Mayo Clinic neurosurgeon Maziyar A. Kalani, M.D., discusses minimally invasive spine surgery advancements at Mayo Clinic. Topics include virtual reality, robotics and enhancing recovery. He also discusses a variety of different types of minimally invasive spinal therapies that are performed and the reasons why they are performed.
The reason behind doing minimally invasive surgery is because it disrupts the tissue as little as possible. What you get out of it is smaller incisions, less blood loss, less length of stay at Mayo Clinic. We're constantly looking to identify ways to diagnose patients pain. Every patient can benefit from some element of minimally invasive surgery in their spinal care. On this model. What you see is some pedicle screws. These are screws placed through the back into the spine. Often they are connected by a titanium rod minimally invasively. We can place these spacers either through the belly or through the side. You might be wondering how is that minimally invasive? Well, we don't have to actually touch any of the muscles in the back. We don't have to strip the muscles off of the spine. We don't have to interfere with the joints of the spine with disc arthroplasty surgery. We make an incision, remove the disc and instead of fusing the two bones together, we place a device that maintains the normal range of motion of the neck in that area. Our goal is to remove either the offending arthritis or disc with lumbar decompressive surgery we place either a tubular retractor or self retaining retractor through the smallest incision possible. And with the help of either an endoscope or a microscope. After trimming a small piece of bone, removing the offending arthritic compression or disc during spinal fusion, the goal is to essentially marry two bones or more together. Oftentimes we remove arthritis, remove nerve compression or spinal cord compression and place a spacer often filled with either cadabra bone or the patient's own bone, which helps act as a scaffold to marry two bones together. You can think of rods and screws as like a cast. It's a brace we put in the spine to keep the two levels from moving with respect to each other. That static environment allows the bone to grow at Mayo Clinic. We're using some of the most advanced 3D technology. We use everything from advanced neuromonitoring to image guidance to the most recent implant technology to obtain a good result. So virtual reality is actually very useful because it gives us a lot of pre operative planning that we can do. We can share this with the patient. Patients generally have a much better experience of understanding what their anatomy looks like, but also what their surgery will be like within the or we actually do augmented reality. And this is very useful because it's ergonomically very helpful for the surgeon, but also allows us to have a nuanced understanding of what's actually happening deep inside the patient there is no area in spine surgery that is more dependent on technology than minimally invasive surgery, whether that's neck surgery or low back surgery, the technology both in terms of what's implanted, in terms of how it's done, how the patients are taken care of after surgery, that's really changing. And I wanna give the patients the best opportunity to do well with the least amount of invasiveness. I think it's important to know that truly minimally invasive surgery is really changing. How we do spinal surgery. Here at Mayo Clinic, we work collaboratively and as a result, employ all resources necessary to do the operation safely.
