7. What are the latest advancements is spine surgery?
There are a number of exciting areas of research related to the spine:
  1. Minimally Iinvasive Surgery
    We are constantly working toward relieving spine and nerve pain through the smallest incision possible. What is more important than the size of the incision(s) is the amount of soft tissue we must disrupt between the skin and the spine. Through microinvasive techniques and the use of the latest operative microscopes, we can often approach the spine with minimal muscular irritation. Studies show that patients treated with minimally invasive techniques typically heal faster.
  2. Disc Replacements
    Over the past 10 years, companies developed disc replacements for the neck and low back. The idea is to avoid several problems associated with fusions:
    1. Avoid Bony Healing Time
      bones typically take 6-8 weeks to heal, sometimes longer. By placing a mobile spacer between the bones, we do not need to worry about immobilizing the body, and this bony healing time is unnecessary. This typically allows for a quicker recovery period.
    2. Avoid Added Pressure on Neighboring Motion Segments
      when a disc is fused, the level above and below have to absorb a bit more pressure due to the lack of motion in the fused segment. Sometimes this motion can lead to early breakdown of the neighboring segments. By allowing the discs to continue to move, there will be no additional stress on the adjacent segments.
However, with every advancement, there are risks:
    1. Breakdown Over Time
      Just like knee or hip replacements, all metal motion surfaces eventually wear out. It is one thing to do a revision of a hip or knee procedure, because the implants are close to the skin. However, in the spine, revision of these implants is much more difficult, and potentially dangerous. The disc replacements are not alive like a fusion mass, so the body has no ability to heal it over time.
    2. Positioning is Critical
      if the implant is not placed perfectly, it may not move at all, and most of the potential benefits go away. Many spine surgeons believe disc replacements in the neck are better use of the technology, because they have to carry much less weight.
  1. Dynamic Rod Technologies
    several companies are working with different rod types including relatively flexible materials to limit the pressure on the neighboring levels.
  2. Short Segment Fusions
    advanced pedicle screw designs (the screws we use in the spine) allow us to take firm control of the levels we are going to fuse. This often allows us to place very little if any restrictions after surgery, shortens recovery times, and improves fusion rates. This is especially true in scoliosis surgery, where we try to keep the majority of the spine as mobile as possible.
  3. Advanced Spinal Alignment Techniques
    sometimes the spine is fused in a bad position, or the body leans forward or to the side over time. Dr. Rinella has been one of the leading surgeons in complicated bone-cutting procedures (osteotomies) in the Chicago area for the past 7 years.