Computer navigation helps spine surgery patients get their lives back

Thanks to technology designed to increase precision and reduce radiation during back surgery, a teenage ballet dancer with scoliosis plans a return to the stage.

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Norton Children’s orthopedic surgeons are using computer navigation technology to treat kids and teenagers with scoliosis and other spine deformities.

The technology, called 7D, is an imaging guidance system designed to aid surgeons in the operating room. Norton Children’s Hospital is the first pediatric hospital in Kentucky to use the technology.

“With most spine surgeries, we place screws into the spine to hold rods that hold the spine in position,” said Joshua W. Meier, M.D., pediatric orthopedic surgeon with Norton Children’s Orthopedics of Louisville, affiliated with the UofL School of Medicine. “One of the more challenging aspects of that surgery is placing the screws in the spine, because they’re close to the spinal cord and nerve roots.”

Traditionally, surgeons use live X-ray to help with placing the screws. The new technology takes a CT scan of the patient’s spine, then it uses that scan during surgery to help the surgeon direct where these screws are going. The computer navigation allows for more detailed placement.

“7D uses a light. Basically, you shine a light onto the spine, and that light bounces off the bone. The computer then recognizes what level of the spine you’re at based on how much of that light comes back. It knows that you’re at a certain spot of the spine and that you’re right in that level that you say you are,” Dr. Meier said.

Uses less radiation

The goal of using the technology is to make surgery as effective as possible, but there’s also a potential safety component. With surgeons no longer needing to use live X-ray during the procedure, the patient and others in the operating room have less exposure to radiation.

“Medical radiation is always getting better and safer, but it’s a cumulative effect over time,” Dr. Meier said. “So the less radiation we can use — especially in a pediatric patient — and the less radiation we’re exposed to as surgeons, has a better long-term health benefit.”

Helping a patient dance again

Bridget Alicna, a 13-year-old from Elizabethtown, Kentucky, was one of the first Norton Children’s patients to have surgery with the technology. Bridget, who loves to dance, perform ballet and paint, was diagnosed with scoliosis following an annual school physical with Kristina L. Knisley, M.D., pediatrician with Norton Children’s Medical Group.

“The scoliosis started to cause her pain and impacted her dancing,” said Kelsey Floyd, Bridget’s mom. “It was twisting her ribs, and she couldn’t stand up straight.”

Bridget was referred to Kent L. Walker, D.O., orthopedic surgeon with Norton Children’s Orthopedics of Louisville.

“Bridget had a severe curve – more than 60 degrees,” Dr. Walker said. “Without treatment, her condition could have caused damaged to her lungs and other organs.”

Dr. Walker and the family determined Bridget eventually would need surgery.

“There were a few tears shed, and we hugged it out for a second because it’s overwhelming,” Kelsey said.

“I was nervous but I wanted to make sure I could continue dancing,” Bridget said.

Dr. Walker brought up the new technology to the family.

“Bridget’s case was very complex, and because of her desire to dance at a high level, we had to make sure she can regain as much movement as possible,” Dr. Walker said.

Dr. Walker performed Bridget’s surgery in April at Norton Children’s Hospital. Less than 24 hours later, she was walking up and down stairs. After a few days, she went home.

“I’m excited to get back to dancing,” she said.

While she’s still recovering, Bridget is regaining her range of motion. Her goal is to be ready to perform this winter in a local production of “The Nutcracker.”

“Everyone has been so wonderful,” Kelsey said. “Every doctor and nurse was happy to explain everything. Even the housekeeper, Christina, was great.”

The future of navigation technology

Seeing positive results, doctors are looking to incorporate navigation technology in future surgeries. Dr. Meier is excited about the possibilities for not only spine surgeries.

“I think the complexity of operations we can do using this technology is definitely higher,” he said. “Right now, it’s really for spine deformity surgery, but I think as it grows, this type of technology may be utilized for different types of orthopedic surgeries. We’re excited to see what this type of technology could do in other areas of our field to help more patients.”