Endoscopic Spine Surgery is an ultra minimal invasive spinal surgical technique, performed through keyhole incision (usually < 1cm) to treat a range of spinal conditions. Dr Lee has undergone vigorous training in spine endoscopy and has started offering endoscopic spine surgery to suitable selected patients.

Proposed advantages of Endoscopic Spine Surgery include:

• Safe (as the procedure is performed under constant neuromonitoring which monitor spinal nerve function)
• Tiny incision
• Minimal muscle and bone dissection
• Reduced blood loss
• Reduced postoperative pain
• Reduced requirement for strong analgesia (pain killers)
• Early mobilisation and rehabilitation
• Reduced hospital stay
• Early return to work

For more information, visit Endoscopic Spine Surgery.

In general, Dr Lee would typically favour non-fusion surgery techniques such as lumbar decompression (aka laminectomy) or microdiscectomy to address spinal conditions that has failed extended period of conservative therapy.

However, some spinal conditions cannot be adequately addressed using non-fusion surgery techniques. Hence on the rare occasion, Dr Lee may have to recommend spinal fusion / lumbar fusion.

Spinal conditions that may require spinal fusion include:

1. Foraminal Stenosis. Foraminal stenosis occurs when the spinal nerve is being compressed exiting spinal canal. This is usually due to collapse of the disc space from disc degeneration. To address foraminal stenosis adequately, an interbody fusion cage (disc spacer) is inserted as part of spinal fusion to restore the foraminal height.
2. Spinal instability such as spondylolisthesis. Spondylolisthesis occurs when a vertebra slips forwards out of normal position over the other parts of the spine. This can occur in patients with pre-existing pars defect or from disc generation. There is often associated foraminal stenosis causing sciatica leg pain. Spinal fusion restores alignment and spinal stability. Spinal fusion also restores foraminal height in the setting of foraminal stenosis.
3. Revision Spinal Surgery such as for recurrent disc herniation or facet cyst. Spinal fusion is recommended in some patients who had previous spinal surgery as there is often scaring of the dura from previous surgery. Spinal fusion can avoid significant dissection of previously scared neural tissue, reducing risk of dural tear and nerve injury related complications.
4. Lumbar disc degeneration. While spinal fusion is typically done to address neural compression (address sciatic leg pain), on rare occasion spinal fusion is offered to patients with intractable discogenic back pain from single level and occasionally two-level disc degeneration.
5. Spinal deformity such as scoliosis.

However not all patients can have spinal fusion (even if the spinal problem is present). Contraindications for spinal fusions includes:

1. Osteoporosis. Due to weak bone density, spinal fusion may not be an option due to risk of implant failure/breakage.
2. Obesity.
3. Medical co-morbidities (other medical conditions precluding ability to have safe surgery) and age.

While spinal fusion may have a bad reputation traditionally, spine fusion techniques have improved significantly over the past decade. Spinal fusion can now be achieved using minimal invasive spine fusion techniques. Spinal fusion has its place in appropriately selected few patients.

Dr Lee will always take time to discuss clearly your spinal condition and the various spinal treatment options available.

Long term sufferers of back pain are often unsure when to seek specialist advice. Spine Surgeon, Dr Yu Chao Lee, discusses the common triggers.

Dr Yu Chao Lee was recently interviewed for the Surgical News magazine of the Royal Australasian College of Surgeons. Click through to read about how the RACS Margorie Hooper Travel Scholarship allowed him the opportunity to refine his surgical skills at the largest spinal deformity unit in Europe, and apply these expertise to his Adelaide practice.

To read the full article about Dr Lee’s medical career and his love for bonsais, check out page 39 of the publication here: https://www.surgeons.org/-/media/Project/RACS/surgeons-org/files/surgical-news/Artwork/JulAug_2021_SurgicalNews_web_updated.pdf?rev=

Dr Lee recently published on minimal invasive surgical algorithm for revision lumbar spinal surgery in the Journal of Spine Surgery to guide spinal surgeons select the most appropriate minimally invasive spinal surgical technique when undertaking revision spinal surgery.

Compared to traditional open spinal surgery, minimally invasive spinal surgery involves smaller incision, reduced muscle and soft tissue dissection. The aim of minimally invasive spinal surgery is to achieve outcomes similar to open techniques with lesser trauma and collateral injury to surround tissues. With specialised retractor and instrumentation system, spinal conditions can now be addressed through smaller working channel. Using intraoperative navigation technologies, spinal implants can also be inserted more accurately and through small percutaneous stab incisions in the skin.

For further information, visit: http://jss.amegroups.com/article/view/4715

International Podium Presentation: British Association of Spinal Surgeons Conference, Brighton, United Kingdom, April 3 – 5, 2019

Dr Lee recently attended the British Association of Spinal Surgeons (BASS) Conference and Exhibition in Brighton, U.K. This conference was attended by spinal experts across the world to exchange knowledge on the recent advances of spinal surgery.

Dr Lee presented his research on early experience and clinical results using expandable hyperlordortic cages for anterior lumbar interbody fusion in patients with adult spinal deformity.

Dr Lee will be returning home to Adelaide after a year of working abroad in the United Kingdom. Dr Lee had been working at the Royal National Orthopaedic Hospital (RNOH), Stanmore, the largest spinal deformity centre in Europe. During his time at the RNOH, Dr Lee worked closely with local spinal surgeons specifically Mr Robert Lee, Mr Hanny Anwar and Mr Julian Leong on managing complex spinal conditions such as adult spinal deformity, paediatric spinal deformity, revision spinal surgery and spinal tumours.

Dr Lee would like to thank all surgeons and staff at the RNOH for the wonderful experience.

Dr Lee is excited to be returning home and providing a high-quality spinal service to the community of Adelaide.

International Podium Presentation: British Association of Spinal Surgeons Conference, Brighton, United Kingdom, April 3 – 5, 2019

Dr Lee recently attended the British Association of Spinal Surgeons (BASS) Conference and Exhibition in Brighton, U.K. This conference was attended by spinal experts across the world to exchange knowledge on recent advances in spinal surgery.

Dr Lee presented his research on the incidence of new onset sacroiliac joint pain following lumbar fusion surgery. In addition, Dr Lee also presented a poster on using intraoperative navigation for sacroiliac joint fusion.

For more information on sacroiliac joint dysfunction, please click here.