Advances in minimally invasive spine surgery

This story was originally published in the Winter 2021 edition of Providence Health Matters.

[3 MIN READ]

Key Takeaways:

• Accessing the spine for surgery is often challenging, but technology makes it easier.

• The ExcelsiusGPS robotic system’s new technology improves surgical accuracy in the operating room and reduces patient recovery time.

• Dr. Jiang offers expert insights about the robotic system and details its state-of-the-art navigation and real-time 3D image guidance.

Shirley Chang stopped dancing five years ago. As her back pain continued to worsen, the ballroom dance champion would sit in her yard and simply visualize the steps.

In fact, the pain from spinal stenosis compressed her nerves and steadily took away all the 84-year-old’s favorite things: dancing, days of shopping-til-you-drop and making dinner for friends and family.

“Every movement caused pain,” explains the Hacienda Heights resident and grandmother of five. She says she was afraid to have back surgery until she met Bowen Jiang, MD, and heard about robotic spine surgery. “I saw several doctors who looked at my images, expressed surprise I could still walk and suggested conventional back surgery,” she says. “But after talking to Dr. Jiang, I knew he was the one, and his solution to my pain was much, much better.”

Innovative spine treatments at Providence

Chang needed a laminectomy (to relieve compression on her spinal cord) and a fusion (to restore stability). Dr. Jiang, a neurosurgeon at Providence St. Jude, performed both in a single minimally invasive procedure that had Chang back to grocery shopping within days.

Fellowship-trained in minimally invasive and robotic spine surgery, Dr. Jiang used the ExcelsiusGPS robotic system to dramatically reduce the invasiveness of the surgery while also improving its precision.

“This technology combines the benefits of state-of-the-art navigation, real-time 3D image guidance and robotics into one technology,” explains Dr. Jiang. “The result is far better visualization, access and maneuverability, allowing us to advance back surgery in ways that just weren’t possible before.” Today, Dr. Jiang uses his love of technology and his neurosurgeon training from Johns Hopkins to lead Providence St. Jude’s efforts to create one of the nation’s first dedicated robotic spine centers.

Traditional back surgery requires exposing the spine to see the bony landmarks, often leaving behind a 15-inch scar. With a robotic approach, the surgeon can separate muscles surrounding the spine rather than cut through them — leaving behind a few Band-Aid-size incisions. This significant reduction in tissue damage means fewer complications, less pain and afar quicker recovery. Surgeries that normally require three to five days in the hospital now often only require an overnight stay.

“I didn’t even need a cane to walk into my house after I was discharged,” Chang reports. “Three weeks later, I was walking 4,000 steps a day. And as soon as I can, I’ll be back dancing.”

Planning before procedures

In addition to spinal stenosis, Dr. Jiang uses the new technology to treat herniated disks, scoliosis, nerve compression, spinal tumors and trauma. “Spine surgery often involves challenging anatomy and very difficult trajectories, yet the robotic system makes it far easier,” explains Dr. Jiang. Having performed more than 150 robotic spine procedures, he also trains surgeons throughout the western U.S. on using the technology to improve outcomes. “It brings us as close to perfect accuracy as can be achieved.”

The advantages of the system’s 3D modeling capabilities extend outside the surgical suite by making it possible for Dr. Jiang to preplan surgeries on a tablet. “It allows me to think about and strategize a surgery beforehand,” he explains. “Patients don’t need to be on the table [for me] to visualize the entire surgical plan and problem-solve issues.”

Chang worked as an operating room nurse at Providence St. Jude before retiring in 2000. So, she wasn’t surprised to find the most innovative approach to her back pain could be found only at St. Jude. “The robot is new, but the excellence is the same,” she says. “St. Jude offers a culture that attracts some of the nation’s best doctors. It was true 20 years ago, and it’s still true today.”

To schedule an appointment with Dr. Jiang, please call 949-570-9432.

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This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.