Lumbar Artificial Disc Replacement Through the Belly Button
A first-of-its-kind surgery in the United States was recently performed by two Vail-Summit Orthopaedics surgeons at Summit Medical Center in Frisco.
Dr. Ernest Braxton and Dr. Jonathan Schoeff completed the trans-umbilical (belly button) implantation of lumbar artificial disc, allowing the patient to heal without any scarring on the belly. The method patent holder for natural orifice surgery to the spine is Raymond Cloutier, who Dr. Braxton said confirmed that Vail-Summit Orthopaedics had in fact performed the first of these procedures in the United States.
Dr. Braxton said this particular procedure corrects a degenerated disc in the spine that causes debilitating pain. The more common surgical correction would be to fuse two bones together in a procedure known as a spinal fusion operation. However, that procedure can end up creating more stress on the body, sometimes resulting in something called adjacent segment disease which can necessitate more surgery in the future.
Dr. Braxton said he’s done hundreds of artificial disc surgeries through the skin in the abdomen, but this is a first doing the implant via the belly button.
“It is more difficult to do it this way,” Dr. Braxton said. “It really depends on the anatomy of each patient. I wouldn’t want to compromise the success of the operation by trying to minimize the scar, but in this case this patient just happened to have favorable anatomy.”
Dr. Braxton and Dr. Schoeff worked as a team to implant the artificial disc. Dr. Schoeff provided the access, while Dr. Braxton did the implant. With little to no scarring, Dr. Braxton said Vail-Summit Orthopaedics is hoping to be able to offer the procedure to more patients in the future.
“The effects and outcome of the surgery are the same, but there’s significant improvement in cosmesis (a preservation of the body’s original beauty),” Dr. Braxton said. “We have a minimally invasive practice and we try to minimize scars whenever possible.”
That being said, Dr. Braxton said scars remain a secondary concern during orthopaedic surgeries. The physicians first must focus on a successful surgical outcome. Dr. Braxton said he thinks it’s because of this that more surgeons aren’t practicing this particular procedure in the U.S., even though it’s common in cultures where physical scarring is more taboo.
In South Korea, for example, this procedure is very common. Dr. Braxton, who is half Korean, said it’s common in Korean culture for people to go to great lengths to avoid obvious scars on the body.
Both types of procedures result in a similar recovery outlook for most patients, but the trans-belly button procedure likely results in less pain because of less surgical disruption of tissues. Dr. Braxton recommends patients rest for 2 to 3 weeks before starting physical therapy for about 6 to 8 weeks. By about 3 months, most patients are fully recovered and can get back to doing all of the physical activities they previously enjoyed.