Big Surgery on a Tiny Scale: New Spinal Surgery Technology Helps Welder Move Again 

Carl was in his welding shop, focused on his work when he lost his footing and fell. A sharp, searing pain jolted through his lower back and radiated down his leg. When he stood up, he felt unsteady. It was suddenly a challenge to walk.

As time passed, Carl’s back pain didn’t improve. He started using a cane, but it became more challenging to sit and stand. “I just didn’t know if I would be able to get up,” he says.

Then, one day, he couldn’t move. Carl went to the emergency department, where an MRI revealed that he had a herniated disc. “The disc had ruptured and the matter from the disc was pushing against my spinal column,” he says.

The emergency department referred Carl to neurosurgeons that specialize in spine surgery at Emory University Hospital Midtown—where Carl would learn he’d need to consider spinal surgery.

The potential for spinal surgery shook Carl. His career as a welder and fabricator depends on movement—bending, pulling and twisting are regular occurrences in his work.

He was also afraid he wouldn’t be able to enjoy his hobby, canoeing the Chattahoochee River. “It’s one of my favorite things in the world to do,” he says, and the place he finds tranquility.

With these worries in mind, Carl met with Daniel Refai, MD, vice chair of neurosurgery and director of spinal oncology at Emory Spine Center. He learned that his major-seeming surgery could have a minimally-invasive approach—in fact, the technology is called “ultra-minimally invasive” (UMI).

Emory Healthcare is home to Georgia’s first and only academic medical center using UMI endoscopic technology. Dr. Refai uses this technology to perform complex spinal surgery with a very small footprint and a speedy recovery.

And Carl was the perfect candidate for the procedure.

As the name implies, this is big surgery at a tiny scale. In fact, with this procedure, surgeons make an incision the size of a pencil tip. The built-in 4K camera and light source create a high-resolution image on the screen and improve depth perception at the surgical site. This technology allows smaller, more precise incisions.

“This technology represents a significant advancement in patient care,” says Daniel Barrow, MD, chair of neurosurgery at Emory Healthcare. “Emory is proud to be the first in Georgia to offer this progressive treatment to our patients.”

In contrast, standard minimally invasive endoscopic technology typically uses lower-resolution HD cameras. Lower resolution may not capture the same level of detail or depth perception as the 4K camera.

Depending on the complexity of the condition, UMI endoscopic spine surgeries can take 45 minutes to an hour using this new technology and can go home that day. In comparison, traditional open surgery can take at least an hour and a half and requires an overnight hospital stay.

“The visualization is incredible,” says Dr. Refai. “I’m able to look around the nerve roots and underneath the nerve, which I couldn’t do before. And we’re doing it with very little manipulation of tissue.”

Not everyone is a candidate for this surgical approach. If back or neck pain lasts longer than six to 12 weeks or does not improve with nonsurgical treatments such as physical therapy, an individual may be a candidate for UMI spine surgery.  

UMI spine surgery has proven to be safer, more precise and less invasive. Patients walk out of the hospital on the same day as surgery, experience less pain and recover sooner.

“The smaller the surgery, the faster patients can get back to a normal life,” says Matthew Gary, MD, neurosurgeon and associate professor of neurosurgery at Emory University School of Medicine. “We want to do everything we can to minimize pain and maximize recovery. In general, we’ve found the outcomes are better with this ultra-minimally invasive procedure.”

Most patients only need muscle relaxants or over-the-counter pain relievers for recovery. “I generally tell patients to take two weeks off after the procedure. But many of them are back to a normal lifestyle within the first two or three days,” says Dr. Gary.

Physical therapy after UMI spine surgery can help with recovery. Guided exercises and conditioning can help strengthen back muscles, reduce stiffness and improve mobility.

Carl returns to work and the water

After surgery, it took only a week for Carl to get back to work and to do what he loves—canoeing on the Chattahoochee River.

“I felt almost immediate relief from the worst of the symptoms I was having,” he says.

He sees the endoscopic surgery he received at Emory and his speedy recovery as a gift. 

Get help for back pain

For pain you can no longer control on your own, Emory Spine Center offers the latest options in spine surgery and post-surgical spine care. Our expert spine care teams, which include physiatrists, spine surgeons and neurosurgeons, can diagnose the cause of your neck, back and spine pain.

UMI spine surgery may benefit individuals with herniated discs, spinal stenosis or degenerative disc disease. We also use UMI endoscopic surgery to remove pituitary tumors at the base of the brain. Surgeons can more accurately perform surgery and minimize the risk of damage to the pituitary gland and surrounding nerves and blood vessels.

We’ll provide the personalized treatment you need to get back to the life you love. Our advanced spine care includes innovative nonsurgical spine treatment, minimally invasive spine procedures and expert spine surgery care.

If you are experiencing neck, back or radiating leg pain, schedule an appointment online or call 404-778-3350 to meet with a spine expert. For neurosurgery, call 404-778-5770.