Dr. Michael Copeland is no stranger to performing lateral spine fusion surgeries.
But for the first time on Friday, Copeland fused spinal vertebrae using new 3-D imaging technology at St. Vincent Healthcare’s Neuroscience Center — a technology that’s been used in only about five other spine fusion operations in the country.
“It’s a little intimidating because you are kind of reinventing the wheel,” Copeland said. “I’ve done plenty of these surgeries, but on Friday I’m relying on different information to do it. I will have so much more information to guide my hands, so it is quite a luxury.”
The imaging system, called O-arm Surgical Imaging System, allows surgeons to view skeletal anatomy during surgery as they navigate a complex procedure, Copeland said on Wednesday.
The machine gives physicians a more comprehensive understanding of patients’ brain and spinal columns — two of the most intricate and fragile parts of the body — through three-dimensional images viewed on a large, flat, high-definition screen, he said.
The system is synced in real time, projecting images of the operation as it happens. The large, circular-shaped scanning machine rotates around the patient’s body to capture 360-degree views composed of 750 images in a matter of 26 seconds.
“Instead of looking at the patient or the X-rays, I’m looking at a computer screen where I have three-dimensional rendering to know exactly where in space I am,” said Copeland, who was the first to use the system at St. Vincent Healthcare in October while performing brain surgery.
The enhanced view shows surgeons the exact location of their medical instruments in relation to patient’s body and helps with precision when placing hardware.
Copeland said the imaging system allows him to see inside the patient before beginning the procedure, allowing him to proceed in the least invasive way.
That was particularly important on Friday morning performing a spinal fusion on Billings resident Pauline Wambolt, Copeland said.
One of the greatest benefits of using the imaging system is the ability to operate with a smaller incision, a crucial component when operating on older patients, he said. Smaller incisions result in less pain, faster recovery, and decreased chance of infections and other complications.
“A three-month recovery period is a small price to pay for a longer period of time to feel well, and at least be able to take walks again without wondering if I’m going to be able to get back or not,” Wambolt said.
Wambolt, who requested that the Gazette not reveal her age, retired from a 45-year nursing career in 1994. She was in unbearable pain when her doctor referred her to the Neuroscience Center in January.
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Although surgery always has risks, Wambolt said it was one she was more than willing to take.
“It was easy for me to make the decision because I can’t continue to go on like this. The pain just gets worse each day,” she said.
The decision to perform spinal surgery came after several discussions between the surgeon and his patient, as well as a bone-density test that determined Wambolt’s spine could bear the operation.
“Our spine is designed to be youthful for about 40 years, and we’ve decided to live long beyond those years,” Copeland said. “And some of it is a punishment for working so hard for so many years.”
Wambolt has had two previous fusions, but the lumbar spine disc that takes the most load — the L23 — has worn down to bone against bone.
Spinal fusions are one of the fastest-growing types of orthopedic surgeries performed today. Between 1998 and 2008, the annual number of spinal fusions has increased more than twofold.
The O-arm technology cost St. Vincent Hospital more than $600,000 when they purchased the machine in October 2012.
St. Vincent Healthcare is the only hospital in Montana using the technology for spinal fusion surgery and is one of only 17 in the western half of the country that is utilizing the O-arm system.
“St. Vincent has been awesome in coming to the plate and giving us this tool,” Copeland said.
As for Wambolt, she is most excited about being able to spend quality time with her five grandchildren and three great-grandchildren.
“I look forward to being free of this pain, being able to take walks and spend time with my family,” she said. “Overall, I’ll be glad to have more independence again.”
Days before her surgery, Wambolt said she felt calm and confident about her surgery, her doctors and staff at St. Vincent Healthcare.
“I think it’s very exciting, and I feel privileged to be a part of this new technology,” she said. “It’s certainly to my advantage — less operation time, less radiation exposure, a rapid recovery and less trauma with the less invasive surgery option.”