Calgary doctor performs spine surgery on conscious patient

Todd Bene, who has been dealing with chronic lower back and leg pain, was wide awake for a discectomy to remove the damaged part of a herniated disc.

(A previous version of this story stated this procedure was believed to have been the first of its kind performed in Canada, based on information provided by Alberta Health Services. That belief was genuine, but incorrect – spine surgery on awake patients has been performed previously in Canada over the years, albeit infrequently. CTV Calgary has revised this story and apologizes for any confusion caused.)

A Calgary doctor who recently performed a spinal surgery on an awake patient hopes to expand this technique in Alberta to ease pressure on the health-care system.

"This is just the first step of a long journey that we have, the plan that we have to help more Albertans," said Dr. Michael Yang, a spine surgeon at Foothills Medical Centre.

Last month, Yang performed a discectomy to remove the damaged part of a herniated disc in the spine, on a patient who was conscious.

Todd Bene, the man on the operating table, got the surgery to relieve his chronic lower back and leg pain.

"I thought, well, I'll try anything once," he said. "It was kind of cool. You know, I didn't feel much. Every once in a while, you would feel a little something."

The surgery took about 55 minutes and Bene was able to go home less than five hours later. The next day, he was up cooking breakfast for his grandkids and even made a trip to IKEA.

"It was just night and day for the pain," he said. "I was just so surprised when I got up the first time after the surgery and also standing up straight."

Bene had a previous heart attack, heart failure and coronary artery disease, so Yang thought putting him under general anesthetic would be too risky.

Instead, he chose to perform the surgery without it and only with a local anesthetic — something he learned while studying at the University of Miami.

"The patients have less pain after surgery, less nausea, less vomiting after surgery. Patients are able to get up much quicker and walk around and thereby, facilitating their recovery," Yang said.

"Also, without general anesthetic, it causes less stress on the heart and lungs, so there's less risk of developing complications during the operation."

The surgical team and neuroanesthesiologists worked together to sedate Bene just enough so it wouldn't hurt and he'd be able to communicate if it did.

"So we minimize the harm that we could potentially cause on a patient during the surgery," Yang said. "The surgery itself is not super innovative, but it's putting a team together to be able to do it awake that is innovative."

Yang says he plans to perform more procedures, and hopes to use this method for more complex surgeries, like spinal fusions.

He says spinal fusions, surgery to connect two or more bones in any part of the spine, typically require a two-to-three-day hospital stay, but with this method, the patient could go home the same day.

"This can really help reduce health-care utilization while maintaining excellent outcomes for our patients and be able to help more Albertans get the surgery they need in a more timely fashion," Yang said.

However, Yang warns "awake surgery" isn’t for everyone. He advises against doing it on patients who are obese, have anxiety or require a longer surgery because there can be more risks.

Meanwhile, Bene has been off work for six weeks and is about to start physiotherapy. He has advice for other patients:

"Just don't be scared of it. It'll change your life."