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Instrument Tracking Reduces Radiation Exposure and Increases Efficiency in Prone Lateral Lumbar Interbody Fusion: A Retrospective Cohort Study.

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Awake Spine Surgery: A 5-Year Institutional Experience in Academic and Ambulatory Settings.

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Updated: Sep 5, 2025

Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
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How to start an awake spine program: Protocol and illustrative cases.

Romaric Waguia1, Elisabeth Kakmou Touko1, David A W Sykes1

  • 1Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA.

IBRO Neuroscience Reports
|July 5, 2022
PubMed
Summary

Awake spine surgery offers reduced risks, opioid use, and costs compared to traditional anesthesia, particularly for lumbar procedures. This approach, though facing resistance, shows promise for improved patient outcomes.

Keywords:
Awake Spinal FusionAwake protocolAwake spine casesAwake spine surgeryERASSpinal anesthesia

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Area of Science:

  • Neurosurgery
  • Orthopedic Surgery
  • Anesthesiology

Background:

  • Advancing surgical techniques increase patient eligibility for spine surgery.
  • Aging populations drive higher spine surgery rates.
  • General anesthesia is traditional, but awake spine surgery is emerging.

Purpose of the Study:

  • To outline essential steps for establishing awake spine surgery programs.
  • To present case studies demonstrating clinical benefits of awake spine surgery.

Main Methods:

  • Literature review on advancements in spine surgery and anesthesia.
  • Development of a framework for implementing awake spine surgery programs.
  • Case report analysis of patients undergoing awake spine surgery.

Main Results:

  • Awake spine surgery demonstrates potential for decreased perioperative risks.
  • Reduced postoperative opioid consumption is associated with awake procedures.
  • Cost savings are noted, especially in lumbar spine surgeries.

Conclusions:

  • Awake spine surgery presents a viable alternative to general anesthesia.
  • Implementation requires addressing systemic resistance and providing foundational guidance.
  • Case reports suggest improved clinical outcomes and patient benefits.