk. In a disc replacement surgery, a damaged disc is removed and replaced with an artificial disc, permitting continued motion of the spine. In an interlaminar implant surgery, a U-shaped device is placed between two backbones in the lower back, maintaining the space between. All of these surgeries can be done independently or in a combination depending on the condition of the spine and recommendation by a doctor.
NEW TECHNOLOGY: The Mazor Robotics Renaissance Guidance System is one of the latest tools that increase precision for minimally invasive spine surgery. Specially-trained surgeons use the advanced 3-D planning software to create a tailored procedure for each individual patient. Once in the operating room, the surgeon is guided by this specific blueprint to perform necessary treatments or place implants safely and accurately. The robot is placed over the patient’s back during the operation to provide the trajectory. Andrew Cannestra, M.D., Ph.D., and neurosurgeon with Lyerly Neurosurgery at Baptist Medical Center in Jacksonville, Fla., told Ivanhoe, “Precision is the big advantage. Traditionally X-rays are used which expose you to a lot of radiation…this is a way to decrease radiation in the operating room.” The tools and implants of this technology are guided with 1.5 mm accuracy, and is also cleared for fusions, deep brain stimulation and Parkinson’s disease.
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