Ask Dr. Santos: How Has Imaging Technology Improved Surgical Precision?
Surgical accuracy is critical to good outcomes in any surgery, and is particularly important for procedures performed on and around the delicate structures of the spine. Dr. Santos explains how imaging technology is used to guide spine procedures and ensure surgical precision.
“Today’s spine surgeries are performed with the benefit of cutting-edge technology,” explains Summit spine surgeon Dr. Edward Santos. “Imaging advances have been particularly valuable for those of us who perform spine instrumentation and fusions.
“The success of spinal fusion surgery relies on the proper healing of the fused bone,” he explains. “Pedicle screws were developed to provide stability across the fused segments during the healing process. These screws are placed in the spine to help hold the bone in place while we are waiting for the fusion to mature.”
The introduction and use of pedicle screws for spinal fusions has led to better outcomes. Fusion rates have improved significantly with the use of pedicle screws.
“In years past, when we did not have the advantage of computer imaging technology, we would insert these screws freehand,” says Dr. Santos. “As you can imagine, this was not ideal. Without precise visual guidance, a surgeon used his or her best judgment to position the screws. Placing them in the right track was crucial because a placement that was a few millimeters too far to the right or left could damage a nerve or even the spinal cord.”
Today, advanced imaging technology guides every screw placement in real time. CT scanners in the surgery room are used to generate three-dimensional images of the spine as the surgical team operates. “When we place a pedicle screw,” says Dr. Santos, “we can see the image of the screw as it is being inserted. We know exactly where the screw is going. More importantly, we know exactly where it is not going—it’s not going into the spinal canal or the area where the spinal cord and the nerves are.”
Patient outcome analysis has demonstrated the improved safety and accuracy of image-guided pedicle screw placement. Imaging has markedly reduced the incidence of malpositioned screws in spinal fusion surgeries.
“Advanced imaging is just one example of technology’s contribution to health care,” says Dr. Santos. “As we look to the future, I am most excited about the refinement of our current techniques. Technology advances increase precision, and I think that will go hand in hand with the development of surgical procedures that are less invasive. The evolution of medical technology is the most dynamic area of spine surgery and spinal research. As we continue to advance, I look forward to the introduction of more techniques that can address a larger number of spine disorders.”
“I am committed to providing the best care possible for all of my patients with spine disorders. I treat each and every patient as I would treat any member of my family. I believe that patients’ concerns and expectations deserve to be heard. I also believe in the importance of having a thorough discussion of both surgical and nonsurgical options, with the goal of relieving pain and restoring function.”