In some cases, it is necessary to obtain a small piece of tissue from the spine in order to perform microscopic studies. This is particularly true in cases of spinal tumors to determine if a lesion is benign, malignant, or infected. Biopsies are usually taken with a needle through a small incision without direct visualization of the tumor. In many cases, surgeons use CT scans or X-ray images to guide the needle into the correct location. This process involves additional radiation and in some cases it can be difficult to find the right spot for the biopsy. Robot-guidance allows our surgeons at the Virginia Spine Institute to pinpoint the exact location for the biopsy reducing the amount of radiation and the time needed for surgery.
Approximately 30 percent of patients have recurrent sinus disease. Once you have operated on these patients, you have essentially removed the anatomic landmarks, making subsequent surgery a bit more difficult. Image Guided Sinus Surgery eliminates that problem. The Sinus Center was one of the first in the region to use state-of-the-art computer systems designed to pinpoint surgical accuracy and minimize sinus surgery complications. Image Guided Sinus Surgery allows the physician to actually see the precise position of the surgical instrument and track his/her movements throughout the surgery. The image guided system allows the doctor to visualize areas of the patient's skull anatomy using 3-D computer animation which correlate with the views taken during the patient's CT scans. The image guided system is so accurate that a majority of leading medical schools are using the technique to teach future ENT surgeons.
In a retrospective study, Narozny and associates (2001) investigated the clinical effectiveness of nerve root blocks (., peri-radicular injection of bupivacaine and triamcinolone) for lumbar mono-radiculopathy in patients with a mild neurological deficit. These researchers analyzed 30 patients (aged 29 to 82 years) with a minor sensory/motor deficit and an unequivocal MRI finding (20 disc herniations, 10 foraminal stenoses) treated with a SNRB. Based on the clinical and imaging findings, surgery (decompression of the nerve root) was justifiable in all cases. Twenty-six patients (87 %) had rapid (1 to 4 days) and substantial regression of pain, 5 required a repeat injection. Furthermore, 60 % of the patients with disc herniation or foraminal stenosis had permanent resolution of pain, so that an operation was avoided over an average of 16 months (6 to 23 months) follow-up. The authors concluded that SNRBs are very effective in the non-operative treatment of minor mono-radiculopathy and should be recommended as the initial treatment of choice for this condition.