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Advances in Minimally Invasive Spine Surgery

This story was originally published in the Winter 2021 edition of Providence Health Matters.


Key points to remember:

  • Accessing the spine for surgery is often difficult, but technology is making it easier.

  • the New technology in the ExcelsiusGPS robotic system improves surgical precision in the operating room and reduces patient recovery time.

  • dr. jiang offers expert information about the robotic system and details its state-of-the-art navigation and real-time 3D image guidance.

Shirley Chang quit dancing five years ago. As her back pain continued to worsen, the ballroom dancing champion would sit in her backyard and simply visualize the steps.

In fact, the pain of spinal stenosis compressed her nerves and regularly took away all of the 84-year-old’s favorite things: dancing, shopping until she was exhausted and cooking dinner for friends and family.

“Every movement caused pain,” says the Hacienda Heights resident and grandmother of five. She says she was afraid to have back surgery until she met Bowen Jiang, MD, and heard about robotic spine surgery. “I saw several doctors who looked at my pictures, expressed surprise that I could still walk, and suggested conventional back surgery,” she says. “But after talking to Dr. Jiang, I knew it was him, and his solution to my pain was much better.”

Innovative Spine Treatments in Providence

Chang needed a laminectomy (to relieve compression in his spinal cord) and a fusion (to restore stability). Dr. Jiang, a neurosurgeon in Providence St. Jude, performed both in one minimally invasive procedure that got Chang back to the grocery store within days.

Fellowship trained in minimally invasive and robotic spine surgery, Dr. Jiang used the ExcelsiusGPS robotic system to significantly reduce the invasiveness of the surgery while improving its accuracy.

“This technology combines the advantages of advanced navigation, real-time 3D image guidance and robotics into a single technology,” says Dr. Jiang. “The result is much better visualization, access and maneuverability, allowing us to advance back surgery in a way that was simply not possible before.” Today, Dr. Jiang uses his love of technology and his training as a neurosurgeon at Johns Hopkins to lead Providence St. Jude’s efforts to create one of the nation’s first dedicated robotic spine centers.

Traditional back surgery requires exposing the spine to see the bony landmarks, often leaving a 15 inch scar. With a robotic approach, the surgeon can separate the muscles surrounding the spine rather than cutting them, leaving behind a few bandage-sized incisions. This significant reduction in tissue damage means fewer complications, less pain and a much faster recovery. Surgeries that normally require three to five days in the hospital now often only require an overnight stay.

“I didn’t even need a cane to get into my house after I was released from the hospital,” Chang said. “Three weeks later, I was taking 4,000 steps a day. And as soon as I can, I’ll be back dancing.

Planning before procedures

In addition to spinal stenosis, Dr. Jiang uses new technology to treat herniated discs, scoliosis, nerve compression, spinal tumors and trauma. “Spinal surgery often involves difficult anatomy and very difficult trajectories, but the robotic system makes it much easier,” says Dr. Jiang. Having performed over 150 robotic spine procedures, he also trains surgeons across the western United States in the use of technology to improve outcomes. “This brings us as close as possible to perfect precision.”

The benefits of the system’s 3D modeling capabilities extend beyond the operating room by allowing Dr. Jiang to pre-plan surgeries on a tablet. “It allows me to think things through and strategize ahead of time for surgery,” he explains. “Patients don’t need to be on the table [for me] to visualize the entire surgical plan and resolve issues.

Chang worked as an operating room nurse at Providence St. Jude before retiring in 2000, so she was not surprised to discover that the most innovative approach to her back pain could only be found ‘at St. Jude. “The robot is new, but the excellence is the same,” she says. “St. Jude offers a culture that attracts some of the best doctors in the country. That was true 20 years ago, and it’s still true today.

To schedule an appointment with Dr. Jiang, please call 949-570-9432.

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When you need spine care, talking to a trusted doctor can help you determine the path that’s right for you. Learn more about spine care services in Providence. Or you can search for a primary care physician in our provider directory.

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This information is not intended to replace professional medical care. Always follow the instructions of your healthcare professional.

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