Standing Tall: How Spinal Fusion Surgery and AI Fixed One Woman’s Spinal Deformity
A woman in her late 50s fell and broke her ankle in the summer of 2021, and it turned out to be a life-changing event. The ankle injury itself was not eventful. But it brought her to the Inova Loudoun Hospital emergency room, where she met the orthopedic surgeon who would finally fix her spine.
New Hope for a Spine Problem
Mark Shasti, MD, was the on-call orthopedic surgeon the day a woman came in with a broken ankle. He operated on her injury with no idea how intertwined their futures would be.
Six weeks after the surgery, Dr. Shasti cleared the patient to walk on her newly healed ankle during a follow-up appointment. That’s when he saw the real issue she was facing.
“She walked like an old person, hunched over and unable to stand tall,” says Dr. Shasti, who subspecializes in spine surgery. “When I asked why she was walking like that, she responded that it’s just who she is and how she walks.”
With a little more prodding, Dr. Shasti learned that the woman had spinal fusion surgery more than a decade earlier that caused a spinal deformity called flatback syndrome. People with flatback syndrome appear to be hunched forward. They often have chronic back pain and difficulty standing straight and walking because their weight is no longer centered over their pelvis and legs.
She’d had six surgeries to correct the issue, but none were successful. She had resigned herself to a life of pain medication. Her spinal deformity left her sedentary most of the time. It interfered with her balance and ability to walk and— it was the reason she fell and broke her ankle in the first place.
What Is Adult Spinal Deformity?
The human spine is not straight, even though it may look that way from the back. When viewed from the side, the spine has gentle curves that work together to distribute weight and keep the back flexible. The curves also keep your body’s center of gravity aligned over the pelvis and hips.
Adult spinal deformity occurs when abnormal curvature pulls the spine out of alignment, often due to age, degeneration or trauma. As a result, the spine can’t function as it should, causing pain, mobility issues and possible neurological problems.
The initial spinal surgery caused the spinal deformity Dr. Shasti’s patient was experiencing — her spine was fused flat, without the curvature necessary for alignment. The surgeries that followed attempted to fix her flatback syndrome, but only worsened the problem.
Predicting Surgical Outcomes with Artificial Intelligence
Dr. Shasti believed he could fix the woman’s back using adult spinal deformity surgery, also called spinal fusion surgery. But he also knew it would be complicated. He studied images of her spine and created four or five surgical plans. Then he relied on artificial intelligence to take the guesswork out and give his patient the best possible outcome.
Dr. Shasti uploaded the woman’s information, all her spinal imaging, the goal of the surgery and his surgical plans into an advanced computer system. The system compared this case and Dr. Shasti’s surgical strategies against 9,000 other patients with same diagnosis and surgery. It analyzed the surgical options and recommended the best plan for Dr. Shasti’s patient.
“I created the plan we used, but I relied on artificial intelligence for reassurance,” Dr. Shasti says. The computer also determined the precise dimensions and curvature for the metal implants needed for the surgery. Within 72 hours, Dr. Shasti had his patient’s personalized implants and was ready for surgery. “I implemented the plan for each stage of the surgery. There was no guesswork.”
Performing Complex Spinal Fusion Surgery
The plan Dr. Shasti created and carried out involved undoing as many of the previous fusions as possible before he fused the woman’s spine with the proper curvature. The operation, which took place in March 2022, required three separate surgeries over two days.
Dr. Shasti broke his patient’s back during the first surgery and undid the previous fusions. That same day, in a second surgery, he worked through her abdomen to correct her spine’s curvature and alignment. The next day, during the third surgery, Dr. Shasti fused the spine to keep the curvature in place.
“It was a big operation,” Dr. Shasti says. “But I utilized the most advanced technology to plan, program and execute the surgery, and we got an excellent outcome. My patient had no complications.”
Road to Recovery
The woman’s recovery following surgery was challenging, but not just because her back was healing. She wanted to be free of the prescription drugs she had been taking for years to manage her pain.
“We have strong evidence that shows that patients who are chronic opioid users have horrific outcomes after spine surgery,” Dr. Shasti says. “They tend to have pain problems, infection and longer hospital stays. It wasn’t easy for my patient, but three months out from surgery, she was done. No more narcotics. No more medication. She was very motivated.”
Her focus now is regaining the muscle strength she lost during the years she lived with spinal deformity. But she’s standing tall, happy to be biking, running and hiking with her husband.
“This patient took a huge leap of faith with me,” Dr. Shasti says. “And I can’t thank her enough for taking that risk. I see patients all the time who can’t enjoy their lives as they want to. My hope as a surgeon is to give their life back to them. There is nothing more rewarding than that.”
Learn more about the Inova Spine Program and spinal orthopedics surgery with Mark Shasti, MD, and Christopher Silveri, MD.
Original source can be found here
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