‘Awake surgery’ offers new hope to high-risk patients

New approach to spinal repair brings better outcomes, faster recovery

Story by Blain Fairbairn | Photo by Leah Hennel

CALGARY — Living with chronic pain for decades was a bitter reality for Lethbridge resident Todd Bene. But thanks to a novel procedure recently performed by physicians at Foothills Medical Centre, Bene now revels in the simple pleasures most of us take for granted.

“I think my grandkids are probably the most excited,” the 59-year old jokes. “Now I can do things with them again that I hadn’t done since they were little — maybe not as rough, but I’m looking forward to it.”

Bene suffered from a herniated disc, which caused severe pain in his leg. It was so bad, he told his surgeon, that he’d thought about ending his life.

Years of dirt biking and water skiing had taken their toll, but it was a couple slips on the ice while working that sent Bene over the edge. His physician referred him to spine surgeon Dr. Michael Yang who said a routine discectomy — a procedure to remove the damaged part of a herniated disc in the spine that irritates or presses on nearby nerves, resulting in pain and numbness — should bring relief.

But there was a catch.

Bene also has heart issues which make him a high-risk candidate for general anesthesia, the typical protocol for spinal surgery. Even for healthy patients, there are risks to being put under. But for those like Bene, the potential for complications rise significantly — cardiac arrest being among the most dire.

So Dr. Yang asked him if he would be open to a local anesthetic and mild sedative only. This is known as ‘awake surgery’ — and it’s an exceedingly rare occurrence in Canada due to the specialized training it requires. Bene agreed without hesitation. Within weeks he was in the OR.

“The advantages of awake surgery are quite significant for patients and healthcare providers,” says neuroanesthesiologist Dr. Kyle Rogan, who collaborated closely with Dr. Yang on the novel surgery.

“Awake patients usually go home sooner compared to those given general anesthesia. There’s no risk of post-operative nausea or vomiting. The potential for complications is much lower, and it’s a much faster recovery.

“From a system perspective, we can increase the number of procedures we perform while helping to ease capacity issues and freeing up beds and resources for patients who need them most,” Rogan adds.

Bene’s surgery was over in 55 minutes and, after about four hours of recovery, he was on his way back to his hotel.

“This was a true team effort that went as well as we could have hoped,” says Dr. Yang, who previously performed similar awake surgeries during his fellowship at UHealth-University of Miami Health System. “If we gave him a general anesthetic, that would have meant admitting him for a few days, daily diagnostic testing because of his heart issues, and consultation with internal medicine teams.”

Dr. Yang is optimistic the number and frequency of awake spine surgeries will steadily increase, with applications beyond decompression procedures such as discectomies, to include other common back surgeries such as spinal fusions.

“We have such a high volume of spine surgeries in Calgary, performing about 2,000 each year,” says Dr. Yang. “With the success of Mr. Bene’s surgery, we’re very excited about the huge potential awake surgery holds for giving more patients better outcomes in less time.”

Bene’s relishing his newfound relief and says he’s grateful to have access to world-class care and physicians such as Dr. Yang and Dr. Rogan.

“My wife was at Foothills years ago after a heart attack and the doctors all worked together and did some really cool things, it was all cutting-edge,” he says. “I’m looking forward to getting back to work and getting on with life. It’s like night and day.”