Original Article

Evolving Minimally Invasive Spine Surgery (MISS) and Technological Consideration.

J Chiu, H Huang

Citation

J Chiu, H Huang. Evolving Minimally Invasive Spine Surgery (MISS) and Technological Consideration.. The Internet Journal of Minimally Invasive Spinal Technology. 2008 Volume 3 Number 4.

Abstract

Degenerated spinal disc and spinal stenosis are common problems requiring decompressive spinal surgery. Open spinal discectomy is associated with significant morbidity, long-term convalescence, prolonged general anesthesia and wide dissection of tissues that can cause bleeding, scarring and eventual destabilization of spinal segments. The evolving less traumatic minimally invasive endoscopic lumbar decompression procedure is free from these potential complications. Therefore the pursuit of minimally invasive spine surgery (MISS) began. Current and future trends of spinal surgery are toward minimally or less invasive and biologic material. This endoscopic spine surgical procedure, its surgical indications (for treatment of herniated lumbar discs, post fusion junctional disc herniation, neural compression, osteophytes, spinal stenosis, vertebral compression fractures, spinal tumor, synovial cysts and etc.), its operative techniques (both transforaminal endoscopic approach and interlamina endoscopic assisted approach) including tissue modulation technology (i.e. laser and radiofrequency surgical application), requires preoperative planning, intraoperative monitoring, control and image data collection and utilization.Problems and challenges facing minimally invasive spinal surgery: Additional problems and challenges facing MISS include large number of surgical personal for each case, slow turn over time, preoperative review of numerous medical records, imaging and X-rays studies, no biometric confirmation of the surgical patient, many multiple scattered intraoperative data monitors/displays, lack of adequate bio sensors and warning systems, lack of organized educational and training displays for MISS etc.Answer: With increased utilization of complex high tech and digital technologies, and instruments in the digital operating room (DOR), it requires seamless connectivity and control to perform the surgical procedures, in a precise and orchestrated manner. The Surgical ePR Control System (SECS), SurgMatix® prototype, a new integrated DOR, image-data based convergence and control system has been developed and utilized to facilitate MISS. This system is designed to promote seamless integration of all aspects related to the surgical procedure and to reduce surgical time and personal requirement significantly. This ease to use SECS, SurgMatix® system creates an organized control instead of organized chaos is needed. In addition, it can provide training of other spinal surgeons to perform the minimally invasive spinal surgery.Providing a picture of the patient’s medical information and status by consolidating data from multiple IT and OR systems - “being patient transparent” and “patient centric”. Seamless integrated digital OR is needed to provide effective, safer and higher quality in spinal surgical patient treatment.

 

References

1. Chiu J, Digital Technology Assisted Minimally Invasive Spinal Surgery (MISS) for Spinal Motion Preservation. In: Lemke H.U, Vannier MN, Invamura RD, eds. Computer Assisted Radiology and Surgery. Amsterdam, San Diego, Oxford, London; Elsevier Medical Publisher; 2004, pp.461-466
2. Chiu J, Surgeon’s Perspective and Consideration: OR Digital Technology Convergence and Control System for Minimally Invasive Spine Surgery, Presented at Special Session, Minimally Invasive Spine Surgery, CARS 2008, Computer Assisted Radiology and Surgery 22nd International Congress and Exhibition, Barcelona, Spain, Proceedings, P. 8 June 23-28, 2008
3. Jaikumar, S, Kim, D, Kam, A,, History of Minimally Invasive Spine Surgery, Neurosurgery Supp 2002;51 l2:1-14, 2002
4. Chatenever D., Minimally invasive surgical visualization past, present and future. J of Minimally Invasive Spinal Technique, 2001; 1(1): 2-7.
5. Mogel, Greg, Special Assistant to Director of TATRC, Fort Detrick MD, The Future of Med informatics Technology Implementation and Digital Imaging in Spinal Surgery, 4th Global Congress on Minimally Invasive Spinal Surgery and Medicine, AAMISMS 5TH Annual Meeting, Thousand Oaks, CA, 11/19-22, 2003, Proceedings, page 11
6. Perez-Cruet MJ, Balabhadra RSV, Samartzis D, Kim D., Historical Background of Minimally Invasive Spine Surgery. In Kim D, Fessler R, Regan J, eds. Endoscopic Spine Surgery and Instrumentation. New York: Thieme Medical Publisher; December 2004: Chapter 1, pp 3-17. December 2004
7. Chiu, J., Clifford, T., Greenspan, M., Richley, R., Sison, R., Percutaneous Microdecompressive Endoscopic Cervical Discectomy with Laser Thermodiskoplasty. The Mt. Sinai J of Med, 9/2000; 67(4): 278-282.
8. Chiu, J., Anterior Endoscopic Cervical Microdiscectomy. In Kim D, Fessler R, Regan J, eds. Endoscopic Spine Surgery and Instrumentation. New York: Thieme Medical Publisher; December 2004: Chapter 5, pp 48-58. December 2004
9. Chiu J, Endoscopic Assisted Microdecompression of Cervical Disc and Foramen In, Szabo Z, Coburg AJ, Savalgi R, Reich H, Yamamotto M, eds. Surgical Technology International XVII, UMP, San Francisco, CA 2008: p.269-279
10. Chiu, J., Babur, H., Clifford, T. Sison, R., Survey on Minimally Invasive Spinal Surgery, The Practice of Minimal Invasive Spinal Technique, Special Millennium Edition, AAMIMS, Ed. LLC 2001; 219-220.
11. Chiu, J., Clifford, T., Posterolateral Approach for percutaneous thoracic endoscopic discectomy. J of Minimally Invasive Spinal Technique, 2001; 1(1): 26-30
12. Chiu, J., Posterolateral Endoscopic Thoracic Discectomy. In Kim D, Fessler R, Regan J, eds. Endoscopic Spine Surgery and Instrumentation. New York: Thieme Medical Publisher; December 2004: Chapter 11 pp 125-136. December 2004
13. Chiu, J., Endoscopic Lumbar Foraminoplasty In Kim D, Fessler R, Regan J, eds. Endoscopic Spine Surgery and Instrumentation. New York: Thieme Medical Publisher; December 2004: Chapter 19, pp 212-229. December 2004
14. Chiu J, Evolving Transforaminal Endoscopic Microdecompression for Herniated Lumbar Discs and Spinal Stenosis: In, Szabo Z, Coburg AJ, Savalgi R, Reich H, eds. Surgical Technology International XIII, UMP, San Francisco, CA 2004: pp. 276-286
15. Huang, H.K., PACS, informatics, and the neurosurgery command module. J of Minimally Invasive Spinal Technique, 2001; 1(1): 62-67.
16. Rosser J, “The Impact of Video Games on Training Surgeons and Physicians in the 21st Century”, presented at the Video Game/Entertainment Industry Technology and Medicine Conference ’04, December 10-11, 2004, Marina Del Rey, California
17. Chiu J, Complications and Avoidance in Endoscopic Spine Surgery, presented at the North American Spine Society Minimally Invasive Spine Technique: Hands-on Course , Barrow Neurological Institute (BNI), Phoenix, AZ, May 16-17, 2003
18. Haller, J., Ryken, T., Vannier, M., Image guided surgery of the spine - Case Report. J of Minimally Invasive Spinal Technique, 2001; 1(1): 87-92.
19. Martin, N., Digital Integration and Informatics in the OR of the Future, 4th Global Congress on Minimally Invasive Spinal Surgery and Medicine, AAMISMS 5TH Annual Meeting, Thousand Oaks, CA, 11/19-22, 2003, Proceedings, page 5

Author Information

John C. Chiu, M.D., FRCS, D.Sc
Director, Neurospine Surgery, California Spine Institute Medical Center

H.K. Huang, Ph.D.
Professor of Informatics, University of Southern California, Medical University

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