Collaborative Care for the Spine

Penn Medicine is a regional and national leader in spine care and the Penn Spine Center neurosurgical team uses the latest advances in technology and surgical techniques to achieve the best possible outcomes for spine patients. Now team members are collaborating with surgeons from urology and otorhinolaryngology to perform minimally invasive spinal procedures.

“We have taken our program to the next level and are performing spinal procedures that are not being done anyplace else,” said William C. Welch, MD, professor of neurosurgery and chief of neurosurgery at Pennsylvania Hospital. “With the daVinci® surgical robot we have the ability to perform minimally invasive spinal surgery. ”

“We have taken our program to the next level and are performing spinal procedures that are not being done anyplace else. With the daVinci® surgical robot we have the ability to perform minimally invasive spinal surgery.”

William C. Welch, MD

Repairing the Craniocervical Junction and Upper Cervical Spine

The two most common problems people have with the cervical spine, or the part of the spine in the neck, are disk herniation and stenosis, a narrowing of the spine causing pressure on the spinal cord or nerves. The specific surgery depends on the exact nature of the problem and is traditionally performed through an incision either through the front or back of the neck.

Penn neurosurgeons and otorhinolaryngologists have blended their expertise in spinal surgery and transoral robotic surgery (TORS) to access the upper levels of the cervical spine through the back of the mouth.

“In the procedure, the surgical robot is used to access the craniocervical junction and upper cervical spine,” said John Y.K. Lee, MD, neurosurgeon at Pennsylvania Hospital. “We still perform the spinal surgery using traditional methods, but TORS and the robot provide us better access to the source of the patient’s problem.”

Dr. Lee has published several investigative and preliminary papers in the field of robotic-assisted spinal access surgery.

Fusing the Lower Spine

Similarly, surgeons from Penn Urology are working with spine surgeons to access the lower spine.

Robotic-assisted surgery is commonly used in many urologic procedures, such as prostatectomy. At Pennsylvania Hospital, urologists are using the robotic procedure to access the lower lumbar and sacrum regions of the spine through the abdomen. Penn neurosurgeons are then able to fuse the spine, providing needed stability for patients with lower back problems.

“The surgical robot is providing us with a new ability to perform these procedures laparoscopically,” Dr. Welch said. “At Penn, we are truly performing minimally invasive spine procedures.”

As with all types of procedures, robotic-assisted surgery may not be the answer for all patients, according to Drs. Lee and Welch. However, it provides Penn neurosurgeons with another tool so that they can provide the best possible option—and best possible outcome—for their patients.