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Spine Surgery

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Overview

The Spine Institute at Miracle Mile Medical Center provides advanced diagnostic and treatment modalities for the relief of back pain and other spine disorders. Depending on a patient's diagnosis, surgery is most often the last resort. The Spine Institute offers an array of non-surgical services including chiropractic care, pain management, acupuncture, dietary assessment, psychological support, and physical therapy. If surgery is determined to be appropriate, the surgical team works with the patient to ensure the best results.

Lumbar Laminectomy - When narrowing of the spine compresses the nerve roots, causing pain and/or affecting sensation, doctors sometimes open up the spinal column with a procedure called a laminectomy. Laminectomy is most commonly performed to treat spinal stenosis. In a laminectomy, the doctor makes an incision down the affected area of the spine and removes the lamina (a portion of the vertebral bone) and any bone spurs, which are overgrowths of bone that may have formed in the spinal canal as the result of osteoarthritis. Removal of substantial amounts of bone and tissue may require additional procedures to stabilize the spine, such as a spinal fusion.

Spinal Fusion – When a degenerated disc is painful, the surgeon may recommend removing it and fusing the disc to help with the pain. This fusion can be done through the abdomen, a procedure known as anterior lumbar interbody fusion, or through the back, called posterior fusion. When a slipped vertebra leads to the enlargement of adjacent facet joints, surgical treatment generally involves both laminectomy (as described above) and spinal fusion. In spinal fusion, two or more vertebrae are joined together using bone grafts, screws, and rods to stop slippage of the affected vertebrae. Bone used for grafting comes from another area of the body, usually the hip or pelvis. In some cases, donor bone is used. Some newer technologies, such as artificial disc replacement, preserve spinal motion.

Disc Replacement – When a disc is herniated, one alternative to a discectomy – in which the disc is simply removed – is removing it and replacing it with a synthetic disc. Replacing the damaged one with an artificial one restores disc height and movement between the vertebrae.

Vertebroplasty - When back pain is caused by a compression fracture of a vertebra due to osteoporosis or trauma, doctors may make a small incision in the skin over the affected area and inject a cement-like mixture called polymethyacrylate into the fractured vertebra to relieve pain and stabilize the spine. The procedure is generally performed on an outpatient basis under a mild anesthetic.

Kyphoplasty - Much like vertebroplasty, kyphoplasty is used to relieve pain and stabilize the spine following fractures due to osteoporosis. Kyphoplasty is a two-step process. In the first step, the doctor inserts a balloon device to help restore the height and shape of the spine. In the second step, he or she injects polymethyacrylate to repair the fractured vertebra. The procedure is done under anesthesia, and in some cases it is performed on an outpatient basis.

Spine Surgery Procedures

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In Depth Data

Discectomy

A Discectomy (also called open discectomy) is the surgical removal of herniated disc material that presses on a nerve root or the spinal cord. The procedure involves removing the central portion of an intervertebral disc, the nucleus pulposus, which causes pain by stressing the spinal cord or radiating nerves. Advances in options have produced effective alternatives to traditional discectomy procedures (i.e. Microdiscectomy, Endoscopic Discectomy, and Laser Discectomy). In conjunction with the traditional discectomy, a laminectomy is often involved to permit access to the intervertebral disc. In this procedure, a small piece of bone (the lamina) is removed from the affected vertebra, allowing the surgeon to better see and access the area of disc herniation.

Spine Fusion

Spinal fusion, also known as spondylodesis or spondylosyndesis, is a surgical technique used to join two or more vertebrae. Supplementary bone tissue, either from the patient (autograft) or a donor (allograft), is used in conjunction with the body's natural bone growth (osteoblastic) processes to fuse the vertebrae.

Spinal Disc Replacement

Artificial Disc Replacement, also known as artificial disk replacement, refers to the artificial disc replacement surgery and to the man-made device, which replaces the entire function of the diseased or damaged intervertebral disc of the spinal column. The Artificial Disc Replacement (ADR) was developed to overcome the shortcomings of older fusion technology, which is associated with reduced flexibility, poor success rates, high re-operation rates and adjacent segment syndrome.

Spinal stenosis surgery

The operation involves surgical resection of the bone and soft tissues that are impinging on the nerves and/or spinal cord. Operation is generally considered only with persisting, intolerable symptoms

Orthopedic spine surgeon

The branch of surgery that deals with the correction of injuries or disorders of the skeletal system and associated muscles, joints, and ligaments.

Stenosis spine surgery

Narrowing of the spaces in the spine, resulting in compression of the nerve roots or spinal cord by bony spurs or soft tissues, such as disks, in the spinal canal. This occurs most often in the lumbar spine (in the low back) but also occurs in the cervical spine (in the neck) and less often in the thoracic spine (in the upper back). When symptoms are severe, surgery is necessary. The operation involves surgical resection of the bone and soft tissues that are impinging on the nerves and/or spinal cord. Operation is generally considered only with persisting, intolerable symptoms.

Lumbar spine surgery

A spinal fusion surgery is designed to stop the motion at a painful vertebral segment, which in turn should decrease pain generated from the joint. There are many approaches to lumbar spinal fusion surgery, and all involve adding bone graft to an area of the spine to set up a biological response that causes the bone graft to grow between the two vertebral elements and create a fusion, thereby stopping the motion at that segment.

Spinal cord surgery

If you've recently experienced a spinal cord injury, it might seem like every aspect of your life will be affected by this injury. A spinal cord injury often causes permanent disability or loss of movement (paralysis) and sensation below the site of the injury. Many scientists are optimistic that advances in research will someday make the repair of spinal cord injuries an attainable goal. In the meantime, treatments and rehabilitation allow many people with a spinal cord injury to lead productive, independent lives.

Minimally invasive spine surgery

A type of spine surgery that uses advanced, computer-assisted technology and highly specialized tools and provides patients with a quicker recovery after surgery, less post-operative pain, and smaller incisions than traditional open spine surgery.

Cervical spine surgery

The goal of cervical spine surgery is to relieve pain, numbness, tingling and weakness, restore nerve function and stop or prevent abnormal motion in the spine. Your surgeon does this by removing a disc or a bone and fusing the vertebrae together with a bone graft either in front of or behind the spine. The bone graft may be one of two types: an autograft (bone taken from your body) or an allograft (bone from a bone bank). Sometimes metal plates, screws or wires are also used to further stabilize the spine. These techniques are called instrumentation. When the vertebrae have been surgically stabilized, abnormal motion is stopped and function is restored to the spinal nerves.

Anterior and Posterior Fusion

Anterior Lumbar Interbody Fusion (ALIF) is a type of back surgery used to fuse the disc space of the spine through entering the front of the body through the abdomen. In an ALIF, an incision is made on the left side of the abdomen and the abdominal contents and muscles are pulled to the side to allow access to the front of the spine.
Posterior Lumbar Interbody Fusion (PLIF) is a spinal fusion surgical approach to fuse the disc space of the spine through entering from the back of the body. An incision is made at the midline of the back and the left and right erector spinae muscles are stripped of the lamina of the affected vertebrae to allow access to the nerve roots. The nerve roots are then retracted and the disc material is removed from the disc space and replaced with the bone graft and anterior interbody cages. As in any spinal fusion, the bone grows from vertebral body to vertebral body to stop the motion at the segment causing pain. PLIF has the advantage that it provides anterior fusion of the disc space without having a second incision as would be necessary with an anterior/posterior spine fusion surgery.

 
 
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