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Spinal column surgery: More quality of life
The number of operations on the spinal column is increasing. This is due above all to improved operating procedures and innovative medical techniques and technology. “Today we are able to carry out operations which would have been unthinkable 15 years ago”, emphasises Dr Frederic Bludau, head of spinal column surgery. At the same time the rise in life expectancy results in more and more people wanting to remain mobile into old age. Owing to innovative procedures such people can now be given significantly better help and support.
The combination of open surgery with minimally invasive procedures in spinal column surgery has been the standard in the Orthopaedic & Traumatic Surgery Centre for some considerable time. The specialists in our centre are among the pioneers in Germany for example in the use of pedicle screws, which are inserted into the vertebral body percutaneously – that is through the skin. This minimally invasive procedure has proved itself to be effective in stabilising large sections of the spinal column. At the same time it avoids extensive surgical wounds and thus speeds up recovery.
With the hybrid operating facilities in the surgical centre, which was opened in 2013, University Hospital Mannheim fulfils all the spatial and technical requirements for optimising such gentle and effective surgery. Because of the proximity to the spinal cord and vital blood vessels, operations on the spinal column make very high and challenging demands of the surgeon. In the state-of-the-art hybrid operating theatre imaging diagnostic procedures such as angiography, computer tomography (CT) and magnetic resonance tomography (MRT) can be combined with the therapeutic possibilities of conventional surgery. “During the operation we gather high-resolution image data enabling the surgeons to work safely even in areas which are hidden from view”, says Dr Bludau. “CT data is transmitted directly to a navigation device so that the surgeons can find even the smallest interventional corridor with great precision.”
Milestone in tumour therapy
A major focus in spinal column surgery is that of tumour operations. Many types of cancer form metastases in bones, 70 percent of these in the spine as this is well supplied with blood. For patients suffering from such conditions University Hospital Mannheim has developed a pioneering and highly effective surgical method which has been further enhanced by the possibilities of hybrid operations: kypho-IORT (intraoperative radiotherapy), which merges two previously separate therapy steps into one single intervention. This minimally invasive technique combines kyphoplasty, in which specialists use bone cement to stabilise the vertebral body affected by metastases, with IORT, in which the metastases are irradiated during the operation. “With hybrid surgery we can position the irradiation device accurately and deliver the optimal irradiation dosage with the highest accuracy”, explains Dr Bludau. The irradiation dosage is calculated with the greatest precision in each individual case so that it does not damage the adjacent bone marrow while at the same time destroying the metastases.
Kypho-IORT was developed by University Hospital Mannheim specialists in cooperation with Professor Udo Obertacke, Deputy Director of the Orthopaedic & Traumatic Surgery Centre. Since the first operation in 2009, the University Hospital Mannheim specialists have made continual enhancements to the procedure. In the meantime kypho-IORT has proved to be an extremely successful operation technique also outside University Hospital Mannheim and is used in hospitals throughout the world. It is of major benefit to patients affected as it immediately relieves pain, provides a precisely focused treatment of the metastases and saves valuable time in the fight against cancer.
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Prof Dr med Hanns-Peter Scharf