There is no doubt about it, spine surgery is a serious event for any patient. Patients are in severe pain, and the surgery usually involves operating near spinal nerves, and the bones and ligaments of the spine. The risks are high.
Traditional techniques of spinal surgery often involved long operations, with large incisions, and major blood loss in order to improve the diseases of the spine. Whether it is scoliosis reconstruction, or spinal stenosis, the older traditional means of spinal surgery have been traumatic for patients. As surgeons, we knew there was a better way.
Necessity is indeed the mother of invention. Fortunately, technological advances, and improved surgical exposure, gave rise to Less Exposure Spine Surgery and Minimally Invasive Spine implants and procedures. These modern techniques have created a paradigm shift in what options spinal surgeons can offer patients. As more surgeons accepted and mastered these less invasive surgery options, the device industry began to meet the demand of what surgeons insisted was better for their patients. These advances included performing the same operations as traditional surgery, but using tiny incisions, scopes, and less hardware. This has resulted in typically faster recovery, less pain, and improved outcomes for patients. While some forms of traditional spine surgery are still necessary, more and more surgeons are attempting Minimally Invasive Spine Surgery whenever possible. Thus, these new techniques are steadily becoming the new “gold standard” for spinal surgery procedures.
Another “Holy Grail” of spine procedures has been disc replacement surgery. Around the year 2004, there was a major push from spinal surgeons to perform disc replacement surgery. Most of the early designs of disc replacement were based on our knowledge of orthopedic hip and knee replacements. These first generation designs were usually metal implants, with a plastic spacer in between so that motion could be preserved. Surgeons could potentially perform fewer spinal fusion procedures, by replacing the disc of the spine, rather than fusing the spine. The early data showed promising results, but as always, there were hurdles to overcome. One major flaw was the excessive wear of the plastic disc, as well the lack of “natural motion” of these early disc replacements. Many patients have been helped with these devices, but some data showed the need to revise some of these disc replacements with a second fusion operation. Another major setback, was that health insurance companies fought back against this new technology, in an effort to keep costs down. Many patients were left to pay for the implants themselves, after medical insurance denied paying for this helpful technology. Because of these battles with insurance companies, as well as the limitations of this first generation design of disc replacements, surgeon backed away from this as an option, and went back to spine fusion as the primary option. As with many new emerging technologies in medicine, the status quo of surgeons, and the rest of industry, just was not ready for this new innovation of spine surgery.
We have come to yet another crossroad in the advancement of spinal surgery. Less Exposure Spine Surgery advancements, have allowed surgeons to raise the bar for a higher status quo. This new generation of spine surgeons are trained and accepting of the recent advances in minimally invasive procedures and disc replacement surgeries. The next generation of disc replacement surgery has solved many of the “ball and socket” designs of previous disc replacements. These new discs, can now be inserted with Minimally Invasive and Less Exposure Spine Surgery techniques. In addition, the new discs are truly “viscoelastic”. In other words, these new disc replacements mimic what a patient’s normal disc does. This means that the disc is able absorb shock, rotate, and compress, much like a normal disc. This new technology has been over 10 years in the making. The Axiomed Freedom disc and is an example of one of these new innovative discs. Surgical cases performed in Europe, Australia, and even Jamaica have shown promising results. Soon, these new discs will be available for use in the United States. The benefits of this new disc replacement technology will change the way surgeons approach damaged spinal discs.
The ability to perform these surgeries less invasive once again proves that necessity is the mother of invention. Surgeons have once again “found a way” to get closer to offering patients a more “natural” surgical option other than traditional fusion surgery. As new companies begin to mimic the new Axiomed disc technologies, surgeons will have even more options to offer the kind of disc replacement surgeries that truly cater to each individual patient’s needs. As surgeons, we know that we can never truly replace the miracle of what God has given us. We still strive for this perfection, knowing that we can never fully achieve it. By striving for this goal, we as surgeons hope and pray to do the best we can to help our patients lives improve. These new viscoelastic disc replacement bring us one step closer.