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Surgical Techniques in Spinal Surgery Cervical Spine: Medicine & Health Step by Step Approach to Anterior Subaxial Cervical Spine,
Table of contents
- Mark J. Spoonamore, M.D.
- Surgical Approaches to the Spine
- Surgical Technique
- Spine Surgeries and Procedures | Goodman Campbell Brain and Spine
Spine surgery includes treatment of the spinal column, or the support structures around the spinal cord and spinal nerves. Compression or constriction of the nerves and spinal cord by the bony overgrowth of the spine or herniated disks can cause pain, sensory changes or weakness. Spinal column disorders requiring surgery range from degenerative processes to traumatic injury to tumors. In some circumstances the stability of the spine is affected.
When needed, spinal fusion with or without instrumentation or "hardware," is used to re-establish spinal stability. Minimally invasive techniques and microsurgical techniques are utilized when appropriate to get the best results for the patient. Humans are born with 33 separate vertebrae. By adulthood, we typically have 24 due to the fusion of the vertebrae in the sacrum. The top 7 vertebrae that form the neck are called the cervical spine and are labeled C1-C7.
The seven vertebrae of the cervical spine are responsible for the normal function and mobility of the neck. They also protect the spinal cord, nerves and arteries that extend from the brain to the rest of the body. The upper back, or thoracic spine, has 12 vertebrae, labeled T1-T The lumbar spine bears the most weight relative to other regions of the spine, which makes it a common source of back pain.
The sacrum S1 and coccyx tailbone are made up of 9 vertebrae that are fused together to form a solid, bony unit. Spinal cord disorders that require surgery include tumors or structural abnormalities of the spinal cord. Spinal cord tumors range from benign to aggressive and surgery or biopsy might be needed to obtain a diagnosis and aid in treatment.
Some tumors can be completely treated with surgery alone, others might require other therapies in conjunction with surgery. Structural abnormalities of the spinal cord can include dilated, fluid-filled channels in the spinal cord syrinx, syringomyelia , tethered spinal cords and other developmental problems. Although most of these present in childhood, some become problems as we get older. Surgery in these circumstances helps to alleviate symptoms by altering the structure of the spinal cord.
The problems involving the spinal nerves often come from compression. Degeneration and herniation of the disks in the neck, back and low back can compress spinal nerves as they exit the spinal column.
Mark J. Spoonamore, M.D.
Symptoms can range from numbness to pain to weakness in an arm or leg and difficulty walking. Surgery might include removal of all or part of the disk. If the whole disk is removed, spinal fusion is usually required to maintain stability of the spine. Degeneration of joints in the spine can also cause spinal nerve compression giving very similar symptoms.
Finally, tumors of the nerves themselves can cause pain and dysfunction. All of these can be treated surgically if indicated. Less common than disorders of the structural elements of the spine, spinal tumors and tumors of the spinal cord also also treated by neurosurgeons. These tumors can be metastatic from other parts of the body or can spread from tumors near the spine.
These are often cancers and will require other forms of treatment along with or instead of surgery. The tumors of the spinal cord and the nerve roots themselves are often benign and can be treated with surgery alone.
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Is there anything else I should know? For patients who have had a fusion, we would recommend refraining from anti-inflammatory agents for 3 months. We would also recommend waiting 3 months for any elective medical procedures e. Paul C. McCormick , Michael G.
Surgical Approaches to the Spine
Kaiser , Peter D. Angevine , Alfred T. Mandigo , Patrick C. Degenerative Spine Conditions. Herniated Disc cervical, thoracic, lumbar. Cervical Spondylotic Myelopathy. Adolescent Idiopathic Scoliosis. Search for:.
Surgical Technique
McCormick Dr. Peter D. Angevine Dr. Christopher E. Mandigo Dr. Donald O. Quest Dr. Patrick C. Reid Dr. Neil A. Feldstein Pediatric Specialist Dr. Evan Johnson Dr. Anterior Cervical Discectomy. What is an Anterior Cervical Discectomy? When is this procedure performed? How is this procedure performed? This procedure is performed under general anesthesia.
If surgical treatment is recommended to trim or remove the herniated disc, it may be possible to perform this procedure with MIS surgery using tubular dilators and a microscope or endoscope. Spinal decompression: Spinal stenosis, which is a narrowing of the vertebral canal, is a common condition that can result in compression of the nerves. This can produce a variety of symptoms, including pain, numbness and muscle weakness. If surgery is recommended, it may be possible to remove the bone and soft tissues causing the nerve compression through an MIS approach using tubular dilators and a microscope or endoscope.
The more common decompressive procedures include laminectomy and foraminotomy. Transforaminal Lumbar Interbody Fusion TLIF : This is a MIS technique that is performed for patients with refractory mechanical low back and radicular pain associated with spondylolisthesis, degenerative disc disease and recurrent disc herniation. The procedure is performed from the back posterior with the patient on his or her stomach. Utilizing two small incisions, screws and rods are placed between two or more vertebral levels.
The intervertebral disc is removed and a cage filled with bone is placed in that void with the goal of stabilizing the levels affected. For more than 30 years, the NREF has funded research and training to improve treatments like minimally invasive spine surgery. Learn more about the NREF and make a donation today.
A doctor will be able to tell which MIS surgeries, if any, might be an option for treating a spinal condition. In some situations, MIS surgery may not be as safe or effective as traditional open surgery. If so, the doctor will be able to inform you about the relative risks and benefits. In addition, there are some conditions that are not truly treatable with MIS surgery.
Spine Surgeries and Procedures | Goodman Campbell Brain and Spine
Spinal fusion is an operation that creates a solid union between two or more vertebrae. This procedure may assist in strengthening and stabilizing the spine and may thereby help to alleviate severe and chronic back pain. Almost all of the surgical treatment options for fusing the spine involve placement of a bone graft between the vertebrae.