If you have chronic back pain or another condition affecting your spine, and you have exhausted nonsurgical, conservative, or traditional methods to no avail, then spinal surgery may be an option worth considering. With advances in medical technology, many spinal surgeries can now be carried out in a minimally invasive manner, making back surgery far safer and with fewer risks than traditional surgery.
What Is Minimally Invasive Spine Surgery?
Surgeons are now able to perform minimally invasive spinal procedures for conditions such as herniated discs, degenerative disc disease, spinal stenosis, spinal fractures, spondylolisthesis, and scoliosis. These are complex medical procedures that utilize highly specialized, yet extremely small surgical tools which can be inserted through incisions often less than 2 inches long.
The surgeon also uses an operating microscope which provides light and magnification during the surgery. The instruments enable real-time X-ray video images to be transmitted onto a screen in the operating room to guide the procedure.
The many benefits of minimally invasive surgery include:
- Shorter hospital stays
- Smaller incisions requiring fewer stitches
- Less blood loss during surgery
- Smaller scars
- Less pain
- Fewer complications and surgical risks such as infection
- Quicker recovery and return to daily activities
Not all types of spine surgeries can be carried out in a minimally invasive way, so traditional surgery is still used for certain procedures.
Types of Spine Surgeries
Some of the most common spinal surgeries that are performed by spine surgeons include the following:
Lumbar Fusion Surgery
A lumbar fusion is designed to treat lower back pain and leg pain as a result of degenerative disc disease, herniated discs, spinal stenosis, or other spinal injuries. Lumbar fusion is performed in the hospital under general anesthesia, and it usually requires at least a 3- to 4-day hospital stay, depending on the extent of the surgery.
Spinal fusion surgery involves joining (fusing) adjacent vertebrae together in order to strengthen and stabilize that segment of the spine. It minimizes pain by eliminating movement between the affected vertebrae in the back. Since most spinal surgeries involve only a small area, the patient’s range of motion remains relatively normal after healing.
During this procedure, the surgeon will use bone grafts to fuse the damaged vertebrae together. The graft may come from one of your own bones. The graft is then held in place by a small plate which is attached to the spine with screws or other tools as necessary.
Sometimes the disc between two vertebrae may need to be removed, because it is causing pain and is too badly damaged to be repaired. To fill the empty disc space after removal, a device with bone graft is implanted between the adjacent vertebrae where the disc was before. It may take up to 12 months or longer for the graft and vertebrae to heal, or fuse together, to form one solid piece of bone.
Lumbar Decompression Surgery
Lumbar decompression is performed to relieve pain caused by pinched nerves in the lower back (lumbar region) as a result of a herniated disc, spinal stenosis, facet joint arthritis, or tumors. During the procedure, the surgeon removes a small portion of the bone over the nerve root and/or disc material from under the nerve root, which relieves pressure on the nerve – literally removing the compression on the nerve.
The two most common surgical approaches for decompression are microdiscectomy and lumbar laminectomy:
Microdiscectomy is a minimally invasive spine surgery performed on an outpatient basis. This approach reduces injury to muscles and surrounding tissue. The patient is sedated using general anesthesia but will go home the same day.
During the procedure the surgeon makes a small 1- to 1.5-inch incision over the affected disc. Visualization tools and specialized instruments are then inserted to remove the portion of the disc that is compressing the nerve root.
Lumbar laminectomy, or open decompression, is also performed under general anesthesia but requires a hospital stay of up to 3 days. This procedure differs from a microdiscectomy because the incision is longer and there is more muscle retraction, so it is not a minimally invasive procedure.
A lumbar laminectomy involves removing a portion of the lamina (the back part of the vertebra that covers your spinal canal). During the procedure, the surgeon makes a 2- to 5-inch incision over the affected disc(s) and moves muscle and tissue away from the spine above and below the affected disc. Part of the lamina is then removed in order to relieve the pressure and pain.
This enlarges the spinal canal and relieves compression of the spinal cord. It also allows the surgeon to identify and relieve any compressed nerves.
Anterior Cervical Discectomy and Fusion Surgery
An anterior cervical discectomy and fusion (ACDF) is a similar procedure to that of lumber fusion and decompression surgery, but it is carried out to relieve the pressure on nerves in the neck (cervical spine) rather than the lower spine. The affected cervical disc is removed, and the space between the vertebrae is filled with a bone graft and/or implant.
A cervical fusion eliminates movement between the adjacent vertebrae. Only a small area of the cervical spine is affected, however, so range of motion in the neck remains relatively unaffected.
Kyphoplasty / Vertebroplasty Surgery
Kyphoplasty and vertebroplasty are minimally invasive surgical procedures used to treat spinal compression fractures resulting from osteoporosis. These procedures help to relieve pain, prevent further collapse of the fracture, and restore normal spinal alignment.
They can be performed on both the cervical (neck) and lumbar (low back) spine. Both are performed on an outpatient basis, and surgery takes about an hour for each vertebra involved – meaning patients can go home the same day.
Kyphoplasty – During this procedure, the surgeon inserts a balloon into the fractured vertebra and inflates it to create a space where the fractured bone was. This restores the vertebra to its proper height and shape. The balloon is then deflated and removed, and a special type of bone cement is inserted into the vertebra.
Vertebroplasty – This is a similar procedure except that it does not entail the use of a balloon. Instead, the doctor simply injects the cement directly into the fractured vertebra. The downside is that it does not restore the natural height of the vertebra.
Posterior Cervical Foraminotomy Surgery
For some patients, this procedure may be a viable alternative to a discectomy or spinal fusion. Posterior cervical foraminotomy is a minimally invasive back surgery that relieves nerve root compression in the neck.
The procedure enlarges the foramen (the space where the nerve root exits the spinal cord). The procedure is performed under general anesthesia, and it typically requires a brief hospital stay of up to 2 nights.
During the procedure, the surgeon makes a small 1- to 2-inch incision in the back of the neck and moves muscles and soft tissue out of the way to access the spine. The surgeon then makes an even smaller incision to insert a thin tube with a retractor that allows access to the spine without disrupting the surrounding tissues.
Once the surgeon reaches the spinal canal, small amounts of bone are removed from the foramen to expose the nerve root and relieve pressure. If other factors are causing compression, such as a herniated disc or bone spur, the surgeon may also remove the part of the disc or spur which is pushing on the nerve.
A cervical laminoplasty is recommended if you have spinal stenosis in your neck. This tends to cause symptoms of myelopathy, such as numbness, pain, or weakness in the arms or hands; difficulty using your hands; and balance problems. During the procedure, the surgeon creates an opening in the lamina, the bone lying over the spinal cord. This creates more space for the spinal cord and thereby removes pressure on the nerves.
This surgery requires a hospital stay of up to 3 days. A neck collar is usually worn for several weeks, and physical therapy may be required to strengthen the neck muscles. Most patients recover nerve function within several months after surgery, with continued improvement over 6 to 18 months as the spinal cord heals.
Spine Surgery in Colorado
At Front Range Spine and Neurosurgery, we pride ourselves in providing you with the best possible experience and results. Our friendly staff have a wealth of knowledge in this field, and our surgeons are qualified to perform intricate procedures using advanced minimally invasive spinal surgery for many conditions.
If you would like more information about the treatments and surgical procedures we offer, call us at (303) 790-1800 or use our simple online form to request an appointment today. We look forward to assisting you.