Dr Anurag Saxena, HOD and Consultant, HCMCT Manipal Hospitals explains about Posterior Lumbar Decompression and Fusion (PLDF), a surgical procedure designed to relieve pain and pressure on the spinal cord and the lower back’s nerves, can be used to treat spinal decompression
Any back pain can make it difficult for a person to carry out daily tasks or recreational activities. It can cause crippling pain and immobility when there is pressure on the spinal cord and nerves in the lower back. Fortunately, surgical procedures can be used to treat this condition. Posterior Lumbar Decompression and Fusion (PLDF), a surgical procedure designed to relieve pain and pressure on the spinal cord and the lower back’s nerves, can be used to treat spinal decompression.
However, due to the complex anatomical structures of the spine and its proximity to numerous significant tissues, spine and fusion surgeries have evolved into technically demanding and difficult procedures. A growing clinical concern is enhancing the accuracy and safety of spinal surgery. The accuracy and safety of spinal surgery has been enhanced by computer-assisted navigation, an extension and application of precision technology in neurosurgery. This method is expanding quickly, which will see a wider adoption. This method helps surgeons perform precise operations by using computer guidance and medical images.
The surgical tools are tracked in 3D space, and the postural data is then analyzed by the software and overlayed onto the electronically stored images of the spine, creating a visual display that the surgeon can understand. Using reference points to intraoperatively locate the images and instrumentation, the software can pre-obtain the recorded spinal images. As an alternative, the apparatus itself generates an X-ray or Computed Tomographic (CT) image sequence in the operating room, calibrates these pictures, and then refers to the instrumentation.
Understanding the workings of neuro navigation
To make sure that there is no obstruction in the path between the camera and the trackers during this procedure, the camera is positioned on one side of the operating bed, above and toward the operating field. On the opposite side of the operating table is the C-arm. The computer system can be put in a location that is far from the work area. It is possible to arrange additional tools as needed, including electrophysiological monitors and autologous blood transfusion equipment.
Neuro navigation can be used in most spinal surgeries
Enhancing internal fixation precision and tracing lesion boundaries are the main goals of this technique. With regard to minimally invasive spinal surgery and spinal revision surgery, navigation-assisted techniques are advantageous for patients who have anatomical variations, malformations, or ambiguous bony anatomical landmarks.
Spinal navigation for purposes other than screw placement
The primary benefit of using navigation systems is to increase the accuracy and safety of pedicular screw placement, but the fact must also be considered that there are other procedures in instrumented spinal surgery that might be helped by a stereotactic guidance system.
Transpedicular vertebral biopsy procedures have been found to benefit from neuro navigation. This can help stabilise a spine by jumping the pathological vertebra and inserting screws above and below it. The procedure can be completed by taking various samples from the pathological body via a transpedicular route. But surgeons have to be certain that they have accurately and completely centered the lesion thanks to the availability of a navigation system.
It takes practice and mastery to use computer-assisted navigation effectively. The other advantage of navigation system is significant reductionin number of x-rays taken during spinal surgery which in turn reduces radiation exposure to patient and opearting team. The length of the learning process affects how long an operation takes, how much radiation is exposed, and how accurately pedicle screws are placed, but these factors get better with the surgeon’s experience and training.