CERVICAL, THORACIC & LUMBAR SPINE SURGERY
Procedures
Anterior cervical discectomy and fusion is a combined surgical procedure to decompress spinal nerves and stabilize the cervical spine. This surgery is performed to relieve pain, numbness, and weakness in the neck and upper back and to provide stability in this portion of the spine. As the name indicates, this procedure is performed through an incision at the front, or anterior, of one side of the neck. With this surgical approach, the disc can be accessed without disturbing the spinal cord, the neck muscles, and uninvolved spinal nerves. The operation is performed under general anesthesia.
The cervical spine begins at the base of the skull and consists of seven vertebrae with discs between them. One of the most important parts of the body, the neck is also the most articulate portion of the spine, moving more freely and in more directions than the other sections. Beyond that, the cervical spine is also responsible for protecting the spinal cord and providing support to the skull, which in turn protects the brain. Because of the neck’s vital functions, injury or disease of the cervical spine is a very serious condition.
This procedure is usually performed under local anesthesia in an outpatient setting but can be performed under general anesthesia. Kyphoplasty is performed through a very small incision and a hollow needle (trocar) is inserted into the skin through the back while the patient lays on their stomach. With the aid of fluoroscopy, a type of X-ray, the trocar is guided through the muscles and into the correct position in your bone. Next, an inflatable balloon is inserted into the trocar and the balloon is inflated to create the space needed for the bone cement and a cement mixture is injected to fill up the space. X-rays are taken throughout the procedure to ensure proper placement and to confirm the cement is distributed properly. Once the cement is in place it solidifies in approximately 10 minutes and a back brace is not needed to be worn afterwards.
Patients go home the same day as this is usually performed in an outpatient setting
Lateral lumbar interbody fusion (LLIF) is a spinal fusion technique performed from the side of the body rather than from the back or through the abdomen. Spinal fusion procedures are performed for the relief of persistent pain in the lower back, the lumbar region of the spine. Interbody fusion refers to surgery in which an interverterbal disc is removed and the adjacent vertebrae are joined. The connection between the two vertebrae is accomplished through the use of a bone graft. LLIF can be used to treat nerve compression, disc degeneration, spondylolisthesis, and other painful lower back conditions.
A minimally-invasive lumbar microdecompression procedure is ideal for treating conditions that cause pressure on the spinal nerves, such as lumbar spinal stenosis. It will attend to the cause of the symptoms, providing pain relief as well as improved mobility in patients. A minimally-invasive lumbar decompression procedure can also benefit those patients whose pain is the result of excess ligament. Using imaging technology to guide the procedure, your doctor will insert specialized instruments through the small incision to remove the ligament and bone putting pressure on your spinal canal.
Minimally-invasive lumbar microdecompression offers several benefits over traditional surgical approaches, including:
- Only a one-inch incision needs to be made
- It is typically an outpatient procedure
- Complications are rare
- No implants are used
- Recovery time is minimal, with patients generally returning to work and light activity in approximately one week
A microdiscectomy, also known as microdecompression spine surgery, is a surgical procedure that removes part of an impinged intervertebral disc in order to relieve pain, weakness, and numbness throughout the body. It is usually reserved for patients with severe symptoms that do not respond to more conservative treatments, and significantly affect the patient’s quality of life.
The microdiscectomy procedure is most effective in relieving lower back and leg pain caused by lumbar disc herniation, although it may be performed in the cervical and thoracic spine as well. A herniated disc is a common condition that occurs as a result of gradual wear and tear or an injury to the intervertebral discs, causing it to bulge and break open. Patients with this condition often experience pain, numbness, and weakness in the affected area, as well as through the legs or arms, depending on the location of the disc.
In some cases, microdiscectomy can be performed laparoscopically, in which surgical instruments and a camera are inserted through several tiny incisions. The camera allows the surgeon to magnify the view of the affected area and precisely remove the disc with no damage to the surrounding area.
Oblique Lateral Interbody Fusion (OLIF) is a minimally invasive surgery that involves stabilizing the spine from the back by placing screws, rods, and an interbody cage that contains bone graft to fuse the vertebrae together through the left oblique muscles to alleviate corresponding pain, weakness, numbness, and/or tingling.
This procedure is performed under general anesthesia and is usually done in two phases. During the first phase, an incision is made on the left lateral aspect of the abdomen below the 12th rib to access the spine and an interbody cage with bone graft is inserted through a corridor between the psoas muscle and the peritoneum after disc material and bone spurs are removed. By spreading a plane through the oblique muscles, there is less blood loss and scar tissue that forms. Neuromonitoring is done during this phase to help minimize nerve damage.
During the second phase, the patient is turned onto their stomach and screws and rods are inserted through two incisions off-midline. OLIF can be used to treat nerve compression, degenerative disc disease, spondylolisthesis, and other painful lower back conditions.
Most patients typically stay in the hospital for 1-2 nights following surgery, however some patients may go home the same day for single level lumbar fusions.
This procedure is performed under general anesthesia through a midline incision or two incisions off-midline at the back, or posterior aspect, of the lumbar spine. PLIF is one of the original approaches for lumbar interbody fusions and has evolved into more minimally invasive approaches such as the transforaminal lumbar interbody fusion (TLIF). This approach still allows excellent visualization and decompression of the nerve roots. Usually, two interbody cages with bone graft are inserted side by side after removal of the intervertebral disc. PLIF can be used to treat nerve compression, degenerative disc disease, spondylolisthesis, and other painful lower back conditions.
Most patients typically stay in the hospital for 1-2 nights following surgery.
This procedure is performed under general anesthesia through an incision at the back, or posterior aspect, either cervical, thoracic, or lumbar spine. With this approach, the appropriate levels can be accessed, decompressed, and ultimately fused together with metal screws and rods and bone graft that are placed along the back sides of two or more vertebrae instead between the disc spaces (interbody fusion).
This procedure is used to treat various spinal conditions such as spondylolisthesis, spinal fractures, tumors, or scoliosis and may be performed in conjunction with or without a posterior decompression (laminectomy).
Most patients typically stay in the hospital for 1-2 nights following surgery.
Scoliosis is a spinal deformity that causes a sideways curvature in your spine. The spinal deformity may cause a horizontal C- or S-shape in your spine, which affects the natural curve and structure of your spine. Scoliosis correction depends on the age and severity of the deformity. It usually involves stabilizing the thoracic and/or lumbar spine from the back, or posterior aspect, by placing screws, rods, and/or bone graft on the sides or in between (interbody) of multiple vertebrae to correct the deformity and to alleviate corresponding pain, weakness, numbness, and/or tingling if conservative treatment including physical therapy, medications, and bracing have been exhausted.
This procedure is performed under general anesthesia usually through a midline incision at the back, or posterior aspect, of the thoracic and/or lumbar spine. Other types of lumbar fusions such as an oblique lateral interbody fusion may be used in conjunction to help correct the scoliosis deformity. The Mazor-X robotic platform may be used to help assist in surgery for increased accuracy and precision and decrease anesthesia time.
Most patients typically stay in the hospital for 1-3 nights following surgery, depending on the extent of the scoliosis deformity.
A spinal cord stimulator is an implantable device that treats chronic nerve pain in the back. It works by disrupting the pain impulses sent from an injured nerve to the brain. This stops the pain signal from reaching the brain, which reduces or eliminates pain. It can transform debilitating pain into manageable pain and can be life changing for some patients.
The first step to using a spinal cord stimulator is a trial period to determine if it’s the right solution for your pain. If you get adequate pain relief during the trial phase, you may then have an implantable pulse generator placed permanently.
During the trial phase, the lead is inserted into the epidural space usually as an in-office procedure, but the pulse generator is not implanted. Instead, it is “worn” outside the body on the back for 2-7 days. The spinal cord stimulator company representative will program the pulse generator and instructs the patient on how to use the remote device to change the programming. The lead and generator are removed in the office after 2-7 days and pain relief percentage is documented. If 50% or more of pain relief is achieved, then the patient is a candidate for the permanent placement.
During the permanent phase, surgical implantation is done under general anesthesia. The permanent lead is inserted through a midline incision in the thoracic spine and tunneled to the pulse generator, or battery, which is implanted in the fat layer of the back, either on the right or left side depending on patient preference.
Patients go home the same day as this is usually performed in an outpatient setting.
Scoliosis is a spinal deformity that causes a sideways curvature in your spine. The spinal deformity may cause a horizontal C- or S-shape in your spine, which affects the natural curve and structure of your spine. Scoliosis correction depends on the age and severity of the deformity. It usually involves stabilizing the thoracic and/or lumbar spine from the back, or posterior aspect, by placing screws, rods, and/or bone graft on the sides or in between (interbody) of multiple vertebrae to correct the deformity and to alleviate corresponding pain, weakness, numbness, and/or tingling if conservative treatment including physical therapy, medications, and bracing have been exhausted.
This procedure is performed under general anesthesia usually through a midline incision at the back, or posterior aspect, of the thoracic and/or lumbar spine. Other types of lumbar fusions such as an oblique lateral interbody fusion may be used in conjunction to help correct the scoliosis deformity. The Mazor-X robotic platform may be used to help assist in surgery for increased accuracy and precision and decrease anesthesia time.
Most patients typically stay in the hospital for 1-3 nights following surgery, depending on the extent of the scoliosis deformity.
This procedure is performed under general anesthesia and when done minimally invasively, two incisions approximately an inch are made off-midline. Transforaminal refers to crossing the foramen, which is the opening within each of the spinal bones that allows nerve roots to pass through. This approach is chosen because it allows excellent decompression with minimal manipulation of the pinched nerve roots. Interbody fusion refers to the removal of an intervertebral disc, which is replaced with a spacer cage packed with bone graft to fuse the adjacent vertebrae together. TLIF can be used to treat nerve compression, degenerative disc disease, spondylolisthesis, and other painful lower back conditions.
This surgery is very similar to the posterior lumbar interbody fusion (PLIF) except that a TLIF exposure allows a larger and potentially safer window in which to place the cage, thus minimizing nerve root manipulation and potential damage. Robotic navigation may also be used to assist in surgery for increased accuracy and precision.
Most patients typically stay in the hospital for 1-2 nights following surgery, however some patients may go home the same day for single level lumbar fusions
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