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UC Health, Greater Cincinnati’s academic health system, has become the first health system in southwest Ohio to offer patients the option of awake spinal surgery.

The novel minimally-invasive technique utilizes spinal anesthesia instead of general anesthesia, providing more options to patients who require surgery for degenerative spinal disorders.

UC Health’s awake spinal surgery program was created by Owoicho Adogwa, MD MPH, physician-scientist at the UC Gardner Neuroscience Institute; and Jessica Garrett, MD, a UC Health anesthesiologist and assistant professor of anesthesiology at the UC College of Medicine.

“The implementation of an awake spinal surgery protocol, complemented by genotype-guided opioid therapy post-surgery, is a pivotal component of our holistic approach aimed at providing tailored, patient-centric spinal healthcare services within Cincinnati and beyond,” Adogwa said. “This approach is underpinned by the collaborative efforts of a multidisciplinary team, boasting expertise across a spectrum of disciplines, all dedicated to enhancing the well-being and quality of life of individuals afflicted with back pain and spinal pathologies.”

The first awake spinal surgery conducted by UC Health occurred at the University of Cincinnati Medical Center in late 2023. Melinda, a Cincinnati-area mother of three, had been undergoing non-surgical therapies from Adogwa for almost a year before the operation.

Melinda had a history of severe post-operative nausea in reaction to anesthesia, so Adogwa and Garrett started seeking alternative therapies when her treatment path reached the stage where she needed surgery. Throughout the 1.5-hour procedure, Melinda was awake and comfortably listening to music she enjoyed. She had no post-operative complications and was released from the hospital 3 hours after the operation.

“I’m the first, but because of how this all came to be, now other patients can benefit because we have paved the way for others to have the opportunity when they may not have otherwise,” Melinda said. “My care was unbelievably beautiful, thoughtful, compassionate. It was patient-focused. It was outcome-focused. It was a team effort.”

“As an anesthesiologist who cares for each of my patients individually, I worked with Melinda, Dr. Adogwa and the care team to provide safe, personalized care. This is just one example of how we tailor each anesthetic to the specific needs of each patient to accomplish the surgical objectives, so that we can provide the optimal patient experience,” Garrett said.

Under the guidance of Dr. Adogwa and his team, Melinda’s post-operative rehabilitation program has included physical therapy, cardiovascular exercises, and mindful practices like yoga. This holistic approach helped her regain strength and mobility quickly, and today she has regained her physical well-being.

As one of the few surgeons in the country cross-trained in orthopedic spine surgery and neurosurgery, Adogwa’s unique expertise helped launch this innovative program at UC Health. He hopes that it provides hope to other patients like Melinda.

“Our overarching objective is to establish the UC Gardner Neuroscience Institute as the nation's preeminent center for spinal care, distinguished not only by our innovative surgical methodologies but also by our commitment to achieving high patient satisfaction rates,” he said.