Spinal surgery is a delicate process within Traumatology, since it involves operating an area in contact with nervous tissue: nerves and / or spinal cord. Advances in spine surgery allow better prevention of risks and complications during operation and improve the accuracy of surgery and minimize the time during and after the intervention.
Development in spine surgery
Development in prevention measures before, during and after surgery is a huge step forward in the safety of such interventions, as well as the materials currently used, they all meet ISO standards to be implanted in humans.
Another current developments lies in reducing the aggressiveness of surgery using minimally invasive techniques (MIS). These include those made with the support of a surgical microscope are included.
The material is the same, the change is that it has been partially modified implant design adapted to the placement technique to produce less aggression in the tissues. It is evident and it is shown that if the aggression takes place in the tissues before entering the column is minimal, postoperative is much better and faster recovery. This is a technique that requires greater surgical knowledge and a "learning curve" suitable to be performed. It fits any level of the spine.
However an unprecedented development is the introduction of robotics and browsers in surgery.
Surgical robots and surgical browsers
Robotics is only a part of cybernetics. virtual reality and cybernetics are the basis for the development of this surgical procedure. This is the origin of robotic surgery or computer-assisted surgery.
Surgical robots can be of two types:• autonomous robot: it has a program designed to perform a particular surgical technique.• Robot "Slave" are not capable of autonomous movement and depends on the surgeon. In this case, the surgeon determines instantly maneuvering the robot runs on the patient from the "control center". The instruments are changed at all times for the various phases of intervention.It is more common in certain neurosurgical procedures.
However, the most used and first to appear in traumatology are the "Browsers Surgical" (CAOS). Introduced in 1995, this technique facilitates greater precision in the placement of implants to vertebrae level.
The process surgery "surgical browsers" elapses as follows:1. A patient CT is performed with features defined as "Preoperative Protocol Navigation Spinal Tap" and the images are transferred to the computer.2. The computer generated images reconstruction of the anatomy of the patient's spine from the TAC. With the image obtained on the screen and this in connection with surgical instruments, through appropriate software, planning and subsequent surgical procedure in "virtual reality" is performed.
Currently this procedure can be performed using images obtained by other means and in real time.
When the technical results of a procedure done with conventional browser and show technique compares errors in placing implants are much lower in favor of the art browser. This situation is evident when there is a deformity of the spine (scoliosis).The use of this system, in the case of having it, help during surgery, but when the procedure is performed by an experienced surgeon is not essential for the implant is put in place and properly.
Edited by Noelia García Pino