Although back pain is one of the most common medical complaints, spinal surgery is less common than you may expect. Often, non-surgical treatments such as medication or physical therapy are sufficient to relieve symptoms. When non-invasive treatments are not effective to resolve the neurological-related pain you are experiencing, surgery may be recommended.
The need for spinal neurosurgery may come after years of chronic back pain or due to acute pain caused by an accident, herniated disc or an abscess caused by infection. Your neurologist will discuss the best course of treatment with you depending on your unique situation.
Artifical Disc Replacement
When the cause of your back pain is diagnosed as being caused by the degeneration of the discs in your lumbar spine, your neurosurgeon may recommend artificial disc replacement instead of lumbar fusion. In this procedure, the damaged disc is carefully removed from between two vertebrae and an artificial one put in its place.
While a relatively new procedure, the neurosurgeons at St. Vincent Healthcare are experts in the placement of artificial lumbar discs. Patients who undergo this procedure generally experience reduced pain while maintaining motion and flexibility.
A lumbar discectomy may be performed when you experience symptoms resulting from additional pressure placed on your spine due to the herniation of one or more lumbar discs. During this procedure, an opening is made in your spine to access the damaged disc. The disc, or portions of it, will then be removed.
The goal of any discectomy is to relieve spinal pressure and reduce the symptoms of disc herniation, such as leg pain, muscle weakness or numbness. Depending on your situation, your neurosurgeon may also perform a laminectomy, laminotomy or lumbar fusion in conjunction with the discectomy to allow you to more easily complete daily tasks and enjoy a more active lifestyle.
Intraspinous Process Decompression
Also referred to as IPD, intraspinous process decompression is a new, minimally invasive procedure designed to relieve the back pain and leg numbness for patients diagnosed with spinal stenosis. It is an alternative to spinal fusion or laminectomy.
During this procedure, you may be placed under general anesthesia or you may be given a combination of sedative and local anesthesia. Your neurosurgeon will make a small incision in your back to gain access to the rear of your spine. Using a tool called a sizing distractor, he or she will create a space between the spinous processes - the knobby bones you can feel when you run your hands down your spine. A permanent implant is then inserted to maintain the larger space and relieve pressure.
Most patients are able to return home within 24 hours after undergoing IPD. Your neurologist and/or neurosurgeon may recommend physical therapy following surgery to help you regain strength and mobility.
If you have been diagnosed with spinal stenosis, your neurosurgeon may suggest that you undergo a laminectomy. During this procedure, the lamina (part of the bone that makes up a vertebrae) and/or bone spurs which may have developed along your spine are carefully removed to make additional room for your spinal column. A foraminotomy or lumbar diskectomy may be completed at the same time to relieve any additional pressure placed on spinal nerves.
Your neurosurgeon may opt to perform a laminotomy instead of a laminectomy depending on your specific situation. A laminotomy differs from a laminectomy in that a small portion of the lamina is removed.
This type of surgery is not appropriate for every patient. Your St. Vincent Healthcare neurosurgeon will review your individual symptoms and situation and discuss your options with you.
Patients who have chronic low back pain who are unable to alleviate pain through the use of medication or physical therapy may be candidates for lumbar fusion. This type of surgery permanently fuses, or joins, two or more spinal vertebrae together to restrict movement using bone grafts or metal rods or plates.
Lumbar fusion is most commonly utilized for individuals who have had injuries to the bones in the spine or whose spine has become weakened over time. If you feel that lumbar fusion may be right for you, ask your St. Vincent Healthcare neurosurgeon for additional information.