Advanced Surgical Technologies
Posted on Dec 01, 2016
Our speaker for the evening was Dr. Neville Alleyne, a gifted surgeon, speaker and author; he has inspired patients and colleagues alike with his in-depth interest in spine-related subjects. He specializes in orthopedics and orthopedic surgery, diagnosing neck and back problems and providing medical and surgical remedies.
Dr. Alleyne is currently a consultant for several spine companies. In addition to his lectures and publications, he is also responsible for a number of patients at Scripps Memorial Hospital Encinitas and Tri-City Medical Center.
Dr. Alleyne had previously presented at Carlsbad Rotary. He spoke about spinal stenosis, narrowing of the spinal canal, usually experienced with age. In 2012 he went to Texas to learn the new robotic guidance technology being introduced in the US by Mazor Robotics, an Israel based company. The robotic guidance system consists of a metal frame that fits over the back during surgery and has an arm on it that is guided by the mapping the surgeons have done pre-surgery on the computer. This system allows for the surgeon to place screws in the spine with 99.8% accuracy of correct placement to relieve spine issues. Tri City is one of only two hospitals in the nation to have two Mazor robotic systems. Dr. Alleyne does the surgeries along with 2 other surgeons and they have now performed more than 1,000 surgeries using this robotic guidance system.
It is interesting to note that Aldora Eller, the spouse of Carlsbad Rotary member Ray Eller, just recently had the robotic spinal surgery at TriCity Medical and is now recovering at home. Aldora has our prayers and good wishes for a full recovery. Ray has promised to bring her to a Rotary meeting when she is fully recovered.
At this meeting, Dr. Alleyne expanded on his previous talk with expanded discussions on spinal Compression and Burst fractures, supported by an excellent Powerpoint presentation.
Compression fractures are vertebral body collapse; with Burst fractures the vertebral body is severely compressed. Osteoporosis is the number one cause of Compression Fractures, affecting approximately 25% of all postmenopausal women in the US. Annually about 750,000 people are affected, estimated 40% percent of women age 80 and older.
The leading causes of Burst factures are immediate trauma such as a car accident or a severe fall. Burst fractures of the spine account for 14% of all spinal injuries. 25% of burst fractures are misdiagnosed as compression fractures when just radiography is used.
Compression fractures are considered to be stable. They may be asymptomatic, with gradual onset back pain, loss of height, severe band-like pain that radiates from the spine around both sides of the body. It is worse with walking, and better with rest. Almost two-thirds of spinal compression fractures are never diagnosed because many patients think their back pain is merely a sign of aging and arthritis.
The symptoms of Burst fractures are moderate to severe back pain, which gets worse with movements. There is loss of height, and loss of bowel or bladder control. Causes are also a variety of neurological deficits. Depends on the amount of spinal cord compromise, there could be no symptoms to complete paralysis.
If the pain is tolerable, with less-tan-40% vertebral height-loss, stable fracture and no neurological deficit, conservative treatment options for both Compression and Burst fractures include: NSAIDS, short-course of pain meditation, back-bracing, injections and physical therapy.
Dr. Alleyne showed excellent pre-op and post-op diagrams and photographs and to illustrate Kyphoplasty, used with Compression fractures; also Vertebroplasty, used in both Burst and Compression fractures. The primary goal is to stabilize the fracture and stop the pain.
There were several perceptive and interesting questions from the audience. Dr. Alleyne is an excellent speaker, with spontaneous humor and providing insightful answers.
Weblinks:
Dr. Neville Alleyne, Orthopedic Curgery, Tri-City Hospital: