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Surgical treatment optionsMicrodiscectomyA microdiscectomy is typically performed for a herniated lumbar disc. In a microdiscectomy, a small window is made in the bone over the nerve and disc and the portion of the disc that is compressing the nerve is removed. A microdiscectomy is performed through a small (1 to 1.5 inch) incision in the back. Muscles are moved aside to allow the surgeon to see the bone to be removed and then see the nerve and disc. The surgeon positions a surgical microscope or uses magnifying loupes to illuminate and magnify the nerve and surrounding structures so they can be seen clearly. This procedure is often done on an outpatient basis. Anterior Cervical Discectomy and FusionAnterior cervical discectomy and fusion (ACDF) is a surgical treatment for patients with cervical disc disease causing arm and/or neck pain. In an ACDF, an incision is made on the front of and to one side of the neck. An assistant gently protects the trachea (windpipe) and esophagus (the connection between the mouth and stomach) so that the surgeon can remove the disc. Removing the disc relieves pressure from the nerve roots and/or spinal cord. To maintain the space between the vertebrae, a graft is placed where the disc had been. The body will then fuse this area growing new bone to join the two spinal vertebrae together. The fusion also helps to maintain adequate space for the decompressed spinal cord and/or nerve roots. Anterior cervical fusions are also performed to treat cervical instability due to trauma (fractures or dislocations), tumors, infection or kyphosis – a deformity of the spine. Depending on the condition being treated, this may also be an outpatient procedure. LaminectomyA laminectomy involves removing the bone that forms the back part of the spinal column. It can be done to remove pressure from the nerves or spinal cord. A laminectomy can involve a single level of the spine or multiple level in some cases. The procedure may be the only surgical treatment needed or may be a part of a spinal fusion or other operation. It is a common surgical treatment for spinal stenosis. Lumbar spinal fusionA lumbar spinal fusion is done to eliminate motion at a vertebral segment, which in turn should decrease pain. This procedure is often used to treat low back pain from degenerative disc disease. It is also done to treat pain from an unstable spine as a result of a tumor, fracture, scoliosis or other deformity. In a lumbar spinal fusion surgery, a degenerated disc may be replaced with a graft. The graft causes the 2 vertebrae segments to grow together into one bone, thereby eliminating the motion and the pain. In many cases, lumbar spinal fusions are supported by implanting spinal hardware in the form of screws and rods to hold the spine still while the body "fuses" a bone graft. Minimally invasive lumbar fusionSome patients can be treated effectively with a minimally invasive lumbar fusion. In this procedure, the surgeon uses different devices, which require a much smaller incision than a traditional spinal fusion, causing less trauma to the surrounding tissues. This typically results in a faster recovery for the patient. Vertebroplasty and kyphoplasty for spinal compression fracturesVertebroplasty and kyphoplasty are procedures to reduce the pain of vertebral compression fractures associated with osteoporosis, tumors, and trauma. Both vertebroplasty and kyphoplasty involve the injection of acrylic cement into a fracture vertebra to control pain and prevent the vertebrae from further collapse. For some patients, the techniques can be performed as an outpatient procedure. Kyphoplasty differs from vertebroplasty in that it also is designed to restore the height of a compressed vertebrae by inflating a balloon in the vertebrae before the acrylic is injected. Both procedures provide pain relief from vertebral compression fractures. Intradiscal Electrothermal Therapy (IDET)IDET is a minimally invasive, outpatient treatment option for chronic low back pain due to degenerative disc disease or contained disc herniation. IDET provides some patients with pain relief. IDET involves inserting a catheter into the disc and heating it up. This procedure helps some people reduce their pain without undergoing spine surgery. Treatment of congenital abnormalities of the spine Treatment options are available for congenital abnormalities of the spine including neural tube defects such as spina bifida. Congenital abnormalities are conditions that are present from birth. In many cases, when congenital abnormalities of the spine need surgical treatment, it is useful for a multi-disciplinary team of doctors to evaluate and treat the patient. Get maps, directions, phone numbers and more
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