Awake procedures, performed for many years in neurosurgery, is a relatively new development in the spine field and helps surgeons ensure that no damage is being done to the patient.
Duke’s first awake spine surgery was performed in November by Dr. Abd-El-Barr at the request of a patient with spondylolisthesis who previously had an adverse reaction to general anesthesia.
Undergoing awake spine surgery without general anesthesia typically means a quicker recovery, fewer postoperative complications and a shorter hospital stay for patients.
Dr. Abd-El-Barr performed the surgery with a spinal robot in a procedure he coined awake spinal anesthetic robotic lumbar fusion. Duke began offering robotic spine surgery in early 2019.
The procedure involves the anesthesia team administering a spinal anesthetic to numb the patient “from trunk to toes” and placing local anesthetic on both sides of the lumbar spine using ultrasound guidance, according to Jeffrey Gadsen, MD, associate professor of anesthesiology at Duke.
Dr. Abd-El-Barr has since connected with Alok Sharan, MD, co-director of the Westmed Spine Center in Yonkers, N.Y., an early adopter of awake spine surgery, to form a virtual study group to share best practices on the procedure.
According to Dr. Sharan, there are fewer than 10 surgeons in the U.S. performing awake spinal fusion.
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