Cutting-edge spinal surgery now at UWI

Erica Virtue,  Senior Gleaner Writer

Two Jamaican medical doctors - University of the West Indies consultant neurosurgeon Dr Carl Bruce and Harvard-trained, United States-based orthopaedic spine surgeon Dr Kingsley Chin - are mending badly damaged spines and sending patients home in record time from the University Hospital of the West Indies.

Charged by the Medical Association of Jamaica and the Ministry of Health to present the latest techniques being pursued in spine surgery, Bruce and Chin are now making keyhole cuts through patients' sides (flanks) to treat serious spinal damage.

Smaller incisions

Gone are the long surgical cuts in the backs of patients with spine damage, as less exposure surgery (LES), procedures are now performed on the spine with minimal damage to the soft tissue.

"Some say keyhole surgeries, but we call it less exposure surgeries. So we performed a less exposure spine surgery, the first of its kind in the Caribbean, where rather than opening the back to see the spine, we went through the patient's side and did the procedure.

"After that, we use tiny keyholes in the back, to fix the spine. It's the first time we had done the keyhole fixation with the screws," explained Bruce.

Flank cuts were done for the second time in last month's surgery, but using screws through the keyholes was being done for the first time.

"It is surgery that results in advanced patient recovery time; less blood loss; less time in hospital and quicker time to return to work. We also wanted to make sure that these new techniques come out comparable or cheaper to the older open surgery," explained Bruce.

Regarded as one of the world leaders in new technologies for spine surgeries, Chin attended Titchfield High School in Portland before receiving a scholarship to Columbia University where he studied engineering and mathematics.

After venturing into the business world, he went to Harvard to study medicine. Chin invented techniques and devices for LES, which allows for inpatient and outpatient surgeries, which other surgeons often deem inoperable because of the complexities involved.

Chin needed no convincing to perform the surgery here. "Jamaica is my home. My family is here. And when Carl (Bruce) says 'Kingsley' I am on the next available plane. My staff here go crazy when Dr Bruce calls, because they know I am leaving," said Chin, in an interview from Miami.

Since the start of this year, the two have done at least five such surgeries and Chin was again in Jamaica for another surgery last Friday.

Chin, who owns and operates the Institute for Minimally Invasive Spine Surgery in Florida, is one of the most published and respected in the field of spine surgeries. Four weeks ago, the duo performed surgery on a female patient who became convinced after the benefits were explained.

"We showed the patient the benefits, all the options, fusing the spine in the traditional way as opposed to newer techniques which are now established and also approved by the Federal Drug Administration. The surgery is now only done at the University Hospital," said Bruce, who wants to extend that to other hospitals.

Training programmes

Neurosurgeons at other local hospitals benefit from training programmes and lectures offered by Chin - as a way of giving back to his country.

"Patients need not worry that inferior technology is being used. You have the best doctors, trained right here at UWI. I bring equipment in and my expertise, along with Carl, and we are doing cutting-edge surgeries right there at home," said Chin, on a day in which he saw 68 patients and administered 20 injections.

Minimally invasive surgeries have been done for other injuries. Bruce explained that, "Rather than take out or fix a fracture, sometimes we would just put a needle in, and put bone cement." Bone cement is a substance commonly used to hold implants in bone and is used mostly for hip and knee replacement surgeries.

"It is almost like digging a hole and putting concrete in it, so that it stays firm. It's on several fronts that we have been doing these less invasive surgeries, and so I would say that the programme has started and we will continue in that vein," declared Bruce.