St. Louis native H. Dennis Mollman, MD, PhD, helped pioneer the use of minimally invasive technology during his years as a spine surgeon in Minnesota. With his arrival at SLUCare–The Physicians of Saint Louis University, he now applies a seasoned understanding of that technology as well as decades of broad surgical experience to produce superior outcomes for patients from throughout the region.
Historically, spine surgery regularly entailed 12-inch incisions and three months of recovery time. Today, however, minimally invasive spinal procedures can yield not only excellent outcomes but also numerous other benefits. Those benefits, according to Dr. Mollman, neurosurgical spine surgeon for SLUCare, include:
- incisions of 1–2 inches in length
- recovery times reduced by half
- markedly lower risk of infection
- less postoperative pain
- fewer complications
Dr. Mollman utilizes the O-arm 3-D imaging system for virtually all spine surgeries, and his knowledge of the minimally invasive technology is exceptional — in part because he trained on the first two O-arms in the country while practicing in Minnesota.
“I’ve been using it since 2006 and have handled a very large number of cases,” he says.
His expertise with the O-arm allows him to make expansive use of its capabilities.
“We use the O-arm in a very cutting-edge manner,” he says. “Many surgeons utilize it to start or follow up on cases, but they don’t use it for navigation during the procedure. I use the O-arm to guide the procedure throughout. It’s like a GPS. Everything is navigated with the device.”
For a patient with degenerative spine disease in the low back, for instance, the O-arm’s guidance system attaches to a hip bone in the back, scans the patient’s spine in real time and sends that data to a computer on which the image of the spine is displayed, Dr. Mollman says. The guidance system and the images it provides facilitate precise placement of screws, rods and grafts via small incisions.
The procedure typically requires a hospital stay of only three days, compared with up to 10 days for an open procedure. Blood loss is reduced from nearly 1 liter to 100 cc or less.
Broader Scope of Care
The O-arm’s precision and Dr. Mollman’s expertise with the equipment are evident in patient outcomes.
“For open surgery done with fluoroscopes, the error rate in terms of a screw not being optimally positioned is about 10 percent,” he says. “Those patients often require revision surgery. With the O-arm, in my last 1,000 cases, we’ve had no mal-positioned screws.”
Recent research — including a paper Dr. Mollman is currently writing — found no infections in 5,000 patients who underwent minimally invasive spinal procedures, compared with a typical infection rate of 0.8 percent for open surgeries.
In addition, O-arm procedures have made surgery a more promising option for the elderly.
“Everything is addressable with this technique: scoliosis, degenerative disease, herniated discs and other conditions,” Dr. Mollman says. “We’ve performed minimally invasive fusions on people in their late 80s and early 90s, and they actually do quite well.”
SLUCare–The Physicians of Saint Louis University practices at multiple locations throughout the St. Louis area. To refer patients to Dr. Mollman, please call 314-577-8717. For more information, visit slucare.edu/neurosurgery.