Medical miracle in Jerusalem: 74-year-old awake during back surgery

Hadassah is the only hospital in Israel that can perform the surgery this way.

David Avital with his Hadassah doctors (photo credit: Courtesy)
David Avital with his Hadassah doctors
(photo credit: Courtesy)
Hadassah Medical Center recently performed a unique and complex operation on a 74-year-old patient with a fractured spine. During the procedure, he was fully awake.
When David Avital fell at home, he fractured his spinal vertebrae. Upon arrival at Hadassah-University Medical Center in Jerusalem’s Ein Kerem, the orthopedic specialists determined that he would need emergency surgery.
However, given Avital’s age and that he suffers from severe heart and lung problems, undergoing traditional back surgery in which he would be anesthetized and lying on his stomach put him at high-risk. As such, the Hadassah team decided to perform the operation in a way unique to its hospital: awake, with only local anesthesia. 
Hadassah is the only hospital in Israel that can perform the surgery in this manner. 
"Fracture is a common fall injury in adults that sometimes causes them instability or uncontrollable pain, and they need surgery to recover – and the recovery and rehabilitation process is much more difficult after these surgeries," explained Dr. Josh Schroeder. "On the other hand, we know that the danger of general anesthesia in adults increases due to background diseases from which they suffer.”
The Hadassah team therefore decided to keep Avital awake for back surgery that included the insertion of screws and rods to fix the bone fragments, using advanced simulation navigation that allows for maximum accuracy with minimal cuts. “Cement” – a material for fixing vertebrae – was also injected. 
"When I entered the operating room I was very frightened," Avital said. “I did not feel any pain at all.”
“This case demonstrates a modern approach to surgery,” said Prof. Jose Cohen, director of the Endovascular Neurosurgery Unit at Hadassah. “Thanks to a multidisciplinary team and advanced equipment, we at Hadassah are able to bring the most advanced [techniques of] medicine in the world."