How have spinal surgeries become safer?

Spinal surgery affects the backbone and the local motor system, Dr Tow says. “With operations that affect the spinal cord and nerves there is always the fear of injury to the spinal cord and injury to the nerves, resulting in paralysis after surgery and the inability to walk after the surgery.”

Advances in technology have allowed us to be able to do spinal surgery more safely. For example, we can now do spinal surgery with intra-operative neural monitoring, which means that during the surgery electrodes are placed in the thigh and the calf, the legs, and the hands to monitor the spinal cord. We monitor the nerve functions so that if something is amiss or if the nerves are being accidentally compressed or touched, even before that damage occurs, alarms will go off so that we do not accidentally damage the spinal cord and nerves.

Furthermore, recent advances in surgery now allow us better visualization. The use of the microscope to visualize the nerves; we can now magnify objects, many, many times so that tiny objects, which are not normally visible to the naked eye, can be seen. Using the microscope also allows us to do precise decompression and precise maneuvers to free the spinal cord and the nerve from compression without injuring vital structures.

Over and above all that, minimally invasive surgery, also known as keyhole surgery, has allowed us to do spinal surgery more safely, with fewer complications like bleeding and wound infections and a faster recovery. Minimally invasive surgery allows us to do the same operation as an open surgery but with a very tiny incision and this smaller incision means less tissue destruction and less bleeding because of a reduced area of exposure. Now a smaller operation, a smaller cut and less bleeding also allows the patient to recover faster – they can get out of bed as soon as the first day after surgery. The smaller incision also means less pain medication is used so the patient will have fewer side effects from the pain medicines, like gastric side effects, nausea, and vomiting immediately after surgery. A smaller incision also means less infection, less wound healing, and less surface area for wounds to heal, meaning that infections are almost unheard of in minimally invasive spinal surgery.

Dr Benjamin Tow is a consultant orthopeadic and spine surgeon, with extensive experience in treating degenerative conditions of the spine, deformity-surgery and minimally-invasive spine surgery, as well as treating general orthopaedic conditions in children and adults. He is in private practice at The Orthopaedic and Spine Clinic in Singapore and can be contacted at +65 6235 5774.