6 OCTOBER 2019 • HEALTHCARE INNOVATIONS


NEW TECHNOLOGIES TO ‘HELP THE BODY HEAL ITSELF’ Regenerative medicine and stem cells are being investigated and utilised more regularly in medical treatments and we were at the forefront of this as it was developed and brought into medicine. In 2009, we invented a research technology to ascertain the nutrition of lumbar discs in our back. We tried to predict which lumbar discs will degenerate in the future and how external factors aff ect this degeneration — a bit like looking into a crystal ball. Professor Rangana- than is the fi rst and only UK surgeon to have been awarded the prestigious ISSLS Prize for this research.


FUTURE OF SPINAL SURGERY — ROBOTICS, VIRTUAL REALITY WITH HAPTICS AND ARTIFICIAL INTELLIGENCE T e development of robotics is ongoing to include the correction of spinal deformities, such as scoli- osis, as the current technology uses increased radiation exposure to the patient,


for the imaging technology


that guides the robot. With the intro- duction of any technology in health- care, there must be a balance of the costs and accuracy advantages. At the moment, there’s not much evidence that robotics is better than a skilled surgeon in spinal curva- tures — robotic systems only focus on


Specialist clinics


41


PROFESSOR RANGANATHAN, ALONG WITH A PROMISING MEDICAL STUDENT RHEA SRINIVASAN AND A TEAM OF SCIENTISTS, HAVE DEVELOPED THE FIRST HAPTIC DEVICE WITH TORQUE TO PROVIDE TACTILE FEEDBACK FOR PEDICLE SCREW PLACEMENT (PICTURED ABOVE). THIS WILL REVOLUTIONISE THE WAY FUTURE GENERATIONS OF SPINAL SURGEONS WILL BE TRAINED.


With the advent of regenerative


technologies such as PRP, Lipogems and other adipose tissue stem cell like cell system, we can now eff ec- tively treat patients to give them relief from their pain and symptoms ahead of surgery. If the discs can’t get nutri- tion, then stem (stromal) cells can’t survive in this atmosphere, leading to failure of treatment. We’re now working towards predicting which patients will respond better to regen- erative treatments.


NAVIGATION AND ROBOTIC TECHNOLOGY IN SEVERE SPINAL CURVATURES Spinal curvatures or scoliosis and kyphosis


have traditionally been


performed using the skill of the surgeon and years of highly special- ised training. T ere are few spinal surgeons who specialise in this fi eld, given the high risks involved and the long learning curve. T ese surgeries are


undertaken in a select few


centres across UK, especially since the surgeries are mostly undertaken in children. Severe spinal curvatures some- require


times special equipment


that helps with screw placement and also to radiologically study the spine during the operation — this is off ered by computerised systems called navigation. Unfortunately, these severe curves


tend to occur in third-world coun- tries. We had the chance to train and perform surgeries in Vietnam in these severe spinal curvatures.


VR AND HAPTICS T e application of VR and haptics in the medical training fi eld aids in reducing negative implications of traditional training methods, espe- cially reducing patient risk. VR and haptics-based simulators provide a safe environment for medical trainees to develop their skills to a certifi ed level even before coming into contact with actual patients. Mr Kash Akhtar, Consultant Knee Surgeon, has been pioneering this technology for teaching in Queen Mary University.


part of the operation and are unable to consider other factors such as 360-degree alignment and rotation. T ese technologies also increase the surgical time, require more personnel and device in the operating room — all of which increase the risk of infection. T e


current technology


works well in conditions such as frac- tures and spinal fusions.


PROFESSOR RANGANATHAN AND HIS TEAM AT THE ROYAL LONDON HOSPITAL. THEY PERFORMED A LIFE-CHANGING OPERATION ON BRAVE 18-YEAR-OLD CHLOE TO STRAIGHTEN HER SPINE ON CHANNEL 5’S OPERATION LIVE SERIES FOR THE VERY FIRST TIME IN THE WORLD.


KASH AKHTAR, CONSULTANT KNEE SURGEON


Augmented Reality (AR) headsets are also showing great promise in allowing X-ray, CT and MRI images to be overlaid on top of the actual surgical fi eld in order to ensure optimal results for patients. Artifi cial Intelligence (AI) has the capability to develop scenarios for enhanced surgical training experience. T e integration of technology,


intelligence and surgical skills are increasing the scope and safety of modern-day spinal surgery.


THE SPINAL TEAM AT THE ROYAL LONDON HOSPITAL, LED BY MR ALEXANDER MONTGOMERY, WAS FIRST IN THE UK TO PERFORM A SPINAL FRACTURE WITH A ROBOTIC ARM. MR SYED AFTAB PERFORMED THIS FIRST UK CASE WITH THE NEW ROBOTIC TECHNOLOGY.


SEVERE SPINAL CURVES REQUIRE SPINAL NAVIGATION WHICH PROFESSOR RANGANATHAN HAS HELPED TO INTRODUCE IN COUNTRIES SUCH AS VIETNAM, SOUTH EAST ASIA AND INDIA.


T: 020 7908 3721 E: ar@londonspinecare.co.uk


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