Awake spinal fusion - 5 key findings


The Journal of Neurosurgery published an article outlining "awake spinal fusion" using the endoscopic transforaminal lumbar interbody fusion technique without general anesthesia.

The article authors review the first 100 cases of single- or two-level awake spinal fusion performed by Michael Wang, MD, at the University of Miami Hospital from July 2014 to August 2017. The study included 56 women and 44 men, with single level procedures for 84 of the patients. 

Five things to know:

1. Patients undergoing awake endoscopic MIS TLIF typically receive light to moderate sedation and local analgesia so they remain conscious during the procedure. Patients can then provide feedback to the surgeon and anesthesiologist during surgery.

2. For the patients studied, patients reported a 1.4 day hospital stay on average and surgical time lasted 84.5 minutes for one-level procedures and 128.1 minutes for a two-level procedure.

3. Blood loss during surgery was 65.4 mL for one-level procedures and 74.7 mL for two level procedures among the awake endoscopic MIS TLIF patients.

4. At the one-year follow-up, none of the patients reported mechanical instability based on an X-ray and clinical examination.

5. The Oswestry Disability Index scores showed clinical improvement with strong statistical significance from the preoperative to the postoperative time period. However, the surgical plan was revised in four patients and four patient experienced postoperative complications that required revision.

"As more and more people every year suffer from spinal disease both in America and around the world, spine surgeons have worked tirelessly to develop the safest, most effective, and least daunting therapies to offer our patients," said Dr. Wang. "We believe this study demonstrates that the awake TLIF procedure is one such new technique to afford patients relief from disabling pain, without a debilitating surgery."

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