Calgary doctor believed to be 1st in Canada to perform spine surgery on conscious patient

In what's believed to be a first for Canadian health care, Todd Bene, a Calgary man who had chronic pain due to a damaged disc in his back, recently underwent spinal surgery while awake.

"The next day I was up cooking breakfast for my grandkids and everything else," he said. "It was just night and day pain-wise."

Bene had a disectomy last month at the Foothills Medical Centre to remove the damaged part of a herniated disc in his spine — something he said had contributed to intense pain and impacted his life negatively.

But after about 50 minutes in the operation room — the approximate length of the procedure — it all came to an end.

In a traditional case, a patient would be under anesthetics and intubated with a breathing tube.

In Bene's case, it was different. He was awake, even sitting on the table for part of the procedure. He was given a sedative, a local anesthetic instead of a general one, and was communicating with the doctors, including Dr. Michael Yang, who led the operation.

"The biggest benefit of doing [awake] spine surgery is that patients recover from their spine surgery much faster," Yang said.

"That's because the patient have less pain after surgery, less nausea, less vomiting after surgery … also without general anesthetic it causes less stress on the heart and lungs so that there's less risk of developing complications during the operation."

Yang explained that Bene had a previous heart attack, heart failure and that he also has coronary artery disease. So performing the surgery under general anesthetic posed a risk, Yang said, because it can induce a lot of stress in a patient and can lead to heart complications.

Yang became familiar with the innovative practice during his fellowship at the University of Miami, where such operations of this were a lot more common.

He noted that while the surgery itself was "minimally invasive," it was not necessarily groundbreaking in a procedural sense.

But the process and teamwork, and what it means for the future of health care and technology in Calgary, was.

"We do a lot of minimally invasive surgery in Calgary, but it's the collaboration between neuro-anesthesia and the whole team to be able to do it awake — that was innovation," Yang said.

"Having said that, we want to do more awake surgery in Calgary and we want to do more complex surgery awake in Calgary. So this is the first step in the grand plan of being able to do these."

Yang says the team plans to perform more procedures, and hopes to expand to some other types of spinal surgeries, in an effort to create faster timelines that could ease the pressure on the health-care system in the province.