October 5, 2021

UAMS Pioneers Minimally Invasive Spine Surgery

Before and after photos of the 59-year-old man whose back deformity was repaired using the minimally invasive LIP technique.

Before and after photos of the 59-year-old man whose back deformity was repaired using the minimally invasive LIP technique.

A new minimally invasive surgical technique at UAMS is streamlining spine surgery, allowing more precise work and speeding up patients’ recovery time.

Called Lateral-in-Prone or ‘LIP,’ the new technique allows surgeons to operate on patients through their back as they lie face-down, or prone, as spine surgery has traditionally been performed, while simultaneously accessing the area of concern from the side.

Operating on a patient’s spine from the side was introduced at UAMS seven years ago by Noojan Kazemi, M.D., an associate professor in the UAMS Department of Neurosurgery and director of UAMS’ Spine Neurosurgery Program. It gives surgeons more direct access to the lumbar spine without moving the nerves or opening up muscles in the back.

But until the last year or so, spine surgeons couldn’t simultaneously access problem areas from the posterior and lateral side of the patient. They would have to pause between the two procedures to break down the operating field and turn the patient, which used resources and added infection risks and extra hours to often already long  surgeries.

The new ‘LIP’ technique, largely created at UAMS, “has suddenly led to a huge increase in our capacity to treat more conditions efficiently,” Kazemi said. UAMS spine surgeons have performed about 40 of the LIP procedures, and are training other spine surgeons in the revolutionary technique. In one case, a 59-year-old man who had back surgery at another institution came to UAMS leaning forward (termed a ‘kyphotic deformity’) at a 53-degree angle. He had weakness in his legs and severe back pain due to nerves pinched between two lumbar vertebrae. Surgical screws were loose, and he had an infection – “a dire situation,” Kazemi said. A wedge-like titanium expandable cage implanted from the side between the two compressed vertebrae while surgeons worked through the back to replace instrumentation corrected the deformity and allowed the patient to stand up straight again. Kazemi predicts the technique will be used to treat both simple and complex spine conditions.

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