Trinity adopts latest technologies in medical therapy

Dr. Charles Wood, a Trinity neurosurgeon, performs a spine procedure. Submitted Photo

Medicine continues to make great strides in treating illness and getting patients back on their feet faster. Trinity Health in Minot has recently added new procedures and equipment to benefit patient health, improving care in areas of spine surgery, skin cancer, depression and hemorrhage.

In March 2017, Trinity became the first hospital in North Dakota to offer Transcranial Magnetic Stimulation, a treatment option for patients with a history of resistant depression. Dr. Kenneth Osiezagha, psychiatrist with Trinity’s Behavioral Health Department, reported impressive results using the new therapy.

Transcranial Magnetic Stimulation is a non-invasive and non-drug treatment option approved by the Food and Drug Administration in 2008 for patients who have failed to respond to antidepressant medications and who have recurrent major depressive disorder.

According to information from Trinity, depression results from the poor functioning of the part of the brain that regulates emotion. Transcranial Magnetic Stimulation delivers repetitive magnetic pulses to the under-active neurons, leading to the release of neurotransmitters.

The procedure is done in-office, in a specialized chair much like a dentist’s chair, with a treatment coil placed on the patient’s head. The typical protocol is five treatments a week for four to six weeks. The first treatment of about three hours is typically the longest and involves consultation with the physician about the procedure and “mapping.” The mapping helps locate the proper location for pulses to be delivered. Subsequent sessions can last 30 to 45 minutes.

Another newer treatment at Trinity is small-incision spine surgery.

Dr. Thomas Frimpong, a neurological and spine surgeon, brought small-incision spine surgery to Minot, having been fellowship-trained in minimally invasive and complex spinal surgery.

“Minimally invasive surgery has made steady progress across every surgical specialty, primarily because patients see its benefits,” Frimpong said in a release about the surgery. “They understand that an operation performed through a small puncture instead of a large incision produces less tissue trauma and avoids significant damage to the muscles surrounding the spine, which generally means a quicker recovery.”

Minimally invasive techniques can now be applied to the most common spinal disorders, such as nerve decompressions, degenerative disc disease, herniated discs, scoliosis and other spinal deformities, spinal stenosis, and even some fusion and stabilization procedures.

Spine surgeons face challenges with minimally invasive surgery that their counterparts in other specialties often don’t. Spine surgeons must operate within the tight confines of the spinal anatomy, where sensitive neurovascular structures require extra care and caution.

Trinity explains these limitations were initially overcome with surgical microscopes inserted through tubular retractors. For complex surgeries, more sophisticated imaging techniques were required. Fluoroscopy, an X-ray machine in the shape of a C that gives surgeons a 360-degree view of a patient’s spine in real time, served that purpose. More recently, image-guided, computer-assisted methods have revolutionized spine surgery.

“These image-guided approaches have enhanced our ability to navigate complex spinal anatomy in real time,” Frimpong said. “By combining imaging, navigation systems, and software, we’re able to visualize the patient’s spine during surgery in three dimensions and precisely track the location of our surgical instruments in relation to the anatomy, which leads to improved surgical outcomes.”

Another innovation is osteobiologics – the science of engineering bone. Osteobiologics enables doctors to perform spinal fusions with bone graft substitutes so they no longer have to harvest bone from a patient’s pelvis.

The result is spinal surgery that used to require seven or eight hours now frequently can be performed as an outpatient procedure.

Trauma patients are the beneficiaries of another new technique using a balloon device to stop fatal bleeding. Acute internal hemorrhage is the leading cause of death in trauma patients, said Dr. Gary Wease, director of Trinity’s Trauma Program.

Traditionally, doctors had to stop uncontrolled bleeding by performing major surgery that involved a large chest incision to put a clamp on the aorta, the body’s main artery. The new catheter with a collapsed balloon at its tip employs a technology similar to the technique cardiologists use to open arteries of the heart. The catheter is inserted into the femoral artery of the leg and threaded up into the aorta. Once the balloon has reached the optimal spot, it’s inflated, causing a temporary blockage of the aorta.

Earlier this year, Trinity Health became the first North Dakota hospital and one of nearly 250 worldwide to have staff trained to offer the device.

Introducing yet another innovation, the Trinity CancerCare Center acquired a form of radiation therapy for treating non-melanoma skin cancer. Dr. Michael Grant, radiation oncologist, said the technique, called skin brachytherapy, is ideal for treating cancers on areas of the body that are cosmetically sensitive.

“It’s a very good treatment option for non-melanoma cancers on the head, neck and face – obviously visible areas where you want to avoid scarring or noticeable grafts. It’s particularly excellent for cancers on the nose, ears and other facial features that don’t lend themselves to surgical closure,” Grant said in a release about the new procedure.

Skin brachytherapy is non-invasive and pain-free. It reduces the risk of recurrence if there are remaining cancer cells after small resections.

During the treatment, a small, lightweight surface applicator is placed on the lesion and connected to the treatment machine, which delivers a carefully calibrated dose of low-energy X-ray to the target area. It’s very precise and comes with unique shielding tools to protect healthy tissue.

Grant said the system also has applications for other types of cancer, such as gynecological cancers.