In many cases of back and neck pain, conservative measures such as medication by mouth or injection, exercise and physical therapy can be successful in eliminating the problem. But when these measures do not work, surgery may be an effective alternative.
There are many surgical options depending on your diagnosis. The specialists at the Spine Center perform more than 2,500 procedures annually and offer the latest minimally invasive techniques to help you recover faster. We have designated surgical suites that are fully equipped and staff specially trained for these specific surgical procedures and recovery.
After surgery, we plan continuing rehabilitation with each patient’s physician before she or he leaves the hospital. This may include additional treatment at Thoms Rehabilitation Hospital or physical therapy through the physician’s office or the patient’s local hospital or rehabilitation facility.
See Jonathan D. Sherman, MD discuss surgical options for a variety of spine problems.
Relieving Pressure on Spinal Nerves
Discectomy
The discs that cushion sections of vertebrae can weaken and bulge, putting pressure on spinal nerves. When this happens, the resulting condition is referred to as a herniated disc. Discectomy is the most common surgical treatment for herniated discs. During a discectomy, the bulging part of the disc is carefully removed to relieve the pressure. This process may also require a laminectomy or laminotomy to gain access to the affected disc.
See K. Craig Boatright, MD discuss discectomy.
Laminectomy and Laminotomy
Just as discs can put pressure on nerves, so can the bones of the spinal column. Laminectomy and laminotomy procedures relieve this pressure. These surgeries involve removing part or all of the lamina, the back part of the bone that covers the spinal canal, to relieve pressure on the spinal cord and nerve roots. These procedures are most often performed to treat leg pain related to herniated discs, spinal stenosis and other related conditions and may be performed in conjunction with a discectomy.
Foraminotomy
This surgery enlarges the passageway where a spinal nerve root exits the spinal canal. During this procedure, the surgeon removes bone or tissue that obstructs the passageway to relieve pressure and reduce inflammation. Disorders that can cause nerve root compression include spinal stenosis, degenerative disc disease, bulging or herniated discs and bone spurs.
Interspinous Vertebral Decompression
This procedure uses a titanium implant to treat pain caused by spinal stenosis. Spinal stenosis is a narrowing of the spinal canal, which puts pressure on the spinal nerves and causes back pain and/or weakness, numbness or pain in the legs. During this minimally invasive procedure, surgeons use x-ray guidance to insert the titanium implant between the spinous processes (bones that slightly protrude off the back of each vertebral body, to which muscles and ligaments are attached). The implanted device distracts the space and maintains the spine in a slightly flexed position, relieving the pressure on the spinal nerves. Interspinous Vertebral Decompression is usually a one-hour, outpatient procedure performed with local anesthesia, and most patients are able to resume their normal activity within two weeks.
Strengthening and Stabilizing the Back
Vertebroplasty
This minimally invasive procedure is performed to treat certain conditions such as osteoporosis and some spinal tumors that can cause fractures, bone collapse and pain. Vertebroplasty involves using x-rays to guide a needle through the skin into the weakened vertebra. Special bone cement is then carefully injected, serving to strengthen the bone and relieve the pain. Vertebroplasty is usually performed with local anesthesia. Frequently, more than one vertebra will have a fracture, especially if there is severe osteoporosis. Often these fractures can be treated at the same time. Vertebroplasty requires no stitches, only a bandage to cover the needle’s entry site. Most patients go home within two hours after completion of the procedure, and almost all patients experience immediate and complete relief from pain.
See Jonas H. Goldstein, MD discuss vertebroplasty.
Helen Gabert found relief from chronic back pain caused by osteoporosis with Mission's vertebroplasty procedure. See her talk about her experience at Mission.
Kyphoplasty
This minimally invasive surgery involves using x-ray guidance to insert a balloon into a collapsed or crushed vertebra. The balloon is then expanded to create a cavity, which is then filled with bone cement. This procedure is especially well suited for recent fractures. Most patients undergo this procedure on an outpatient basis and are allowed to leave the hospital within a few hours of the procedure.
See Michael Goebel, MD discuss kyphoplasty.
Spinal Fusion
This surgery uses surgical hardware and/or bone from the patient or a donor to strengthen and stabilize damaged areas of the neck and spine. Spinal fusion may also be used to normalize the spines of people with cerebral palsy whose backs have been pulled out of alignment by unequal muscle tone.
Surgery for scoliosis (curvature of the spine) and kyphosis (severe hunching of the spine, usually seen in older people with osteoporosis). In severe cases of these illnesses, surgery may be used to give the spine a more normal configuration.
