Back Surgery Approach Poses No Threat to Male Fertility

March 7, 2011

Young men with back pain may opt out of spinal fusion or other such surgeries in exchange for a cutting-edge procedure which may preserve male fertility.

Young men with back pain may opt out of spinal fusion or other such surgeries in exchange for a cutting-edge procedure which may preserve male fertility.

Spinal fusion, while a common procedure for many patients whose back pain is chronic, poses a moderately high risk of damaging male fertility. This is not the only surgery to carry such a side-effect, however; some approaches to back surgeries can cause as many as 40 percent of male patients to encounter fertility issues.

During the surgery, clumps of miniscule nerves located in the abdomen which affect sexual function and fertility can be damaged. Recently, surgeons at the University of Pennsylvania have been testing a high-tech approach to solve this problem, hoping to eliminate this risk.

A three dimensional robotic operating device has been implemented into many of the back surgeries performed at this hospital, the goal being to avoid harming the nerves that control sexual function during procedures.

Anthony Williams, a man in his early twenties, was in a car accident that left him with a herniated and bulging disc which caused him increasingly intolerable pain. With surgery as his best option, he received a procedure using the robotic approach and reports that his pain has been alleviated with no side effects.

"At 20, 21...Looking ahead as far as a family," said Williams.

Using the robot, urologists can assess the situation and advance the surgical instruments before the neurosurgeons step in to fuse the spine endoscopically.

“We could actually see these individual nerves branching off and spreading out," said Daniel Eun, MD, Assistant Professor of Urology at the University of Pennsylvania School of Medicine and Director of Minimally Invasive Robotic Urologic Oncology and Reconstruction at The Pennsylvania Hospital. “If you can see them, you can spare them.”

While the robot-assisted approach to spinal surgery has been approved by the FDA, the approach is not used by neurologists during the spinal fusion itself.