Robotic spinal surgery offers accuracy, efficiency and faster healing times.
Does your back ache? If so, you’re not alone. The American Chiropractic Association reports that up to 80% of the population will experience back pain at some time in their lives.
Most of the reported back pain is caused by mechanical problems like sprained ligaments, ruptured disks, and irritated joints rather than serious conditions such as inflammatory arthritis, infection, fracture or cancer. The causes are varied and can include sports injuries, poor posture, obesity, stress and arthritis. Even simple movements can set off spasms of pain at times.
“The most common reason people come to see me is due to degeneration of the spinal discs,” said Brian R. Subach, M.D., of Arlington-based Subach Spinal Solutions, a leading practice in the care and treatment of back pain, degenerative disc disease, neck pain, osteoporosis and scoliosis. “When the discs degenerate in the lower back, they cause pain. And as the spine starts to collapse, it pinches the nerve going down the legs. Patients tell me they can’t stand, sit or find any comfortable position other than lying down. They are miserable.”
Robotic Spinal Surgery Innovation
One of the newest and most effective technologies in the recent history of spinal surgery is through the use of Mazor Robotics,” Dr. Subach said. He employs the Mazor Robotic Screw Fixation robotic guidance system for spinal surgery, most commonly used for spinal deformities or trauma to the spine, or for severe and chronic lower back pain. It offers surgeons a minimally-invasive, more accurate and effective method to help fuse two vertebrae together to stabilize the spine, allowing patients to recover more quickly and smoothly.
“The spinal disc itself is a cartilage structure that sits between two bones,” Dr. Subach explained. “When the disc wears out, the bones become closer together and the disc starts to collapse. That becomes the pain generator.” In such cases, Dr. Subach often recommends a spinal fusion. Using the Mazor system and a smaller incision than traditional back surgery, the surgeon can remove existing disc material and screw in a spinal fixation device fitted to keep the vertebrae together while they fuse naturally. Made of titanium, the device has a roughened surface and bone will eventually grow into the spacer, fusing the two vertebrae together. An FDA-approved bone growth substance called BMP (bone morphogenetic proteins) is applied to encourage the bone growth. Interestingly, the BMP is created in a lab through genetic engineering. “We can open a box and put it in the patient with no risk of disease transmission or infection.”
The recovery time from robotic spinal surgery is much shorter than traditional spinal surgery. “There can be just three days recovery time as opposed to three days in the hospital and weeks of recovery at home.” Formerly, spinal surgery required a much more complicated approach. A lumbar fusion may have required a 4” incision, with muscles stripped away and blood vessels damaged during a three-hour back operation. With the Mazor robotics it takes about one hour to put the screws in from the back side of the body, with just a 1” incision. “It is more time efficient for the operating room staff and significantly better for the patient,” he said. The downside: “Every time you fuse two spinal bones, you sacrifice some ability to move.”
“We recently performed an anterior/posterior fusion. On Monday, the patient came in and we did surgery from the belly side. On Thursday, we put in the Mazor screws on the back side with this minimally invasive approach. Using the robotics, I didn’t have to see anything inside the spine to place the screws accurately,” Dr. Subach described. The robotics and proprietary 3D software perfectly guided the surgeon’s placement without having to completely expose the spine.
Causes and Cures for Back Pain
Some of the common causes of back pain and back problems include body weight, occupation, and heredity factors. It does run in families. Age can also be a factor, but degeneration can happen at any age. “Most commonly, the people I see are still active and moving,” Dr. Subach said. For example, a client may have been playing tennis and herniated a disc when bending forward. Older people aren’t moving as much, and arthritis stiffens them.” To help avoid back problems, people need to strengthen their core muscles through exercise or physical therapy. “Your core strength and flexibility are hugely important.”
“Back problems are so prevalent it would boggle your mind,” he added. However, he claims that surgery is not always the answer. “About 50% of the people I see don’t need surgery. They are frustrated by not knowing what is causing their back pain. And once we identify the problem, they want to know how to fix it.”
The choices people think they have are often physical therapy, chiropractic, or drugs, which only offer a temporary benefit, but doesn’t fix the problem. Subach Spinal Solutions offers a number of treatments in addition to robotic spinal surgery to assist with back and neck pain issues.
Follow-up after surgery is also important for good back health. After a year, Dr. Subach performs a CT (CAT) Scan on patients to ensure proper healing has taken place. Once the bone has successfully fused, he offers to remove the screws if the patient desires.
Dr. Subach is both a neurosurgeon and a complex spine surgeon, Board-Certified in both disciplines. In addition, he holds a functional medicine certification in age management medicine, giving him a unique perspective on the progressive degenerative changes that affect the spine, advanced treatments for refractory osteoporosis and the unique benefits of intravenous nutritional therapy. He is a nationally-recognized expert in the treatment of spinal disorders.
Brian Subach, M.D. opened his own practice, Subach Spinal Solutions, in April 2019. His office is located at 1635 N. George Mason Drive, Suite 150, Arlington VA 22205, and he performs surgery out of Virginia Hospital Center, part of the Mayo Clinical Care Network.
Brian R. Subach M.D., F.A.C.S. has been is both a neurosurgeon and a complex spine surgeon, and is Board-Certified in both disciplines. In addition Dr. Subach holds a functional medicine certification in age management medicine from the AMMG.
Subach Spinal Solutions
Brian R. Subach M.D., F.A.C.S.
Robotic Spine Surgery