Project Wonder - The art of science at the Medical College of Wisconsin

Spine Surgery Psychics

What if spine surgeons could predict your future after a procedure? Rather than relying on arcane rituals, a crystal ball or a deck of tarot cards, physician-scientists and researchers at MCW use finite element modeling to simulate how a patient’s spine will react to different surgical options. The goal is to peer into the patient’s future through these 3D simulations, specific to the individual patient, to personalize a surgical plan that will lead to the best recovery and quality of life.

While the common perception is that spinal cord injury is most often caused by traumas such as car accidents and ill-fated collisions during sporting events, degenerative cervical myelopathy (DCM) actually is the leading cause of spinal cord injury among adults. DCM is precipitated by the narrowing of the spinal canal as patients age, which can compress the spinal cord and cause pain, stiffness and difficulty with fine motor skills such as writing and eating, as well as with gross motor skills such as walking and balancing.

Surgery often is needed to treat DCM as it worsens over time, but choosing the correct course can be challenging. Surgeons must choose between several options. The spinal canal can be widened with two different techniques. In a laminoplasty, the bony sections at the rear of the vertebrae (the lamina) are opened up and metal hinges inserted to create more space. In a laminectomy, the laminae are completely removed. This procedure can be combined with the use of bone grafts to fuse vertebrae together to reduce instability in the spine.

Scientists at MCW are working to make it easier to pick from these methods by creating 3D models of a patient’s spine and simulating how the spine will move and flex following each of these surgical options. The research team also uses the simulation to determine how much stress and strain the spinal cord experiences in different neck movements and after different surgical procedures. The group published results in the Journal of Neurosurgery: Spine in July 2023 detailing how 3D modeling and simulations were used to predict that a laminectomy with fusion surgery was associated with the lowest spinal cord stress and strain for a patient.

While more research is needed before spine simulations are commonplace in clinics, the potential benefits for more personalized treatments are clearer than any fortuneteller’s vague pronouncements. If surgeons can predict the future biomechanics of your spine and spinal cord before selecting the surgical procedure, the best possible path can be picked to optimize recovery.

Narayan Yoganandan, PhD and Aditya Vedantam, MD

3D Model Design & Analysis:
Balaji Harinathan MS

Alex Boyes