Article originally published in St Vincents Private Hospital Community News.
Awake lumbar spinal surgery is one of the latest surgical innovation led by St Vincent’s Private Hospital Melbourne (SVPHM) Neurosurgeon Mr Yi Yuen ‘Ian’ Wang and Anaesthetist Dr Jeremy Wong.
They have performed around 10 spinal surgeries, including microdiscectomies, laminectomies and even selected spinal fusions, while the patient has been awake.
Previously patients were travelling to the USA for treatment, however they don’t need to search very far anymore, with this highly specialised surgery performed right here at St Vincent’s Private Hospital, Fitzroy.
Historically patients undergoing spine surgery have been given a general anaesthetic, where the patient is put to sleep for surgery. Unfortunately not all patients suffering from spinal ailments are deemed medically fit for this type of anaesthetic and as a result, some older and medically unfit patients requiring spinal surgery are declined by their treating physicians.
There are a number of reasons why someone may not be eligible for a general anaesthetic, it can be due a compromised lung or heart function, and in some instances there may be a concern about cognitive reduction post general anaesthetic, particularly in some elderly patients.
“The patients that qualify for this awake lumbar spinal surgery are those who have health conditions that would not tolerate a GA. It can be a last resort for some patient’s and so it’s a viable option for them,” said Mr Wang.
Mr Wang and Dr Wong look at each case individually and offers presenting patients who struggle to qualify for surgery with general anaesthetics, a different opportunity.
“Mr Wang is finding a solution for patients who have had previous road blocks who have been told “no” to surgery,” said Dr Wong.
Mr Wang specialises in Minimally Invasive Surgical Techniques and one of his key focuses is increasing the safety and accuracy of complex spinal reconstructive surgery. He uses cutting edge technics and technology and is currently involved in a research project on spinal navigation.
Mr Wang and Dr Wong have worked closely together for over a decade, and have seen a need for spinal surgery to be accessible to patients who are at great risk if they were to undergo a general anaesthetic. Awake lumbar spinal surgery has helped fill this need.
The patients undergo a spinal block instead of a general anaesthetic, a technique used for many other types of operations. Dr Wong notes that although not completely risk free, the spinal block means the patient can still proceed with the surgery and avoid the risks associated with having a general anaesthetic.
“The lumbar spinal surgery is performed between the L2 and L5 vertebrae after a spinal block injection, there is a two hour time frame, so only specific conditions can be treated in this procedure“, said Mr Wang.