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What are the Spinal Orthopedic Procedures?

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Anthony Kristovich III Orthopedic surgeons frequently perform spinal orthopedic procedures to relieve symptoms caused by spinal nerve compression. Nerves that exit the spinal column between the vertebrae can be compressed by an intervetebral disc, by the vertebrae themselves or by bony spurs that have grown next to the nerve. When the nerves are compressed, you have sensory symptomspain, numbness or tinglingand/or motor symptomsweakness or loss of bladder or bowel control. Spinal orthopedic procedures relieve the pressure on the spinal nerve.

Surgical Procedures

Until recently, the only spinal orthopedic procedures available were surgical, and surgery is still frequently performed. The lumbar and cervical spine (low back and neck) are most prone to injury, and most surgeries are performed in those areas. The thoracic spine is more stable, but surgery may be necessary to correct deformities such as scoliosis or kyphosis. Laminectomy/discectomy and spinal fusion are the most common spinal orthopedic procedures performed.

Laminectomy/discectomy involves removing the portions of the disc and bony parts of the vertebrae that are compressing the nerve. The surgeon removes extraneous material and enlarges the opening to relieve the pressure on the nerve. If the disc is badly damaged, it may be replaced with an artificial one.

If the vertebrae are unstable or misaligned and they could re-compress the nerve, the spine is fused, using bone grafts from other parts of the body or rods and hardware. Spinal fusion immobilizes that portion of the spine so that it cannot compress or injure the nerve.

These procedures are usually done as open surgical procedures. The surgeon may approach the spine from the front of your body (anterior procedure) through your abdomen, or he may operate on the back of your body (posterior procedure). In either case, an incision is made in the skin and the muscles and surrounding tissue must be cut in order to reach the spine. That means time in the hospital and a lengthy recuperation afterward, plus the risk of infection or complication.

Minimally Invasive Procedures

In some instances, new minimally invasive spinal orthopedic procedures can be done instead of open surgery. Instead of cutting through the muscle and exposing the spine, a trained surgeon can use a thin, flexible tube with a microscope camera attached to it. This requires only a tiny incision in the back, and the muscle fibers are pushed aside instead of being cut. The surgeon can run laser or surgical instruments down the tube and remove excess tissue to open up the area around the nerve.

Minimally invasive procedures, when they can be used, are safer and sometimes more effective than traditional spinal orthopedic procedures. You don’t have to be admitted to the hospital and are usually back to most of your normal activities within a few days.

Minimally invasive procedures are a wonderful option for some people, but they are not always the best choice. Your orthopedic surgeon is the best person to determine which spinal orthopedic procedure is right for you.

Glenn Betz is a consultant doing work for Laser Spine Surgery

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