Awake spine surgery is slowly growing and is expected to play an increased role in the specialty.
Five things to know:
1. Stanley Hoang, MD, performed LSU Health Shreveport's (La.) first awake spine surgery in March. He performed a minimally invasive discectomy with local anesthesia, and the patient was able to go home the same day of surgery.
2. Ernest Braxton, MD, neurosurgeon at Vail (Colo.) Summit Orthopaedics and Neurosurgery, completed the first awake spine surgery in Nepal in February.
3. Dr. Braxton told Becker's he expects spine surgery to become more standardized over the next five years.
"Advances in regional anesthesia techniques and monitoring technology will likely further enhance its safety and effectiveness," he said. "Additionally, as more data on outcomes and patient experiences become available, surgeons will have a better understanding of the indications and limitations of awake spine surgery, leading to improved patient selection and surgical planning."
4. Awake spine surgery holds promise in the outpatient setting, especially for making endoscopic spine surgery more accessible.
"Awake spine surgery techniques with epidural, spinal and fascial blocks can allow more patients to undergo spine surgery without the need for general anesthesia," Don Park, MD, told Becker's. "This will allow older patients with more medical comorbidities to have endoscopic spine surgery performed in the outpatient setting."
5. Although the lack of standardization has held back outpatient spine migration, Alok Sharan, MD, has found ways to strengthen patient outcomes. His practice, which focuses on awake spine surgery also leverages an IV nutrition program for post-op recovery.
"Many patients who undergo surgery with our awake spinal fusion protocol are going home within four hours of surgery, and are taking minimal opioids post surgery," Dr. Sharan said. "As we are learning to optimize patients better prior to surgery, I am predicting that we will soon be able to offer opioid-free spinal fusion surgery."