Would YOU trust a robot to operate on your spine when a 1mm slip could be ... trends now

Would YOU trust a robot to operate on your spine when a 1mm slip could be ... trends now
Would YOU trust a robot to operate on your spine when a 1mm slip could be ... trends now

Would YOU trust a robot to operate on your spine when a 1mm slip could be ... trends now

Bending down to pick up the final package of his day's round, delivery driver Richard Fuller felt a sudden stabbing pain in his lower back.

'It was as if someone had stuck a knife into my kidney,' recalls Richard, now 57, who managed to drive home but was 'in absolute agony'.

Assuming he'd pulled a muscle, he took some paracetamol and went to bed, hoping rest might help. The next day, however, his back was so stiff and painful that he could barely get up.

'I live alone, so my parents came over to help me as I could only get around bent over and shuffling about,' says Richard, who lives in Canterbury, Kent.

When things hadn't improved within a few days, he saw his GP, who referred him to hospital, where he was diagnosed with a slipped (or prolapsed) disc.

In March this year, Richard Fuller became the first NHS patient to undergo a new way of doing spinal fusion surgery using robot technology

In March this year, Richard Fuller became the first NHS patient to undergo a new way of doing spinal fusion surgery using robot technology

The robot, called Mazor, is used to perform a minimally invasive technique known as oblique lumbar interbody fusion (OLIF), where two or more vertebrae are fused together to stop the movement causing the pain

The robot, called Mazor, is used to perform a minimally invasive technique known as oblique lumbar interbody fusion (OLIF), where two or more vertebrae are fused together to stop the movement causing the pain

The discs act as shock absorbers between the bones (the vertebrae) of the spine. Discs have a hard outer shell and a jelly-like interior: if the shell becomes weak and ruptures, often as a result of wear and tear, the jelly bulges out, pressing against the spinal nerve and causing intense pain.

Eight out of ten Britons suffer back problems at some point in their lives, with slipped discs a leading cause.

For Richard, it would have a devastating impact on his life. Forced to give up his job — he was in too much pain to lift packages or drive — he had to claim state benefits (which he hated), and took increasing quantities of painkillers, including high doses of morphine.

'Everything was a struggle, from putting on socks and shoes to bending down to feed my cat,' he recalls. 'I stopped going out and became very isolated.'

After the initial incident in August 2019, Richard underwent two operations. Neither helped. The first, in November 2019, was lumbar decompression surgery, where a section of bone is removed from the vertebrae to ease the pressure from the disc pushing against the affected nerve.

This was followed, a month later, by a double discectomy, removing the damaged section of two of his discs.

While around three-quarters of those who have decompression surgery experience significant improvement, two months after his second operation, Richard was in 'a new level of agony' after developing a serious infection.

By early summer 2020, a year after his problems started, he also developed a shooting pain in his spine whenever he put his left foot on the ground.

The pandemic put paid to any further treatment. But Richard was then referred to Michael Mokawem, a consultant spinal surgeon at the Royal National Orthopaedic Hospital in Stanmore, North-West London, a specialist centre for complicated spinal cases.

In March this year, he became the first NHS patient to undergo a new way of doing spinal fusion surgery using robot technology. The robot, called Mazor, is used to perform a minimally invasive technique known as oblique lumbar interbody fusion (OLIF), where two or more vertebrae are fused together to stop the movement causing the pain.

Using the robot reduces surgery and recovery time, and can be done at half the cost of the traditional approach.

Fusion surgery is already used for several back problems, including spinal stenosis (when the spinal canal housing the nerves and spinal cord narrows with age).

Traditionally, it is performed as two separate operations, each lasting at least three hours and often a week or more apart (partly due to logistics of orchestrating such a lengthy procedure).

In the first operation, the patient lies on their side while a 5-7cm incision is made in their abdomen (to avoid damaging back muscles). The damaged disc is then removed and a flexible titanium cage inserted to act as a spacer between the two vertebrae due to be fused.

In the second operation, the cage is fixed in place with screws and rods, and additional bone (from a bone bank or using artificial

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