Article originally published by SaltWire. Photo credit: Tim Krochak, SaltWire.
QEII Foundation says N.S. creating standard of care
A matter of millimetres can change a patient’s outcome when it comes to spinal surgery.
And thanks to a spinal robot at the QEII Health Sciences Centre in Halifax, Dr. Sean Christie says neurosurgeons are down to “submillimetre or subdegree precision of where the screw goes.”
Late Tuesday afternoon, Christie stood in front of the robot used to perform spinal surgery and reflected on how things used to be before the QEII Foundation purchased the MAZOR X Stealth Edition.
“Because of the accuracy of your hand or what have you, you could be here or you could be here,” Christie said while looking at an example image of a spine needing a spinal fusion.
“That doesn’t look like much of a difference, but that means I’m either going right through this bone or I might be getting into this joint.”
Christie said the repercussions of going through a joint may mean more wear and tear, resulting in a patient needing another operation.
For some, a misplaced screw or rod can even mean the difference between life and death or being able-bodied or infirmed.
But the spinal robot lines up an arm of the machine with where the surgeon needs to focus on and allows them to operate with stability assistance from the machine.
“One of the things my patients sometimes ask is, ‘Am I going to do the operation or is the robot doing the operation?’ and the autonomy sort of thing is that robots aren’t making diagnoses or doing stuff at this point in time, but they do help us do things that we want to do better and that’s the advantage,” Christie said.
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Christie is familiar with the technology. He was the first in Canada to perform a patient procedure using the robot in Halifax in July 2022.
He has since gone on to perform 21 surgeries with the robot – making up just shy of half of the surgeries done using the technology at the QEII Health Sciences Centre.
Susan Mullin, president and chief executive officer of the QEII Health Sciences Centre Foundation, said the foundation took it upon itself to purchase the spinal robot.
“We wouldn’t have this right now if we were depending on the government to fund it because there’s too many other baseline kind of requirements in the system, right?” Mullin said.
Since then, donors have been stepping up to repay the $3 million purchase.
On Wednesday, Irving Shipbuilding announced it was donating $1 million dedicated for the robot and its research.
As a nod of recognition, patients and families who have spinary surgery will be cared for in the Irving Shipbuilding Spinal Robot Surgical Suite in the QEII Health Sciences Centre.
“People want to learn on the latest technology. They want to be able to deliver the best care possible. So for us, the $1 million investment from Irving Shipbuilding is advancing all of that,” Mullin said.
Christie said the robot gives a level of accuracy that benefits both the surgeon and the patient.
Aside from the level of precision the robot gives, it also shortens the time it takes for a surgeon to insert screws into the spine.
“If you’ve ever tried to change the trajectory of a screw once you’ve screwed something in, it’s really hard to get it to go somewhere else, so you end up messing around with that and it’s minutes, 10, maybe 15, five minutes or whatever per screw. Whereas this, you’re going in there once and you’re under two minutes,” Christie said.
He said previously, patients were in hospital for seven to nine days following a spinal fusion, with patients who had a minimally invasive procedure staying in hospital for about five days. Now, patients who have surgery with the assistance of the robot are typically in hospital for three to five days.
Patients are also less likely to need surgeries down the road.
Shannon Nearing said her joy returned after she had spinal fusion surgery with the assistance of the MAZOR X Stealth Edition last August.
Nearing said she had been experiencing extreme pain due to her degenerative disc disease. She had a minimally invasive surgery in 2022, but said it was unsuccessful and she continued to live in pain.
That's when Christie offered to treat her with the spinal robot.
"It was limiting my day-to-day life, meaning walking, fitness activities, which were a big part of my life, I wasn't able to do because it was just making me feel worse in terms of pain," Nearing said, adding she also was limited in what she could do with her two grandsons.
"Those life things, those are things that are important to me and it was so frustrating for me to have to stop."
Since her surgery, Nearing is able to go to spin, yoga and Pilates classes, play with her grandsons and walk her dog without taking breaks.
"So far, it's been great and I haven't had any setbacks or problems," she said.
Christie said while the surgeons aren’t fighting over access to the spinal robot (as of yet, anyway), he said it will have additional features down the road, such as guiding surgeons in bone removal procedures, and will start to be used in more cases.
“There’s been an awful lot of stuff that was a one-off that now is mandatory. It’s in every room on every case. This will be like that,” Christie said of the spinal robot.
Mullin said the hope is that the provincial government will take a similar approach as it did with the Ethos radiotherapy system with HyperSight imaging solution. The foundation purchased the first cancer radiotherapy treatment machine before the province pitched in funding for two more.
“This is another good example where we bring in the latest technology, (the health-care workers) prove its value in all kinds of ways and then the government can come in and add more. I think that’s the power of philanthropy,” she said.
Mullin said the QEII Foundation is embracing new technology as it becomes available and does its best to make it available to health-care workers and their patients. It currently leads the country for the number of surgical robots in one facility.
“Our role is to really take programs from good to great. We can be the innovators and invest in technology that is still at the leading edge and maybe hasn’t yet become the standard of care and that means we create the standard of care and our patients in Nova Scotia get the best possible treatment at the earliest point,” she said.