Spinal Treatment & Surgery

Minimally Invasive Approaches

A minimally invasive surgical approach is a unique technique of carrying out surgery with insignificant damage to adjoining tissues and with a more rapid recovery. Minimally invasive surgeries can be employed to treat fractured vertebrae, lumbar instability, spine deformities such as scoliosis or kyphosis, cervical disc hernias, tumors, back pain and failed back syndrome. Spondylolisthesis, a painful disorder of the spine produced by disc displacement or slipped disc, can be treated with minimally invasive lumbar fusion procedure.

Disc Disease

Degenerative disc disease is slow degeneration of the discs joining the vertebrae, the spinal bones of the back. It is a common occurrence with ageing where the discs start losing fluid. Loss of fluid in the discs diminishes the proficiency to work as shock absorbers and accordingly produces loss of flexibility. The exterior ring of the disc called the annulus fibrosis, becomes weak and is more prone to develop tears. Correspondingly at the same time the nucleus pulposus, the central softer segment of the disc, becomes desiccated and contracts. As a consequence the disc center leaks out through the tears in the annulus and causes the disc to bulge or rupture.

 

Back Pain

Back pain is often a frequent symptom of numerous disease conditions. Back pain may vary from simple or dull pain to abrupt and sharp pain. If the pain continues for limited days, it is considered acute pain. However, if it continues for more than 3 months, it is deemed as chronic pain. In most cases, back pain will resolve without any treatment but if it lasts for more than 3 days, medical intervention is essential.

 

Spinal Tumors

Spine tumor is anomalous uncontrolled growth of tissue or cells in and around the spinal cord. Tumors can be categorized as cancerous (malignant) and non-cancerous (benign). Certain benign spinal tumors include osteoma, osteoblastoma, hemangioma, and osteochondroma. However malignant spinal tumors include chondrosarcoma, Ewing’s sarcoma, lymphoma, osteosarcoma, and multiple myeloma. Tumors that arise in the spine are called primary spinal tumors. Tumors that spread to the spine from further parts such as the breast, prostate, lung, and other areas are called secondary spinal tumors.

 

Trauma

Spine trauma is impairment of the spine due to injury caused by an accidental fall or any other physical injury. Spinal injuries may arise while playing, executing normal activities, controlling heavy machines, lifting heavy objects, driving automobiles, or when you undergo a fall. Injury to the spine may result in numerous conditions comprising fractures, dislocation, partial misalignment (subluxation), disc compression (herniated disc), hematoma (accumulation of blood) and partial or complete tears of ligaments.

 

Anterior Cervical Discectomy – Inter Body Cage

An Anterior Cervical Discectomy – inter body cage is performed to treat damaged cervical discs. This surgery approaches the spine from the front. A skin crease cut is made across the side of the neck.

An x-ray is taken during surgery to confirm the correct level of the spine before removing the disc. Using a microscope the damaged disc is removed. Any bony spurs which may be compressing the nerve roots and spinal cord are also removed.

Once the disc is removed, the space between the neck bones is empty. To prevent the bones from collapsing and rubbing together, the open disc space is filled with an interbody cage. An interbody cage is a prosthetic device used to maintain the normal height of the disc space.

The interbody cage is filled with a bone graft substitute and some of your own bone. This fuses the two neck bones together which prevents the bones rubbing together and collapsing.

The cut will be closed with sutures or staples.

 

Cervical Foraminotomy

A Cervical Foraminotomy is performed to relieve cervical spinal nerve compression.

An X-ray is taken during surgery and used to confirm the correct level of surgery.

A cut is made in the back of the neck.

A small amount of bone and ligament is removed from the spine to gain access to the nerves of the spine.

The structures which are compressing the nerve are removed to create space around the affected nerve.

The cut will be closed with stitches.

 

Cervical Laminectomy

A Cervical Laminectomy is performed to relieve the pressure on the spinal cord in your neck.

A cut will be made in the skin at the back of your neck. X-rays will be taken during surgery and used to confirm the correct levels of the spine.

Small portions of bone and ligaments will be removed from the affected cervical spine to relieve the pressure on the spinal cord.

The cut will be closed with stitches or staples.

 

Cervical Laminoplasty

A Cervical Laminoplasty is performed to repair a restricted spinal canal. The procedure creates more space for the spinal canal and nerve roots immediately relieving pressure.

This method is sometimes called an open door laminoplasty, because the back of the spine is made to swing open like a door.

A cut is made on the back of the neck. Muscles on the back of the cervical spine are stripped from the back of the spine to identify the area of compression.

A groove is cut down one side of the spine to create a hinge.

The other side of the spine is cut all the way through.

The tips of the bones on the back of the spine are removed to create room for the spine to swing open like a door.
The back of each spinal bone is opened, taking the pressure off the spinal cord and nerve roots.

Small wedges of bone are placed in the opened space which allows the bone door from completely closing on the spinal cord.

The cut will be closed with stitches.

 

Insertion of Syrinx Shunt

A Syrinx is a disease in which fluid filled cavities form within the spinal cord and compress the nerve fibres.

A Syrinx shunt is a tube (shunt) inserted into the fluid filled cavity within the spinal cord to allow the fluid to drain away.

A cut in the skin is made which corresponds to the correct level of the fluid filled cavity. Some bone from the spine is removed and a small cut is made in the spinal cord.

A small piece of plastic tubing (shunt) is placed into the fluid filled cavity. The fluid from the cavity can be drained into the fluid around the spinal cord or to another site.

The cut will be closed with stitches or staples.

 

Lumbar Decompression Laminectomy

This procedure is performed to relieve pressure on the nerve roots in the lower back.

An x-ray will be taken during surgery and used to confirm the correct level of surgery.

A cut is made down the middle of the back, over the site where the nerves are compressed.

The muscles are stripped from the bones at the back of the spine. The bones on the back of the spine (spinous process and laminae) are removed from the spine.

Further bone and ligament is removed until the pressure is relieved from the nerves of the spine.

A small plastic tube (drain) may be inserted to allow any residual fluid to be drained away. This will be removed within 24 – 48 hours.

The cut is closed with stitches or staples.

 

Lumbar Decompression & Pedicle Screw Instrumented Fusion for Spondylolisthesis

This procedure is performed to relieve pressure on the fibrous sheath which contains the spinal nerves and stabilise the spine from slipping forward.

X-rays will be taken during surgery to determine the correct levels of surgery.

A cut is made down the middle of the back, over the decompression site. To decompress the spine, the muscles are stripped from the bones at the back of the spine. The bones on the back of the spine (spinous process and laminae) maybe removed from the spine to relieve pressure.

Following the decompression, supporting screws are inserted into the pedicles of the vertebrae which require support. Sometimes, a computer navigation system is used for screw placement.

X-rays are taken to ensure the screws are in the correct place. The screws are then joined together with a number of rods and nuts.

A separate cut may be made over the hip to harvest some hip bone. Harvested bone is sometimes mixed with a bone substitute. It is then packed along the sides of the rods to fuse the spine.

A small plastic tube (drain) may be inserted to allow any residual fluid to be drained away. This will be removed within 24 – 48 hours.

The cut is closed with stitches or staples.

 

Lumbar Laminectomy for Discectomy

A Lumbar Laminectomy for Discectomy is performed to remove a prolapsed disc or disc fragments to relieve pressure on the spinal nerve roots or spinal cord.

An x-ray will be taken during surgery and used to confirm the correct levels of the spine.

A cut is made in the middle of the back, over the site of the prolapsed disc. The muscles are stripped from the back of the spine. The bones on the back of the spine (spinous process and laminae) are removed from the spine.

Further bone and ligament are removed from the spine to identify the disc.

Once the prolapsed disc is identified, the prolapsed disc or disc fragments are removed from the spine.

A small plastic tube (drain) may be inserted to allow any residual fluid to be drained away. This will be removed within 24 – 48 hours.

The cut is closed with stitches or staples.

 

Lumbar Microdiscectomy

A Lumbar Microdiscectomy is performed to remove a prolapsed disc or disc fragments to relieve pressure on the spinal nerve roots or spinal cord.

An x-ray will be taken during surgery and used to confirm the correct level of surgery.

A small cut is made in the middle of the back over the site of the prolapsed disc. With the help of a microscope the prolapsed disc is identified. Once identified, the prolapsed disc or disc fragments are removed from the spine.

A small plastic tube (drain) may be inserted to allow any residual fluid to be drained away. This will be removed within 24 – 48 hours.

The cut is closed with stitches or staples.

 

Minimally Invasive Decompression for Lumbar Canal Stenosis

This procedure is performed to relieve pressure on the spinal cord and nerve roots in the lower back.

A small cut is made in the back, over the site where the nerves are compressed.

Using x-ray for guidance, a tube retractor will be passed through the muscles and placed down on the spine. Through this tube, and using a microscope, bone and ligament and other material which are pressing on the spinal cord and nerves will be removed.

A small plastic tube (drain) may be inserted to allow any residual fluid to be drained away. This will be removed within 24 – 48 hours.

The cut is closed with stitches or staples.

 

Minimally Invasive Lumbar Discectomy

This procedure is performed to remove a prolapsed disc or disc fragments which will relieve the pressure on the spinal nerve roots or spinal cord.

A small cut will be made to the side of the middle of the back.

Using x-ray for guidance, a tube retractor will be passed down through the muscles on the back and placed over the correct area of the spine.

Through this tube, and using a microscope, bone and ligament and other material will be removed to identify the disc.

Once the disc is identified, the prolapsed disc or disc fragments are removed from the spine.

A small plastic tube (drain) may be inserted to allow any residual fluid to be drained away. This will be removed within 24 – 48 hours.

The cut is closed with stitches or staples.

 

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