Treatment Options

Accessing the Spine The surgeon creates two small incisions in the patient's side. These incisions are much smaller than those used in traditional back surgery. A probe is inserted through one incision. The second incision is used to help guide the surgical instruments. Avoiding Nerves The surgeon uses the probe to stimulate and detect nerves along the side of the spine. When a nerve is found it can be avoided and left undamaged. Fluoroscopic x-ray images also are used to guide the probe to the proper position on the spine. Dilation Tubes Inserted A series of dilation tubes are slid over the probe to create a larger opening. Then, a retraction device is used to move aside muscle tissue and gain access to the spine. Disc Partially Removed The surgeon operates through the channel created by the retractor. The damaged disc is partially removed, eliminating the inflammatory proteins within the disc. Implant...

What Is A Minimally Invasive PLIF? Posterior lumbar interbody fusion (PLIF) is a type of spine surgery that involves approaching the spine from the back (posterior) of the body to place bone graft material between two adjacent vertebrae (interbody) to promote bone growth that joins together, or “fuses,” the two structures (fusion). The bone graft material acts as a bridge, or scaffold, on which new bone can grow. The ultimate goal of the procedure is to restore spinal stability. Today, a PLIF may be performed using minimally invasive spine surgery, which allows the surgeon to use small incisions and gently separate the muscles surrounding the spine rather than cutting them. Traditional, open spine surgery involves cutting or stripping the muscles from the spine. A minimally invasive approach preserves the surrounding muscular and vascular function and minimizes scarring.1, 2 Why Do I Need This Procedure?...

What is the YESS Selective Endoscopic Discectomy Procedure? 1. Guide Wire Inserted After the disc protrusion is confirmed, a guide wire is inserted to the affected disc. The surgeon uses a special type of x-ray machine called a fluoroscope to ensure that the route to the herniated disc is made in the correct location. 2. Obturator Inserted A two-hole obturator tube is passed over the guide wire to push apart the tissue down to the disc and to move the nerve root out of the way. Painful tissue in the path of the obturator may be anesthetized. 3. Working Sleeve Inserted The working sleeve, through which the surgery will be performed, is slid over the dilating tube. It is positioned on the disc surface. The guide wire and dialator are then removed. 4. Endoscope Inserted An endoscope (which contains a surgical light and small camera) is placed through the tube, allowing the surgeon to view the annulus,...

This minimally-invasive procedure is performed through a tubular device. It is designed to relieve pain caused by herniated discs pressing on nerve roots. This surgery is usually performed on an outpatient basis, which allows the patient to leave the hospital the same day. Guide Wire Inserted A guide wire is inserted through a small incision to locate the a1t'ected disc level. The surgeon uses a special type of x-ray machine called a fluoroscope to ensure that the route to the herniated disc is made in the correct location. Dilating Tubes Inserted A series of dilating tubes are passed over the guide wire to push apart the tissue down to the vertebrae. The guide wire is then removed. Retractor Inserted The tubular retractor, through which the surgery will be performed, slides over the dilating tubes. It is positioned on the bone surface. All the dilating tubes are then removed. Instruments Inserted A...

What is A Lumbar Microdiscectomy? A lumbar microdiscectomy is an operation that involves using a surgical microscope and microsurgical techniques to access and treat the lumbar spine. By providing magnification and illumination, the microscope allows for a limited dissection. Only that portion of the herniated disc, which is pinching one or more nerve roots, is removed. The term discectomy is derived from the Latin words discus (flat, circular object or plate) and -ectomy (removal). Why is it done? Pressure placed on one or more nerve roots by a herniated disc may irritate these neural structures and cause: Debilitating leg pain Weakness and/or numbness in the legs and/or feet, and Bowel/bladder incontinence. Patients who suffer from these symptoms as a result of a pinched nerve are potential candidates for this operation. The Operation An understanding of what a lumbar microdiscectomy involves will help...

What Is A Minimally Invasive TLIF? Transforaminal lumbar interbody fusion (TLIF) is a form of spine surgery in which the lumbar spine is approached through an incision in the back. The name of the procedure is derived from: transforaminal (through the foramen), lumbar (lower back), interbody (implants or bone graft placed between two vertebral bodies) and fusion (spinal stabilization). The TLIF is a variation of the posterior lumbar interbody fusion (PLIF), in that it provides 360-degree fusion, avoids anterior access and associated complications, decreases manipulation of neural structures, reduces damage to ligamentous elements, minimizes excessive bone removal, enhances biomechanical stability, and provides early mobilization. Traditional, open spine surgery involves cutting or stripping the muscles from the spine. But today, a TLIF may be performed using minimally invasive spine surgery, a treatment...

Preparation The patient is anesthetized and placed in a face down position to allow access to the lower back. The area is cleaned and sterilized. Creating the Incision The surgeon creates a tiny incision next to the coccyx (the tailbone). The procedure will be performed through this incision, avoiding the need to cut through any major muscles, tendons or nerves. Accessing the Damaged Disc Using fluoroscopic guidance, the physician pushes a series of dilation tubes along the tailbone and the front of the sacrum. The physician inserts a drill through the tube and uses it to create a channel through the upper portion of the sacrum, allowing access to the center of the damaged disc. Clearing the Damaged Disc Tools are pushed into the disc, and the center of the disc is broken apart and removed through the dilation tube. The hollow center of the disc is then filled with bone...

What is an ALIF? Anterior lumbar interbody fusion (ALIF) is a spine surgery that involves approaching the spine from the front (anterior) of the body to remove all or part of a herniated disc from in between two adjacent vertebrae (interbody) in the lower back (lumbar spine), then fusing, or joining together, the vertebrae on either side of the remaining disc space using bone graft or bone graft substitute. The graft material acts as a binding medium and also helps maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together and stabilize the spine. Instrumentation, such as rods, screws, plates, cages, hooks and wire also may be used to create an “internal cast” to support the vertebral structure during the healing process. Depending on your condition and your surgeon’s training, experience and preferred methodology, an ALIF may...

What is Spinal Fusion Surgery? Spinal fusion is a surgical technique in which one or more of the vertebrae of the spine are joined together (fused) to stop them from moving against each other. This is done by placing bone grafts or bone graft substitutes between the affected vertebral bone. The graft material acts as a binding medium and also helps to maintain normal disc height – as the body heals, the vertebral bone and bone graft eventually grow together to join the vertebrae and stabilize the spine. Why Do I Need This Procedure? There are a number of reasons your surgeon may recommend spinal fusion. This procedure is frequently used to treat: One or more fractured (broken) vertebrae Spondylolisthesis (slippage of one vertebral bone over another) Abnormal curvatures of the spine, such as scoliosis or kyphosis Protruding or degenerated discs (the cartilaginous “cushions” between...