Awake Spine Surgery: Dr. Andrew Chan Looks to a New Frontier in Treatment

Thomas Anderson Shares His Awake Spinal Microdecompression Surgery Story

On the afternoon before Thomas Anderson was to receive his awake spine surgery, he got a call from Dr. Andrew Chan. “I assumed they were going to ask me a few more questions about my medical history,” says Tommy, a 89-year-old man who despite trying to remain active had been suffering from debilitating back pain for twelve years. 

But Dr. Chan asked, “Can you tell us what’s your favorite opera?”

For some background, Tommy had been preparing for his awake spinal surgery. Awake spine is a new horizon in neurosurgery, where the patient does not have to undergo general anesthesia. Instead the surgery is performed while the patient is awake, providing  an alternative for patients who are unable to go under general anesthesia due to comorbidities, patients who are not comfortable with “going under” and for patients, like in Tommy’s case, who are elderly and have increased risks associated with anesthesia including the additional stress it can cause on the heart and lungs. 

Tommy, an NYC resident who has retired from an incredible career in Hollywood, working with the likes of Elizabeth Taylor on the launch of her iconic White Diamonds perfume, had previously been a strong athlete even in his late eighties.  “I can run for five miles around the Central Park Reservoir,” he says proudly.  But Tommy started to suffer from terrible back pain and after twelve years and two previous surgeries, even sitting for more than ten minutes left him in incredible pain. 

After Tommy took a fall in his apartment, he knew he needed to try another approach and  was eventually connected to Dr. Andrew Chan (profile).

Dr. Chan says, “The goal of minimally invasive spine surgery is to decrease complications, recovery times, and postoperative pain. Aligned with this aim, the use of local and spinal anesthetic allows spine surgery to be performed without general anesthesia. The risks of intubation and induction are eliminated, and adverse effects from this process, such as nausea and memory loss, can be avoided. Also, the cardiopulmonary risks—including hemodynamic instability and cardiac dysrhythmias—are avoided. This permits surgery to be performed in those in which general anesthesia would be contraindicated, including elderly patients and those with high perioperative risk due to medical comorbidities. “

For this case, Dr. Chan closely partnered with Dr. Anis Dizdarevic (profile) “Spinal anesthesia, using local anesthetics, combined with sedation, presents a very compelling alternative to general anesthesia and opioids for select patients undergoing spine surgery procedures,” says Dr. Dizdarevic, who serves as an Associate Professor of Anesthesiology. “Patients feel no pain during the surgery and in the recovery, can select desired levels of sedation and relaxation and have faster recovery with less side effects.  Our anesthesiology team works in close collaboration with surgical colleagues to provide the best and safest experience for our patients.”

Tommy shares, “Dr. Chan was extremely easy to work with and he immediately allows for you to open up.  I respected that he said there is never a 100% chance of success and ‘This is your decision, Tommy’ but he felt confident he could help me. My instincts told me this was the right person for the job.”

On the day of the surgery, Dr. Chan’s team prepared Tommy for the awake procedure.  The reason for the ‘favorite opera’ question was so the team could give Tommy (who has shared with the team his deep love of opera) a set of headphones with La Boehme playing to help him feel relaxed and peaceful. 

As for being awake during a spine surgery, Tommy shares that he felt absolutely no pain.  “I was totally comfortable, not quite asleep but not quite awake. I remember Dr. Chan coming to my head at the table and despite his surgical mask, his eyes smiled at me and made me feel totally relaxed.”

As for the results, Tommy shares that he recovered for one night in the hospital and by the next day he had no pain. “Not even a twitch,” says Tommy. “I felt wonderful.”

As for others who are suffering from chronic back pain, Tommy advises it’s important never to rush into any type of procedure, “The fact that Dr. Chan took so much time to evaluate my case was what made me comfortable and less afraid. I did my part and the team did theirs. Sometimes if you have faith, you are going to receive a miracle.”