NeuroCare Brain & Spine Center

Surgical Treatment Options of the Spine

Microdiscectomy

A microdiscectomy is an operation done to treat 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 1/2 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 Fusion

Anterior 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 is also an outpatient procedure.

Laminectomy

A 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 need or may be a part of a spinal fusion or other operation. It is a common surgical treatment for spinal stenosis.

Lumbar Spinal Fusion

A 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 two 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 fusion

Some 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.