At Galeazzi, the world’s first hip and spine surgery in a single minimally invasive surgical session

January 3, 2021

The 2 in 1 surgery was able to solve in a single surgical session and with minimally invasive techniques the problem of hip and spine syndrome in a 48 years old patient. The intervention received congratulations from the Italian Prime Minister, Mr. Giuseppe Conte, on his Twitter account where he underlined the extraordinary nature of the event: “A goal that makes us proud of our healthcare system” – said the President.

The surgery took place at the Galeazzi teaching Hospital and Research Institute in Milan, an “Eurospine” certified Orthopedic Center of Excellence part of the San Donato Hospital Group, the innovative intervention carried out by a team of professionals from the hospital who together have corrected, for the first time in the world, this serious pathology of the hip and spine (hip-spine syndrome) in a single minimally invasive intervention. The patient, after two hours in the operating room, in half a day was able to get himself out of bed.

Multiple benefits for the patient

The procedure has been carried out with minimally invasive techniques thanks to the competences of the orthopedic surgical team of the structure headed by Dr. Roberto Bassani, Director of the Department of Spine Surgery II, Prof. Giuseppe Peretti, Director of University Team of Regenerative and Reconstructive Orthopedics and Dr. Paolo Sirtori Orthopedic Surgeon from the same Unit.

What is Hip-spine Syndrome

Hip-spine syndrome is a pathology, often disabling, that affects both the spine and the hip joint, and is degenerative in nature.
In the case of the 48-year-old patient, already returning from a previous failed surgery on the spine (carried out in another Center), the problem was due to a degeneration of the vertebral disc associated with a painful hip symptomatology due to Coxarthrosis, a state of advanced osteoarthritis.
“As far as the column is concerned, it was a revision intervention, as the patient had previously been operated on with traditional techniques, but without success, always for the same problem – explains Dr Bassani -.
In addition to this, hip problems have also been added, resulting in difficulties in movement and worsening of the quality of life. These conditions are, in fact, secondary to a degeneration of scales that has inevitably led to a reduction in lumbo-sacral lordosis: when the disc degenerates, the lumbo-sacral curve changes, leading to a hypolordosis, that is, a forward imbalance of the trunk and resulting in a change in the position of the basin due to compensation”.

Hip and column correction

After extensive studies, the patient underwent the replacement of a severely degenerate vertebral disc with a minimally invasive anterior approach, in order to remove the mechanical cause of pain and restore the natural curve of the spine, which was followed in the same session, the reconstruction of the hip joint, always with a minimally invasive anterior approach.
“Some great advantages of these minimally invasive techniques that combine hip and spine – explains Dr Sirtori – are those related to:
1. Safeguarding the musculature of the subject;
2. Limitation of blood loss (no transfusions);
3. Reduction of surgical wounds.
4. Patient who faces only one surgery with reduced surgical times and only one anesthesia.
5. Two of normally separate surgical gestures performed in a single operation (lasting less than 2 hours) saving months that would normally have taken place between operations;
6. Reduction of complications both in terms of prolonged hospitalization (one hospitalization instead of two) and anesthesia (one session instead of two);
7. Thanks to the fast-track protocol and the minimal invasiveness of the techniques, the patient was discharged after 2/3 days, put back on his feet after 6 hours making him walk in his room (without drainage), with a rapid resumption of daily activities;
8. Compared to traditional techniques, the patient will have a functional recovery without the need to undergo rehabilitation sessions and without the help of crutches, with a set-up already 6 hours after the surgery.

The future of hip-spine syndrome treatment

This intervention represents a further step forward for a hospital of excellence such as Galeazzi.
“At this time like this, when we are facing the Covid emergency, it becomes even more important to be able to guarantee the patient the care he needs, always maintaining high quality standards and ensuring them a quick return home and in total safety – concludes Prof. Peretti -.
Our idea is to plan, in the future, other interventions like this, making it a reproducible and standardized model for all our patients suffering from this pathology”.

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